Clinical Nurse Leader Practice Exam

Upon noticing a patient with CHF has dangerously high blood pressure and an order for labetalol, what is your first action as the Clinical Nurse Leader?

1. Administer the labetalol immediately as per the chart

2. Verify the patient’s allergies and the order

3. Get a new order for an additional dose

4. Ensure the order is not carried out, as beta-blockers are contraindicated

The correct answer is: Ensure the order is not carried out, as beta-blockers are contraindicated

The correct action in this scenario is to ensure the order is not carried out, as beta-blockers, such as labetalol, can have contraindications in specific patient populations, including those with severe congestive heart failure (CHF) and significantly elevated blood pressure. In patients with CHF, particularly if they are decompensated, the use of beta-blockers may worsen heart failure symptoms due to their negative inotropic effects, which can lead to further complications. Recognizing this critical situation demonstrates the Clinical Nurse Leader's role in patient safety and comprehensive care management. It emphasizes the importance of assessing the overall clinical picture before administering medication, considering how a patient’s current state may interact with prescribed treatments. Understanding medication contraindications is essential in avoiding potential harm to the patient. Verifying allergies and the order or obtaining a new order for an additional dose may seem prudent; however, these actions do not adequately address the immediate risk posed by administering a contraindicated medication in a patient with such conditions as CHF and high blood pressure. In this case, prioritizing patient safety by withholding the medication in light of its known risks is the most appropriate first action.