رجل عمره ٦٠ سنة عنده ذبحة مستقرة، بدأ ميتوبرولول قبل شهر، ونبضه الآن ٦٢ وضغطه ١٢٢/٧٤. يقول إن النوبات قلت كثيراً. الممرض يراجع معه التعليم. أي عبارة منه تدل أنه فهم التعليم؟

A 60-year-old man with stable angina started metoprolol a month ago; HR is now 62 and BP 122/74. He says attacks are much less frequent. The nurse reviews his teaching. Which statement shows he understood?

1. I will stop the medicine if my pulse is below 70
2. I will stop checking my pulse because the drug does not affect it
3. I will take an extra dose if I get chest pain
4. I will not stop the medicine suddenly, even if I feel better

Answer: D) I will not stop the medicine suddenly, even if I feel better. Abrupt withdrawal of a beta-blocker can cause rebound tachycardia, hypertension and angina or MI. It is tapered under medical supervision. A pulse of 60–70 is usually acceptable on this drug.