✅ Right route — This is correct because the route determines how the medication enters the body (e.g., oral, IV, IM), and using the wrong route can cause serious harm.

✅ Right dose — This is correct because administering the correct amount ensures safety and effectiveness. An incorrect dose can lead to overdose or subtherapeutic effects.

✅ Right person — This is correct because verifying the patient’s identity (e.g., using two identifiers) ensures the medication is given to the intended individual.

✅ Right documentation — This is correct because documenting what was given, when, and how ensures continuity of care and legal accountability.

✅ Right to refuse — This is incorrect as part of the original five rights, although it is considered an additional right in some expanded models (seven or more rights of medication administration).

💨 Wheezing — This is correct because metoprolol is a beta-blocker, and in clients with asthma, especially non-selective beta-blockers, it can cause bronchoconstriction leading to wheezing and respiratory distress. Asthmatic clients should be monitored closely when prescribed beta-blockers.

💨 Increased respiratory rate — This is incorrect because metoprolol typically causes bradycardia and does not directly increase the respiratory rate.

💨 Bronchodilation — This is incorrect because metoprolol does not promote bronchodilation. It may actually cause bronchospasm in susceptible individuals.

💨 Decreased sputum production — This is incorrect because metoprolol has no direct effect on sputum production.

🥤 Dextrose 10% in water — This is correct because TPN contains high concentrations of glucose, and a sudden stop in TPN infusion can lead to hypoglycemia. Dextrose 10% in water (D10W) is the best temporary replacement to maintain blood glucose levels and prevent complications until the TPN is restarted.

🥤 3% sodium chloride — This is incorrect because it is a hypertonic saline solution used for severe hyponatremia, not for substituting TPN.

🥤 Lactated Ringers — This is incorrect because it does not contain the necessary glucose content to prevent hypoglycemia.

🥤 0.9% sodium chloride — This is incorrect because it also lacks glucose and does not provide nutritional support or blood sugar maintenance in the absence of TPN.

⚠️ Serum potassium level of 5.5 mEq/L — This is correct because potassium-sparing diuretics can cause hyperkalemia, and a potassium level above 5.0 mEq/L is abnormal and potentially dangerous. A level of 5.5 mEq/L increases the risk of cardiac dysrhythmias and requires prompt medical attention.

⚠️ Serum sodium level of 140 mEq/L — This is incorrect because this is a normal sodium level and does not warrant notifying the provider.

⚠️ Blood pressure of 130/80 mmHg — This is incorrect because it is within the normal range and does not indicate a complication.

⚠️ Serum potassium level of 3.5 mEq/L — This is incorrect because it is at the lower end of the normal potassium range and does not require intervention.

⏳ Tolerance — This is correct because tolerance refers to a state where the body becomes used to a drug over time, leading to reduced effectiveness and requiring higher doses to achieve the same level of relief. This is a common and expected response with long-term opioid use.

⏳ Allergy — This is incorrect because an allergy would involve immune reactions such as rash, itching, or anaphylaxis—not reduced effectiveness.

⏳ Addiction — This is incorrect because addiction involves psychological craving and compulsive use despite harm, not diminished drug effect.

⏳ Withdrawal — This is incorrect because withdrawal involves physical symptoms that occur when a drug is abruptly stopped, not a reduced response while still taking it.