Editing Pharmacology – LPN Practice Questions (section)

==Question 3==
The practical nurse is administering oral medications. Which medication should the nurse '''not''' crush?
# A plain acetaminophen 325 mg tablet
# A metoprolol succinate extended-release tablet
# A scored lisinopril 10 mg tablet
# A chewable calcium carbonate tablet

'''Answer:''' 2 (B) A metoprolol succinate extended-release tablet.

''Rationale:'' Extended-release and enteric-coated forms, labeled with abbreviations such as XL, XR, SR, CR, LA, and EC, must never be crushed, because crushing destroys the release mechanism and delivers the entire dose at once, which can cause profound bradycardia and hypotension with metoprolol. Options 1, 3, and 4 are immediate-release or chewable formulations. When a client cannot swallow, the nurse reports this and requests an alternative formulation rather than crushing.