In which circumstance should the nurse question the medication order for metoprolol?

In the context of administering metoprolol, a beta-blocker, careful consideration of vital signs and patient history is essential. A blood pressure of 118/78 is within the normal range and does not typically indicate a need to question the medication order. Beta-blockers like metoprolol are commonly used to manage hypertension and other cardiovascular conditions. Thus, a stable and normal blood pressure suggests that the drug can be safely administered.

Other circumstances, such as a heart rate of 90, a history of asthma, or the presence of heart palpitations, could warrant more scrutiny. In particular, a heart rate nearing the lower threshold for administration, the use of beta-blockers in asthmatic patients, or an acute symptom like heart palpitations could indicate that metoprolol may not be the best choice or that its administration should be closely monitored. The normal blood pressure in this scenario supports the rationale for proceeding with the medication order rather than questioning it.