A client who suffers from hypertension and headaches is prescribed propranolol. The nurse would educate the client on which side effects associated with this medication?

rebound hypotension

vomiting

bradycardia

tremors

masking of hypoglycemia

bronchoconstriction

Answer and Explanation

Correct Answer : C,E,F

A. Rebound hypotension is more commonly associated with abrupt withdrawal of beta-blockers rather than a direct side effect, so it is not typically included as a side effect to expect while on the medication.
B. Vomiting is not a common side effect associated with propranolol; the nurse would not educate the client on this.
C. Bradycardia is a known side effect of propranolol, as it is a beta-blocker that decreases heart rate, so clients should be educated about monitoring their heart rate.
D. Tremors can be related to withdrawal from beta-agonists rather than propranolol, which may alleviate tremors in some individuals; thus, it's not a common side effect of the medication.
E. Propranolol can mask the symptoms of hypoglycemia (e.g., tachycardia), making it important for clients with diabetes to be aware of this potential effect.
F. Bronchoconstriction can occur in clients with reactive airway diseases, as propranolol non-selectively blocks beta receptors, so clients should be educated about this risk, especially if they have asthma or other pulmonary conditions.

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Correct Answer is B

Explanation

A. Cherries do not contain tyramine, which is the compound of concern for clients on MAOIs, so they can be included in the diet.
B. Cheddar cheese is high in tyramine, which can lead to hypertensive crises when consumed by clients taking MAOIs. Therefore, it should be eliminated from the diet.
C. Chicken is generally safe for clients on MAOIs as it does not contain significant amounts of tyramine.
D. Fresh fish is also safe to consume while on MAOIs as long as it is fresh and not aged, fermented, or spoiled, which could contain higher tyramine levels.

A. The drug will be most effective when given orally. B. The drug will be more effective when given in a non-enteral route. C. The drug is excreted by the kidneys at a slower rate than most medications. D. The kidney will metabolize some of the drug before it reaches the bloodstream.

Correct Answer is B

Explanation

A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.

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A client who suffers from hypertension and headaches is prescribed propranolol. The nurse would educate the client on which side effects associated with this medication?

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