A nurse in a long-term care facility is contributing to the plan of care for a client who has a new prescription for propranolol. The nurse should plan to monitor the client for which of the following adverse effects of the medication?

Ringing in the ears

Bradycardia

Hypertension

Headache

Answer and Explanation

The Correct Answer is B

A. Ringing in the ears (tinnitus) is incorrect. Tinnitus is not a common adverse effect of propranolol. This symptom is more commonly associated with ototoxic medications, such as certain antibiotics or diuretics.

B. Bradycardia is correct. Propranolol is a beta-blocker that reduces heart rate and blood pressure by blocking beta-adrenergic receptors. One of its primary adverse effects is bradycardia (slow heart rate., which can lead to dizziness, fatigue, or hypotension.

C. Hypertension is incorrect. Propranolol is used to treat hypertension, not cause it. By reducing cardiac output and suppressing sympathetic nervous system activity, propranolol generally lowers blood pressure.

D. Headache is incorrect. While some clients might experience headaches due to changes in blood pressure, headache is not a primary adverse effect of propranolol.

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Correct Answer is B

Explanation

A. BUN 20 mg/dL: This is not specific to HELLP syndrome. A BUN level of 20 mg/dL is within the normal range and does not indicate the presence of HELLP syndrome, which is associated with liver dysfunction and low platelet count.

B. Platelet count 77,000/mm3: This is correct. HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets) is characterized by a low platelet count, often less than 100,000/mm3, which is a critical indicator of this condition.

C. Hemoglobin 12 g/dL: This is a normal hemoglobin level and is not typically associated with HELLP syndrome, where hemolysis (destruction of red blood cells) can cause anemia, which would lower hemoglobin levels.

D. WBC count 18,000/mm3: While an elevated WBC count can indicate infection or inflammation, it is not specifically associated with HELLP syndrome. The hallmark features of HELLP syndrome are low platelets and liver enzyme elevation, not elevated WBC.

A. "You can take a stool softener to prevent constipation." B. "You can remove your eye patch during the day." C. "You should bend from the waist to pick up objects." D. "You can apply a warm, moist compress to your forehead to reduce pain."

Correct Answer is A

Explanation

A. "You can take a stool softener to prevent constipation." is correct. After a retinal detachment repair, clients should avoid straining during bowel movements, as increased intracranial pressure could affect the healing eye. Taking a stool softener is a helpful preventive measure to avoid constipation.

B. "You can remove your eye patch during the day." is incorrect. The eye patch should typically be worn continuously to protect the eye and support healing. The surgeon's specific instructions should be followed regarding when the patch can be removed.

C. "You should bend from the waist to pick up objects." is incorrect. After retinal surgery, clients should avoid bending from the waist as this can increase intraocular pressure, potentially compromising the surgical repair. Instead, clients should use proper body mechanics and bend at the knees.

D. "You can apply a warm, moist compress to your forehead to reduce pain." is incorrect. Applying a warm compress to the forehead is not typically recommended following a retinal repair. Clients should follow the specific post-operative instructions from the surgeon, which may include cold compresses or other methods of managing discomfort.

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A nurse in a long-term care facility is contributing to the plan of care for a client who has a new prescription for propranolol. The nurse should plan to monitor the client for which of the following adverse effects of the medication?

Nursing Test Bank

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