A nurse is caring for a client who has a prescription for propranolol for the treatment of atrial fibrillation. Which of the following actions should the nurse take?

Withhold the medication if the systolic blood pressure is less than 90 mm Hg.

Request a dosage increase if the apical heart rate is less than 60/min.

Inform the client to expect increased hair growth.

Administer the medication with an antacid.

Answer and Explanation

The Correct Answer is A

Choice A reason: Withholding the medication if the systolic blood pressure is less than 90 mm Hg is an appropriate action, as propranolol is a beta-blocker that can lower blood pressure and cause hypotension, which can impair tissue perfusion and cause dizziness, fainting, or shock.

Choice B reason: Requesting a dosage increase if the apical heart rate is less than 60/min is an inappropriate action, as propranolol can slow down the heart rate and cause bradycardia, which can lead to fatigue, weakness, or cardiac arrest. The nurse should monitor the apical pulse before administering propranolol and withhold it if it is less than 60/min.

Choice C reason: Informing the client to expect increased hair growth is an incorrect statement, as propranolol does not cause hypertrichosis or excessive hair growth. However, another beta-blocker, minoxidil, can cause this side effect.

Choice D reason: Administering the medication with an antacid is not an appropriate action, as antacids can interfere with the absorption of propranolol and reduce its effectiveness. The nurse should administer propranolol on an empty stomach or with food that does not contain antacids.

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Correct Answer is D

Explanation

Choice A: This is incorrect. The client having difficulty reading large print indicates a need for an ophthalmology referral, not an occupational therapy referral. An ophthalmologist can assess and treat vision problems caused by stroke.

Choice B: This is incorrect. The client coughing while drinking from a straw indicates a need for a speech therapy referral, not an occupational therapy referral. A speech therapist can assess and treat swallowing problems caused by stroke.

Choice C: This is incorrect. The client being unable to bear her full weight while walking indicates a need for a physical therapy referral, not an occupational therapy referral. A physical therapist can assess and treat mobility problems caused by stroke.

Choice D: This is correct. The client becoming exhausted after performing activities of daily living indicates a need for an occupational therapy referral. An occupational therapist can assess and treat functional problems caused by stroke, such as fatigue, self-care, cognition, and leisure activities.

A. Complete breast self-examinations one week prior to menstruation. B. Expect clear discharge from the nipples. C. Consume a diet high in antioxidants. D. Include meats grilled over high heat in the diet.

Correct Answer is C

Explanation

The correct answer is C. Consume a diet high in antioxidants.

Choice A: Complete breast self-examinations one week prior to menstruation.

Performing breast self-examinations one week prior to menstruation is not recommended. The best time to perform a breast self-exam is about 3 to 5 days after your period starts, when your breasts are least likely to be tender or swollen. This timing helps in detecting any unusual changes more accurately.

Choice B: Expect clear discharge from the nipples.

While some nipple discharge can be normal, it is not something that should be expected as a routine part of breast health. Clear, yellow, or white discharge can occur due to hormonal changes, but any spontaneous discharge, especially if it is bloody or from one breast, should be evaluated by a healthcare provider.

Choice C: Consume a diet high in antioxidants.

Consuming a diet high in antioxidants is beneficial for overall health and may help reduce the risk of various diseases, including cancer. Antioxidants help neutralize free radicals, which can damage cells and contribute to cancer development. Foods rich in antioxidants include fruits, vegetables, nuts, and whole grains.

Choice D: Include meats grilled over high heat in the diet.

Including meats grilled over high heat in the diet is not advisable for someone concerned about cancer risk. Grilling meats at high temperatures can produce carcinogens such as heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs), which have been linked to an increased risk of cancer. Therefore, it is better to avoid or limit the consumption of grilled meats.

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A nurse is caring for a client who has a prescription for propranolol for the treatment of atrial fibrillation. Which of the following actions should the nurse take?

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