A nurse is obtaining vital signs for a client who has been taking propranolol. Which of the following findings should the nurse identify as an adverse effect of the medication?

Respiratory rate 24/min

Oral temperature 38.9° C (102° F)

Blood pressure 118/78 mm Hg

Apical pulse 50/min

Answer and Explanation

The Correct Answer is D

A. A respiratory rate of 24/min is elevated and may suggest respiratory distress, but it is not a specific adverse effect of propranolol.

B. An oral temperature of 38.9° C (102° F) indicates fever, which is not a typical adverse effect of propranolol.

C. A blood pressure of 118/78 mm Hg is within normal limits and does not indicate an adverse effect of propranolol, which is often used to manage hypertension.

D. An apical pulse of 50/min indicates bradycardia, a known adverse effect of propranolol, which can occur due to its action on the heart rate.

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Correct Answer is B

Explanation

A. "Remove the patch for two to four hours daily.": This is incorrect because transdermal nitroglycerin patches should be worn continuously for 24 hours, with a scheduled time to remove them (usually overnight) to prevent tolerance.

B. "Apply a new patch each day after waking up.": This instruction is correct; clients should apply a new patch daily to ensure continuous therapeutic effects while also allowing a break to reduce tolerance.

C. "Cover the patch with plastic wrap.": This is incorrect; covering the patch with plastic wrap can alter the absorption of the medication and is not necessary.

D. "Replace the existing patch with a new patch as soon as anginal pain begins.": This is incorrect; clients should not replace the patch immediately for angina. Instead, they should use sublingual nitroglycerin for immediate relief and follow the prescribed patch schedule.

A. Apply a warming blanket prior to administration. B. Infuse the medication over 1 hr. C. Administer diphenhydramine prior to administration. D. Monitor vital signs once per hour following administration.

Correct Answer is C

Explanation

A. Applying a warming blanket is not appropriate, as it may exacerbate the client's reaction to the infusion and is not a standard pre-medication strategy.

B. Infusing amphotericin B deoxycholate over 1 hour is too rapid; it is typically infused over 2-6 hours to minimize adverse effects.

C. Administering diphenhydramine prior to the administration of amphotericin B can help prevent or alleviate infusion-related reactions such as fever and chills, which the client experienced during previous infusions.

D. Monitoring vital signs once per hour following administration is insufficient; vital signs should be monitored more frequently during and immediately after the infusion to promptly detect and address any adverse reactions.

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A nurse is obtaining vital signs for a client who has been taking propranolol. Which of the following findings should the nurse identify as an adverse effect of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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