A nurse is reviewing the health history of a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider?
The client has a history of migraine headaches.
The client has a history of hypertension.
The client has a history of bronchial asthma.
The client has a history of hypothyroidism.
The Correct Answer is C
Choice A reason : While propranolol can be used to reduce the frequency and severity of migraine headaches, it is not contraindicated in patients with a history of migraines⁴.
Choice B reason : Propranolol is often prescribed for hypertension and is not contraindicated in such cases. It works by blocking beta-adrenergic receptors, which reduces heart rate and blood pressure⁴.
Choice C reason : Propranolol is contraindicated in patients with bronchial asthma. As a non-selective beta-blocker, it can cause bronchoconstriction and exacerbate asthma symptoms. Therefore, the nurse should report this finding to the provider⁴⁶.
Choice D reason : Hypothyroidism is not a contraindication for propranolol. However, the medication may mask signs of hypothyroidism, such as a slow heart rate, so the provider should be aware of the client's thyroid condition⁴.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason : While it is important to assure the client, the nurse must first verify that there is a formal DNR order in place to legally honor the client's wishes¹².
Choice B reason : Checking for a DNR order in the medical record is the correct action to ensure that the client's wishes regarding resuscitation are documented and will be followed by all healthcare providers¹².
Choice C reason : Asking about a healthcare proxy is important, but it is secondary to confirming that the client's wishes are documented in the medical record through a DNR order or advance directives¹².
Choice D reason : Verifying a signed copy of the advance directives is crucial, but the immediate step is to check for a DNR order, which is specifically related to the client's request not to be resuscitated¹².
Correct Answer is D
Explanation
Choice A reason : Abdominal distension is more commonly associated with right-sided heart failure due to fluid accumulation in the abdominal cavity. Left-sided heart failure primarily affects the lungs, leading to respiratory symptoms¹.
Choice B reason : Jugular venous distention is typically a sign of right-sided heart failure, indicating increased pressure in the right atrium and venous system. It is not a primary symptom of left-sided heart failure¹.
Choice C reason : Dependent edema, or swelling in the lower extremities, is also more indicative of right-sided heart failure, where fluid accumulates due to poor venous return. In left-sided heart failure, fluid backs up into the lungs rather than the extremities¹.
Choice D reason : A hacking cough, especially when lying down, is a symptom of left-sided heart failure, as fluid backs up into the lungs causing pulmonary congestion. This can lead to coughing and shortness of breath, particularly during exertion or when lying flat¹.
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