A nurse is reviewing the health history of a patient with angina pectoris who has a prescription for propranolol hydrochloride PO 40 mg twice daily.
Which historical finding should the nurse report to the provider?
The patient has a history of migraine headaches.
The patient has a history of hypothyroidism.
The patient has a history of hypertension.
The patient has a history of bronchial asthma.
The Correct Answer is D
Choice A rationale
Propranolol is sometimes used to prevent migraines, so a history of migraines would not typically be a contraindication.
Choice B rationale
Hypothyroidism is not typically a contraindication for propranolol. However, propranolol can affect the metabolism of thyroid hormones and may mask signs of hyperthyroidism.
Choice C rationale
Propranolol is often used to treat hypertension, so a history of hypertension would not typically be a contraindication.
Choice D rationale
Propranolol is a non-selective beta-blocker, which means it blocks beta receptors in both the heart and the lungs. This can potentially cause bronchoconstriction and exacerbate asthma symptoms, so it should be used with caution in patients with a history of bronchial asthma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["1160"]
Explanation
Step 1: Convert All Fluid Intake to Milliliters (mL)
To accurately record the patient's fluid intake, first, convert each fluid measurement to milliliters:
- 1 cup of coffee = 240 mL
- 4 oz of orange juice = 118.3 mL
- 3 oz of water = 88.7 mL
- 1 cup of flavored gelatin = 236.6 mL
- 1 cup of tea = 240 mL
- 5 oz of broth = 147.9 mL
- 3 oz of water (another serving) = 88.7 mL
Step 2: Calculate Total Fluid Intake
Add all the converted fluid amounts together:
- Total fluid intake = 240 mL (coffee) + 118.3 mL (orange juice) + 88.7 mL (water) + 236.6 mL (gelatin) + 240 mL (tea) + 147.9 mL (broth) + 88.7 mL (water) = 1,160.2 mL
Step 3: Round to the Nearest Whole Number
Round the total to the nearest whole number:
- Rounded total = 1,160 mL
The nurse should record 1,160 mL on the patient’s chart.
Correct Answer is A
Explanation
Choice A rationale
The symptoms described, including the paradoxical movement of the chest wall (moving inward during inspiration and outward during expiration), are indicative of a flail chest, which is a life-threatening condition that occurs when a segment of the rib cage breaks due to trauma and becomes detached from the rest of the chest wall.
Choice B rationale
Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity). It’s often caused by chest trauma. It does not cause the chest to move inward during inspiration and outward during expiration.
Choice C rationale
Atelectasis is a complete or partial collapse of the entire lung or area (lobe) of the lung. It does not cause the chest to move inward during inspiration and outward during expiration.
Choice D rationale
Pneumothorax is a collapsed lung. It does not cause the chest to move inward during inspiration and outward during expiration.
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