If a patient diagnosed with hypertension is prescribed Propranolol (Inderal), what patient history should prompt the nurse to consult with the healthcare provider before administering this drug?

Choice A rationale
Idiopathic vasospasm, or spontaneous constriction of the blood vessels, can cause myocardial ischemia. However, this is a relatively rare cause compared to atherosclerosis.
Choice B rationale
Atherosclerosis, a condition characterized by the buildup of fatty plaques in the arteries, is the most common cause of myocardial ischemia. These plaques can restrict blood flow to the heart muscle, leading to ischemia.
Choice C rationale
Venous emboli, or blood clots that form in the veins, typically do not cause myocardial ischemia. These clots are more likely to cause problems in the lungs (pulmonary embolism) if they travel through the bloodstream.
Choice D rationale
Arterial emboli from a heart valve can cause myocardial ischemia, but this is less common than atherosclerosis. These emboli, or blood clots, can block blood flow to the heart muscle if they travel through the bloodstream.

Choice A rationale
Weight loss is often recommended as a first-line therapeutic approach to lowering blood pressure in patients diagnosed with essential hypertension. Excess weight can increase the strain on the heart and blood vessels, leading to higher blood pressure.
Choice B rationale
Regular physical activity is another important part of managing hypertension. Exercise can help lower blood pressure by improving heart health and reducing weight.
Choice C rationale
Beta-blockers, such as propranolol, are a type of medication used to treat hypertension. However, they are not typically the first choice for initial therapy unless the patient has a specific indication for this class of medication, such as heart failure or angina.
Choice D rationale
Decreasing sodium intake is another lifestyle change that can help lower blood pressure. Consuming too much sodium can cause the body to retain fluid, which can increase blood pressure.
Choice E rationale
Smoking cessation is also recommended for patients with hypertension. While smoking does not directly cause high blood pressure, it can damage blood vessels and increase the risk of heart disease.