A nurse in a long-term care facility is contributing to the plan of care for a client who has a new prescription for propranolol. The nurse should plan to monitor the client for which of the following adverse effects of the medication?

Ringing in the ears

Bradycardia

Hypertension

Headache

Answer and Explanation

The Correct Answer is B

A. Ringing in the ears (tinnitus) is incorrect. Tinnitus is not a common adverse effect of propranolol. This symptom is more commonly associated with ototoxic medications, such as certain antibiotics or diuretics.

B. Bradycardia is correct. Propranolol is a beta-blocker that reduces heart rate and blood pressure by blocking beta-adrenergic receptors. One of its primary adverse effects is bradycardia (slow heart rate., which can lead to dizziness, fatigue, or hypotension.

C. Hypertension is incorrect. Propranolol is used to treat hypertension, not cause it. By reducing cardiac output and suppressing sympathetic nervous system activity, propranolol generally lowers blood pressure.

D. Headache is incorrect. While some clients might experience headaches due to changes in blood pressure, headache is not a primary adverse effect of propranolol.

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Correct Answer is D

Explanation

A. Telling the AP to list the steps of the task is not sufficient to ensure correct performance. It may show knowledge of the steps, but it does not ensure the AP is performing the task correctly or safely.

B. Instructing the AP to report back once the task is complete does not allow the nurse to actively observe the AP’s technique or provide feedback on performance.

C. Asking the family if the AP performed the task correctly may provide subjective input, but the nurse is responsible for assessing and ensuring the proper completion of nursing tasks.

D. Requesting the AP to provide a return demonstration of the task is the best method. This allows the nurse to directly observe the AP’s technique, correct any errors, and ensure that the task is performed according to the prescribed standards. This also serves as a valuable teaching opportunity.

A. "You should eat three large meals and two snacks per day." B. "You should elevate the head of the bed while sleeping." C. "You should lay down for 1 hour following a meal." D. "You should only drink 2 cups of coffee per day."

Correct Answer is B

Explanation

A. Eating three large meals and two snacks per day is not advisable for GERD patients. Large meals can increase the pressure on the lower esophageal sphincter (LES), leading to acid reflux. It is better to recommend smaller, more frequent meals to reduce symptoms.

B. Elevating the head of the bed while sleeping is correct. Elevating the head of the bed (usually by 6 to 8 inches) helps prevent acid from refluxing into the esophagus during sleep, a key management strategy for GERD.

C. Laying down for 1 hour following a meal is incorrect. After eating, patients with GERD should avoid lying down for at least 2 to 3 hours to prevent acid reflux. Lying down too soon after eating increases the risk of reflux.

D. Drinking 2 cups of coffee per day is not ideal for people with GERD, as caffeine can relax the LES, leading to increased reflux. While the exact amount varies by individual tolerance, it is generally recommended to limit or avoid caffeine.

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A nurse in a long-term care facility is contributing to the plan of care for a client who has a new prescription for propranolol. The nurse should plan to monitor the client for which of the following adverse effects of the medication?

Nursing Test Bank

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