A nurse is caring for a client who has a prescription for propranolol for the treatment of atrial fibrillation. Which of the following actions should the nurse take?
Withhold the medication if the systolic blood pressure is less than 90 mm Hg.
Request a dosage increase if the apical heart rate is less than 60/min.
Inform the client to expect increased hair growth.
Administer the medication with an antacid.
The Correct Answer is A
Choice A reason: Withholding the medication if the systolic blood pressure is less than 90 mm Hg is an appropriate action, as propranolol is a beta-blocker that can lower blood pressure and cause hypotension, which can impair tissue perfusion and cause dizziness, fainting, or shock.
Choice B reason: Requesting a dosage increase if the apical heart rate is less than 60/min is an inappropriate action, as propranolol can slow down the heart rate and cause bradycardia, which can lead to fatigue, weakness, or cardiac arrest. The nurse should monitor the apical pulse before administering propranolol and withhold it if it is less than 60/min.
Choice C reason: Informing the client to expect increased hair growth is an incorrect statement, as propranolol does not cause hypertrichosis or excessive hair growth. However, another beta-blocker, minoxidil, can cause this side effect.
Choice D reason: Administering the medication with an antacid is not an appropriate action, as antacids can interfere with the absorption of propranolol and reduce its effectiveness. The nurse should administer propranolol on an empty stomach or with food that does not contain antacids.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Eliminating egg whites from the diet is not necessary, as they are a good source of protein and do not contain any fat or cholesterol. The client should limit or avoid egg yolks, which are high in cholesterol and saturated fat.
Choice B reason: Using coconut oil when preparing food is not advisable, as it is a source of saturated fat that can raise blood cholesterol levels and increase the risk of atherosclerosis and heart disease. The client should use unsaturated fats, such as olive oil or canola oil, which can lower blood cholesterol levels and improve heart health.
Choice C reason: Eating fish three times a week is a good practice, as fish are rich in omega-3 fatty acids that can reduce inflammation, lower blood pressure, and prevent blood clots that can cause heart attacks or strokes. The client should choose oily fish, such as salmon, tuna, or mackerel, which have higher amounts of omega-3 fatty acids.
Choice D reason: Including 2 percent milk in the diet is not recommended, as it contains more fat and calories than skim or 1 percent milk. The client should choose low-fat or fat-free dairy products, such as yogurt, cheese, or milk, which can provide calcium and protein without excess fat.
Correct Answer is C
Explanation
Choice A: This is incorrect because Sims position is used for clients who have lower back pain, abdominal surgery, or enemas. It is not appropriate for clients who have a closed head injury.
Choice B: This is incorrect because modified Trendelenburg position is used for clients who have hypovolemic shock or poor venous return. It is not appropriate for clients who have a closed head injury.
Choice C: This is correct because semi-Fowler's position is used for clients who have increased intracranial pressure, respiratory distress, or head trauma. It elevates the head and chest to reduce cerebral edema and facilitate breathing.
Choice D: This is incorrect because prone position is used for clients who have acute respiratory distress syndrome, spinal cord injury, or pressure ulcers. It is not appropriate for clients who have a closed head injury.
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