A nurse is reviewing the health history for 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 hypertension.
The client has a history of hypothyroidism.
The client has a history of bronchial asthma.
The client has a history of migraine headaches.
The Correct Answer is C
Choice A reason: The client has a history of hypertension is not the correct answer. Hypertension is a condition in which the blood pressure is abnormally high, usually above 140/90 mmHg. Propranolol is a beta-blocker that lowers the blood pressure and reduces the workload of the heart. Propranolol is indicated for the treatment of hypertension and angina pectoris, which is a type of chest pain caused by reduced blood flow to the heart. The nurse does not need to report this finding to the provider, as it is consistent with the prescription.
Choice B reason: The client has a history of hypothyroidism is not the correct answer. Hypothyroidism is a condition in which the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy levels. Propranolol can mask some of the signs of hypothyroidism, such as tachycardia, tremors, and anxiety. Propranolol can also interfere with the absorption and conversion of thyroid hormones. The nurse should monitor the client's thyroid function tests and report any abnormal values to the provider, but this finding is not a contraindication to the use of propranolol.
Choice C reason: The client has a history of bronchial asthma is the correct answer. Bronchial asthma is a chronic inflammatory disorder of the airways that causes wheezing, coughing, and shortness of breath. Propranolol is a non-selective beta-blocker that blocks the beta-1 receptors in the heart and the beta-2 receptors in the lungs. Blocking the beta-2 receptors can cause bronchoconstriction, which can worsen the symptoms of asthma and trigger an asthma attack. Propranolol is contraindicated in clients who have bronchial asthma, and the nurse should report this finding to the provider immediately.
Choice D reason: The client has a history of migraine headaches is not the correct answer. Migraine headaches are recurrent episodes of severe and throbbing pain, usually on one side of the head, that can be accompanied by nausea, vomiting, and sensitivity to light and sound. Propranolol is effective in preventing migraine headaches, as it reduces the frequency and severity of the attacks. Propranolol is indicated for the prophylaxis of migraine headaches, and the nurse does not need to report this finding to the provider, as it is consistent with the prescription.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A - Catheter Occlusion: This occurs when the catheter is blocked, preventing the flow of fluids or medication. It is usually indicated by difficulty in flushing the catheter or a slow drip rate¹. However, it does not typically cause a gurgling sound.
Choice B - (Catheter migration) is correct because when a central venous catheter (CVC) migrates from its original position, the tip can enter a smaller vein or a different location where turbulence occurs. This may cause the client to hear a gurgling or bubbling sound, especially during infusion or with position changes. Migration can happen due to coughing, movement, or changes in pressure, and it doesn’t necessarily involve the catheter being visibly out of place
Choice C - (Catheter dislodgment) is incorrect because dislodgment typically refers to the catheter being partially pulled out of the insertion site. This would be more likely to cause external signs like visible catheter movement or fluid leakage at the insertion site, rather than internal gurgling sounds. Gurgling is more associated with internal changes in catheter position, as seen with migration.
Choice D - Catheter Rupture: This is a break or tear in the catheter. It can cause serious complications, including infection and embolism. However, a gurgling sound is not a typical symptom of a catheter rupture¹.
Correct Answer is C
Explanation
Choice A reason: Atropine is not the correct answer, as it is an anticholinergic medication that is used to treat bradycardia, not warfarin overdose. Atropine has no effect on the INR or the coagulation cascade.
Choice B reason: Epinephrine is not the correct answer, as it is a catecholamine medication that is used to treat anaphylaxis, cardiac arrest, or severe hypotension, not warfarin overdose. Epinephrine has no effect on the INR or the coagulation cascade.
Choice C reason: Vitamin K is the correct answer, as it is the antidote for warfarin overdose. Vitamin K is a fat-soluble vitamin that is essential for the synthesis of clotting factors II, VII, IX, and X. Vitamin K can reverse the effects of warfarin and lower the INR to a therapeutic range.
Choice D reason: Protamine is not the correct answer, as it is the antidote for heparin overdose, not warfarin overdose. Protamine is a protein that binds to and neutralizes heparin, but has no effect on warfarin or the INR.
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