A nurse is reviewing the health history of a client diagnosed with angina pectoris and has a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the client's health history should the nurse report to the provider?
The client has a history of bronchial asthma.
The client has a history of migraine headaches.
The client has a history of hypertension.
The client has a history of hypothyroidism.
The Correct Answer is A
A. The client has a history of bronchial asthma: Propranolol is a non-selective beta-blocker and can potentially exacerbate bronchospasm in individuals with asthma due to its beta-blocking effects on beta-2 receptors in the bronchioles. Therefore, this finding should be reported to the provider for further assessment and consideration of alternative medications.
B. The client has a history of migraine headaches: Propranolol is commonly used prophylactically to prevent migraine headaches, so this finding is not a contraindication for its use and does not require immediate reporting to the provider.
C. The client has a history of hypertension: Propranolol is often prescribed for hypertension, so this finding is expected and not a cause for concern.
D. The client has a history of hypothyroidism: While propranolol can affect thyroid function tests, a history of hypothyroidism alone is not a contraindication for its use, and it does not
require immediate reporting to the provider. However, thyroid function should be monitored during therapy.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Wheezing in all lung fields may indicate respiratory issues but does not directly support the diagnosis of Excess Fluid Volume.
B. Pitting edema in bilateral lower extremities is a classic sign of fluid overload, which directly supports the diagnosis of Excess Fluid Volume.
C. An oral fluid intake of 2000 mL in 24 hours is within normal limits for an adult and does not necessarily indicate Excess Fluid Volume without other symptoms.
D. Significant fatigue for more than one month could be related to a variety of conditions and is too nonspecific to support the diagnosis of Excess Fluid Volume without additional assessment data.
Correct Answer is A
Explanation
A. Administration of erythropoietin (Epoetin): In chronic renal disease, the kidneys may not produce enough erythropoietin, leading to anemia. Epoetin is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in these clients.
B. Transfusion of red blood cells (RBCs): While transfusion of RBCs may be necessary in severe cases of anemia or acute blood loss, it is not the first-line treatment for anemia related to chronic renal disease. Erythropoietin-stimulating agents are preferred to stimulate endogenous RBC production.
C. Weekly monitoring of complete blood count (CBC): Monitoring of CBC is important to assess the response to treatment and adjust therapy as needed but does not represent a specific treatment for anemia in chronic renal disease.
D. An order for iron replacement medication: Iron replacement may be indicated if iron deficiency is contributing to the anemia, but it is not the primary treatment for anemia in chronic renal disease. Erythropoietin-stimulating agents are typically used first to address the underlying cause of anemia.
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