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.

Answer and Explanation

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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Correct Answer is C

Explanation

A. Instruct the client to avoid high-potassium foods: While important for long-term management, it is not the priority when the client is experiencing hyperkalemia, as immediate interventions are necessary to prevent complications.

B. Redraw the potassium to verify results: Redrawing the potassium may be necessary if there is concern about sample contamination or if the result is significantly different from what is expected. However, it is not the priority when the client is at risk of complications from hyperkalemia.

C. Check the client's blood pressure: This is the priority action because hyperkalemia can lead to cardiac dysrhythmias, including potentially life-threatening arrhythmias. Checking the blood pressure helps assess the client's cardiovascular status and any potential effects of hyperkalemia on cardiac function.

D. Obtain a serum sodium level: While monitoring electrolyte levels is important in ESRD, sodium levels are not the priority when the client is experiencing hyperkalemia. Monitoring potassium and managing its effects take precedence.

A. Hypokalemia B. Hypocalcemia C. Hypernatremia D. Hyperkalemia

Correct Answer is A

Explanation

A. Hypokalemia: Furosemide is a loop diuretic that works by increasing urinary excretion of sodium, chloride, and water, which can lead to potassium loss. Hypokalemia is a common electrolyte imbalance associated with the use of loop diuretics like furosemide. Potassium depletion can cause various complications, including cardiac dysrhythmias, muscle weakness, and fatigue.

B. Hypocalcemia: Furosemide does not directly affect calcium levels, so hypocalcemia is not a common electrolyte imbalance associated with its use.

C. Hypernatremia: Furosemide promotes the excretion of sodium, so hypernatremia (elevated serum sodium levels) is not typically a concern with its use.

D. Hyperkalemia: Furosemide can cause potassium loss, so hyperkalemia is not a risk associated with its use.

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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?

Nursing Test Bank

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