A nurse is reviewing the health history of 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 migraine headaches.
The client has a history of hypertension.
The client has a history of bronchial asthma.
The client has a history of hypothyroidism.
The Correct Answer is C
Choice A reason : While propranolol can be used to reduce the frequency and severity of migraine headaches, it is not contraindicated in patients with a history of migraines⁴.
Choice B reason : Propranolol is often prescribed for hypertension and is not contraindicated in such cases. It works by blocking beta-adrenergic receptors, which reduces heart rate and blood pressure⁴.
Choice C reason : Propranolol is contraindicated in patients with bronchial asthma. As a non-selective beta-blocker, it can cause bronchoconstriction and exacerbate asthma symptoms. Therefore, the nurse should report this finding to the provider⁴⁶.
Choice D reason : Hypothyroidism is not a contraindication for propranolol. However, the medication may mask signs of hypothyroidism, such as a slow heart rate, so the provider should be aware of the client's thyroid condition⁴.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
Choice A reason : Pupillary changes, such as unequal pupil sizes or a sluggish reaction to light, can be a sign of increased ICP. The cranial nerves that control the pupils may be compressed due to the swelling of the brain, leading to these changes¹.
Choice B reason : Disorientation, including confusion and changes in alertness, can occur with increased ICP as the pressure affects the brain's ability to process information and maintain consciousness².
Choice C reason : Headache is a common symptom of increased ICP. It can be severe and persistent due to the pressure exerted on the meninges and blood vessels within the brain³.
Choice D reason : Slurred speech may result from increased ICP if the areas of the brain responsible for speech and muscle control are affected by the pressure².
Choice E reason : Neck pain and stiffness, particularly when trying to flex the neck forward, can be indicative of meningeal irritation, which can be associated with increased ICP⁴.
Correct Answer is A
Explanation
Choice A reason : In end-stage kidney disease, the kidneys are unable to excrete excess fluid, leading to fluid overload or hypervolemia. This condition can manifest as shortness of breath due to pulmonary edema, swelling in the lower extremities, and crackles in the lungs upon auscultation. Elevated blood pressure is also a common finding in hypervolemia due to the increased volume of fluid in the bloodstream⁵⁶⁷⁸.
Choice B reason : Hypovolemia, or decreased blood volume, is not consistent with the symptoms described. It typically presents with signs of dehydration, low blood pressure, and tachycardia, which are not mentioned in the client's manifestations.
Choice C reason : Hyponatremia, or low sodium levels in the blood, can occur in ESKD due to dilution from retained fluids, but the primary symptoms described by the client are more indicative of fluid overload rather than electrolyte imbalance alone.
Choice D reason : Hyperkalemia, or high potassium levels, is a serious complication of ESKD due to the kidneys' inability to excrete potassium. While it is a concern in ESKD, the symptoms described by the client are more directly related to fluid overload.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.