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.

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason : Reducing stimuli is crucial for a patient emerging from a coma, especially after a traumatic brain injury (TBI). Excessive sensory input can overwhelm the patient's already compromised neurological state. The goal is to provide a calm and controlled environment to prevent overstimulation, which can lead to increased intracranial pressure (ICP), agitation, and delayed recovery. Interventions may include minimizing noise, dimming lights, and limiting the number of visitors. It's important to tailor the level of stimuli to the individual patient's response and recovery stage.

Choice B reason : Darkening the room can be part of reducing stimuli, but it is not the sole intervention needed. While a darker environment may help some patients rest, it is not universally applicable and should be considered as one aspect of an overall strategy to reduce stimuli. The nurse must assess the patient's individual needs and responses to determine if darkening the room is beneficial.

Choice C reason : The application of restraints is generally considered a last resort due to the potential for physical and psychological harm. Restraints can increase agitation and disorientation, potentially leading to self-injury or interference with medical devices. The use of restraints requires careful consideration, adherence to protocols, and often legal documentation. Non-pharmacological interventions and environmental modifications should be attempted first to manage restlessness.

Choice D reason : The administration of opioids is not typically indicated solely for restlessness in patients emerging from a coma. Opioids can depress the central nervous system, potentially masking neurological assessments and delaying recovery. They are primarily used for pain management. If restlessness is due to pain, then appropriate analgesia, including opioids, may be considered, but the underlying cause of restlessness should be thoroughly assessed and treated.

A. Answering questions with nonsensical phrases. B. Seeing, hearing, or feeling something that is not really there. C. The feeling that external events such as the weather forecast or news story have special meaning for the patient. D. Trouble staying on a schedule or finishing what the patient starts. E. Inability to socially connect with others.

Correct Answer is ["A","B","C"]

Explanation

Choice A reason : Answering questions with nonsensical phrases is a positive symptom of schizophrenia. It reflects disorganized thinking and speech, which can manifest as incoherence or irrelevance in the patient's verbal communication². This symptom can significantly impair the patient's ability to engage in meaningful conversation and is often one of the more noticeable signs of schizophrenia during an assessment³.

Choice B reason : Seeing, hearing, or feeling something that is not really there, also known as hallucinations, are hallmark positive symptoms of schizophrenia. These sensory experiences occur without an external stimulus and can involve any of the senses, although auditory hallucinations are the most common in schizophrenia². Hallucinations can be extremely distressing for patients and can lead to difficulties in distinguishing reality from delusion³.

Choice C reason : The belief that personal significance is attached to trivial or unrelated external events, known as delusions of reference, is another positive symptom of schizophrenia. Patients may believe that messages are being sent to them through the television, radio, or other public means². This can lead to a profound sense of misunderstanding and isolation as the patient navigates a world they perceive as filled with hidden messages meant specifically for them³.

Choice D reason : While trouble staying on a schedule or finishing tasks can be associated with schizophrenia, it is not considered a positive symptom. These issues are more reflective of the negative symptoms of schizophrenia, which include avolition or the lack of motivation to initiate and complete goal-directed activities⁴.

Choice E reason : An inability to socially connect with others is also not a positive symptom but rather a negative symptom of schizophrenia. Negative symptoms represent a loss or a decrease in the ability to initiate plans, speak, express emotion, or find pleasure in everyday life⁴. Social withdrawal and impaired social interaction are common negative symptoms that can be mistaken for introversion or depression³.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who had a traumatic brain injury and is emerging restlessly from a coma. Which of the following interventions should the nurse include in the plan?

Correct Answer is A

Explanation

A patient diagnosed with schizophrenia may demonstrate these positive symptoms (select all that apply) :

Correct Answer is ["A","B","C"]

Explanation

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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?