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 D

Explanation

Choice A reason : Nitroglycerin is used to treat angina pectoris and does not typically cause a decrease in potassium levels¹.

Choice B reason : Metoprolol is a beta-blocker used to treat high blood pressure and heart failure but is not known to significantly affect potassium levels¹.

Choice C reason : Spironolactone is a potassium-sparing diuretic and would not contribute to low potassium levels; it is more likely to cause hyperkalemia¹.

Choice D reason : Furosemide is a loop diuretic that can lead to hypokalemia by increasing the excretion of potassium in the urine. It is known to contribute to low potassium levels and should be identified as the medication affecting this lab value¹².

A. Sore throat B. Dry mouth C. Thyroid problems D. Lymphedema

Correct Answer is A

Explanation

Choice A reason : A sore throat is a common side effect of radiation therapy to the neck area, particularly for cancer of the larynx. The radiation can cause inflammation and irritation of the throat and laryngeal tissues, leading to pain and discomfort when swallowing¹⁵. This side effect can be managed with pain relief medications and dietary adjustments to include softer foods and liquids.

Choice B reason : Dry mouth, or xerostomia, occurs when radiation damages the salivary glands, reducing saliva production. This can lead to difficulties in speaking, tasting, chewing, and swallowing, as well as an increased risk of dental problems¹³. Patients undergoing radiation therapy are often advised to stay hydrated and may be prescribed saliva substitutes or stimulants.

Choice C reason : Radiation to the neck might damage the thyroid gland, leading to hypothyroidism. Symptoms of thyroid problems due to radiation can include fatigue, weight gain, feeling cold, and having dry skin or hair³. Regular monitoring of thyroid function is recommended for patients who have received radiation therapy in the neck area.

Choice D reason : Lymphedema is swelling that can occur when radiation therapy affects the lymph nodes and vessels, impeding the flow of lymph fluid. In the context of neck radiation, this can lead to swelling in the neck and face³. Management includes physical therapy, compression garments, and careful skin care to prevent infection.

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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 caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as contributing to this lab value?

Correct Answer is D

Explanation

A nurse is caring for a client scheduled to receive external radiation to the neck for cancer of the larynx. During a pre-treatment exam, the nurse explains to the client that the most likely side effect would be :

Correct Answer is A

Explanation

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