A nurse is reviewing the health history of a patient with angina pectoris who has a prescription for propranolol hydrochloride PO 40 mg twice daily.
Which historical finding should the nurse report to the provider?
The patient has a history of migraine headaches.
The patient has a history of hypothyroidism.
The patient has a history of hypertension.
The patient has a history of bronchial asthma.
The Correct Answer is D
Choice A rationale
Propranolol is sometimes used to prevent migraines, so a history of migraines would not typically be a contraindication.
Choice B rationale
Hypothyroidism is not typically a contraindication for propranolol. However, propranolol can affect the metabolism of thyroid hormones and may mask signs of hyperthyroidism.
Choice C rationale
Propranolol is often used to treat hypertension, so a history of hypertension would not typically be a contraindication.
Choice D rationale
Propranolol is a non-selective beta-blocker, which means it blocks beta receptors in both the heart and the lungs. This can potentially cause bronchoconstriction and exacerbate asthma symptoms, so it should be used with caution in patients with a history of bronchial asthma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}
Explanation
The nurse should first: C. Administer additional morphine for pain management, followed by B. Reposition the client for comfort.
The client is reporting a pain level of 6 on a scale from 0 to 10, which indicates moderate to severe pain. As per the medication administration record, the client has an order for Morphine 4 mg IV bolus every 6 hours PRN for pain. Since the client is in pain, it would be appropriate to administer the morphine first to manage the pain.
After addressing the client’s pain, the nurse should then reposition the client for comfort. This can help to alleviate any discomfort or pressure points that may be contributing to the client’s pain. It’s also important to ensure the client’s safety and comfort by making sure the call light is within reach.
The options related to restraints (A and D for Response 1, and A, B, C, D for Response 2) are not relevant in this scenario as there is no indication in the provided information that the client is being restrained or that restraints are necessary. The client is drowsy but arouses easily to verbal stimuli and is able to follow simple commands, suggesting that they are not at risk of harming themselves or others, which would necessitate the use of restraints. Therefore, these options can be ruled out.
Correct Answer is D
Explanation
Choice A rationale
After a total laryngectomy, patients may have difficulty swallowing fluids due to changes in the anatomy of the throat.
Choice B rationale
It is not accurate to say that it is no longer possible for the patient to choke on or aspirate food after a total laryngectomy. While the risk of aspiration is reduced because the airway and digestive tract are separated, the patient can still experience choking on food if it is not properly swallowed.
Choice C rationale
Adding a thickener to liquids can help prevent aspiration, but this is typically more relevant for patients with dysphagia or other swallowing disorders, not specifically for patients post- laryngectomy.
Choice D rationale
Tucking the chin when swallowing, also known as the chin-tuck maneuver, can help prevent aspiration by narrowing the entrance to the airway. This can be a useful technique for patients after a laryngectomy.
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