What factor would contraindicate the use of propranolol (Inderal) in a 38-year-old obese African American patient with diabetes who is being evaluated for hypertension control?

Weight.

Age.

Diabetes.

Race.

Answer and Explanation

The Correct Answer is C

Choice A rationale
While obesity can contribute to hypertension and other cardiovascular diseases, it is not a contraindication for the use of propranolol. Weight management would be part of the overall treatment plan for hypertension, but it would not prevent the use of this medication.
Choice B rationale
Age is not a contraindication for the use of propranolol. While older adults may be more susceptible to certain side effects of the medication, age alone would not prevent a patient from taking propranolol.
Choice C rationale
Diabetes is a contraindication for the use of propranolol. Propranolol is a non-selective beta- blocker, which can mask symptoms of hypoglycemia, a common condition in people with diabetes. Therefore, it’s generally not recommended for people with diabetes.
Choice D rationale
Race is not a contraindication for the use of propranolol. While there are some differences in how people of different races may respond to certain medications, race alone would not prevent a patient from taking propranolol.

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Correct Answer is B

Explanation

Choice A rationale
Digoxin slows the heart rate and increases the force of heart contractions, which can be beneficial in heart failure. However, if the pulse is below 60 beats/min, taking digoxin could further slow the heart rate and potentially lead to bradycardia.
Choice B rationale
Nausea can be a side effect of digoxin and hydrochlorothiazide. If the patient develops nausea, they should notify their healthcare provider as this could indicate that the medication dose needs adjustment.
Choice C rationale
Hydrochlorothiazide can cause the body to lose potassium, so limiting dietary intake of potassium could potentially lead to hypokalemia, a condition characterized by low potassium levels in the blood.
Choice D rationale
Taking hydrochlorothiazide at bedtime could potentially lead to nocturia, which is the need to wake up at night to urinate. This could disrupt the patient’s sleep.

A. Evaluate the need for smoking cessation B. Apply TED hose to both legs C. Consult with physical therapy D. Obtain Ankle-Brachial Index (ABI) using a hand-held Doppler

Correct Answer is B

Explanation

Choice A rationale
Evaluating the need for smoking cessation is a standard part of nursing care, especially for patients with circulatory issues. Smoking can exacerbate circulatory problems and delay wound healing.
Choice B rationale
Applying TED hose to both legs might not be appropriate for this patient. TED hose are compression stockings designed to prevent deep vein thrombosis and promote circulation. However, in a patient with weak pedal pulses and a full-thickness wound on the leg, the compression from the stockings could potentially worsen circulation to the area and impede wound healing.
Choice C rationale
Consulting with physical therapy could be beneficial for this patient. Physical therapists can provide exercises and interventions to improve circulation and mobility, which could help with the patient’s circulatory issues and wound healing.
Choice D rationale
Obtaining an Ankle-Brachial Index (ABI) using a hand-held Doppler could be useful in this situation. The ABI is a simple, non-invasive test that can help diagnose peripheral artery disease (PAD), a condition that could be causing the patient’s weak pedal pulses and wound healing issues.

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What factor would contraindicate the use of propranolol (Inderal) in a 38-year-old obese African American patient with diabetes who is being evaluated for hypertension control?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In the context of Interprofessional Care of the Client and Family Across the Lifespan, a nurse is planning discharge teaching for a patient with chronic heart failure who has been prescribed digoxin (Lanoxin) and hydrochlorothiazide. What instruction should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is providing care for a patient who has weak pedal pulses, no hair on both legs, and a full-thickness wound on the right lateral malleolus with defined margins, which includes a small amount of serous exudate. Which intervention should not be performed?

Correct Answer is B

Explanation

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