A nurse is collecting data from a client who has hypertension and a prescription for propranolol. A history of which of the following conditions should be reported to the provider?
Depression
Glaucoma
Migraine
Heart failure
The Correct Answer is D
A. Depression: While propranolol can sometimes worsen symptoms of depression, this is not as critical as the impact on conditions like heart failure.
B. Glaucoma: Propranolol does not typically affect glaucoma; however, some beta-blockers are used to treat glaucoma.
C. Migraine: Propranolol is sometimes used to prevent migraines, so a history of migraines would not require discontinuation.
D. Heart failure: Propranolol can exacerbate heart failure by reducing myocardial contractility. Clients with heart failure require careful monitoring or an alternative medication.
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Correct Answer is C
Explanation
A. "A heart murmur is a high-pitched sound due to a narrow valve." Not all murmurs are high-pitched, nor are they always due to a narrow valve.
B. "This means that there is some inflammation around your heart." A murmur does not indicate inflammation around the heart; it typically indicates abnormal blood flow.
C. "This indicates turbulent blood flow through a valve." A heart murmur is caused by turbulent blood flow, often through a damaged or abnormal valve.
D. "A heart murmur is an extra sound due to blood entering an inflexible chamber." While inflexible chambers can cause extra heart sounds, this does not describe a murmur.
Correct Answer is B
Explanation
A. Creatine kinase-myocardial band (CK-MB) test: While CK-MB is also a marker of myocardial injury, it is less specific than troponin and can be elevated in other conditions, such as muscle injury.
B. Troponin T test. The Troponin T test is highly specific and sensitive for myocardial injury and is considered the gold standard for diagnosing a myocardial infarction. Troponin levels rise within hours of cardiac muscle injury and remain elevated for days, providing an early and reliable indicator of cardiac muscle damage.
C. Brain natriuretic peptide (BNP) test. BNP levels are used to assess heart failure and do not indicate acute cardiac muscle injury.
D. Creatine kinase (CK) test. CK measures overall muscle injury, not specific to cardiac muscle.