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 D
Explanation
A. Creatinine phosphokinase (CPK): CPK levels peak within 24 hours after an MI and return to normal within 2-3 days.
B. Myoglobin: Myoglobin rises within hours but returns to normal within 24 hours after MI.
C. Creatinine kinase-MB (CK-MB): CK-MB peaks 12-24 hours post-MI and returns to baseline within 2-3 days.
D. Troponin T: Troponin T remains elevated for up to 10-14 days after an MI, providing long-term evidence of myocardial injury.