A nurse is obtaining vital signs for a client who has been taking propranolol. Which of the following findings should the nurse identify as an adverse effect of the medication?
Respiratory rate 24/min
Oral temperature 38.9° C (102° F)
Blood pressure 118/78 mm Hg
Apical pulse 50/min
The Correct Answer is D
Rationale:
A. A respiratory rate of 24/min is elevated and may suggest respiratory distress, but it is not a specific adverse effect of propranolol.
B. An oral temperature of 38.9° C (102° F) indicates fever, which is not a typical adverse effect of propranolol.
C. A blood pressure of 118/78 mm Hg is within normal limits and does not indicate an adverse effect of propranolol, which is often used to manage hypertension.
D. An apical pulse of 50/min indicates bradycardia, a known adverse effect of propranolol, which can occur due to its action on the heart rate.
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Correct Answer is B
Explanation
Rationale:
A. "Remove the patch for two to four hours daily.": This is incorrect because transdermal nitroglycerin patches should be worn continuously for 24 hours, with a scheduled time to remove them (usually overnight) to prevent tolerance.
B. "Apply a new patch each day after waking up.": This instruction is correct; clients should apply a new patch daily to ensure continuous therapeutic effects while also allowing a break to reduce tolerance.
C. "Cover the patch with plastic wrap.": This is incorrect; covering the patch with plastic wrap can alter the absorption of the medication and is not necessary.
D. "Replace the existing patch with a new patch as soon as anginal pain begins.": This is incorrect; clients should not replace the patch immediately for angina. Instead, they should use sublingual nitroglycerin for immediate relief and follow the prescribed patch schedule.
Correct Answer is C
Explanation
Rationale:
A. Sargramostim is a granulocyte-macrophage colony-stimulating factor (GM-CSF) used to stimulate the production of white blood cells but is not specifically indicated for anemia.
B. Filgrastim is a granulocyte colony-stimulating factor (G-CSF) that increases white blood cell counts and is not used for treating anemia.
C. Epoetin is an erythropoiesis-stimulating agent that stimulates red blood cell production, making it the appropriate choice for treating chemotherapy-induced anemia.
D. Romiplostim is a thrombopoietin receptor agonist used to treat thrombocytopenia (low platelet count) and is not indicated for anemia.