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 C
Explanation
Rationale:
A. Furosemide is a diuretic that promotes urine production but is not indicated for treating bladder distention or urinary retention post-surgery.
B. Lorazepam is an anxiolytic medication and does not address urinary retention or bladder distention.
C. Bethanechol is a cholinergic agent that stimulates bladder contraction and is used to treat urinary retention. It helps to facilitate voiding in clients who have difficulty.
D. Atropine is an anticholinergic medication that can actually inhibit bladder contraction, making it inappropriate for this situation.
Correct Answer is C
Explanation
Rationale:
A. Applying a warming blanket is not appropriate and may worsen the client’s reaction to the infusion. It does not help prevent infusion-related reactions.
B. Infusing amphotericin B deoxycholate over 1 hour is too fast; the medication should be infused over 2-6 hours to reduce the risk of adverse effects.
C. Administering diphenhydramine prior to administration is recommended to help prevent infusion-related reactions, such as fever and chills, which the client experienced during previous infusions.
D. Monitoring vital signs once per hour is inadequate; vital signs should be monitored more frequently during and immediately after the infusion to promptly identify and manage any adverse reactions.