During change-of-shift report, the nurse obtains the following information about a hypertensive patient who received the first dose of nadolol(Corgard) during the previous shift. Which information indicates that the patient needs immediate intervention?

Correct Answer: C

Rationale: The most urgent concern for this patient is the wheezes, which indicate that bronchospasm(a common adverse effect of the noncardioselective b-blockers) is occurring. The nurse should immediately obtain an oxygen saturation measurement, apply supplemental oxygen, and notify the health care provider. The mild decrease in heart rate and complaint of cold fingers and toes are associated with b-receptor blockade but do not require any change in therapy. The BP reading may indicate that a change in medication type or dose may be indicated. However, this is not as urgently needed as addressing the bronchospasm.

Correct Answer: C

Rationale: Structural and functional changes in the heart and blood vessels contribute to increases in BP that occur with aging. Venous insufficiency does not cause hypertension, however. Increased BP is not primarily a result of neurologic changes.

Correct Answer: D

Rationale: The last parts of the myocardium to depolarise typically do not include the septum, which depolarises early.

Correct Answer: C

Rationale: Decreased extracellular K+ generally does not cause vasodilation; rather, increased K+ can promote vasodilation.