A nurse is collecting data from a client who is taking propranolol. The nurse should monitor the client for which of the following adverse effects?

A. Bradycardia: Propranolol is a nonselective beta-adrenergic blocker that inhibits both β1 and β2 receptors. Blockade of β1 receptors in the sinoatrial and atrioventricular nodes decreases heart rate and conduction velocity. Excessive beta blockade can result in clinically significant bradycardia, hypotension, and reduced cardiac output, requiring monitoring of pulse and BP. B. Hypertension: Propranolol lowers blood pressure by decreasing cardiac output and suppressing renin release from the kidneys. Its pharmacologic action is antihypertensive rather than hypertensive. Elevated blood pressure would not be expected as a direct adverse effect of appropriate beta-blocker therapy. C. Tinnitus: Tinnitus is more commonly associated with medications such as salicylates, loop diuretics, or certain antibiotics. Propranolol does not typically affect the auditory system or cochlear blood flow in a way that produces ringing in the ears. D. Urinary hesitancy: Urinary hesitancy is often linked to anticholinergic medications or conditions such as benign prostatic hyperplasia. Propranolol does not have significant anticholinergic effects and does not commonly interfere with bladder detrusor muscle contraction or urinary flow.