A nurse is reinforcing teaching with a client who has a new prescription for propranolol. The nurse should include which of the following as a potential adverse effect of this medication?

Rationale: A. Decreased heart rate: Propranolol is a non-selective beta-blocker that reduces heart rate by blocking beta-1 receptors in the heart. Bradycardia is a common and expected adverse effect, and clients should be taught to monitor their pulse regularly and report significant drops. B. Sudden weight loss: Sudden weight loss is not a typical adverse effect of propranolol. If it occurs, it may indicate an underlying condition or adverse reaction unrelated to the pharmacologic action of beta-blockers and should be evaluated separately. C. Increased urinary output: Propranolol does not act on the kidneys to promote diuresis. While beta-blockers may be used in combination with diuretics, increased urine output is not a direct effect of this medication and is not expected. D. White patches on the tongue: White patches on the tongue suggest oral candidiasis, which is more commonly associated with inhaled corticosteroids, not beta-blockers like propranolol. This symptom is unrelated to the medication’s mechanism of action.