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?

A. Decreased heart rate: Propranolol is a nonselective beta-adrenergic blocker that reduces sympathetic stimulation of the heart, resulting in decreased heart rate and cardiac output. Bradycardia is a common adverse effect and requires monitoring, especially in clients with preexisting conduction abnormalities. B. Sudden weight loss: Propranolol does not directly promote weight loss. Any changes in weight are typically related to underlying disease or lifestyle, not a pharmacologic effect of this medication. C. White patches on the tongue: Oral candidiasis or leukoplakia are unrelated to propranolol therapy. These findings are not associated with beta-blocker use and would suggest a separate oral health issue. D. Increased urinary output: Propranolol does not have diuretic properties and does not directly affect renal fluid excretion. Changes in urine volume are not a known adverse effect of beta-blockers.