A client who receives multiple antihypertensive multiple medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse’s decision to hold the client’s scheduled antihypertensive medications?

Increased urinary clearance of the multiple medications has produced diuresis and lowered blood pressure.

The synergetic eﬀect of the multiple medication has resulted in drug toxicity and resulting hypotension.

The antagonistic interaction among the various blood pressure medications has reduced their eﬀectiveness.

The additive eﬀect of multiple medications has caused the blood pressure to drop too low.

Answer and Explanation

The Correct Answer is D

The client is experiencing syncope (fainting) due to a drop in blood pressure to 70/40 mm Hg, which is too low. This suggests that the client's blood pressure medications are reducing their blood pressure too much, resulting in hypotension. The rationale for the nurse's decision to hold the client's scheduled antihypertensive medications is to prevent further hypotension and allow the client's blood pressure to stabilize at a safer level.

Option a is incorrect because diuresis (increased urine output) is not a likely cause of the client's hypotension.

Option b is incorrect because the client's symptoms suggest hypotension due to reduced blood pressure, rather than drug toxicity.

Option c is incorrect because the antagonistic interaction among blood pressure medications would result in reduced eﬀectiveness but would not necessarily cause hypotension.

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Correct Answer is C

Explanation

Oxybutynin is a medicine used to treat symptoms of an overactive bladder. One of the side eﬀects of oxybutynin is that it can cause dry mouth, constipation, and dry skin21. These side eﬀects can increase the risk of dehydration. Additionally, oxybutynin can cause ﬂushing and heat stroke. Therefore, it is important for the client to take measures to avoid dehydration and over-heating while training for a marathon.

A. Eliminate use of nonsteroidal anti-inﬂammatory drugs. (NSAIDs) B. Avoid consuming all foods that contain Iodine. C. Notify healthcare provider prior to dental procedures. D. Monitor blood glucose levels daily.

Correct Answer is A

Explanation

Lithium carbonate is a mood stabilizer commonly used to treat bipolar disorder. However, it has a narrow therapeutic index and requires careful monitoring of serum levels to avoid toxicity. One of the major concerns with lithium therapy is the potential for drug interactions and toxicity. NSAIDs such as ibuprofen and naproxen can increase lithium levels by reducing its excretion and can lead to lithium toxicity. Therefore, it is essential to instruct the client to eliminate the use of NSAIDs while taking lithium.

Option b) Avoid consuming all foods that contain iodine is incorrect because iodine is not contraindicated with lithium. However, excessive iodine intake can interfere with thyroid function, which can exacerbate mood instability.

Option c) Notify healthcare provider prior to dental procedures is not specific to lithium therapy and is a general precaution that patients with bipolar disorder should follow before any medical or dental procedures.

Option d) Monitor blood glucose levels daily is also not directly related to lithium therapy. While lithium can cause diabetes insipidus, which can lead to excessive thirst and urination, it does not typically aﬀect blood glucose levels.

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A client who receives multiple antihypertensive multiple medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse’s decision to hold the client’s scheduled antihypertensive medications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a marathon. Which instruction should the nurse emphasize?

Correct Answer is C

Explanation

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?

Correct Answer is A

Explanation

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