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

The correct answer is C. Liver function lab results.

Choice A: Weight change in the last month

Weight change is a relevant factor to monitor in patients starting on antidepressants, including duloxetine, as some antidepressants can cause weight gain or loss. However, it is not the most critical information to obtain initially. Monitoring weight can help manage potential side effects and ensure the patient’s overall health, but it does not directly impact the immediate safety and efficacy of starting duloxetine.

Choice B: Recent use of other antidepressants

Recent use of other antidepressants is crucial information because combining duloxetine with other antidepressants, especially MAOIs (Monoamine Oxidase Inhibitors), can lead to serious interactions such as serotonin syndrome. This condition can be life-threatening and requires careful management. However, while this information is important, it is not as immediately critical as liver function tests when starting duloxetine.

Choice C: Liver function lab results

Liver function lab results are the most important information for the nurse to obtain. Duloxetine is metabolized in the liver, and patients with pre-existing liver conditions or impaired liver function are at higher risk for hepatotoxicity. Monitoring liver function is essential to prevent severe liver damage, which can be life-threatening. Baseline liver function tests help ensure that the patient can safely metabolize the medication and identify any potential issues early.

Choice D: Family history of mental illness

Family history of mental illness can provide valuable context for understanding the patient’s condition and potential genetic predispositions. It can also help in tailoring the treatment plan and anticipating the patient’s response to medication. However, while this information is useful for long-term management, it is not as immediately critical as liver function tests when initiating duloxetine therapy.

A. Avoid crowds to help prevent acquiring infections. B. Wear protective padding to protect from bruising if a fall occurs. C. Take measures to avoid dehydration and over-heating. D. Keep skin and eyes covered to protect from sun injury.

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.

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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?

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Naxlex Comprehensive Predictor Exams

The nurse is planning care for a patient with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

Correct Answer is C

Explanation

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

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