A client who receives multiple antihypertensive 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 the blood pressure.

The synergistic effect of the multiple medications has resulted in drug toxicity and 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

Choice A reason: Increased urinary clearance of the multiple medications is not the cause of the client's syncope. Diuresis is a common side effect of some antihypertensive medications, such as diuretics, but it does not lower the blood pressure to a dangerous level. The nurse should monitor the client's fluid and electrolyte balance and urine output, but it is not the priority action in this situation.

Choice B reason: The synergistic effect of the multiple medications is not the cause of the client's syncope. Synergism is when two or more drugs work together to produce a greater effect than the sum of their individual effects. This can be beneficial or harmful, depending on the drugs and the doses. The nurse should check the client's medication history and avoid prescribing drugs that have a negative synergistic effect, but it is not the most likely explanation for the client's hypotension.

Choice C reason: The antagonistic interaction among the various blood pressure medications is not the cause of the client's syncope. Antagonism is when two or more drugs work against each other to reduce or cancel out their effects. This can decrease the effectiveness of the treatment and increase the risk of complications. The nurse should check the client's medication history and avoid prescribing drugs that have a negative antagonistic effect, but it is not the most likely explanation for the client's hypotension.

Choice D reason: The additive effect of multiple medications is the most likely cause of the client's syncope. Additivity is when two or more drugs have a similar effect and their combined effect is equal to the sum of their individual effects. This can lower the blood pressure too much and cause symptoms such as dizziness, fainting, and shock. The nurse should hold the client's scheduled antihypertensive medications and notify the healthcare provider. The nurse should also monitor the client's vital signs, level of consciousness, and perfusion.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A reason: Taking levothyroxine on an empty stomach ensures better absorption and prevents interference from food or other medications. The client should take levothyroxine at least 30 minutes before breakfast or four hours after the last meal of the day.

Choice B reason: Consuming foods that are high in iodine is not recommended for clients taking levothyroxine, as it may affect the thyroid function and the dosage of the medication. Foods that are high in iodine include seafood, seaweed, dairy products, and iodized salt.

Choice C reason: Administering levothyroxine at bedtime is not advisable, as it may cause insomnia, anxiety, or palpitations. Levothyroxine is best taken in the morning, as it mimics the natural secretion of thyroid hormones.

Choice D reason: Avoiding the use of iron supplements is not necessary for clients taking levothyroxine, as long as they are taken at different times. Iron supplements can interfere with the absorption of levothyroxine, so they should be taken at least four hours apart.

A. Replace salt with a salt substitute. B. Monitor skin for excessive bruising. C. Cover your skin before going outside. D. Limit intake of high-potassium foods.

Correct Answer is D

Explanation

Choice A reason: This is not an appropriate instruction for the nurse to include in the client's plan of care. Replacing salt with a salt substitute is not recommended for clients taking spironolactone, as most salt substitutes contain potassium. Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia, or high levels of potassium in the blood. The client should avoid salt substitutes and other sources of potassium.

Choice B reason: This is not an appropriate instruction for the nurse to include in the client's plan of care. Monitoring skin for excessive bruising is not related to the use of spironolactone, as it does not affect the blood clotting process. The client should monitor for signs of bleeding, such as nosebleeds, gum bleeding, or blood in the urine or stool, if he or she is taking other medications that can interfere with clotting, such as aspirin or warfarin.

Choice C reason: This is not an appropriate instruction for the nurse to include in the client's plan of care. Covering the skin before going outside is not necessary for clients taking spironolactone, as it does not cause photosensitivity or increased risk of sunburn. The client should protect the skin from sun exposure as part of general health promotion, but it is not specific to spironolactone therapy.

Choice D reason: This is the appropriate instruction for the nurse to include in the client's plan of care. Limiting intake of high-potassium foods is important for clients taking spironolactone, as it can prevent hyperkalemia and its complications, such as cardiac arrhythmias, muscle weakness, or paralysis. The client should avoid foods that are rich in potassium, such as bananas, oranges, tomatoes, potatoes, spinach, and dairy products. The client should also have regular blood tests to monitor the potassium levels.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client who receives multiple antihypertensive 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 client receives a new prescription for levothyroxine. Which statement made by the client indicates to the nurse that the education was effective?

Correct Answer is A

Explanation

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care?

Correct Answer is D

Explanation

A client with atrial fibrillation receives a new prescription for dabigatran. Which instruction should the nurse include in this client's teaching plan?

The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the client's therapeutic response to the drug?

Prior to administering the evening dose of carbamazepine, the nurse notes that the client's morning carbamazepine level was 84 mcg/L (35.6 mmol/L). Which action should the nurse take?

The health care provider prescribes the antibiotic tetracycline HCl for an adult client who arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

The nurse is administering muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention is the most important for the nurse to implement?

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

The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?