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 B

Explanation

Cyclosporine is an immunosuppressive medication commonly used to prevent graft rejection after organ transplantation. St. John's Wort is known to induce cytochrome P450 enzymes, which can increase the metabolism and decrease the eﬀectiveness of many medications, including cyclosporine. This interaction can lead to decreased plasma concentrations of cyclosporine, which can increase the risk of graft rejection. Therefore, it is important to advise the client to discontinue the use of St. John's Wort and inform their healthcare provider about any herbal or supplement use to prevent potential interactions with prescribed medications. Options a, c, and d are not directly related to the client's current condition and are not as significant as option b.

A. Consult a pharmacist about the scheduling of the dose one hour after the client eats. B. Assign unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk. C. Withhold the medication until the client’s breakfast tray is available on the unit. D. Instruct the client that it is necessary to take nothing but water with the medication.

Correct Answer is D

Explanation

Risedronate should be taken with plain water only. It should be taken on an empty stomach, at least 30 minutes before eating or drinking anything other than plain water. Taking risedronate with milk or other beverages can interfere with its absorption and reduce its eﬀectiveness.

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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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Correct Answer is B

Explanation

The nurse administers risedronate to a client with osteoporosis at 07:00. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

Correct Answer is D

Explanation

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