A patient with a history of hypertension is admitted for a procedure. If the patient’s blood pressure decreases, which clinical manifestation would the nurse expect to see?

Decreased heart rate

Erythema

Increased temperature

Increased heart rate

Answer and Explanation

The Correct Answer is D

Choice A reason: Decreased blood pressure triggers the baroreceptor reflex, increasing sympathetic activity to raise heart rate and vasoconstriction to restore pressure. A decreased heart rate would occur with increased blood pressure, not hypotension, as parasympathetic activation dominates. This choice is incorrect as it opposes the body’s compensatory response to low blood pressure.

Choice B reason: Erythema, or skin redness, results from vasodilation or inflammation, not directly from hypotension. While compensatory vasoconstriction occurs in hypotension, it reduces skin perfusion, potentially causing pallor, not erythema. This manifestation is unrelated to the cardiovascular response to decreased blood pressure, making this choice incorrect.

Choice C reason: Increased temperature is not a direct response to decreased blood pressure. Hypotension triggers sympathetic activation, prioritizing heart rate and vasoconstriction to maintain perfusion. Temperature changes may occur in shock states, but they’re not primary manifestations of routine hypotension, making this choice irrelevant to the expected clinical response.

Choice D reason: Decreased blood pressure activates the baroreceptor reflex, stimulating sympathetic nervous system activity. This increases heart rate (tachycardia) to enhance cardiac output, compensating for low pressure to maintain tissue perfusion. This is a primary physiological response to hypotension, making it the correct clinical manifestation expected in this scenario.

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Correct Answer is B

Explanation

Choice A reason: Lipid-soluble drugs cross cell membranes quickly due to their affinity for lipid bilayers, leading to predictable, rapid absorption. Their onset is not unpredictable but typically faster than water-soluble drugs, especially via routes like intravenous or transdermal, making this choice incorrect for lipid-soluble drugs.

Choice B reason: Lipid-soluble drugs, like fentanyl, rapidly cross lipid-rich cell membranes, including the blood-brain barrier, leading to quick onset of action. This is due to their high partition coefficient, allowing fast diffusion into tissues, making rapid effect onset the correct expectation for the nurse.

Choice C reason: Lipid-soluble drugs have faster onset than water-soluble drugs due to easier membrane penetration. Slow effects are more typical of water-soluble or poorly absorbed drugs. Lipid solubility enhances rapid distribution and action, making this choice incorrect for the expected effect timeline.

Choice D reason: Osmosis refers to water movement across membranes, not drug absorption. Lipid-soluble drugs diffuse through lipid bilayers, not via osmosis, which is irrelevant to their pharmacokinetics. This choice is scientifically inaccurate for describing the onset of lipid-soluble drug effects.

A. 0.6 mL B. 1.6 mL C. 2 mL D. 1 mL

Correct Answer is B

Explanation

Choice A reason: For 40 mg at 25 mg/mL: 40 ÷ 25 = 1.6 mL. Choice A (0.6 mL) delivers 15 mg (0.6 × 25), underdosing Benadryl, which could fail to relieve allergic symptoms or sedation needs, making this choice incorrect for the prescribed dose.

Choice B reason: Calculating 40 mg ÷ 25 mg/mL = 1.6 mL accurately delivers the ordered 40 mg of Benadryl (diphenhydramine) for allergy or sedation. This ensures therapeutic efficacy without overdose, aligning with safe administration for intramuscular delivery, making this the correct choice.

Choice C reason: For 40 mg, the volume is 40 ÷ 25 = 1.6 mL. Choice C (2 mL) delivers 50 mg (2 × 25), overdosing Benadryl, risking excessive sedation or anticholinergic effects like dry mouth or confusion, making this choice incorrect and potentially unsafe.

Choice D reason: The correct volume is 1.6 mL (40 ÷ 25). Choice D (1 mL) delivers 25 mg (1 × 25), underdosing Benadryl, which may not achieve therapeutic effects for allergies or sedation, making this choice inadequate for the prescribed dose.

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A patient with a history of hypertension is admitted for a procedure. If the patient’s blood pressure decreases, which clinical manifestation would the nurse expect to see?

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