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Practice Question

The client has recently started antidepressant drug therapy. He approaches the nurse complaining of a headache, palpitations, and stiffness in the neck. What is the nurse's priority action?

Answer Choices:

Correct Answer:

Notify the physician when convenient

Rationale:

🔴 Hypertensive crisis risk – Headache, palpitations, and neck stiffness in a client taking antidepressants (especially MAOIs) are classic warning signs of a hypertensive crisis, which can be life-threatening.

🔴 Immediate intervention required – This condition requires urgent medical evaluation and treatment with antihypertensives to prevent complications such as stroke or intracranial hemorrhage.

🔴 Not a common side effect – These are serious adverse symptoms, not expected mild side effects, making reassurance inappropriate.

🔴 Nursing priority – The nurse’s role is to recognize early warning signs and act quickly to prevent fatal cardiovascular or neurological events.

Want to practice more questions like this?

This question is from ATI LPN Mental Health Quiz Chapter 19-24 which contains 25 questions.

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ATI LPN Mental Health Quiz Chapter 19-24

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Question Details
  • Category: LPN Nursing Exam(s)
  • Subcategory: LPN ATI Exams
  • Domain: Mental Health
  • Answer Choices: 4
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