Four patients arrive in the ED. Which patient presentation indicates a hypertensive EMERGENCY (rather than urg…

Question

Four patients arrive in the ED. Which patient presentation indicates a hypertensive EMERGENCY (rather than urgency) and requires admission to the ICU for IV antihypertensive titration?

Accepted Answer

Option 3: BP 196/124 mmHg, sudden severe occipital headache, vomiting, blurred vision in the left eye, and confusion.

Choice 3 has BP > 180/120 PLUS end-organ damage findings (severe headache, vomiting, blurred vision, confusion suggest hypertensive encephalopathy or possible intracerebral hemorrhage). This is hypertensive EMERGENCY requiring ICU admission and IV antihypertensive (e.g., nicardipine, labetalol, clevidipine) titrated to controlled BP reduction (usually no more than 25% in the first hour). Choices 1 and 2 are hypertensive URGENCY (high BP, no end-organ damage) — managed with oral agent restart and outpatient follow-up. Choice 4 has BP below 180/120 and is asymptomatic, so it is not a hypertensive crisis.

Answer

Option 1: BP 184/118 mmHg, asymptomatic, found at a community health screening. The patient has not seen a provider in 5 years.

Answer

Option 2: BP 188/120 mmHg, headache, no neurologic deficits, normal urine output, no chest pain. The patient ran out of lisinopril 4 days ago.

Answer

Option 4: BP 172/108 mmHg, asymptomatic, on chronic stable hypertension regimen with last clinic visit 2 weeks ago.

Four patients arrive in the ED. Which patient presentation indicates a hypertensive EMERGENCY (rather than urgency) and requires admission to the ICU for IV antihypertensive titration?

In-depth explanation

Clinical scenario

Key concepts

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Four patients arrive in the ED. Which patient presentation indicates a hypertensive EMERGENCY (rather than urgency) and requires admission to the ICU for IV antihypertensive titration?

In-depth explanation

Clinical scenario

Key concepts

Master the NCLEX-RN with MyMerci