# An older adult becomes dizzy when standing after receiving an antihypertensive medication. Which intervention should the nurse implement?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397158&lang=en  
> language: en  
> subject: Accident/Error/Injury Prevention  
> category: SIPC

## Question

An older adult becomes dizzy when standing after receiving an antihypertensive medication. Which intervention should the nurse implement?

## Option

1. Keep the bed in the highest position for easier transfers.
2. Encourage the client to stand quickly to restore circulation.
3. Limit fluid intake for the rest of the day.
4. Assist the client to rise slowly and use call light before ambulating. **✔ Correct answer**

**Correct answer: 4**

## Explanation

Dizziness with position change suggests orthostatic hypotension and increases fall risk. The nurse should assist with slow position changes and ensure help is available before ambulation. A high bed, rapid standing, and fluid restriction can increase risk.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Orthostatic hypotension fall risk.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Orthostatic hypotension fall risk, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Orthostatic Hypotension** — A drop in blood pressure that occurs when moving to an upright position.
- **Fall Prevention** — Interventions that reduce the risk of falling or injury.
- **Call Light** — A device clients use to request assistance from staff.

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