# A client is admitted for monitored initiation of dofetilide. Which home medication should the nurse report before the first dose?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513816&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client is admitted for monitored initiation of dofetilide. Which home medication should the nurse report before the first dose?

## Option

1. Levothyroxine 75 mcg by mouth each morning
2. Acetaminophen 650 mg by mouth as needed for pain
3. Hydrochlorothiazide 25 mg by mouth daily **✔ Correct answer**
4. Docusate sodium 100 mg by mouth twice daily as needed

**Correct answer: 3**

## Explanation

Hydrochlorothiazide is contraindicated with dofetilide because it increases dofetilide exposure and QT prolongation.

## In-depth explanation

Quick answer
Report hydrochlorothiazide before dofetilide is administered.

Why this is correct
DailyMed lists concomitant hydrochlorothiazide use as contraindicated because it significantly increases dofetilide concentrations and QT-interval effects.

Easy analogy or mental picture
Dofetilide is a narrow electrical lane. Hydrochlorothiazide pushes both drug exposure and QT risk into that lane, so the combination needs to be blocked before entry.

Memory hook
Dofetilide plus hydrochlorothiazide is contraindicated.

NCLEX decision rule
During medication reconciliation before a high-risk antiarrhythmic is started, identify labeled contraindications and notify the prescribing team before the first dose.

Why the other choices are wrong
The other listed medications are not the labeled contraindicated combination being tested. Their presence does not replace the need for a full interaction and laboratory review.References
1DailyMed: DofetilideHydrochlorothiazide contraindication and QT prolongation

## Clinical scenario

Pre-dose review
Reconcile prescription, over-the-counter, and recently discontinued medications before the monitored dofetilide initiation protocol begins.

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