# A client who ingested a large amount of extended-release bupropion is awake but agitated and tachycardic. Which action should the nurse take first?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=515770&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client who ingested a large amount of extended-release bupropion is awake but agitated and tachycardic. Which action should the nurse take first?

## Option

1. Start seizure precautions and ECG monitoring; contact the poison center. **✔ Correct answer**
2. Discharge the client because no seizure has occurred yet.
3. Give the next scheduled bupropion dose to prevent withdrawal.
4. Administer flumazenil as the specific bupropion antidote.

**Correct answer: 1**

## Explanation

Extended-release bupropion overdose can produce delayed seizures, conduction abnormalities, dysrhythmias, and cardiovascular collapse; there is no specific antidote.

## In-depth explanation

Quick answer
Prepare for delayed seizures and dysrhythmias.

Why this is correct
The label reports seizures in about one third of overdose cases plus conduction disturbances, arrhythmias, cardiac failure, and arrest. Close monitored supportive care is required.

Easy analogy or mental picture
A quiet fuse can still lead to a delayed electrical storm.

Memory hook
Bupropion overdose: monitor brain and heart.

NCLEX decision rule
Do not use current wakefulness to exclude delayed extended-release toxicity.

Why the other choices are wrong
Discharge, redosing, and flumazenil do not address the known bupropion overdose pattern.References
1DailyMed: Wellbutrin XLOverdose seizures, conduction disturbances, dysrhythmias, and supportive monitoring

## Clinical scenario

Delayed-toxicity surveillance
Monitor neurologic status, ECG, hemodynamics, temperature, glucose, electrolytes, and seizure activity.

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