# A client taking mavacamten for obstructive hypertrophic cardiomyopathy reports new dyspnea and ankle edema. Review the record and select the priority action.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522928&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client taking mavacamten for obstructive hypertrophic cardiomyopathy reports new dyspnea and ankle edema. Review the record and select the priority action.

History

Vitals

Labs

Orders

Notes

Obstructive hypertrophic cardiomyopathy; mavacamten therapy with scheduled echocardiographic monitoring

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1

Give the next dose and repeat the echocardiogram in 6 months.

✕

2

Hold mavacamten, notify the prescriber promptly, and arrange evaluation for systolic dysfunction and interacting drugs.

✕

3

Double the dose because worsening dyspnea proves undertreated obstruction.

✕

4

Stop all cardiac medications without obtaining an echocardiogram.

✕

## Explanation

New heart-failure symptoms with an LVEF below 50% require mavacamten interruption and prompt evaluation. A newly added CYP3A4 inhibitor can increase exposure and worsen systolic dysfunction.

## In-depth explanation

Quick answer
Link new dyspnea, LVEF 47%, and a CYP inhibitor to mavacamten-related systolic dysfunction.

Why this is correct
Mavacamten reduces cardiac myosin activity and can cause heart failure from systolic dysfunction. The labeled monitoring pathway uses symptoms, echocardiography, and interaction review to determine interruption and safe resumption.

Easy analogy or mental picture
Build a medication-safety chain: identify the new cue, connect it to the drug mechanism or labeled limitation, stop preventable exposure, stabilize the client, and verify a measurable response.

Memory hook
Drug, urgent cue, protective action, and reassessment endpoint.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.

Why the other choices are wrong
Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.References
1DailyMed: CAMZYOS (mavacamten)Boxed heart-failure warning, echocardiographic LVEF surveillance, treatment interruption, and interacting-drug safety

## Clinical scenario

Medication-safety review
Verify indication, current assessment, dose and route, organ function, interactions, urgent toxicity cues, authorized action, and measurable follow-up.

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