Progressive Care Nursing Certification (PCCN) Practice Exam

Which medication should be administered immediately to a patient with a severe headache and extremely high blood pressure?

1. Anti-emetics

2. Labetalol

3. Mannitol

4. Analgesics

The correct answer is: Labetalol

In the context of a patient presenting with a severe headache and extremely high blood pressure, the priority is to manage the hypertension, particularly because elevated blood pressure can lead to serious complications such as stroke or hypertensive crisis. Labetalol, a beta-blocker and alpha-blocker, is particularly effective in rapidly lowering blood pressure. Its dual activity not only reduces heart rate but also leads to peripheral vasodilation, making it a preferred choice in acute hypertension management. While analgesics might seem relevant for managing headache pain, they do not address the underlying issue of high blood pressure, which can exacerbate the headache. Anti-emetics would be appropriate if the patient is experiencing nausea, but again, they don't target the acute hypertension. Mannitol is an osmotic diuretic generally used to reduce intracranial pressure, mainly in cases of cerebral edema, but it does not provide a direct and immediate avenue for decreasing blood pressure. Therefore, administering labetalol quickly targets the most pressing clinical concern, stabilizing the patient by managing the hypertension, which may also alleviate the headache as a secondary benefit.