Free BCEN Certified Emergency Nurse (CEN) Practice Question

The patient is showing signs of a hypertensive emergency with high blood pressure and symptoms of end-organ damage (severe headache and confusion). Immediate blood pressure reduction is needed to prevent further organ damage. Intravenous sodium nitroprusside is the best initial pharmacological intervention due to its rapid onset of action and ease of titration to manage severe hypertension. Atenolol and hydrochlorothiazide are not appropriate for immediate reduction of blood pressure in a hypertensive emergency. While oral captopril may be used in urgent situations without acute end-organ damage, it is not the optimal choice for immediate BP reduction in an emergency setting compared to intravenous options.