A 25-year-old woman with myoclonic seizures is well controlled on valproate. She indicates that she is interested in becoming pregnant in the next year. With respect to her antiepilepsy medication, which of the following should be considered?

Correct Answer: B

Rationale: Valproate controls myoclonic seizures but is teratogenic, linked to neural tube defects (e.g., spina bifida) and cognitive deficits in offspring, posing significant pregnancy risks. Switching to lamotrigine, effective for myoclonic seizures and safer (lower teratogenicity), is recommended preconception after titration. Continuing valproate unchanged ignores fetal harm. Adding another drug increases complexity without addressing valproate's risks. Lowering the dose may compromise seizure control. Lamotrigine's efficacy and better pregnancy safety profile, per guidelines, make it the best consideration.

Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Correct Answer: A

Rationale: Nitroglycerin dilates vessels, relieving angina but risking hypotension. BP of 90/60 mmHg indicates excessive drop, requiring immediate action (e.g., stopping infusion) to prevent shock. Heart rate of 80 and respiratory rate of 16 are normal. Pain at 2/10 shows efficacy. Hypotension's threat to perfusion aligns with nitroglycerin's effect, critical in chest pain where stability is key, making A the finding needing swift response.

Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.