The nurse must ask if the patient has taken his prescribed clonidine (Catapres).
The patient has been prescribed with clonidine in order to regulate his blood pressure. Clonidine is a medication which acts on the central nervous system, especially on the alpha-adrenergic receptors and reduces blood pressure. In this example, the patient has a history of hypertension and upon assessment, his blood pressure is at dangerously high levels. He could be suffering from a hypertensive crisis, which is a serious increase in the blood pressure and its symptoms include severe headaches, nausea and chest pain. Forgetting to take the blood pressure medication is one of the primary causes of a hypertensive crisis.