A nurse is assessing a client who has a magnesium level of 4.4 mEq/L (1.3 to 2.1 mEq/L). Which of the following findings should the nurse expect?

Choice A reason: Hypotension is a classic finding of hypermagnesemia. Elevated magnesium levels depress neuromuscular and cardiac function, leading to vasodilation and decreased blood pressure. At levels above the normal range, clients may also experience bradycardia and respiratory depression. This makes hypotension the expected finding and the correct answer. Choice B reason: Tachycardia is not typical in hypermagnesemia. Instead, bradycardia is more common due to magnesium’s depressant effect on cardiac conduction. Tachycardia would be more consistent with hypovolemia or other electrolyte imbalances, not elevated magnesium. Choice C reason: Muscle cramps are associated with hypomagnesemia, not hypermagnesemia. Low magnesium levels increase neuromuscular excitability, leading to cramps, tremors, and tetany. Elevated magnesium causes the opposite effect—muscle weakness and diminished reflexes. Choice D reason: Hyperreflexia is also a sign of hypomagnesemia. In hypermagnesemia, reflexes are diminished or absent due to neuromuscular depression. Therefore, this finding would not be expected.