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Medical interpretation — USMLE Step 3 MCQ

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HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeMedical interpretationUSMLE Step 3

A patient completes an observed esketamine session and feels well 30 minutes later. What monitoring is still required?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Check BP near 40 minutes; monitor respiration for at least 2 hours

The best answer is “Check BP near 40 minutes; monitor respiration for at least 2 hours”. Early symptom resolution does not eliminate the labeled blood-pressure and minimum observation requirements. After esketamine, measure blood pressure at about 40 minutes and monitor for at least 2 hours. If pressure remains high, promptly seek help from a practitioner experienced in blood-pressure management; discharge follows clinical stability rather than elapsed time alone. The alternatives use a different threshold, timing, population, or intervention and therefore do not match the clinical facts presented.

Reference: FDA: SPRAVATO Prescribing Information: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/211243s016lbl.pdf