A patient complains of ringing in the ears, nausea, and cold clammy skin. What is the most likely cause?

The symptoms of ringing in the ears (tinnitus), nausea, and cold clammy skin are indicative of hypotension, or low blood pressure. When a patient experiences hypotension, the body struggles to maintain adequate blood flow to vital organs, which can lead to a variety of symptoms. Cold, clammy skin is a common physical response as the body redirects blood flow to essential areas, while the nervous system may trigger nausea and auditory sensations, such as ringing in the ears.

In hypotension, the cardiovascular system is compromised, and the body's compensatory mechanisms may not be sufficient to prevent these symptoms from manifesting. For example, decreased blood flow to the inner ear can lead to sensations of tinnitus. Overall, the combination of the specified symptoms supports the conclusion that hypotension is the underlying issue affecting the patient.

On the other hand, hyperthermia typically presents with elevated body temperature and other symptoms related to overheating, while dehydration often leads to dry mucous membranes and increased thirst. Anxiety can cause nausea and other physical sensations, but the presence of cold clammy skin strongly points towards a hemodynamic issue rather than an anxiety-related response. Thus, hypotension is the most appropriate cause given the combination of symptoms described.