A client who has a peanut allergy accidentally ingested a cookie that contained peanut butter. The client reports feeling anxious, having difficulty breathing, and having a tingling sensation in the mouth. The nurse should identify that these manifestations indicate which of the following types of hypersensitivity reactions?

Type I

Type II

Type III

Type IV

Answer and Explanation

The Correct Answer is A

Type I hypersensitivity reaction is also known as immediate hypersensitivity or anaphylaxis and occurs within minutes of exposure to an allergen. It involves the activation of mast cells and basophils that release histamine and other inflammatory mediators that cause vasodilation, bronchoconstriction, edema, and pruritus.

B is incorrect because Type II hypersensitivity reaction is also known as cytotoxic hypersensitivity or antibody-mediated hypersensitivity and occurs when antibodies bind to antigens on the surface of cells and cause cell lysis or damage. An example of this type of reaction is hemolytic transfusion reaction.

C is incorrect because Type III hypersensitivity reaction is also known as immune complex-mediated hypersensitivity and occurs when antigen-antibody complexes deposit in tissues and cause inflammation and tissue damage. An example of this type of reaction is serum sickness.

D is incorrect because Type IV hypersensitivity reaction is also known as delayed hypersensitivity or cell-mediated hypersensitivity and occurs when sensitized T cells react with antigens and release cytokines that activate macrophages and cause inflammation and tissue damage. An example of this type of reaction is contact dermatitis.

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Correct Answer is C

Explanation

Answer: C. Intravenous injection is the fastest route for administering diphenhydramine in a severe allergic reaction because it provides immediate onset of action and avoids the first-pass metabolism in the liver.

A and B are incorrect because intramuscular and subcutaneous injections have slower absorption rates than intravenous injection and may not provide adequate relief in an emergency situation.

D is incorrect because oral administration of diphenhydramine has the slowest absorption rate and onset of action and is subject to first-pass metabolism in the liver.

A. Inject the medication into the deltoid muscle. B. Hold the device at a 90-degree angle to the thigh. C. Massage the injection site for 10 minutes after administration. D. Repeat the injection after 5 minutes if symptoms persist.

Correct Answer is B

Explanation

Holding the device at a 90-degree angle to the thigh ensures proper penetration and delivery of the medication into the vastus lateralis muscle.

A is incorrect because injecting the medication into the deltoid muscle may not provide adequate absorption and onset of action.

C is incorrect because massaging the injection site may increase the risk of bleeding and bruising and may decrease the absorption of the medication.

D is incorrect because repeating the injection after 5 minutes may cause overdose and adverse effects such as hypertension, tachycardia, arrhythmias, and myocardial ischemia.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a severe allergic reaction to a medication and requires immediate administration of diphenhydramine. The nurse should administer the medication by which of the following routes?

Correct Answer is C

Explanation

A nurse is teaching a client who has a history of anaphylaxis about the use of an epinephrine auto-injector. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

A client who is receiving a blood transfusion develops a fever, chills, headache, and back pain. The nurse should suspect that the client is experiencing which of the following types of transfusion reactions?

A nurse is preparing to administer epinephrine to a client who is experiencing anaphylaxis after a bee sting. The nurse should administer the medication by which of the following routes?

A client who is receiving intravenous amphotericin B for a fungal infection reports feeling dizzy and having chills and fever. The nurse should recognize that these manifestations indicate which of the following adverse reactions?

A nurse is reviewing the medication list of a client who has a history of allergic reactions to penicillin and sulfa drugs. The nurse should identify that which of the following medications is contraindicated for this client?