A nurse is assessing a client who is receiving penicillin IV. For which of the following findings should the nurse report to the provider as a manifestation of anaphylaxis?
Increased blood pressure
Hypertonia
Wheezing
Urinary retention
The Correct Answer is C
Choice A rationale: While increased blood pressure can occur in various conditions, it might not specifically indicate anaphylaxis to penicillin.
Choice B rationale: Hypertonia might not directly correlate with anaphylaxis and could be caused by other factors.
Choice C rationale: Wheezing is a critical sign of anaphylaxis, a severe allergic reaction to penicillin. Reporting wheezing to the provider is crucial for immediate intervention to prevent further complications associated with anaphylaxis.
Choice D rationale: Urinary retention is not a typical manifestation of anaphylaxis to penicillin and might not be directly linked to the allergic reaction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale: Amphotericin B lipid complex can bind to other solutions, leading to precipitation. Priming the tubing with 0.9% sodium chloride ensures that the medication is not wasted due to precipitation in the tubing.
Choice B rationale: The infusion rate and duration depend on the specific guidelines and conditions but are not directly related to priming the tubing.
Choice C rationale: While the administration method might vary, priming the tubing with a compatible solution is more critical for the initial setup.
Choice D rationale: Color change might not be an accurate indicator of medication integrity or effectiveness in this case.
Correct Answer is C
Explanation
Choice A rationale: Hypotension is not a common side effect of prednisone use.
Choice B rationale: Prednisone can also suppress the immune system, so the client should avoid immunizations that contain live viruses or bacteria.
Choice C rationale: Prednisone is a corticosteroid that can cause osteoporosis and increase the risk of fractures in long-term use. Therefore, the nurse should instruct the client to consume a diet high in calcium and vitamin D to prevent bone loss and promote bone health.
Choice D rationale: Prednisone use is more likely to cause hyperglycemia rather than hypoglycemia.
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