A nurse is caring for a client who develops an anaphylactic reaction to IV antibiotic administration.
After assessing the client’s respiratory status and stopping the medication infusion, which of the following actions should the nurse take next?

Administer epinephrine IM.

Replace the infusion with 0.9% sodium chloride.

Give diphenhydramine IM.

Elevate the clients legs and feet.

Answer and Explanation

The Correct Answer is A

Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, a severe and potentially life-threatening allergic reaction. Epinephrine works by reducing the body’s allergic response and improving the breathing and circulation of the client. Epinephrine should be given as soon as possible after the onset of anaphylaxis symptoms, using an auto-injector device if available.

Choice B is wrong because replacing the infusion with 0.9% sodium chloride (normal saline) is not enough to treat anaphylaxis. Normal saline can help maintain the blood pressure and hydration of the client, but it does not reverse the allergic reaction or improve the breathing of the client. Normal saline can be given after epinephrine, but not before or instead of it.

Choice C is wrong because giving diphenhydramine IM is not enough to treat anaphylaxis. Diphenhydramine is an antihistamine that can help relieve some of the symptoms of anaphylaxis, such as itching and hives, but it works too slowly and does not address the more serious effects of anaphylaxis on the breathing and circulation of the client. Diphenhydramine can be given after epinephrine, but not before or instead of it.

Choice D is wrong because elevating the client's legs and feet is not enough to treat anaphylaxis. Elevating the legs and feet can help increase the blood flow to the vital organs, but it does not reverse the allergic reaction or improve the breathing of the client. Elevating the legs and feet can be done after epinephrine, but not before or instead of it.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Pruritus is a common adverse effect of morphine administered via continuous epidural infusion. It is caused by the release of histamine from mast cells in the skin. Pruritus can be treated with antihistamines or opioid antagonists. Choice A is wrong because gastric bleeding is not a common adverse effect of morphine administered via continuous epidural infusion.

Gastric bleeding can occur due to peptic ulcer disease, nonsteroidal anti inflammatory drugs (NSAIDs), or anticoagulants.

Choice C is wrong because cough is not a common adverse effect of morphine administered via continuous epidural infusion.

Cough can be caused by respiratory infections, asthma, or chronic obstructive pulmonary disease (COPD).

Choice D is wrong because tachypnea is not a common adverse effect of morphine administered via continuous epidural infusion.

Tachypnea can be caused by hypoxia, anxiety, pain, or fever. Morphine can cause respiratory depression, which is characterized by bradypnea, not tachypnea.

A. Hepatitis B vaccine within the last week. B. Chronic kidney disease. C. Diabetes mellitus. D. Alcohol use disorder.

Correct Answer is D

Explanation

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease1 and should be used with caution in patients with hepatic impairment or active liver disease. Alcohol use disorder can cause liver damage and increase the risk of acetaminophen toxicity.

Choice A is wrong because hepatitis B vaccine within the last week is not a contraindication for receiving acetaminophen.

There is no evidence that acetaminophen interferes with the immune response to the vaccine or causes adverse effects.

Choice B is wrong because chronic kidney disease is not a contraindication for receiving acetaminophen.

Acetaminophen is mainly metabolized by the liver and has minimal renal excretion.

However, patients with chronic kidney disease should consult their doctor before taking acetaminophen as they may have other conditions that affect its use.

Choice C is wrong because diabetes mellitus is not a contraindication for receiving acetaminophen.

Acetaminophen does not affect blood glucose levels or interact with oral antidiabetic drugs.

However, patients with diabetes mellitus should consult their doctor before taking acetaminophen as they may have other conditions that affect its use.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is caring for a client who develops an anaphylactic reaction to IV antibiotic administration. After assessing the client’s respiratory status and stopping the medication infusion, which of the following actions should the nurse take next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is receiving morphine via continuous epidural infusion. The nurse should monitor the client for which of the following adverse effects?

Correct Answer is B

Explanation

A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen. Which of the following findings should the nurse identify as a contraindication for receiving this medication?

Correct Answer is D

Explanation

A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?

A nurse is caring for a client who has a prescription for total parental nutrition (TPN). Which of the following routes of administration should the nurse use?

A nurse is caring for a client who has heart failure. The nurse administered furosemide 60 mg IV bolus 30 min earlier. For which of the following findings should the nurse notify the provider?

A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?

A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of the following laboratory values should the nurse report to the provider?

A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler. Which of the following information should the nurse include in the teaching? (Select all that apply)

A client who has Graves’ disease is prescribed methimazole. Which of the following effects should the nurse expect to see after the client has taken the medication for 2 months?

A nurse is caring for a client who develops an anaphylactic reaction to IV antibiotic administration.
After assessing the client’s respiratory status and stopping the medication infusion, which of the following actions should the nurse take next?