A nurse is caring for a client who has cellulitis and is to begin antibiotic therapy. The client has a history of anaphylactic reaction to penicillin. Which of the following medications is contraindicated for this client?

Fluconazole

Tetracycline

Acyclovir

Cephalexin

Answer and Explanation

The Correct Answer is D

A. Fluconazole. Fluconazole is an antifungal medication used to treat fungal infections, such as candidiasis. It is not related to penicillin and does not pose a risk for cross-reactivity in clients with a penicillin allergy. It can be safely administered in this scenario.

B. Tetracycline. Tetracycline is a broad-spectrum antibiotic used to treat bacterial infections, including acne and respiratory infections. It belongs to a different antibiotic class than penicillins and cephalosporins, meaning it does not pose a risk of cross-reactivity in clients with a penicillin allergy.

C. Acyclovir. Acyclovir is an antiviral medication used to treat viral infections, such as herpes simplex and varicella-zoster. Since it does not belong to the beta-lactam antibiotic class, it is not contraindicated for clients with a penicillin allergy.

D. Cephalexin. Cephalexin is a first-generation cephalosporin, which shares a similar beta-lactam ring structure with penicillins. Clients with a history of an anaphylactic reaction to penicillin are at increased risk of cross-reactivity with cephalosporins, particularly first-generation ones like cephalexin. Due to the severity of the client’s allergic reaction, cephalexin should be avoided, and an alternative non-beta-lactam antibiotic should be considered.

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Free Nursing Study Resources

Correct Answer is ["A","B","C","D","E","F","G"]

Explanation

Shortness of breath. The client is experiencing respiratory distress, which could indicate a severe allergic reaction (anaphylaxis). Immediate intervention is needed to prevent airway compromise and respiratory failure.
Intercostal retractions. Retractions occur when breathing is labored, suggesting airway obstruction or bronchoconstriction. This is a sign of worsening respiratory distress, requiring urgent medical attention.
Wheezing auscultated throughout lung fields. Wheezing suggests bronchospasm, which is common in anaphylaxis and asthma attacks. The presence of diffuse wheezing indicates that the airways are narrowing, making breathing more difficult.
Diffuse, raised rash present on trunk. A new-onset rash following antibiotic administration raises suspicion for anaphylaxis or a severe allergic reaction. Immediate treatment with antihistamines and corticosteroids may be required.
Respiratory rate 30/min. The increased respiratory rate indicates that the client is compensating for airway constriction and hypoxia. This is an early warning sign of impending respiratory failure if not treated promptly.
Blood pressure 90/55 mmHg. The drop in blood pressure suggests anaphylactic shock, where vasodilation and fluid leakage from capillaries lead to hypotension. Immediate administration of epinephrine is necessary to prevent cardiovascular collapse.
Oxygen saturation 91% on room air. A decrease in oxygen saturation indicates impaired gas exchange, likely due to airway swelling and bronchospasm. Supplemental oxygen therapy should be provided to prevent further desaturation.

Correct Answer is ["1"]

Explanation

Convert pounds to kilograms:

Conversion factor: 1 kg = 2.2 lb

=145 lb / 2.2 lb/kg

= 65.9 kg

Calculate the total daily dose:

Total daily dose (mg) = Weight (kg) × Dosage (mg/kg/day)

= 65.9 kg 3 mg/kg/day

= 197.7 mg/day

Calculate the dose per administration (divided into two doses):

Dose per administration (mg) = Total daily dose (mg) / Number of doses

=197.7 mg/day / 2 doses

= 98.85 mg/dose

Calculate the number of tablets per dose:

Number of tablets = Desired dose (mg) / Available dose (mg/tablet)

=98.85 mg/dose / 100 mg/tablet

= 0.9885 tablets

Round to the nearest whole number:

0.9885 tablets is 1 tablet

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A nurse is caring for a client who has cellulitis and is to begin antibiotic therapy. The client has a history of anaphylactic reaction to penicillin. Which of the following medications is contraindicated for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","D","E","F","G"]

Explanation

Correct Answer is ["1"]

Explanation

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