A nurse is caring for a client who has urticaria following administration of an antibiotic. Which of the following medications should the nurse prepare to administer?
Diphenhydramine
Hydralazine
Protamine
Naloxone
The Correct Answer is A
A. Diphenhydramine: Diphenhydramine is an H1 receptor antagonist that inhibits the binding of histamine to H1 receptors in the skin and vasculature. By blocking histamine-mediated vasodilation, increased capillary permeability, and sensory nerve stimulation, it reduces the erythema, pruritus, and edema associated with urticaria.
B. Hydralazine: Hydralazine is a direct-acting arteriolar vasodilator used to reduce systemic vascular resistance in hypertensive crises or chronic hypertension. It has no effect on histamine pathways or IgE-mediated allergic responses and therefore does not alleviate urticaria or other manifestations of hypersensitivity reactions.
C. Protamine: Protamine sulfate is a cationic protein used to neutralize unfractionated heparin by forming a stable complex, thereby reversing anticoagulation. It does not interfere with histamine release, IgE receptor binding, or any pathophysiologic mechanisms underlying allergic reactions, making it irrelevant for urticaria management.
D. Naloxone: Naloxone is a competitive opioid receptor antagonist that reverses opioid-induced respiratory depression by displacing agonists at the mu-opioid receptor. It has no role in modulating histamine release or the immunologic processes that produce urticaria, and administration would not alleviate allergic symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Use a 15° angle for the injection: Subcutaneous insulin injections should be administered at a 90° angle for most adults and children with adequate subcutaneous tissue. A 15° angle is too shallow and may result in intradermal administration, affecting absorption.
B. Roll the syringe gently to ensure mixture of the insulins: Only the NPH insulin vial should be gently rolled between the hands to resuspend the cloudy insulin. Regular insulin is clear and should not be shaken, and the mixture occurs in the syringe after drawing up each insulin in the correct sequence.
C. Draw up regular insulin prior to NPH insulin: Drawing up regular (clear) insulin before NPH (cloudy) insulin prevents contamination of the short-acting insulin with intermediate-acting insulin, maintaining proper pharmacologic action and preventing altered onset or peak times.
D. Inject into the vastus lateralis: The preferred sites for subcutaneous insulin injections are the abdomen, upper arm, or anterior thigh. The vastus lateralis can be used in infants but is not the standard site for older children or adults.
Correct Answer is C
Explanation
A. Atrial fibrillation: Atrial fibrillation is characterized by absent P waves and an irregularly irregular ventricular rhythm. A constant P-R interval is not observed in this dysrhythmia.
B. Complete heart block: Complete heart block (third-degree AV block) shows no relationship between P waves and QRS complexes, with atrial and ventricular rhythms independent of each other. A constant prolonged P-R interval is not present.
C. First-degree atrioventricular block: First-degree AV block is defined by a consistently prolonged P-R interval (>0.20 seconds) with all atrial impulses conducted to the ventricles. A P-R interval of 0.35 seconds indicates delayed AV conduction consistent with first-degree AV block.
D. Premature atrial complexes: Premature atrial complexes present as early P waves with abnormal morphology, often followed by a normal QRS. The P-R interval may be normal or slightly altered, but a consistently prolonged P-R interval is not characteristic.
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