A nurse is caring for a client who is has developed anaphylactic shock in response to the ingestion of strawberries. Which of the following medications should the nurse administer first?
Epinephrine
Dobutamine
Methylprednisolone
Furosemide
The Correct Answer is A
A. Epinephrine – Epinephrine is the first-line treatment for anaphylactic shock. It rapidly reverses airway constriction, hypotension, and swelling by stimulating alpha and beta-adrenergic receptors, leading to bronchodilation, vasoconstriction, and increased cardiac output.
B. Dobutamine – Dobutamine is a positive inotrope used to treat cardiogenic shock and may support cardiac output, but it does not address the airway or allergic component of anaphylaxis.
C. Methylprednisolone – This corticosteroid may be given to reduce inflammation and prevent delayed reactions, but it has a slower onset of action and is not the priority in emergency management.
D. Furosemide – This diuretic is used in fluid overload or pulmonary edema, not in the management of anaphylaxis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is []
Explanation
Potential Condition: Atrial Fibrillation
The client presents with an irregular, tachycardic rhythm with unclear P waves, which are classic signs of atrial fibrillation (AF). Symptoms such as palpitations, dizziness, and shortness of breath are common with AF, particularly with a rapid ventricular response.
Actions to Take
• Administer an anticoagulant: AF increases the risk of thrombus formation in the atria, which can lead to embolic stroke. Anticoagulation reduces this risk, especially in symptomatic or persistent cases.
• Obtain a 12-lead ECG: This helps confirm the diagnosis, assess the rhythm in detail, and rule out other arrhythmias or ischemic changes that may be present.
Parameters to Monitor
• Manifestations of stroke: Clients with AF are at increased risk for embolic stroke. Neurological status should be closely monitored for signs of confusion, facial droop, weakness, or speech changes.
• PTT/INR: These lab values help assess coagulation status, particularly when anticoagulants such as warfarin or heparin are initiated, to ensure therapeutic levels and avoid bleeding complications.
Correct Answer is A
Explanation
A. This is the correct sequence of normal electrical conduction through the heart: the impulse originates in the sinoatrial (SA) node, travels to the atrioventricular (AV) node, then to the bundle of His, down the right and left bundle branches, and finally through the Purkinje fibers.
B. This choice places the Purkinje fibers before the bundle branches, which is incorrect.
C. The AV node does not initiate conduction; the SA node is the natural pacemaker of the heart.
D. This sequence incorrectly places the bundle branches before the bundle of His.
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