A nurse is caring for a client with an allergic skin condition. The client develops wheezing, a swollen tongue, and hives. Which of the following is the nursing priority?
Assessing the client's neurologic status
Consulting an allergy specialist
Administering epinephrine
Determining the cause of the hives
The Correct Answer is C
Administering epinephrine is the immediate priority when managing anaphylaxis. Epinephrine is the first-line treatment for anaphylaxis as it helps to rapidly reverse severe allergic symptoms, such as airway constriction, swelling, and hypotension.
A. While assessing the client's neurologic status is important for monitoring their overall condition, it may not be the immediate priority when the client is experiencing symptoms of an allergic reaction, particularly anaphylaxis.
B. While consulting an allergy specialist may be necessary for further evaluation and management of the client's allergic condition, it is not the immediate priority.
D. While determining the cause of the hives is important for identifying the allergen and preventing future allergic reactions, it is not the immediate priority during an acute episode of anaphylaxis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Adaptive feeding devices are specifically designed to assist individuals with limited hand movement in feeding themselves more independently. These devices can include utensils with larger handles, specialized grips, or devices that stabilize food items for easier manipulation. Providing such devices can enhance the client's ability to feed themselves and promote autonomy in their daily activities.
Correct Answer is C
Explanation
A. The nurse should speak directly to the client in the first person, even when using an interpreter. Speaking in the third person can create confusion and distance in communication.
B. This action demonstrates respect and engagement with the client, even though the nurse is using an interpreter. Eye contact can help to build rapport and ensure that the client feels heard and understood.
C. The interpreter should ideally sit beside or slightly behind the nurse, allowing the nurse and client to see each other while the interpreter translates. This setup fosters a more personal interaction between the nurse and the client.
D. Using long sentences can make it difficult for the interpreter to accurately translate the message.
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