A postoperative patient is undergoing antibiotic therapy. She has never had any problems taking medications in the past. When the nurse hung the second dose of IV antibiotics, the patient suddenly developed hives and itching. The nurse recognized this was most likely a(n):

allergic reaction.

side effect.

toxic effect.

idiosyncratic reaction.

Answer and Explanation

The Correct Answer is A

A. An allergic reaction is an immune response to a medication, even if the patient has taken the medication before without issues. Symptoms like hives and itching are classic signs of an allergic reaction.
B. A side effect is an expected, often mild and predictable reaction to a medication, not typically involving an immune response and severe symptoms like hives.
C. A toxic effect refers to harmful effects from a medication overdose or accumulation in the body, not sudden onset after an appropriate dose.
D. An idiosyncratic reaction is an uncommon response not related to allergies or toxic effects, usually not presenting with hives and itching.

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Correct Answer is C

Explanation

A. While a respiratory infection might require medication, it does not inherently increase the risk of toxicity.
B. Hyperthyroidism affects metabolism but is not the most significant risk factor for medication toxicity compared to impaired renal function.
C. A client who requires dialysis has impaired kidney function, reducing the body's ability to excrete medications and increasing the risk of toxicity.
D. Back pain alone does not increase the risk of medication toxicity unless it involves medications that could cause toxicity.

A. "The client has developed drooping facial features." B. "The client has a history of hypertension.” C. "The client is disoriented and pupils are slow to respond to light." D. "The client may benefit from a neurology consult."

Correct Answer is B

Explanation

A. This statement describes the current situation, which is part of the "S" (Situation) in SBAR, not the background. Accurate reporting requires separating current findings from background information.
B. Providing the client's history of hypertension is appropriate for the "B" (Background) component. It gives context to the current situation, helping the provider understand potential underlying conditions.
C. This information describes the patient's current assessment and is appropriate for the "A" (Assessment) part of SBAR. Including this in the background can cause confusion and disrupt the communication flow.
D. This statement provides a recommendation and fits into the "R. (Recommendation) part of SBAR. Mixing recommendation with background information can make the communication less clear.

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A postoperative patient is undergoing antibiotic therapy. She has never had any problems taking medications in the past. When the nurse hung the second dose of IV antibiotics, the patient suddenly developed hives and itching. The nurse recognized this was most likely a(n):

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a group of clients. Which of the following clients should the nurse identify is at the greatest risk of developing medication toxicity?

Correct Answer is C

Explanation

A nurse is caring for a client who has hypertension and recently developed drooping facial features. When contacting the provider, which of the following statements should the nurse include as part of the background component of the SBAR communication tool?

Correct Answer is B

Explanation

A postoperative patient is undergoing antibiotic therapy. She has never had any problems taking medications in the past. When the nurse hung the second dose of IV antibiotics, the patient suddenly developed hives and itching. The nurse recognized this was most likely a(n):

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