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A healthcare professional is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the healthcare professional take?
- A. Administer the prescribed dose.
- B. Withhold the medication.
- C. Ask the provider to change the prescription to an oral form.
- D. Administer an oral antihistamine at the same time.
Correct Answer: B
Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. This information is crucial for the provider to prescribe an alternative antibiotic. Allergic reactions to penicillin can range from mild to severe anaphylaxis, so prior sensitization should be reported to the provider to avoid potential adverse reactions.
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A healthcare professional is monitoring a client who is receiving spironolactone. Which of the following findings should the professional report to the provider?
- A. Serum Sodium 144 mEq/L
- B. Urine output 120 mL in 4 hr
- C. Serum Potassium 5.2 mEq/L
- D. Blood Pressure 140/90 mm Hg
Correct Answer: C
Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia. Spironolactone is a potassium-sparing diuretic that can cause potassium retention. Hyperkalemia is a serious condition that can lead to cardiac dysrhythmias. The healthcare professional should withhold the medication and promptly notify the provider to prevent potential complications.
A healthcare provider is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?
- A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
- B. Obtain help from another healthcare provider to confirm the correct client and blood product.
- C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
- D. Stay with the client for the first 15 to 30 minutes of the transfusion.
Correct Answer: B
Rationale: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction.
A client informs a healthcare professional about taking Gingko Biloba. Which of the following medications is contraindicated for a client using Gingko Biloba?
- A. Acetaminophen
- B. Warfarin
- C. Digoxin
- D. Lisinopril
Correct Answer: B
Rationale: Warfarin is contraindicated for a client taking Gingko Biloba due to the potential interaction that can lead to suppressed coagulation and an increased risk of bleeding or hemorrhage. Warfarin is an anticoagulant, and when combined with Gingko Biloba, which also has anticoagulant properties, the risk of bleeding complications is significantly heightened.
A client who received Prochlorperazine 4 hours ago reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?
- A. Fomepizole
- B. Naloxone
- C. Phytonadione
- D. Diphenhydramine
Correct Answer: D
Rationale: The client's symptoms of face spasms after receiving Prochlorperazine indicate acute dystonia, a known side effect. Diphenhydramine is commonly administered to manage extrapyramidal symptoms, such as muscle spasms, caused by medications like Prochlorperazine. Therefore, the nurse should anticipate a prescription for Diphenhydramine to alleviate the client's symptoms.
A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?
- A. 22 gtt/min
- B. 24 gtt/min
- C. 20 gtt/min
- D. 18 gtt/min
Correct Answer: A
Rationale: To determine the flow rate in drops per minute (gtt/min), you can use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, it would be (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Therefore, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min.