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A healthcare professional is preparing to administer an intramuscular dose of penicillin to a client with a history of anaphylactic reactions to penicillin. Which action should the healthcare professional take first?
- A. Check the medication order for accuracy.
- B. Have an epinephrine injection available.
- C. Administer a test dose to check for a reaction.
- D. Ask the client about any allergies.
Correct Answer: B
Rationale: When dealing with a client who has a history of anaphylactic reactions to penicillin, the priority action for the healthcare professional is to have an epinephrine injection readily available in case of a severe allergic reaction. In such cases, the immediate focus is on being prepared to manage a potentially life-threatening situation. While checking the medication order for accuracy, administering a test dose, and asking the client about allergies are essential steps in medication administration, the first priority is ensuring the availability of epinephrine to address a severe allergic reaction promptly.
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A client is receiving vancomycin (Vancocin). Which of the following is the most important action for the nurse to take?
- A. Monitor the client for signs of nephrotoxicity.
- B. Monitor the client for signs of ototoxicity.
- C. Ensure adequate hydration.
- D. Administer the medication with food.
Correct Answer: A
Rationale: The most important action for the nurse to take when a client is receiving vancomycin is to monitor for signs of nephrotoxicity. Vancomycin can cause kidney damage, so monitoring kidney function and signs of nephrotoxicity are crucial to prevent harm. While monitoring for ototoxicity and ensuring adequate hydration are important nursing actions, they are not as critical as preventing nephrotoxicity when administering vancomycin.
While taking trimethoprim-sulfamethoxazole (TMP-SMZ), a client should be instructed to report which symptom if it develops during the course of this medication therapy?
- A. Nausea
- B. Diarrhea
- C. Headache
- D. Sore throat
Correct Answer: D
Rationale: Clients prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) should be educated about potential blood disorders associated with the medication. Early signs of these disorders include symptoms like sore throat, fever, and pallor. If the client experiences any of these symptoms, they should promptly notify their healthcare provider. Nausea, diarrhea, and headache are common side effects of TMP-SMZ that usually do not require immediate medical attention.
Before administering Methylergonovine (Methergine) to a client with postpartum hemorrhage caused by uterine atony, the nurse checks which of the following as the important client parameter?
- A. Temperature
- B. Lochial flow
- C. Urine output
- D. Blood pressure
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A child is hospitalized with a diagnosis of lead poisoning. The healthcare provider assisting in caring for the child would prepare to assist in administering which of the following medications?
- A. Activated charcoal
- B. Sodium bicarbonate
- C. Syrup of ipecac
- D. Dimercaprol (BAL in Oil)
Correct Answer: D
Rationale: Dimercaprol (BAL in Oil) is a chelating agent indicated for lead poisoning. It works by binding to lead and facilitating its removal from the body. Activated charcoal is used for certain types of poisoning by adsorbing toxins, while sodium bicarbonate can be used to treat acidosis. Syrup of ipecac is no longer recommended for poison treatment due to potential risks.
A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions?
- A. It is not necessary to avoid the use of alcohol.
- B. The medication should be taken with meals to decrease flushing.
- C. Clay-colored stools are a common side effect and should not be of concern.
- D. Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing.
Correct Answer: D
Rationale: Aspirin or a nonsteroidal anti-inflammatory drug can be taken 30 minutes before taking the medication to decrease flushing. Alcohol consumption needs to be avoided because it will enhance this side effect. The medication should be taken with meals, this will decrease gastrointestinal upset. Taking the medication with meals has no effect on the flushing. Clay-colored stools are a sign of hepatic dysfunction and should be immediately reported to the health care provider (HCP).