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A patient was prescribed an oral antibiotic for the treatment of sinusitis. The patient has now stopped, stating she developed a rash shortly after taking the first dose of the drug. What is the nurses most appropriate response?
- A. Encourage the woman to continue with the medication while monitoring her skin condition closely.
- B. Refer the woman to her primary care provider to have the medication changed.
- C. Arrange for the woman to go to the nearest emergency department.
- D. Encourage the woman to take an OTC antihistamine with each dose of the antibiotic.
Correct Answer: B
Rationale: On discovery of a medication allergy, patients are warned that they have a hypersensitivity to a particular medication and are advised not to take it again. As a result, the patient would need to liaise with the primary care provider. There is no need for emergency care unless symptoms worsen to involve respiratory function. An antihistamine would not be an adequate or appropriate recommendation from the nurse.
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A patient with a family history of allergies has suffered an allergic response based on a genetic predisposition. This atopic response is usually mediated by what immunoglobulin?
- A. Immunoglobulin A
- B. Immunoglobulin M
- C. Immunoglobulin G
- D. Immunoglobulin E
Correct Answer: D
Rationale: Atopy refers to allergic reactions characterized by the action of IgE antibodies and a genetic predisposition to allergic reactions.
The nurse is providing health education to the parents of a toddler who has been diagnosed with food allergies. What should the nurse teach this family about the childs health problem?
- A. Food allergies are a life-long condition, but most families adjust quite well to the necessary lifestyle changes.
- B. Consistent use of over-the-counter antihistamines can often help a child overcome food allergies.
- C. Make sure that you carry a steroid inhaler with you at all times, especially when you eat in restaurants.
- D. Many children outgrow their food allergies in a few years if they avoid the offending foods.
Correct Answer: D
Rationale: Many food allergies disappear with time, particularly in children. About one-third of proven allergies disappear in 1 to 2 years if the patient carefully avoids the offending food. Antihistamines do not cure allergies and an EpiPen is carried, not a steroid inhaler.
A patient has presented with signs and symptoms that are consistent with contact dermatitis. What aspect of care should the nurse prioritize when working with this patient?
- A. Promoting adequate perfusion in affected regions
- B. Promoting safe use of topical antihistamines
- C. Identifying the offending agent, if possible
- D. Teaching the patient to safely use an EpiPen
Correct Answer: C
Rationale: Identifying the offending agent is a priority in the care of a patient with dermatitis. Antihistamines are not administered topically and epinephrine is not used to treat dermatitis. Inadequate perfusion occurs with PAD or vasoconstriction.
A nurse knows of several patients who have achieved adequate control of their allergy symptoms using over-the-counter antihistamines. Antihistamines would be contraindicated in the care of which patient?
- A. A patient who has previously been treated for tuberculosis
- B. A pregnant woman at 30 weeks gestation
- C. A patient who is on estrogen-replacement therapy
- D. A patient with a severe allergy to eggs
Correct Answer: B
Rationale: Antihistamines are contraindicated during the third trimester of pregnancy. Previous tuberculosis, hormone therapy, and food allergies do not contraindicate the use of antihistamines.
A patient is receiving a transfusion of packed red blood cells. Shortly after initiation of the transfusion, the patient begins to exhibit signs and symptoms of a transfusion reaction. The patient is suffering from which type of hypersensitivity?
- A. Anaphylactic (type I)
- B. Cytotoxic (type II)
- C. Immune complex (type III)
- D. Delayed type (type IV)
Correct Answer: B
Rationale: A type II hypersensitivity reaction resulting in red blood cell destruction is associated with blood transfusions. This type of reaction does not result from types I, III, or IV reactions.