Nokea
A patient with pneumonia is allergic to cephalosporin antibiotics. He tells you that he breaks out in a rash and itches if he takes it. The health-care provider has prescribed cefazolin (Ancef) for him because it is one of the few antibiotics that will kill the bacteria cultured from his sputum. What will you do?
- A. Hold the medication and notify the health-care provider.
- B. Give the medication and administer oral diphenhydramine (Benadryl) without an order because it is an OTC medication.
- C. Ask the supervising nurse to give the medication because the patient may have an allergic reaction.
- D. Give the medication and watch the patient closely for any signs of anaphylaxis.
Correct Answer: A
Rationale: Due to the patient's known allergy, administering cefazolin risks a severe reaction. Holding the medication and notifying the provider is the safest action.
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A 46-year-old female patient developed swelling of the tongue and throat after taking a new antibiotic. She went to the ER because she was having difficulty breathing. Which drug effect has occurred?
- A. A desired effect
- B. A side effect
- C. An adverse effect
- D. A severe adverse effect
Correct Answer: D
Rationale: Swelling of the tongue and throat with difficulty breathing indicates a severe adverse effect, likely anaphylaxis, which is life-threatening.
List the seven rights of medication administration.
- A. Right patient
- B. Right medication
- C. Right dose
- D. Right route
- E. Right time
- F. Right documentation
- G. Right reason
Correct Answer: A,B,C,D,E,F,G
Rationale: The seven rights ensure safe medication administration by verifying the correct patient, medication, dose, route, time, documentation, and reason for administration.
The oral route of medication administration includes
- A. Sublingual and buccal medicines.
- B. Inhalants and mists.
- C. Ointments and patches.
- D. Eye and ear drops.
Correct Answer: A
Rationale: Sublingual and buccal medications are administered through the mouth, qualifying as oral routes, whereas the others involve different administration methods.
You are caring for a patient who has an order for an IV antibiotic. When you hang the second bag, the patient goes into an anaphylactic reaction. Which actions will you expect to perform?
- A. Stop the medication immediately.
- B. Slow the IV rate and administer diphenhydramine (Benadryl) via the IV route.
- C. Follow the facility policy for responding to anaphylaxis.
- D. Increase IV fluids to help increase the blood pressure.
- E. Obtain IV epinephrine in case it is needed.
Correct Answer: A,C,E
Rationale: In anaphylaxis, immediately stopping the medication, following facility protocol, and preparing epinephrine are critical. Slowing the IV or increasing fluids without addressing the reaction is inappropriate.
Which patient is most likely to have a drug reaction?
- A. A patient with kidney failure who is on dialysis
- B. A patient who is more physically active than the average person
- C. A patient with no known drug allergies (NKDA)
- D. A patient who has never had a reaction to a medicine in the past
Correct Answer: A
Rationale: Patients with kidney failure have impaired drug clearance, increasing the risk of drug accumulation and reactions.