A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?

Contact the healthcare provider.

Give with prescribed antihistamine.

Administer the medication as prescribed.

Monitor the client for a rash or hives.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

Contact the healthcare provider: Given the client’s history of anaphylactic reaction to penicillin, there is a potential risk of cross-reactivity with cephalexin, a cephalosporin. Although the risk of cross-reactivity is relatively low, it is still significant enough to warrant caution. Studies indicate that 1-4% of people with a true penicillin allergy may also react to cephalosporins. Therefore, the nurse should contact the healthcare provider to discuss alternative antibiotics or additional precautions.

Choice B Reason:

Give with prescribed antihistamine: While antihistamines can help manage mild allergic reactions, they are not sufficient to prevent or treat anaphylaxis. Anaphylactic reactions require immediate medical intervention, including epinephrine administration. Therefore, relying solely on antihistamines is not an appropriate or safe action in this scenario.

Choice C Reason:

Administer the medication as prescribed: Administering cephalexin without consulting the healthcare provider could put the client at risk of a severe allergic reaction. Given the client’s history of anaphylaxis to penicillin, it is crucial to verify the safety of cephalexin with the healthcare provider before administration.

Choice D Reason:

Monitor the client for a rash or hives: While monitoring for allergic reactions is essential, it should not be the primary action in this case. The priority is to prevent a potential severe allergic reaction by consulting the healthcare provider before administering the medication. Monitoring alone does not address the underlying risk of cross-reactivity.

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Correct Answer is C

Explanation

Choice A reason:

Placing the new patch on the client’s shoulder and leaving both patches in place for 12 hours is not recommended. Fentanyl patches are designed to be used one at a time, and overlapping patches can lead to an overdose due to excessive absorption of the medication1. The standard practice is to remove the old patch before applying a new one.

Choice B reason:

Removing the patch and consulting with the healthcare provider about the client’s pain resolution is a cautious approach. However, it is not necessary to consult the healthcare provider if the client denies pain and the patch is due for replacement. The nurse should follow the standard protocol for patch replacement.

Choice C reason:

Applying the new patch in a different location after removing the original patch is the correct action. This ensures that the medication is delivered effectively while preventing skin irritation and potential overdose. The new patch should be placed on a different area of intact skin to allow the previous site to recover.

Choice D reason:

Administering an oral analgesic and evaluating its effectiveness before applying the new patch is not appropriate in this scenario. The client is already receiving pain management through the transdermal patch, and additional oral analgesics are not necessary unless there is breakthrough pain. The focus should be on proper patch replacement

A. Breastfeeding is not recommended while taking this medication. B. Do not take multiple vitamins that contain vitamin A while taking this drug. C. Baseline liver function results must be obtained during therapy. D. Discontinue this medication one month before attempting to conceive.

Correct Answer is D

Explanation

Choice A reason: While it is true that breastfeeding is not recommended while taking isotretinoin due to the potential for adverse effects on the infant, this is not the most critical information for a client planning to become pregnant. The primary concern is the teratogenic effects of isotretinoin, which can cause severe birth defects.

Choice B reason: Advising the client not to take multiple vitamins that contain vitamin A while on isotretinoin is important because excessive vitamin A can increase the risk of toxicity. However, this is not the most crucial information for someone planning to become pregnant. The teratogenic risks of isotretinoin are a higher priority.

Choice C reason: Obtaining baseline liver function results is necessary during isotretinoin therapy due to the potential for hepatotoxicity. Regular monitoring helps ensure the liver is functioning properly. However, this information is secondary to the need to avoid pregnancy while on isotretinoin due to its severe teratogenic effects.

Choice D reason: Discontinuing isotretinoin one month before attempting to conceive is the most important information. Isotretinoin is highly teratogenic and can cause serious birth defects. It is crucial to stop the medication well before conception to ensure it is completely cleared from the body, reducing the risk of harm to the fetus.

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A client with a history of anaphylactic reaction to penicillin receives a prescription for cephalexin 500 mg PO twice daily. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. Which action should the nurse take?

Correct Answer is C

Explanation

A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?

Correct Answer is D

Explanation

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