A client with seasonal allergies takes diphenhydramine at bedtime to help their symptoms. The client develops low hemoglobin low white blood cell counts which is otherwise unexplained. What type of reaction is the client experiencing?

Hypersensitivity reaction

Paradoxical reaction

Idiosyncratic reaction

Anti-cholinergic reaction

Answer and Explanation

The Correct Answer is C

A) Hypersensitivity reaction: A hypersensitivity reaction typically involves an immune response where the body reacts to a substance as if it were harmful, leading to symptoms like rashes, swelling, or difficulty breathing. However, low hemoglobin and low white blood cell counts are not typical signs of a hypersensitivity reaction. This would involve more common allergic symptoms like itching or swelling, rather than hematologic changes.

B) Paradoxical reaction: A paradoxical reaction refers to when a medication causes an effect opposite to the expected result. For example, a sedative causing agitation instead of sleepiness. While a paradoxical reaction can involve unexpected effects, the hematologic changes (low hemoglobin and white blood cell counts) in this scenario do not align with this type of response.

C) Idiosyncratic reaction: An idiosyncratic reaction is an unusual or unexpected response to

a medication that is not related to the drug's pharmacologic properties or the dose given. It may be related to genetic factors or other individual differences in how a person metabolizes or responds to the drug. The low hemoglobin and low white blood cell counts in this case are unusual effects of diphenhydramine and suggest an idiosyncratic response, where the client’s body is reacting in an unexpected way to the medication.

D) Anti-cholinergic reaction: Anti-cholinergic reactions are typically related to symptoms caused by the blocking of acetylcholine, such as dry mouth, blurred vision, urinary retention, or constipation. While diphenhydramine has anti-cholinergic properties, the symptoms described (low hemoglobin and white blood cell counts) are not typical of an anti-cholinergic reaction.

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Free Nursing Study Resources

Correct Answer is ["20"]

Explanation

1. Determine the concentration of the guaifenesin:

The label states 100 mg/5 mL.

2. Set up a proportion to find the volume (in mL) needed:

100 mg / 5 mL = 400 mg / x mL

3. Solve for x:

Cross-multiply: 100x = 400 * 5

100x = 2000

x = 2000 / 100

x = 20 mL

Answer: The nurse will administer 20 mL to the client.

A. Ask the client what prescribed medications are taken at home B. Contact the prescriber to clarify the order. C. Wait until the prescriber makes rounds again to clarify the order D. Ask a colleague what the order says.

Correct Answer is B

Explanation

A) Ask the client what prescribed medications are taken at home: While obtaining information about the client's home medications is important, this action does not address the specific issue of the unclear order. It is not an appropriate substitute for clarifying the medication order that the nurse is having difficulty transcribing.

B) Contact the prescriber to clarify the order: This is the best action for the nurse to take. If the nurse is unsure about the order due to illegible handwriting, the safest and most effective way to clarify the order is to directly contact the prescriber. This ensures that the nurse administers the correct medication and dose, reducing the risk of medication errors.

C) Wait until the prescriber makes rounds again to clarify the order: Waiting for the prescriber to make rounds is not an appropriate or timely solution. Medication administration should not be delayed due to unclear orders, as it could lead to treatment delays or potential harm to the patient. Immediate clarification is necessary.

D) Ask a colleague what the order says: While consulting a colleague might be helpful, it is not the most reliable or safe course of action. The nurse should not rely on others to interpret unclear orders, as there may be different interpretations or misunderstandings. Contacting the prescriber directly ensures the order is clarified accurately and safely.

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A client with seasonal allergies takes diphenhydramine at bedtime to help their symptoms. The client develops low hemoglobin low white blood cell counts which is otherwise unexplained. What type of reaction is the client experiencing?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The prescription reads for guaifenesin 400 mg PO every 4 hours as needed for congestion. Using the label below, how many mL will the nurse administer to the client? Enter a numeric value only. Answer to the nearest whole mL.

Correct Answer is ["20"]

Explanation

During a period of time when the computerized medication order system was down, the prescriber wrote admission the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time?

Correct Answer is B

Explanation

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