A nurse is caring for a client who has an allergy to penicillin. The health care provider has prescribed amoxicillin. Which of the following actions should the nurse take?
Discuss the prescription with the health care provider.
Administer the medication as prescribed.
Place an incident report in the medical record.
Call the pharmacist for clarification of the medication contraindications.
The Correct Answer is A
Choice A reason: Discussing the prescription with the provider is critical, as amoxicillin, a penicillin derivative, is contraindicated in clients with penicillin allergies due to risk of anaphylaxis. This ensures patient safety by verifying or correcting the order, aligning with nursing advocacy and safety protocols, making it correct.
Choice B reason: Administering amoxicillin to a client with a penicillin allergy risks severe allergic reactions, including anaphylaxis, violating patient safety principles. Nurses must verify contraindicated orders before administration, making this action dangerous and incorrect in this scenario.
Choice C reason: Placing an incident report is premature, as no error has occurred yet. The nurse’s role is to prevent harm by addressing the contraindicated prescription proactively. This action does not resolve the issue and is inappropriate as the first step, making it incorrect.
Choice D reason: Calling the pharmacist for clarification is less direct than discussing with the provider, who issued the order. While pharmacists can provide guidance, the provider must confirm or change the prescription to ensure safety, making this action secondary and less effective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Amniocentesis involves needle insertion through the uterine wall, which can irritate the uterus and trigger contractions, risking preterm labor at 33 weeks. Monitoring contractions is vital to detect early labor signs, enabling interventions like tocolytics to delay delivery. This protects the premature fetus, ensuring better outcomes by maintaining pregnancy until closer to term.
Choice B reason: Vomiting is not a typical amniocentesis complication. The procedure is localized to the uterus, with minimal systemic effects. Nausea may occur from anxiety, but vomiting is rare and not a priority for monitoring. Focus remains on uterine and fetal complications, like contractions or fluid leakage, which directly impact pregnancy safety and outcomes.
Choice C reason: Hypertension is not directly linked to amniocentesis. The procedure does not typically affect maternal cardiovascular function, as it’s a localized intervention. Monitoring for hypertension is more relevant for conditions like preeclampsia. Post-amniocentesis, the priority is uterine activity and fetal distress, not blood pressure, making this an irrelevant complication to monitor.
Choice D reason: Polyuria is not associated with amniocentesis, as the procedure does not impact renal function or fluid balance. The focus is on complications like contractions, bleeding, or amniotic fluid leakage, which pose direct risks to the pregnancy. Monitoring polyuria is unnecessary, as it does not reflect the procedure’s physiological effects or risks.
Correct Answer is B
Explanation
Choice A reason: Frequent nosebleeds are not linked to coarctation of the aorta, a congenital aortic narrowing. They may result from hypertension or nasal issues, but coarctation causes differential blood pressure, with high upper body pressure, not nasal vasculature changes, making this an unrelated finding.
Choice B reason: Weak femoral pulses are expected in coarctation of the aorta, as the narrowing restricts blood flow to the lower extremities. This creates a pressure gradient, with stronger upper body pulses, detectable in infants, guiding diagnosis and management of this cardiovascular defect.
Choice C reason: Increased intracranial pressure is not associated with coarctation, which affects cardiovascular dynamics, not cranial pressure. It may occur in neurological conditions, but coarctation’s primary effect is hypertension above the narrowing, not brain-related changes, making this an irrelevant finding in this context.
Choice D reason: Upper extremity hypotension is incorrect, as coarctation causes hypertension in the upper extremities due to restricted aortic flow. Blood pressure is higher above the narrowing, with strong brachial pulses, while lower extremities experience reduced flow, opposite to hypotension in the upper body.
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