A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin Gby intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first?

Call the client's provider.

Stop the infusion.

Auscultate the client's breath sounds.

Elevate the head of the bed.

Answer and Explanation

The Correct Answer is B

The client is exhibiting symptoms and signs of anaphylaxis. Anaphylaxis is a severe systemic allergic reaction that occurs due to allergens presenting with (itching) urticaria and sudden onset shortness of breath and/or shock. The first action should be to stop the infusion to prevent worsening the severity of the allergic reaction.

A. Important to allow for further prescription but not a priority

C. Auscultating the lungs allows the nurse to assess for the severity of the reaction but should come after stopping the infusion

D. Elevating the head can improve ventilation but is not a priority

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Correct Answer is C

Explanation

Diphenhydramine is an oral antihistamine used in pruritus. Its main side effect is sedation and hence its recommended for use at bedtime to prevent daytime somnolence.
A. Taking the medication with meals does not reduce daytime sedation.
B. Gradually decreasing the dose once tolerance to the effect is reached may be appropriate in some cases, but it does not address immediate concerns about daytime sedation.
D. Distributing the doses evenly throughout the day may not effectively minimize daytime sedation.

A. Zolpidem B. Ibuprofen C. Omeprazole D. Senna

Correct Answer is D

Explanation

Senna is a laxative that works to stimulate bowel movements by irritating the intestinal lining in clients with constipation. In cases of small bowel obstruction, this can increase the risk of perforation or exacerbate the obstruction in cases.
A. Zolpidem is a sleep medication and is unlikely to affect the bowel obstruction.
B. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastric irritation but is not contraindicated in small bowel obstruction.
C. Omeprazole is a proton pump inhibitor used to reduce stomach acid production and is safe to use in small bowel obstruction.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client Who is prescribed diphenhydramine to relieve pruritus. The client asks the nurse how he can minimize the daytime sedation he is experiencing. Which of the following responses should the nurse give?

Correct Answer is C

Explanation

A nurse is reviewing the medication list for a client who has a new diagnosis of a small bowel obstruction. The nurse should Withhold Which of the following medications?

Correct Answer is D

Explanation

A nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect?

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

The nurse is preparing a medication for a client and observes the date of expiration on the vial occurred 2 months ago. Which of the following actions should the nurse take?

A nurse is teaching a client who has iron deficiency anemia about ferrous sulfate. Which of the following instructions should the nurse include in the teaching?

A nurse is caring for a client who has cirrhosis and a new prescription for lactulose. Which of the following manifestations indicates an adverse effect of the medication?

A nurse is preparing to administer blood to a client. The unit of blood on hand is type B, and the client has type AB blood. Which of the following actions should the nurse take?

A nurse is providing teaching for a client who is on diuretic therapy and has a new prescription for potassium chloride (KCL) 20 mEq extended release PO daily. Which of the following instructions should the nurse provide about the new prescription?

A nurse is caring for a client who has a prescription for olanzapine. The nurse should monitor the client for which of the following manifestations as an expected response to this medication?