A nurse is collecting data from a client before administering a hepatitis B immunization. The nurse should withhold the immunization if the client is allergic to which of the following substances?

Baker's yeast

Nuts

Wheat

Egg yolk

Answer and Explanation

The Correct Answer is A

A. Baker's yeast. The hepatitis B vaccine is contraindicated in individuals with a severe allergy to baker’s yeast. This is because the vaccine is produced using Saccharomyces cerevisiae (baker’s yeast), which can trigger an allergic reaction in susceptible individuals. Symptoms of a yeast allergy may include rash, difficulty breathing, and anaphylaxis, requiring the vaccine to be withheld and an alternative plan considered.

B. Nuts. Nut allergies are not related to the hepatitis B vaccine, as it does not contain nut-derived ingredients. While nut allergies can be severe and cause anaphylaxis, they do not pose a specific risk in the administration of this vaccine. Therefore, the presence of a nut allergy alone does not require withholding the immunization.

C. Wheat. A wheat allergy is not a contraindication for the hepatitis B vaccine. Wheat allergies primarily cause reactions to gluten-containing foods or products but do not have any connection to the components used in the production of the vaccine. The vaccine can be safely administered to individuals with wheat allergies.

D. Egg yolk. While some vaccines, such as the influenza vaccine, may be derived from egg proteins, the hepatitis B vaccine is not produced using egg-based components. An allergy to egg yolk does not pose a risk for adverse reactions to this vaccine, so it should not be withheld in individuals with an egg allergy.

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Correct Answer is B

Explanation

A. Tingling sensation. A mild tingling or paresthesia is a common side effect of sumatriptan due to its vasoconstrictive action. While it should be monitored, it is not typically harmful and does not require immediate medical intervention.

B. Hypertension. Sumatriptan works by constricting blood vessels to relieve migraine symptoms, but it can also cause a dangerous increase in blood pressure. Severe hypertension can lead to complications such as stroke or myocardial infarction. This is the priority finding that requires immediate reporting to prevent life-threatening cardiovascular events.

C. Dizziness. Dizziness can occur due to sumatriptan’s vasoconstrictive properties or from the migraine itself. While it can be uncomfortable, it is not an immediate threat to the client’s safety unless it is severe or associated with other neurological symptoms.

D. Flushing. Facial flushing is a known side effect of sumatriptan and is generally harmless. It occurs due to transient vasodilation in the skin and does not indicate a serious adverse reaction. Monitoring is appropriate, but it does not require urgent intervention.

Correct Answer is ["3"]

Explanation

Convert pounds to kilograms:

Conversion factor: 1 kg = 2.2 lb

66 lb / 2.2 lb/kg = 30 kg

Calculate the dose to administer:

Dose (mg) = Weight (kg) × Dosage (mg/kg)

=30 kg × 0.1 mg/kg

= 3 mg

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A nurse is collecting data from a client before administering a hepatitis B immunization. The nurse should withhold the immunization if the client is allergic to which of the following substances?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is collecting data from a client who continues to have a migraine headache after taking sumatriptan orally 2 hr ago. Which of the following findings is the priority for the nurse to report?

Correct Answer is B

Explanation

A nurse is preparing to administer morphine 0.1 mg/kg IM to a school-age child who weighs 66 lb. What is the dose that the nurse should administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["3"]

Explanation

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