A nurse is collecting data from a client who has gout and is taking allopurinol. Which of the following adverse effects should the nurse identify as the priority to report to the provider?

Rash

Diarrhea

Nausea

Metallic taste in mouth

Answer and Explanation

The Correct Answer is A

A. Rash. A rash while taking allopurinol can indicate a serious hypersensitivity reaction, including Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These life-threatening conditions involve widespread skin blistering, mucosal involvement, and systemic symptoms. Immediate discontinuation of allopurinol and medical intervention are required to prevent severe complications.

B. Diarrhea. Mild gastrointestinal disturbances, including diarrhea, are common with allopurinol use. While bothersome, diarrhea is not life-threatening and can often be managed by adjusting the dose or taking the medication with food. It does not require immediate discontinuation unless severe or persistent.

C. Nausea. Nausea is a common, mild side effect of allopurinol that usually resolves with time or by taking the medication after meals. It is not an emergency and does not require urgent intervention unless accompanied by other concerning symptoms such as vomiting or severe abdominal pain.

D. Metallic taste in mouth. A metallic taste can occur with allopurinol use but is not harmful. It is a minor side effect that does not indicate toxicity or severe adverse reactions. Clients can be reassured that this effect is temporary and not a reason to stop the medication.

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Correct Answer is B

Explanation

A. Restart the infusion in the other extremity. While the IV infusion will need to be restarted in a new site, the priority after discontinuing the infusion is to manage the complications of IV infiltration. Restarting the infusion should be done after addressing the swelling and discomfort in the affected limb.

B. Elevate the extremity. Elevating the extremity reduces swelling and promotes fluid reabsorption following an IV infiltration. This helps minimize pain, tissue damage, and further complications, such as compartment syndrome. It is the next priority action after stopping the infusion.

C. Remove the catheter. The catheter should already be removed when the infusion is discontinued due to suspected infiltration. Keeping it in place could worsen tissue swelling and damage. If the catheter has not been removed yet, doing so is essential, but managing swelling and discomfort remains the priority after removal.

D. Apply warm, moist compresses to the site. Warm compresses are typically used for extravasation of non-vesicant solutions to promote circulation and absorption. However, in cases of severe infiltration or swelling, cold compresses may be used initially to reduce inflammation before applying warmth. The priority action is elevation, followed by applying appropriate compresses based on facility protocol.

A. Fluconazole B. Tetracycline C. Acyclovir D. Cephalexin

Correct Answer is D

Explanation

A. Fluconazole. Fluconazole is an antifungal medication used to treat fungal infections, such as candidiasis. It is not related to penicillin and does not pose a risk for cross-reactivity in clients with a penicillin allergy. It can be safely administered in this scenario.

B. Tetracycline. Tetracycline is a broad-spectrum antibiotic used to treat bacterial infections, including acne and respiratory infections. It belongs to a different antibiotic class than penicillins and cephalosporins, meaning it does not pose a risk of cross-reactivity in clients with a penicillin allergy.

C. Acyclovir. Acyclovir is an antiviral medication used to treat viral infections, such as herpes simplex and varicella-zoster. Since it does not belong to the beta-lactam antibiotic class, it is not contraindicated for clients with a penicillin allergy.

D. Cephalexin. Cephalexin is a first-generation cephalosporin, which shares a similar beta-lactam ring structure with penicillins. Clients with a history of an anaphylactic reaction to penicillin are at increased risk of cross-reactivity with cephalosporins, particularly first-generation ones like cephalexin. Due to the severity of the client’s allergic reaction, cephalexin should be avoided, and an alternative non-beta-lactam antibiotic should be considered.

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A nurse is collecting data from a client who has gout and is taking allopurinol. Which of the following adverse effects should the nurse identify as the priority to report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving a continuous IV infusion and reports pain at the IV insertion site. The nurse observes the arm is swollen and cool to touch. After discontinuing the infusion, which of the following actions should the nurse take next?

Correct Answer is B

Explanation

A nurse is caring for a client who has cellulitis and is to begin antibiotic therapy. The client has a history of anaphylactic reaction to penicillin. Which of the following medications is contraindicated for this client?

Correct Answer is D

Explanation

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