A nurse is reviewing the medical history of a client prior to medication administration and notes a history of an anaphylactic reaction to penicillin. The nurse should identify that which of the following medications is contraindicated for this client?

Vancomycin

Clarithromycin

Metronidazole

Ceftriaxone

Answer and Explanation

The Correct Answer is D

A. Vancomycin: Vancomycin is a glycopeptide antibiotic and does not share cross-reactivity with penicillin. It can be safely administered to clients with a penicillin allergy.

B. Clarithromycin: Clarithromycin is a macrolide antibiotic. It has a different chemical structure from penicillin and is not contraindicated in clients with penicillin allergies.

C. Metronidazole: Metronidazole is an antibiotic used primarily for anaerobic bacterial and protozoal infections. It is unrelated to penicillin and can be given safely to clients with penicillin hypersensitivity.

D. Ceftriaxone: Ceftriaxone is a cephalosporin, which is chemically related to penicillin. Clients with a history of anaphylactic reactions to penicillin have an increased risk of severe allergic reactions to cephalosporins, making ceftriaxone contraindicated in this case.

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Correct Answer is B

Explanation

A. Hypercalcemia: Elevated calcium levels are not commonly associated with long-term omeprazole use. Hypercalcemia typically presents with fatigue, constipation, and kidney stones rather than muscle cramps.

B. Hypomagnesemia: Long-term use of proton pump inhibitors like omeprazole can lead to decreased magnesium absorption, resulting in hypomagnesemia. Low magnesium levels can cause neuromuscular excitability, leading to severe muscle cramps, tremors, and even arrhythmias.

C. Hyponatremia: Sodium imbalances are not a known effect of omeprazole therapy. Hyponatremia usually presents with confusion, lethargy, and seizures rather than isolated muscle cramps.

D. Hyperkalemia: Elevated potassium levels are not typically caused by omeprazole. Hyperkalemia primarily affects cardiac function and may present with arrhythmias, not muscle cramps.

A. Inject air into the vial with NPH insulin in it. B. Draw up the regular insulin dose. C. Inject air into the vial with regular insulin in it. D. Draw up the NPH insulin dose.

Correct Answer is C

Explanation

A. Inject air into the vial with NPH insulin in it: Air should be injected into the NPH vial after preparing the regular insulin to maintain proper technique, but it is not the first step in the process.

B. Draw up the regular insulin dose: Drawing up regular insulin occurs after injecting air into both vials. Ensuring proper air injection first helps maintain accurate dosing and prevents a vacuum from forming in the vials.

C. Inject air into the vial with regular insulin in it: Injecting air into the regular insulin vial is the first step in mixing NPH and regular insulin. This step equalizes pressure inside the vial, making it easier to withdraw the correct dose without contaminating or altering the insulin.

D. Draw up the NPH insulin dose: Drawing up NPH insulin is done last to prevent contamination of the regular insulin with the intermediate-acting insulin. This ensures the correct order of mixing and maintains the integrity of both insulin types.

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A nurse is reviewing the medical history of a client prior to medication administration and notes a history of an anaphylactic reaction to penicillin. The nurse should identify that which of the following medications is contraindicated for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has taken omeprazole for over 10 years and recently reported experiencing severe muscle cramps. Which of the following electrolyte imbalances should the nurse consider as possibly contributing to this issue?

Correct Answer is B

Explanation

A nurse is mixing NPH insulin and regular insulin prior to administration. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

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