The charge nurse asks the practical nurse (PN) to administer diphenhydramine 25 mg IM to a client prior to infusing a blood transfusion. Which explanation should the PN offer the client about the purpose of this drug?

Facilitate rapid infusion of the transfusion

Inhibit the antigen-antibody reaction

Promote relaxation of the client during the blood transfusion

Minimize symptoms related to any allergic reaction

Answer and Explanation

The Correct Answer is D

Choice A reason: Diphenhydramine does not facilitate rapid transfusion. It is an antihistamine used to prevent allergic reactions during transfusions, not to alter infusion speed. Rapid infusion depends on clinical protocols and patient tolerance, not antihistamine effects, making this choice incorrect.

Choice B reason: Diphenhydramine does not inhibit antigen-antibody reactions, which occur in transfusion mismatches. It mitigates histamine-mediated allergic symptoms, like itching or hives, but does not prevent immunological reactions. This choice is incorrect, as it misrepresents the drug’s role in symptom management.

Choice C reason: While diphenhydramine may cause sedation, its primary purpose before transfusion is to prevent allergic reactions, not to promote relaxation. Relaxation is a secondary effect, not the clinical rationale for its use, making this choice less accurate than allergy prevention.

Choice D reason: Diphenhydramine, an antihistamine, minimizes allergic reaction symptoms, such as itching or hives, during blood transfusions by blocking histamine receptors. This premedication reduces the risk of mild transfusion-related allergic responses, ensuring patient comfort and safety, making it the correct explanation.

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Correct Answer is D

Explanation

Choice A reason: Using an Amsler grid monitors macular degeneration, not sildenafil-related visual changes, which include color tinting or blurred vision due to PDE5 inhibition affecting retinal blood flow. This is not a standard monitoring tool for sildenafil side effects, making it inappropriate for this context.

Choice B reason: Instilling eye drops is irrelevant, as sildenafil’s visual changes are systemic, caused by its effect on retinal phosphodiesterase, not a local eye condition treatable with drops. No evidence supports eye drops for this side effect, making this choice incorrect and ineffective.

Choice C reason: Wearing dark glasses may reduce light sensitivity but does not address sildenafil’s visual side effects, like blue-green color distortion, caused by altered retinal signaling. This is a temporary, drug-induced effect, and glasses do not mitigate the underlying issue, making this choice inadequate.

Choice D reason: Reporting visual changes immediately is critical, as sildenafil can cause rare but serious effects like non-arteritic anterior ischemic optic neuropathy, impairing retinal blood flow. Prompt reporting allows the provider to assess severity, adjust dosing, or discontinue the drug to prevent permanent vision loss.

A. Ensure peak and trough serum levels are collected with the third medication dose B. Reassess the client’s pain 30 minutes after medication administration C. Observe the client daily for involuntary movements of the lips and tongue D. Initiate strict intake and output measurements and record every shift

Correct Answer is B

Explanation

Choice A reason: Peak and trough levels are relevant for drugs like vancomycin, not meloxicam, an NSAID. Meloxicam’s efficacy is assessed clinically via pain reduction, not blood levels, as it inhibits inflammation-causing prostaglandins, making this choice irrelevant for costochondritis management.

Choice B reason: Reassessing pain 30 minutes after meloxicam administration evaluates its effectiveness, as this NSAID reduces cyclooxygenase activity, decreasing prostaglandin-mediated pain and inflammation in costochondritis. Timely reassessment ensures adequate relief, guiding further interventions for breathing discomfort, making this the appropriate intervention.

Choice C reason: Involuntary lip and tongue movements are linked to antipsychotics causing tardive dyskinesia, not meloxicam. This NSAID does not affect neurological pathways causing movement disorders. Monitoring for this is irrelevant, as meloxicam’s primary risks are gastrointestinal, not neurological.

Choice D reason: Strict intake and output monitoring is unnecessary for meloxicam, which targets inflammation, not fluid balance. While long-term use may affect renal function, pain reassessment is more immediate for costochondritis, making this choice less relevant than evaluating therapeutic pain relief.

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The charge nurse asks the practical nurse (PN) to administer diphenhydramine 25 mg IM to a client prior to infusing a blood transfusion. Which explanation should the PN offer the client about the purpose of this drug?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is taking sildenafil 50 mg PO PRN reports experiencing visual changes to the practical nurse (PN). Which instruction should the PN give to the client?

Correct Answer is D

Explanation

The practical nurse (PN) is caring for a client with costochondritis who is now experiencing increased discomfort in breathing. The client receives a prescription for meloxicam. Which intervention should the PN include in the client’s POC?

Correct Answer is B

Explanation

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