The nurse is caring for a patient with wheezes, shortness of breath, urticaria and itching after receiving a new antibiotic The nurse understands that the epinephrine in this situation would be administered intramuscularly (IM), rather than intravenously (IV) because:

IM epinephrine is the fastest route of administration

IV epinephrine is only administered during cardiac arrest

Epinephrine would not be administered in this situation

IM epinephrine is less concentrated than IV.

Answer and Explanation

The Correct Answer is B

A) IM epinephrine is the fastest route of administration:
While epinephrine is often administered intramuscularly in cases of anaphylaxis and allergic reactions, the speed of action is not the primary reason for choosing this route over intravenous (IV) administration in this situation. Intramuscular administration of epinephrine allows for a rapid onset of action, but it is not necessarily the fastest route compared to IV. IV administration would act more quickly in an emergency setting where immediate blood circulation is critical, but IM is preferred in allergic reactions to prevent excessive systemic effects and to avoid rapid peaks in plasma levels.

B) IV epinephrine is only administered during cardiac arrest:
Epinephrine is generally administered intravenously during life-threatening situations such as cardiac arrest or severe shock, where immediate circulatory effects are needed. In cases of anaphylaxis, however, intramuscular (IM) administration of epinephrine is the preferred route because it allows for a more controlled absorption rate and reduces the risk of excessive blood pressure and other adverse cardiovascular effects. This is the correct rationale for why epinephrine is administered IM in the context of an allergic reaction.

C) Epinephrine would not be administered in this situation:
Epinephrine is the first-line treatment for severe allergic reactions and anaphylaxis, especially in cases where symptoms like wheezing, shortness of breath, urticaria, and itching are present. Therefore, withholding epinephrine is not an appropriate response in this situation. Immediate intervention with epinephrine is critical to reverse the symptoms of anaphylaxis and prevent further respiratory distress or cardiovascular collapse.

D) IM epinephrine is less concentrated than IV:
The concentration of epinephrine used for IM and IV administration is the same. The primary reason for choosing the IM route over the IV route is the slower absorption and the fact that it minimizes the risk of a rapid increase in systemic blood pressure and other adverse reactions. While IM epinephrine may be absorbed more slowly than IV, its concentration is appropriate for treating anaphylaxis effectively. The choice of IM is based on safety and controlled response, not on the concentration of the drug.

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Correct Answer is D

Explanation

A) Mask-like face and shuffling gait:
While the mask-like face and shuffling gait are common clinical features of Parkinson's Disease (PD), they do not directly explain the fever or the patchy infiltrates seen on the chest x-ray. The mask-like face is due to reduced facial muscle activity and is associated with the motor symptoms of PD, while the shuffling gait results from bradykinesia (slowness of movement).

B) Lack of arm swing and bradykinesia:
Lack of arm swing and bradykinesia are motor symptoms of PD that are indicative of decreased movement and muscle rigidity. While they impact a patient’s mobility and dexterity, they are not directly associated with lung infiltrates or fever.

C) Pill rolling of fingers and flat affect:
Pill rolling (a characteristic tremor where patients move their fingers as if rolling a pill) and flat affect (a reduced emotional expression) are hallmark features of Parkinson's Disease, but again, they do not explain the fever or lung infiltrates.

D) Difficulty swallowing and immobility:
Difficulty swallowing (dysphagia) is a common and serious symptom in patients with Parkinson's Disease. Due to the loss of control over the muscles involved in swallowing, patients with PD are at high risk for aspiration (food, liquids, or saliva entering the lungs), which can lead to aspiration pneumonia. This condition often presents with fever, chest infiltrates, and respiratory distress, which directly correlates with the patient's fever and lung infiltrates seen on the chest x-ray.

A. Packed Red Blood Cells (PRBC's) B. Platelets C. Cryoprecipitate D. Fresh Frozen Plasma (FFP)

Correct Answer is D

Explanation

A) Packed Red Blood Cells (PRBCs):
Packed Red Blood Cells are typically transfused when there is anemia or significant blood loss leading to low hemoglobin levels. In the case of warfarin overdose or elevated PT/INR, the problem is related to coagulation and not red blood cell count.

B) Platelets:
Platelets are typically transfused when there is thrombocytopenia or a need to address platelet dysfunction (e.g., in patients with bleeding due to low platelet counts). However, the elevated PT and INR in this case are related to the coagulation cascade being inhibited by warfarin, not platelet deficiency.

C) Cryoprecipitate:
Cryoprecipitate is primarily used to replace clotting factors such as fibrinogen, factor VIII, and von Willebrand factor. It is typically transfused in patients with hemophilia or bleeding disorders related to low fibrinogen levels. However, in this case, the issue is related to warfarin-induced inhibition of clotting factors (specifically the vitamin K-dependent factors: II, VII, IX, and X), not a deficiency in fibrinogen or specific clotting factors addressed by cryoprecipitate.

D) Fresh Frozen Plasma (FFP):
Fresh Frozen Plasma (FFP) is the most appropriate choice for this patient. FFP contains all the coagulation factors, including the vitamin K-dependent factors that warfarin inhibits. When a patient on warfarin presents with elevated PT and INR (which indicates impaired clotting ability), FFP is used to replace the clotting factors and help reverse the effects of warfarin.

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The nurse is caring for a patient with wheezes, shortness of breath, urticaria and itching after receiving a new antibiotic The nurse understands that the epinephrine in this situation would be administered intramuscularly (IM), rather than intravenously (IV) because:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client diagnosed with Parkinson's Disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain this assessment data?

Correct Answer is D

Explanation

The nurse is caring for patient with a history of atrial fibrillation who is prescribed warfarin. Sometimes I forget my medication, so l double up doses when I remember " The patient's PT and INR are highly elevated. The nurse anticipates the transfusion of which blood product?

Correct Answer is D

Explanation

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