The practical nurse (PN) is preparing to administer a maintenance dose of an antihypertensive medication to an adult client and notes that the client’s blood pressure is 120/72 mm Hg. Which action should the PN take?

Choice A reason: Taking medications with food may reduce gastric irritation but does not prevent anaphylactic reactions to penicillin, which are immune-mediated. This advice is irrelevant for avoiding future allergic responses, as it does not address the systemic hypersensitivity triggered by penicillin exposure.

Choice B reason: A medic alert bracelet is critical for a client with a penicillin anaphylaxis history, as it alerts healthcare providers to avoid penicillin, preventing potentially fatal allergic reactions. Anaphylaxis involves IgE-mediated histamine release, and re-exposure risks rapid, life-threatening symptoms, making this the most important instruction.

Choice C reason: Keeping epinephrine is useful for managing anaphylaxis but is secondary to prevention. A medic alert bracelet proactively avoids penicillin exposure, reducing the need for emergency intervention. Epinephrine treats symptoms but does not address the root cause of re-exposure risk.

Choice D reason: Taking all prescribed ampicillin is dangerous, as the client had an anaphylactic reaction, indicating a severe allergy. Continuing the drug risks recurrent, potentially fatal reactions. This choice is incorrect, as it contradicts the need to avoid the allergen entirely.

Choice A reason: Taking a benzodiazepine with morphine is incorrect, as it increases sedation and respiratory depression risk, a dangerous opioid side effect. This indicates misunderstanding, as morphine’s primary management focuses on pain and side effects like constipation, not concurrent sedative use.

Choice B reason: Observing bowel movements and using a stool softener shows understanding, as morphine causes constipation by slowing gastrointestinal motility via opioid receptors. Proactive management with stool softeners prevents complications like impaction, aligning with safe opioid use in cancer pain management.

Choice C reason: Grapefruit juice avoidance is irrelevant to morphine, as it affects drugs metabolized by CYP3A4, not opioids. Morphine is metabolized via glucuronidation, unaffected by grapefruit. This indicates misunderstanding, as it does not address morphine’s key side effects or management.

Choice D reason: Watching for agitation or insomnia is not a primary concern with morphine, which causes sedation. These symptoms may relate to other conditions, but they do not reflect understanding of morphine’s effects, like constipation, making this choice incorrect.