Adverse Drug Reactions and Side Effects > Pharmacology
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Introduction
Total Questions : 7
Showing 7 questions, Sign in for moreA nurse is reviewing the medication list of a client who has a history of allergic reactions to penicillin and sulfa drugs. The nurse should identify that which of the following medications is contraindicated for this client?
Explanation
Answer: A. Cefazolin is a cephalosporin antibiotic that has a cross-sensitivity with penicillin and should be avoided by clients who are allergic to penicillin.
B is incorrect because ciprofloxacin does not have cross-sensitivity with penicillin or sulfa drugs and can be safely administered to this client.
C is incorrect because vancomycin does not have cross-sensitivity with penicillin or sulfa drugs and can be safely administered to this client.
D is incorrect because Azithromycin does not have cross-sensitivity with penicillin or sulfa drugs and can be safely administered to this client.
A client who is receiving intravenous amphotericin B for a fungal infection reports feeling dizzy and having chills and fever. The nurse should recognize that these manifestations indicate which of the following adverse reactions?
Explanation
Infusion reaction is a common adverse effect of amphotericin B that occurs within 1 to 3 hours of starting the infusion and causes symptoms such as fever, chills, headache, nausea, vomiting, and hypotension.
A is incorrect because anaphylaxis is a severe allergic reaction that causes symptoms such as urticaria, angioedema, bronchospasm, and shock.
C is incorrect because nephrotoxicity is another adverse effect of amphotericin B that causes renal impairment and electrolyte imbalances.
D is incorrect because ototoxicity is an adverse effect of some antibiotics such as gentamicin and vancomycin that causes hearing loss and tinnitus.
A nurse is preparing to administer epinephrine to a client who is experiencing anaphylaxis after a bee sting. The nurse should administer the medication by which of the following routes?
Explanation
Intramuscular injection is the preferred route for administering epinephrine in anaphylaxis because it provides rapid absorption and onset of action.
B is incorrect because subcutaneous injection has a slower absorption rate than intramuscular injection and may not provide adequate relief in an emergency situation.
C is incorrect because intravenous injection of epinephrine can cause severe adverse effects such as cardiac arrhythmias and hypertension and should be reserved for life-threatening situations when other routes are ineffective.
D is incorrect because oral administration of epinephrine is ineffective due to extensive first-pass metabolism in the liver.
A client who has a peanut allergy accidentally ingested a cookie that contained peanut butter. The client reports feeling anxious, having difficulty breathing, and having a tingling sensation in the mouth. The nurse should identify that these manifestations indicate which of the following types of hypersensitivity reactions?
Explanation
Type I hypersensitivity reaction is also known as immediate hypersensitivity or anaphylaxis and occurs within minutes of exposure to an allergen. It involves the activation of mast cells and basophils that release histamine and other inflammatory mediators that cause vasodilation, bronchoconstriction, edema, and pruritus.
B is incorrect because Type II hypersensitivity reaction is also known as cytotoxic hypersensitivity or antibody-mediated hypersensitivity and occurs when antibodies bind to antigens on the surface of cells and cause cell lysis or damage. An example of this type of reaction is hemolytic transfusion reaction.
C is incorrect because Type III hypersensitivity reaction is also known as immune complex-mediated hypersensitivity and occurs when antigen-antibody complexes deposit in tissues and cause inflammation and tissue damage. An example of this type of reaction is serum sickness.
D is incorrect because Type IV hypersensitivity reaction is also known as delayed hypersensitivity or cell-mediated hypersensitivity and occurs when sensitized T cells react with antigens and release cytokines that activate macrophages and cause inflammation and tissue damage. An example of this type of reaction is contact dermatitis.
A nurse is caring for a client who has a severe allergic reaction to a medication and requires immediate administration of diphenhydramine. The nurse should administer the medication by which of the following routes?
Explanation
Answer: C. Intravenous injection is the fastest route for administering diphenhydramine in a severe allergic reaction because it provides immediate onset of action and avoids the first-pass metabolism in the liver.
A and B are incorrect because intramuscular and subcutaneous injections have slower absorption rates than intravenous injection and may not provide adequate relief in an emergency situation.
D is incorrect because oral administration of diphenhydramine has the slowest absorption rate and onset of action and is subject to first-pass metabolism in the liver.
A client who is receiving a blood transfusion develops a fever, chills, headache, and back pain. The nurse should suspect that the client is experiencing which of the following types of transfusion reactions?
Explanation
B. Febrile transfusion reaction is a common type of transfusion reaction that occurs when the recipient's antibodies react with the donor's leukocytes and cause fever, chills, headache, and malaise.
A is incorrect because hemolytic transfusion reaction is a rare but serious type of transfusion reaction that occurs when the recipient's antibodies react with the donor's erythrocytes and cause hemolysis, hemoglobinuria, hypotension, tachycardia, and renal failure.
C is incorrect because allergic transfusion reaction is a type of transfusion reaction that occurs when the recipient's antibodies react with the donor's plasma proteins and cause urticaria, pruritus, angioedema, and anaphylaxis.
D is incorrect because circulatory overload is a type of transfusion complication that occurs when the infusion rate exceeds the recipient's cardiac output and causes dyspnea, orthopnea, crackles, tachycardia, hypertension, and pulmonary edema.
A nurse is teaching a client who has a history of anaphylaxis about the use of an epinephrine auto-injector. Which of the following instructions should the nurse include in the teaching?
Explanation
Holding the device at a 90-degree angle to the thigh ensures proper penetration and delivery of the medication into the vastus lateralis muscle.
A is incorrect because injecting the medication into the deltoid muscle may not provide adequate absorption and onset of action.
C is incorrect because massaging the injection site may increase the risk of bleeding and bruising and may decrease the absorption of the medication.
D is incorrect because repeating the injection after 5 minutes may cause overdose and adverse effects such as hypertension, tachycardia, arrhythmias, and myocardial ischemia.
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