VSIM CHARLIE SNOW PHARMACOLOGY PRE/POST TEST
REVIEW ANSWERED #4
A nurse is teaching new parents about preventing the development of food allergies.
Which of the food should be avoided in patients younger than 1 year to prevent the
development of a food allergy?
A. Peanuts
B. Apples
C. Honey
D. Soy milk - correct answer Ans A
Common food allergens include the following: cow's milk, eggs, peanuts, tree nuts,
citrus, fish, and shellfish. Infants should avoid honey to prevent the risk of botulism, not
because of concern over developing a food allergy. Soy milk and apples are not
common allergens.
The nurse is assessing a patient with and allergic reaction from a food allergen. Which
finding is most concerning?
A. Urticaria
B. Pruritus
C. Vomiting
D. Wheezing - correct answer Ans D
Wheezing can be an ominous sign that the airway is edematous and indicative of a
more severe allergic reaction such as anaphylaxis. The other findings listed are
common signs and symptoms of a food allergy; however, respiratory symptoms are the
most concerning.
A nurse is describing to a new nurse how epinephrine works. Which of the following
correctly describes the mechanism of action of epinephrine?
A. Increases systemic vascular resistance and heart rate
B. Increases cardiac output, blood pressure and renal perfusion
C. Increases cardiac output and inhibits histamine
D. Increases myocardial contractility and heart rate - correct answer Ans A
Epinephrine stimulates α- and β-adrenergic receptors, resulting in increased systemic
vascular resistance and increased heart rate. Atropine increases cardiac output and
inhibits histamine. Dobutamine increases myocardial contractility and heart rate.
Dopamine increases cardiac output, blood pressure, and renal perfusion.
The nurse is preparing a 6-yearold patient who is experiencing and allergic reaction for
an intramuscular epinephrine injection. Which of the following demonstrates that the
nurse understands developmentally appropriate communication?
D. I am going to give you some medicine. It may make you feel a little shaky. Your
parent can help hold your hand and your job is to hold your arm still. - correct answer It
is important to explain procedures to a child in simple terms that are nonthreatening.
, Using terms such as "if" or "okay," or asking if the patient wants to do something, offers
the illusion of a choice when there is not one available. Avoid terms that are too
technical or confusing, which could cause the child to misunderstand what is going to
occur. Hearing "shot" may scare the child or cause the child to think that they will be
shot with a gun. Be honest if a procedure is going to be uncomfortable or cause pain. It
is important to let the patient know that it is acceptable to express feelings and get upset
or cry if in pain.
The nurse is preparing to administer methylprednisolone to a 6-year old patient with
anaphylaxis. The patient is allergic to peanuts with no other pertinent medical
conditions. Which of the following is the priority for the nurse to monitor with
administration?
A. Urine output
B. BP
C. Bone density
D. Blood glucose - correct answer Ans B
Methylprednisolone can cause hypertension and elevated blood glucose. Blood
pressure should be monitored frequently during methylprednisolone infusion. Patients
with a history of diabetes should be monitored for hyperglycemia and glucose in the
urine because additional insulin may be needed, but this is not the priority for the nurse
to monitor during administration. Elderly patients may be more susceptible to
osteoporosis with prolonged use of methylprednisolone, but, again, the priority to
monitor during the actual administration is hypertension.
A nurse is explaining to a coworker the relationship between anaphylaxis and
distributive shock. The nurse's explanation is based on the knowledge that distributive
shock is caused by which of the following?
A. Systemic inflammatory response
B. Decrease in systemic perfusion
C. Ineffective pumping of the heart
D. Massive systemic vasodilation - correct answer Ans D
During anaphylaxis and distributive shock, massive systemic vasodilation occurs,
causing the vascular compartment to expand and requiring more fluid to maintain
cardiac output despite no actual loss of any fluids. When systemic perfusion decreases
as a result of inadequate vascular volume, hypovolemic shock occurs. Ineffective
pumping of the heart, with a resultant decrease in stroke volume, results in cardiogenic
shock. Septic shock is related to a systemic inflammatory response in which there may
be increased cardiac output with a low systemic vascular resistance.
While completing a focused cardiovascular assessment on a 6-year old patient admitted
with anaphylaxis, the nurse notes that the skin is cool, central and peripheral pulses are
weak, and capillary refill is prolonged. The patient is responsive and anxious, with a
heart rate of 140, RR 32, BP 106/60 and oxygen sat of 91%. What is the most
appropriate initial intervention to support perfusion?
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