A 25-year-old woman suffers a bee sting and within a few minutes she notices a blotchy rash appearing on her body. She is taken to A&E where her BP is 90/60 mmHg. The most appropriate immediate therapy would be:

Correct Answer: D

Rationale: Anaphylaxis (rash, hypotension) post-bee sting needs urgent reversal. Oral antihistamine is too slow for systemic shock. IV adrenaline (1:10000) suits cardiac arrest, not initial anaphylaxis. IV hydrocortisone acts slowly, supporting later. IM adrenaline (0.5 mL 1:1000, 0.5 mg) rapidly reverses bronchospasm and hypotension via alpha/beta agonism, the immediate therapy per guidelines. Salbutamol targets asthma, not shock. IM adrenaline's speed saves lives in anaphylaxis.

Correct Answer: B

Rationale: Adrenergic blockers can affect labor, and babies born to mothers taking these drugs may exhibit adverse cardiovascular, respiratory, and CNS effects. Problems with the GI and GU systems have not been reported. The nurse should monitor the newborn for potential adverse effects and intervene as needed to ensure safety.

Correct Answer: A

Rationale: Protamine sulfate is the antidote for Heparin. Heparin is an anticoagulant medication that works by inhibiting the clotting factors in the blood. In cases of Heparin overdose or when there is a need to reverse its anticoagulant effects quickly, protamine sulfate can be administered. Protamine sulfate binds to Heparin and neutralizes its anticoagulant effects, making it an effective antidote. It is important to administer the antidote under the guidance of a healthcare professional to prevent any adverse reactions.

Correct Answer: A

Rationale: The therapeutic range for digoxin levels is typically between 0.8-2.0 ng/mL. A digoxin level of 1.1 ng/mL falls below the lower end of the therapeutic range, indicating that it is below the level considered effective for therapeutic benefits. Therefore, the correct interpretation by the nurse is that it is below the therapeutic level.

Correct Answer: C

Rationale: Protamine sulfate is a medication that can antagonize the anticoagulant effects of heparin. Heparin works by binding to antithrombin III to enhance its activity, which leads to the inhibition of factor Xa and thrombin. Protamine sulfate, a positively charged molecule, binds to heparin to form a stable complex, neutralizing the anticoagulant effects of heparin. This makes protamine sulfate a useful antidote for heparin overdose or in situations where rapid reversal of heparin is necessary to reduce the risk of bleeding complications. The other options listed - acetylcysteine, naloxone, warfarin sodium, and phenindione - do not have a direct antagonistic effect on the anticoagulant effects of heparin.