The nurse is administering Penicillin to a patient who has tested positive for strep throat. The nurse knows to look for which of the following adverse effects as a sign of an acute allergic reaction?

Correct Answer: C

Rationale: When administering Penicillin, one of the adverse effects to watch out for as a sign of an acute allergic reaction is the development of a skin rash or hives. This reaction may indicate an allergic response to the medication. It is important for the nurse to monitor the patient closely for any signs of an allergic reaction, including skin changes, and to act promptly if such symptoms arise. An acute allergic reaction can progress to a severe life-threatening condition known as anaphylaxis, so prompt recognition and intervention are critical in such cases.

Correct Answer: D

Rationale: When a patient is experiencing digoxin toxicity, severe sinus bradycardia that does not respond to cardiac pacing is a clinical situation that would necessitate the use of digoxin-specific antibody fragments (Digibind). This intervention is required to counteract the toxic effects of digoxin on the heart, especially in cases of severe bradycardia that can compromise cardiac output and lead to serious consequences. In this scenario, Digibind works by binding to digoxin molecules, thereby neutralizing their effects and helping to restore normal cardiac function.

Correct Answer: B

Rationale: Mannitol is an osmotic diuretic used to reduce intracranial pressure (ICP) by drawing fluid out of the brain tissue. However, it should be used cautiously in patients with elevated serum osmolality, as it can exacerbate hyperosmolality and lead to renal failure or other complications. In this case, the patient's serum osmolality is already high (330 mOsm/kg), so mannitol should be withheld, and other measures to reduce ICP, such as elevating the head of the bed, maintaining proper oxygenation, and avoiding hypercapnia, should be prioritized. Sodium nitroprusside (C) is used for hypertension, not ICP, and taking no action (D) is inappropriate given the elevated ICP.

Correct Answer: D

Rationale: When a patient requires immediate treatment for atrial fibrillation with digoxin, the fastest way to achieve a therapeutic effect is through intravenous administration. Option D, Digoxin 1 mg IV push now; then 0.25 mg IV daily, is the most appropriate order in this scenario. Intravenous administration allows for rapid absorption and onset of action, making it the preferred route for urgent situations like atrial fibrillation. By giving an initial loading dose intravenously, followed by a lower maintenance dose IV daily or orally, the patient can quickly achieve therapeutic digoxin levels to help stabilize the heart rhythm. Option D provides the most rapid and effective way to manage new-onset atrial fibrillation with digoxin.

Correct Answer: C

Rationale: When administering Penicillin, one of the adverse effects to watch out for as a sign of an acute allergic reaction is the development of a skin rash or hives. This reaction may indicate an allergic response to the medication. It is important for the nurse to monitor the patient closely for any signs of an allergic reaction, including skin changes, and to act promptly if such symptoms arise. An acute allergic reaction can progress to a severe life-threatening condition known as anaphylaxis, so prompt recognition and intervention are critical in such cases.