The nurse practitioner has written a number of stat orders for drugs to treat a patient on the medical-surgical unit who has suffered an acute anaphylactic reaction with hives and bronchospasm during infusion of an IV antibiotic. Which priority drug would the nurse administer first?

Correct Answer: C

Rationale: Epinephrine is the first-line treatment for anaphylaxis due to its rapid action in reversing bronchospasm, vasodilation, and hypotension. It acts on alpha- and beta-adrenergic receptors to constrict blood vessels, relax bronchial smooth muscle, and increase cardiac output. Steroids (A) and diphenhydramine (D) are adjuncts to manage inflammation and histamine release but are not immediate lifesaving measures. Dopamine (B) is used for hypotension but is not the first-line treatment for anaphylaxis.

Correct Answer: C

Rationale: Senna is a natural laxative commonly used to relieve constipation. Its primary mechanism of action is to stimulate the muscles in the intestines, leading to increased contractions and bowel movements. The evaluation of medication effectiveness for senna would typically focus on its ability to promote bowel movements and alleviate constipation. This would manifest as patients experiencing solid, formed bowel movements after taking senna. The options of decreased GI pain and irritation, healing of ulcers, and prevention of nausea and vomiting are not the primary expected outcomes when evaluating the effectiveness of senna as a medication for constipation.

Correct Answer: B

Rationale: In this situation, the nurse's first priority should be to apply pressure to the site with a gauze pad. Bleeding from the antecubital area where venous lab work was drawn can be due to the effect of the thrombolytic drug, particularly in a patient who is already at risk for bleeding due to the acute MI. Applying pressure to the site will help control the bleeding and prevent any further complications. Once the bleeding is controlled, the nurse should monitor the site closely for any signs of increased bleeding or other complications. Slowing the rate of infusion or stopping the infusion of the thrombolytic drug may be considered depending on the severity of the bleeding and the patient's overall condition, but the immediate response should be to apply pressure to the site.

Correct Answer: B

Rationale: Shellfish allergy is a common indicator of potential hypersensitivity to iodinated contrast media due to the shared allergen, iodine. Patients with shellfish allergies should be screened carefully before receiving contrast media. Allergies to eggs, soy, and acidic fruits are not directly related to contrast media reactions.

Correct Answer: D

Rationale: Phenylbutazone is a nonsteroidal anti-inflammatory drug (NSAID) known for its potential to cause bone marrow depression. Bone marrow depression is a serious side effect that can lead to decreased production of blood cells, including white blood cells, red blood cells, and platelets. This can result in an increased risk of infections, anemia, and bleeding disorders. Therefore, phenylbutazone should be used cautiously and under close monitoring to avoid this complication. Aspirin, Colchicine, Ibuprofen, and Acetaminophen are not typically associated with causing bone marrow depression as a side effect.