# A client develops wheezing, generalized hives, and blood pressure 78/42 mm Hg after receiving an antibiotic. Which medication should the nurse prepare to administer first?

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> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client develops wheezing, generalized hives, and blood pressure 78/42 mm Hg after receiving an antibiotic. Which medication should the nurse prepare to administer first?

## Option

1. Oral diphenhydramine
2. Intramuscular epinephrine **✔ Correct answer**
3. Inhaled corticosteroid
4. Oral acetaminophen

**Correct answer: 2**

## Explanation

Wheezing, hives, and hypotension after antibiotic exposure indicate anaphylaxis. Intramuscular epinephrine is the first-line medication because it supports airway, breathing, and circulation. Antihistamines or corticosteroids may be adjuncts but do not replace epinephrine for life-threatening anaphylaxis.

## In-depth explanation

Clinical Judgment
Recognize multi-system allergic reaction with hypotension as anaphylaxis and treat ABCs first.

Memory Tip
Anaphylaxis equals epinephrine first.

KR vs US
NCLEX distinguishes adjunct allergy medications from first-line emergency epinephrine.

## Clinical scenario

Clinical Practice Guide
Anaphylaxis with respiratory compromise or hypotension requires immediate epinephrine and emergency support.

Caution
Do not delay epinephrine while waiting to see whether symptoms improve.

## Key concepts

- **Anaphylaxis** — A severe systemic allergic reaction that may cause airway swelling, bronchospasm, hypotension, and shock.
- **Epinephrine** — First-line medication for anaphylaxis that improves airway tone, bronchodilation, and blood pressure.
- **Hypotension** — Low blood pressure that can indicate shock and inadequate organ perfusion.

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