# For each medication reaction, indicate whether it suggests an allergy and whether it requires immediate emergency action. Select all that apply in each row.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=395666&lang=en  
> language: en  
> subject: Accident/Error/Injury Prevention  
> category: SIPC

## Question

For each medication reaction, indicate whether it suggests an allergy and whether it requires immediate emergency action. Select all that apply in each row.

|  | Suggests allergy | Requires immediate emergency action |
| --- | --- | --- |
| Generalized hives with wheezing minutes after intravenous penicillin |  |  |
| Mild nausea without rash or respiratory or cardiovascular findings after the first oral dose |  |  |
| Tongue swelling and hypotension after an antibiotic |  |  |
| Family history of a medication rash when the client has never had a reaction |  |  |
| Localized pruritic maculopapular rash after starting amoxicillin without airway, breathing, or circulation compromise |  |  |
| Isolated diarrhea after an oral antibiotic without skin, respiratory, or cardiovascular findings |  |  |

## Explanation

Generalized hives with wheezing and tongue swelling with hypotension are allergic patterns with respiratory or cardiovascular danger signs and require immediate emergency action. A localized pruritic rash can suggest a drug allergy but, without airway, breathing, or circulation compromise, does not by itself establish current anaphylaxis. Mild nausea, isolated diarrhea, and family history without a client reaction do not independently establish allergy or an emergency. Suspected anaphylaxis is treated promptly with intramuscular epinephrine under the emergency protocol.

## In-depth explanation

Correct Answer
Mark both columns for generalized hives with wheezing and for tongue swelling with hypotension. Mark allergy only for the localized pruritic rash. Mark neither column for isolated nausea, isolated diarrhea, or family history without a client reaction.

Why It Fits
Wheezing, tongue swelling, and hypotension are respiratory or cardiovascular danger signs after medication exposure. These findings require rapid anaphylaxis management, including intramuscular epinephrine according to protocol.

Clinical Picture
An allergy can be present without current anaphylaxis, as with a non-severe pruritic rash. Gastrointestinal adverse effects may represent intolerance, and a relative's reaction is not the client's documented allergy.

Memory Link
Skin plus breathing or circulation equals emergency until proven otherwise.

NCLEX Rule
Do not delay emergency treatment while waiting for every possible organ system to become involved. Match the complete cue pattern to current airway, breathing, and circulation risk.

Why the Alternatives Fail
Labeling all nausea or diarrhea as allergy creates inaccurate records. Treating family history as the client's reaction is also incorrect. Conversely, classifying wheezing with hives as nonemergent misses a potentially fatal progression.

Source
1CDC: Preventing and Managing Adverse Reactions
22026 NCLEX-RN Test Plan

## Clinical scenario

The nurse is reconciling medication reactions in an acute-care setting. Immediate emergency action means stop the suspected exposure, activate the emergency response, support airway and circulation, and give intramuscular epinephrine according to the emergency protocol when anaphylaxis is suspected.

## Key concepts

- **Medication allergy** — An immune-mediated reaction to a medication. Document the client's actual reaction pattern rather than recording an isolated adverse effect or family history as the client's allergy.
- **Anaphylaxis** — A rapidly progressive, potentially fatal systemic hypersensitivity reaction. Respiratory or cardiovascular compromise after a likely exposure requires immediate emergency action and intramuscular epinephrine according to protocol.
- **Medication intolerance** — A nonimmune adverse effect such as isolated nausea or diarrhea. Intolerance should be assessed and documented accurately but is not automatically an allergy or anaphylaxis.

## Related questions

- [A circulating nurse leads the final time-out for an operative procedure. Complete the safe…](https://mymerci.kr/pages/nclex_q.php?qn_id=393372&lang=en)
- [Review the client's changing fall risk during the shift and select the prevention plan tha…](https://mymerci.kr/pages/nclex_q.php?qn_id=393501&lang=en)
- [An older adult who is confused at night repeatedly tries to get out of bed without assista…](https://mymerci.kr/pages/nclex_q.php?qn_id=393729&lang=en)
- [A client begins having a generalized seizure while in bed. Place the nursing actions in th…](https://mymerci.kr/pages/nclex_q.php?qn_id=393871&lang=en)
- [An older adult is confused and attempts to get out of bed without help. Which intervention…](https://mymerci.kr/pages/nclex_q.php?qn_id=394163&lang=en)
- [An older adult is hospitalized after a near fall. For each cue or intervention, select the…](https://mymerci.kr/pages/nclex_q.php?qn_id=396165&lang=en)
- [Place the nursing actions in order after finding an anticoagulated older adult on the floo…](https://mymerci.kr/pages/nclex_q.php?qn_id=396383&lang=en)
- [A sealed source from a client's temporary low-dose-rate brachytherapy implant becomes disl…](https://mymerci.kr/pages/nclex_q.php?qn_id=397159&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=395666&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=395666&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=395666&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=395666&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=395666&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._