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Practice Test - Epinephrine Question

Stephanie Rossi, IL-PEL CSN, M.S.N., NCSN, RN, DNP

Stephanie Rossi, IL-PEL CSN, M.S.N., NCSN, RN, DNP07-19-2023 09:50 PM

  • 1.  Practice Test - Epinephrine Question

    Posted 07-19-2023 09:11 PM
    Edited by Taria Lee 01-02-2026 09:07 AM

    .



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    Taria Lee
    Pembroke Pines, FL United States
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  • 2.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 09:28 PM
    Depending on what the other options are, I would say this one is an err on the side of caution.  It's not gonna do any harm to administer the epi even if it's not a reaction. 





  • 3.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 09:39 PM
    You need to tell me the question #

    Sent from my iPhone
    Pat Krin





  • 4.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 09:44 PM

    Its test 2, question 65....



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    Taria Lee
    Pembroke Pines, FL United States
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  • 5.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 09:43 PM

    I think there are other more suitable options but I don't know if I can go into further details. I also find the question interesting because there was a similar question in the review book where a student with a history of strawberry allergies admits to eating a strawberry and complains of "throat and mouth itching" and one of the responses was to administer epinephrine however it wasn't the correct answer choice. I think further observation and assessment would be necessary before administering epinephrine. I would have to assume that the child ate peanuts and that is the reason they are nauseous and diaphoretic.



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    Taria Lee
    Pembroke Pines, FL United States
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  • 6.  RE: Practice Test - Epinephrine Question

    Posted 07-20-2023 11:16 AM

    So, when you are answering the questions (or statements) you have to choose from the choices you have.

    I am going to put the questions and choices here ( It's all right if I do it) so that we can discuss. There has been a lot of good discussion about this so feel free to continue, this is how we learn. So anyone who is interested feel free to chose your answer and support your decision. I will comment tomorrow.

    A student allergic to peanuts starts to feel ill, complains of nausea, and is diaphoretic. Which of the following should be done?
    A) Call parent.
    B) Check vital signs.
    C) Offer fluids and observe.
    D) Give epinephrine and call 9-1-1.


    Warm regards,

     

    Pat

     

    Pat Krin, MSN, MS, RN, FNP-BC-Retired, NCSN-E, FNASN

    Executive Director

    NBCSN

    nbcsnexec@nbcsn.org

    www.nbcsn.org

     






  • 7.  RE: Practice Test - Epinephrine Question

    Posted 07-21-2023 08:34 AM
    Edited by Bernadette Berset, MSN, RN, NCSN 07-21-2023 09:17 AM

    Answer D.

    I would class the listed symptoms as two distinct body systems which would trigger administering the epinephrine auto injector immediately and calling 911. 
    The FARE (Food Allergy Research & Education) allergy action plan's algorithm states "for mild symptoms from more than one system area, give epinephrine". 
    Best,



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    Bernadette Berset, MSN, RN, NCSN
    Certified School Nurse
    Vienna, VA.
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  • 8.  RE: Practice Test - Epinephrine Question

    Posted 07-21-2023 08:54 AM

    My answer is A (call parents). 

    The student is allergic to peanuts but is not having an anaphylaxis reaction-no difficulty breathing, swelling, or other symptoms that would warrant administering EpiPen.



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    Africa Thomas, MSN, RN
    Fort Eisenhower, GA
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  • 9.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 09:50 PM
    Hi! 

    My understanding is you would administer Epi because two body systems are affected and they are declining overall. That is enough. Remember, they can die if you don't give it but you loose nothing by giving it! Give the Epi.

    Hope that makes sense. 

    Stephanie 





  • 10.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 09:59 PM

    Would you consider nausea and diaphoresis to be an indication of decline or life threatening? Maybe epinephrine would be needed after further assessment? Maybe I'm reading too much into the question. 



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    Taria Lee
    Pembroke Pines, FL United States
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  • 11.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 10:19 PM
    I just know after listening to the review and looking at the question that what they're looking for is give the Epi. My friends child died because Epi was delayed - so I'm understandably sensitive to this. That's my full disclosure. ❤️






  • 12.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 10:23 PM
    Nausea and diaphoresis are both symptoms of a severe allergic reaction.  Diaphoresis is also a sign of shock, which is life threatening.  One purpose of epinephrine is to prevent anaphylaxis and death from anaphylaxis.  

    On Wed, Jul 19, 2023 at 9:19 PM "Stephanie Rossi, M.S.N., B.S. Nursing, DNP candidate, CSN-IL, CSN/P via" National Association of School Nurses <Mail@connectedcommunity.org> wrote:
    I just know after listening to the review and looking at the question that what they're looking for is give the Epi. My friends child died because...

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    Re: Practice Test - Epinephrine Question
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    Jul 19, 2023 10:19 PM
    Stephanie Rossi, M.S.N., B.S. Nursing, DNP candidate, CSN-IL, CSN/P
    I just know after listening to the review and looking at the question that what they're looking for is give the Epi. My friends child died because Epi was delayed - so I'm understandably sensitive to this. That's my full disclosure. ❤️



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    Original Message:
    Sent: 7/19/2023 10:19:00 PM
    From: Stephanie Rossi, M.S.N., B.S. Nursing, DNP candidate, CSN-IL, CSN/P
    Subject: RE: Practice Test - Epinephrine Question

    I just know after listening to the review and looking at the question that what they're looking for is give the Epi. My friends child died because Epi was delayed - so I'm understandably sensitive to this. That's my full disclosure. ❤️




    Original Message:
    Sent: 7/19/2023 9:59:00 PM
    From: Taria Lee
    Subject: RE: Practice Test - Epinephrine Question

    Would you consider nausea and diaphoresis to be an indication of decline or life threatening? Maybe epinephrine would be needed after further assessment? Maybe I'm reading too much into the question. 



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    Taria Lee
    Pembroke Pines, FL United States
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    Original Message:
    Sent: 07-19-2023 21:49
    From: Stephanie Rossi, M.S.N., B.S. Nursing, DNP candidate, CSN-IL, CSN/P
    Subject: Practice Test - Epinephrine Question

    Hi! 

    My understanding is you would administer Epi because two body systems are affected and they are declining overall. That is enough. Remember, they can die if you don't give it but you loose nothing by giving it! Give the Epi.

    Hope that makes sense. 

    Stephanie 



    Original Message:
    Sent: 7/19/2023 9:11:00 PM
    From: Taria Lee
    Subject: Practice Test - Epinephrine Question

    I just completed practice test 2 and I am not so sure about one of the questions and answer (I am not sure if I am allowed to state the question number). The question is about a student that has a peanut allergy that reports nausea and is diaphoretic. No other signs or symptoms are provided in the question. I am not sure why the correct response would be to administer epinephrine and immediately call 911 if those are the only two symptoms. If I am answering the question solely based on the two symptoms of nausea and being diaphoretic and in the absence of more serious S/S such as dyspnea, chest or throat tightness, or facial swelling etc, then my first response would not be to administer epinephrine simply because the student has a known allergy to peanut.

    Can anyone weigh in on this, please?



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    Taria Lee
    Pembroke Pines, FL United States
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  • 13.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 10:26 PM
    The following is an excerpt from the Mayo Clinic:

    "Symptoms

    An allergic response to peanuts usually occurs within minutes after exposure. Peanut allergy signs and symptoms can include:

    • Skin reactions, such as hives, redness or swelling
    • Itching or tingling in or around the mouth and throat
    • Digestive problems, such as diarrhea, stomach cramps, nausea or vomiting
    • Tightening of the throat
    • Shortness of breath or wheezing
    • Runny nose

    Anaphylaxis: A life-threatening reaction

    Peanut allergy is the most common cause of food-induced anaphylaxis, a medical emergency that requires treatment with an epinephrine (adrenaline) autoinjector (EpiPen, Auvi-Q, others) and a trip to the emergency room.

    Anaphylaxis signs and symptoms can include:

    • Constriction of airways
    • Swelling of the throat that makes it difficult to breathe
    • A severe drop in blood pressure (shock)
    • Rapid pulse
    • Dizziness, lightheadedness or loss of consciousness"





  • 14.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 10:48 PM
    Edited by Taria Lee 07-19-2023 10:50 PM

    I got the question wrong because I think further assessment is necessary. Nausea is a presenting symptom of many health conditions. So is diaphoresis. I am responding to the question as it is written. I am trying not to assume anything that is not stated in the question. My thinking is that because the student has a known allergy to peanuts and is nauseous and diaphoretic that doesn't automatically mean anaphylaxis which is why further assessment would be necessary (in my mind). The question doesn't state that the student ate the peanut or even had contact. It just states that the student has a peanut allergy. Now if the question stated that the student presented with s/s such as rapid pulse, swelling, SOB, chest tightness, throat itching, etc, then sure. I just don't think nausea and diaphoresis are specific enough. 



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    Taria Lee
    Pembroke Pines, FL United States
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  • 15.  RE: Practice Test - Epinephrine Question

    Posted 07-19-2023 11:01 PM
    I completely understand that standpoint! 






  • 16.  RE: Practice Test - Epinephrine Question

    Posted 07-20-2023 10:34 AM
    Diaphoresis is a sign of shock. "Shock is wet" according to Janice. Lol (That is a quote from the on-line corse.) 





  • 17.  RE: Practice Test - Epinephrine Question

    Posted 07-21-2023 03:58 PM
    Edited by Taria Lee 07-21-2023 03:58 PM

    Thanks for all the feedback on this. I appreciate the different approach and point of view. What I would do in the real world is different from in a test situation. 



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    Taria Lee
    FL United States
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  • 18.  RE: Practice Test - Epinephrine Question

    Posted 07-21-2023 07:33 PM
    Taria, I am not sure if you were at any if the most recent retake meetings but my take home message from that was 2 things-breathe and stay out of the real world. You have to choose from the 4 choices based on what the question is asking. Forget what you would do in the real world. Just consider the 4 choices you are given.

    Sent from my iPhone
    Pat Krin




  • 19.  RE: Practice Test - Epinephrine Question

    Posted 07-21-2023 10:01 PM

    Pat, thank you for your feedback on this and for being such a great resource. This was my first time taking the exam so I haven't been to a retake meeting. I took the exam this morning and passed. Such a relief.



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    Taria Lee
    Pembroke Pines, FL United States
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  • 20.  RE: Practice Test - Epinephrine Question

    Posted 07-22-2023 07:44 AM
    So glad you passed. Best of luck in the future.

    Sent from my iPhone
    Pat Krin