Family Nurse Practitioner Exam

Which intervention is the most appropriate for a patient with pruritic hives and no difficulty swallowing or breathing?

1. Perform a complete and thorough history

2. Prescribe an oral antihistamine such as diphenhydramine 25 mg PO QID

3. Give an injection of epinephrine 1:1000 intramuscularly stat

4. Call 911

The correct answer is: Perform a complete and thorough history

Performing a complete and thorough history is the most appropriate initial intervention for a patient with pruritic hives who is experiencing no difficulty swallowing or breathing. This step is essential in understanding the potential triggers of the hives, identifying any recent exposures to allergens, medications taken, or underlying conditions. By gathering comprehensive information about the patient's symptoms, history of allergies, and any other relevant factors, the healthcare provider can make a more informed decision regarding the necessary treatment. In cases of hives, known as urticaria, it is crucial to assess whether the reaction is isolated or part of a more significant allergic response that could escalate. While prescribing an oral antihistamine could be helpful in managing the symptoms of hives, it is typically done after obtaining a complete patient history to ensure that there are no contraindications or underlying issues that require more immediate attention. Administering epinephrine or calling for emergency assistance is typically reserved for severe allergic reactions, such as anaphylaxis, or if the patient presents with respiratory distress, angioedema, or other alarming symptoms. Given that the patient is not experiencing difficulty with swallowing or breathing, these interventions would not be considered the most appropriate first step. Thus, gathering a thorough history remains paramount in the