Advanced Oncology Certified Nurse Practitioner (AOCNP) Certification Practice Test

Which of the following patients is at higher risk for an IV contrast dye reaction?

1. A patient with normal renal function

2. A patient with a history of allergic reactions

3. A patient with a lymphocyte count of 15,000/m3

4. A patient with mild asthma

The correct answer is: A patient with a history of allergic reactions

A patient with a history of allergic reactions is at higher risk for an IV contrast dye reaction due to their previous experiences with allergens, which can sensitize their immune system. This sensitization may cause exaggerated responses when exposed to certain substances, including IV contrast media, which can lead to adverse reactions ranging from mild to severe. Individuals with prior allergic reactions are more likely to have an IgE-mediated response upon re-exposure to similar antigens, whether those are food items, medications, or contrast agents. This predisposition raises the likelihood of an allergic response occurring during or shortly after the administration of IV contrast dye. Other factors, such as asthma, do introduce some risk but are not as strongly correlated with allergic reactions to contrast agents as a documented history of allergies. While those with asthma may also experience reactions, the significant indicator of previous allergic reactions places those patients at a distinctly elevated risk. Thus, having a prior history of allergic reactions is a crucial factor in assessing risk for IV contrast reactions.