Nokea
A client diagnosed with hemophagocytic lymphohistiocytosis requires multiple blood transfusions. One of his family members wishes to donate blood. Which of the following conditions would DISQUALIFY someone from donating blood?
- A. current medical condition of hyperthyroidism
- B. new mother, 10 weeks postpartum
- C. currently ill with common cold
- D. past medical history of tuberculosis; completed treatment and recovered 3 years ago
Correct Answer: C
Rationale: Current illness (e.g., cold) disqualifies blood donation due to infection risk. Hyperthyroidism, postpartum (after 6 months), and treated TB (if fully recovered) may not disqualify.
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A client is being treated for irritable bowel syndrome (IBS). The nurse knows that the involvement of nursing, pharmacy, gastroenterology, and nutritional services is an example of which of the following approaches?
- A. continuity of care
- B. multidisciplinary
- C. managed care
- D. case management
Correct Answer: B
Rationale: A multidisciplinary approach involves multiple specialties (nursing, pharmacy, gastroenterology, nutrition) collaborating to manage IBS.
The nurse recognizes all of the following as type IV hypersensitivity reactions EXCEPT
- A. allergic contact dermatitis.
- B. Crohn's disease.
- C. graft versus host disease.
- D. penicillin allergy.
Correct Answer: D
Rationale: Type IV hypersensitivity is cell-mediated (e.g., contact dermatitis, Crohn’s, GVHD). Penicillin allergy is typically type I (IgE-mediated).
The nurse must administer in one syringe a combined dose of two different insulins from two vials. Place the steps (Roman numerals) in the correct order.
- A. Cleanse tops of vials.
- B. Inject air into vial 1.
- C. Withdraw medication from vial 1.
- D. Change needles.
- E. Withdraw medication from vial 2.
- F. Inject air into vial 2.
Correct Answer: A,B,F,C,E
Rationale: The correct order is: Cleanse vials (I), inject air into vial 1 (II), inject air into vial 2 (VI), withdraw from vial 1 (III), withdraw from vial 2 (V). Changing needles (IV) is not standard.
The nurse is obtaining a history on a 74-year-old client. Which statement made by the client would alert the nurse to a possible fluid and electrolyte imbalance?
- A. My skin is always so dry.'
- B. I often use a laxative for constipation.'
- C. I have always liked to drink a lot of water.'
- D. I sometimes have a problem with dribbling urine.'
Correct Answer: B
Rationale: Frequent laxative use can cause fluid and electrolyte losses (e.g., potassium, sodium), leading to imbalances, unlike the other statements.
The nurse is working with an unlicensed assistive personnel (UAP). In planning the morning's care, which tasks can the nurse delegate to the UAP? Select all that apply.
- A. feeding a client who has lost the use of his hands
- B. starting an IV in a confused client who pulled her IV out
- C. assisting a stable and alert client up to the bedside commode
- D. checking an apical pulse in a client prior to administering digoxin
- E. ambulating a client in the hall for the first time since surgery to repair a fractured T5 vertebra
Correct Answer: A, C
Rationale: Feeding and assisting a stable client to the commode are within the UAP’s scope, while starting an IV, checking an apical pulse, and ambulating a post-surgical client require nursing judgment.