Nokea
A client is to have a transfusion of packed red blood cells from a designated donor. The client asks if any diseases can be transmitted by this donor. The nurse should inform the client that which of the following diseases can be transmitted by a designated donor? Select all that apply.
- A. Epstein-Barr virus.
- B. Human immunodeficiency virus (HIV).
- C. Cytomegalovirus (CMV).
- D. Hepatitis A.
- E. Malaria.
Correct Answer: B,C,E
Rationale: Blood transfusions, even from designated donors, carry a risk of transmitting certain diseases. HIV, CMV, and malaria are known to be transmissible through blood transfusions if the donor is infected, as these pathogens can persist in blood. Epstein-Barr virus is less commonly associated with transfusion transmission, and hepatitis A is primarily transmitted via the fecal-oral route, not blood. The nurse should inform the client of the risks of HIV, CMV, and malaria.
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The nurse in the emergency department is administering an order for 20 mg intravenous furosemide (Lasix) which is to be given immediately. The nurse seems the client's identification and the medication barcode. The medication administration system does not verify that furosemide is ordered for this client; however, the furosemide is prepared in the accurate unit dose for intravenous infusion. The nurse should do which of the following next?
- A. Contact the pharmacist immediately to check the order and the barcode label for accuracy.
- B. Administer the medication now, knowing the medication is labeled and the client is identified.
- C. Report the problem to the information technology team to have the barcode system recalibrated.
- D. Ask another nurse to verify the medication and the client so the medication can be given now.
Correct Answer: A
Rationale: A barcode verification failure indicates a potential error, requiring immediate pharmacist consultation to confirm the order and ensure patient safety.
The nurse is caring for a client prescribed amphotericin b for a systemic fungal infection. The nurse should anticipate a prescription for which medication before the infusion? Select all that apply
- A. Diphenhydramine
- B. Acetaminophen
- C. 0.9% saline bolus
- D. Regular insulin
- E. Sodium bicarbonate
Correct Answer: A,B,C
Rationale: Amphotericin B infusions can cause infusion reactions and nephrotoxicity. Choice A (diphenhydramine) and Choice B (acetaminophen) are given to prevent infusion reactions like fever and chills. Choice C (0.9% saline bolus) helps protect the kidneys by ensuring adequate hydration. Choice D (insulin) and Choice E (sodium bicarbonate) are not routinely used.
Which of the following positions would be appropriate for a client with severe ascites?
- A. Fowler's.
- B. Side-lying.
- C. Reverse Trendelenburg.
- D. Sims.
Correct Answer: A
Rationale: Fowler's position (A) elevates the head, reducing diaphragm pressure from ascites and improving breathing. Side-lying (B), Reverse Trendelenburg (C), and Sims (D) are less effective for respiratory relief.
The nurse is preparing a client for a paracentesis. The nurse should:
- A. Have the client void immediately before the procedure.
- B. Place the client in a side-lying position.
- C. Initiate an I.V. line to administer sedatives.
- D. Place the client on nothing-by-mouth (NPO) status 6 hours before the procedure.
Correct Answer: A
Rationale: Voiding before paracentesis (A) prevents bladder injury. Side-lying (B) is incorrect; upright is preferred. IV sedatives (C) are not routine, and NPO (D) is unnecessary.
The nurse is planning care for a client who is diagnosed with peripheral vascular disease (PVD) and has a history of heart failure. The nurse should develop a plan of care that is based on the fact that the client may have a low tolerance for exercise related to:
- A. Decreased blood flow
- B. Increased blood flow
- C. Increased blood viscosity
- D. Increased blood viscosity
Correct Answer: A
Rationale: In PVD, decreased blood flow to the extremities limits oxygen delivery to muscles, reducing exercise tolerance. In heart failure, reduced cardiac output further exacerbates this limitation, as the heart cannot meet increased oxygen demands during activity. Increased blood flow or viscosity is not relevant, and the options are repeated incorrectly in the document.