Nokea
The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which intravenous solution is correct for use with the PRBC transfusion?
- A. 5% dextrose in water (D5W)
- B. 0.9% sodium chloride (NS)
- C. 5% dextrose in 0.45% sodium chloride (D5NS)
- D. 5% dextrose in lactated Ringer™s solution (D5LR)
Correct Answer: B
Rationale: 0.9% sodium chloride (NS), also known as normal saline, is the correct intravenous solution to use with packed red blood cell (PRBC) transfusion. NS is isotonic and compatible with blood products, making it the preferred solution for blood transfusions to prevent hemolysis of red blood cells. Other solutions such as D5W, D5NS, and D5LR are not recommended for use with PRBC transfusions due to their potential to cause hemolysis or affect the stability of the blood product.
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What should a patient avoid while taking Angiotensin-converting enzymes?
- A. Salt substitutes
- B. Foods high in potassium
- C. Foods high in sodium
- D. All of the above
Correct Answer: A
Rationale: Patients taking Angiotensin-converting enzyme (ACE) inhibitors should avoid salt substitutes because they can contain potassium chloride, which may lead to hyperkalemia. It is important to restrict potassium-rich foods while on ACE inhibitors, but the primary concern with salt substitutes is their potassium content.
A client is prescribed with carbamazepine (Tegretol) for the treatment of bipolar disorder. Which of the following laboratory results indicates that the client is experiencing a side effect of this medication?
- A. Neutrophil count of 1,200/mm3.
- B. Platelet count of 160,000/mm3.
- C. Uric acid level of 4mg/dl.
- D. SGPT (ALT) level 50 units per liter of serum.
Correct Answer: A
Rationale: Carbamazepine can cause leukopenia, including neutropenia, as a side effect. A neutrophil count of 1,200/mm3 is below the normal range and indicates a potential adverse effect. Platelet count, uric acid, and SGPT levels are within normal ranges and do not indicate side effects. Therefore, the neutrophil count is the concerning result.
A healthcare provider is caring for a client who has a new prescription for Epoetin Alfa. Which of the following laboratory values should the healthcare provider monitor?
- A. WBC count.
- B. Platelet count.
- C. Hemoglobin.
- D. Serum potassium.
Correct Answer: C
Rationale: Epoetin alfa is a medication that stimulates red blood cell production, so hemoglobin levels should be monitored to assess the effectiveness of the drug. Monitoring hemoglobin levels helps evaluate the response to Epoetin Alfa treatment and ensures that the client's anemia is being appropriately managed.
A client has a new prescription for Digoxin. Which of the following instructions should the nurse include?
- A. Increase your intake of bran fiber.
- B. Monitor your heart rate before taking the medication.
- C. Take the medication with antacids.
- D. Avoid drinking orange juice.
Correct Answer: B
Rationale: When a client is prescribed Digoxin, it is essential to monitor their heart rate before each dose. Changes such as a heart rate below 60 bpm should be reported to the healthcare provider promptly. This is crucial because Digoxin can affect heart rhythm, and monitoring the heart rate helps in identifying any potential issues early on.
A client has been prescribed Methotrexate to treat Rheumatoid Arthritis. Which of the following instructions should the nurse provide?
- A. Take this medication with food to prevent nausea.
- B. Avoid alcohol while taking this medication.
- C. Wear sunscreen when outdoors while taking this medication.
- D. Take this medication on an empty stomach.
Correct Answer: B
Rationale: Methotrexate is hepatotoxic, and avoiding alcohol is crucial to prevent liver damage. However, Option A (Take this medication with food to prevent nausea) could also be correct, as Methotrexate commonly causes nausea, and taking it with food can help alleviate this side effect. However, the most important instruction is to avoid alcohol due to the risk of liver toxicity.