Nokea
The nurse working in the bloodmobile is screening clients to determine if they qualify for blood donation of whole blood. Besides asking for identification and age, which questions should the nurse ask during the screening interview?
- A. “If you have a tattoo, on what date did you receive the tattoo?”
- B. “Have you had any close contact with anyone with HIV or hepatitis?”
- C. “If you smoke, when was the last time you smoked tobacco products?”
- D. “When were you last immunized for rubella, mumps, or varicella?”
- E. “Did you receive blood products anywhere outside of the United States?”
Correct Answer: A, B, D, E
Rationale: Persons ineligible to donate blood include those with a history of a recent tattoo. B. Persons ineligible to donate blood include those who’ve had close contact with a person with HIV or hepatitis. C. Persons who smoke tobacco products may donate blood unless they have a recent history of asthma. D. Persons ineligible to donate blood include those immunized for rubella, mumps, or varicella within the last month. E. Persons ineligible to donate blood include those receiving transfusions in the United Kingdom, Gibraltar, or the Falkland Islands because of the increased likelihood of transmitting Creutzfeldt-Jakob disease.
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The nurse writes a diagnosis of 'potential for fluid volume deficit related to bleeding' for a client diagnosed with disseminated intravascular coagulation (DIC). Which would be an appropriate goal for this client?
- A. The client’s clot formations will resolve in two (2) days.
- B. The saturation of the client’s dressings will be documented.
- C. The client will use lemon-glycerin swabs for oral care.
- D. The client’s urine output will be greater than 30 mL per hour.
Correct Answer: D
Rationale: DIC risks bleeding/fluid loss; urine output >30 mL/hr (D) indicates adequate volume. Clot resolution (A) is unrealistic, dressing saturation (B) is an intervention, and swabs (C) are unrelated.
The nurse has been teaching the parents of a child with hemophilia about the care he will need. Which statement by the parents indicates a need for more instruction?
- A. If my child needs something for pain or a fever, I will give him acetaminophen instead of aspirin.'
- B. I will take my child to the dentist for regular checkups.'
- C. I will keep my child in the house most of the time.'
- D. My son's Medic Alert Bracelet arrived.'
Correct Answer: C
Rationale: Overprotecting the child by keeping him indoors most of the time prevents normal development. Acetaminophen, dental care, and a Medic Alert bracelet are appropriate.
The client is diagnosed with chronic myeloid leukemia and leukocytosis. Which signs/symptoms would the nurse expect to find when assessing this client?
- A. Frothy sputum and jugular vein distention.
- B. Dyspnea and slight confusion.
- C. Right upper quadrant tenderness and nausea.
- D. Increased appetite and weight gain.
Correct Answer: B
Rationale: CML with leukocytosis causes fatigue, dyspnea, and confusion (B) from hyperviscosity. Sputum/JVD (A) suggest heart failure, RUQ/nausea (C) suggest liver issues, and appetite/weight gain (D) are unlikely.
The client diagnosed with sickle cell anemia comes to the emergency department complaining of joint pain throughout the body. The oral temperature is 102.4°F and the pulse oximeter reading is 91%. Which action should the emergency department nurse implement first?
- A. Request arterial blood gases STAT.
- B. Administer oxygen via nasal cannula.
- C. Start an IV with an 18-gauge angiocath.
- D. Prepare to administer analgesics as ordered.
Correct Answer: B
Rationale: SpO2 91% and fever suggest hypoxia in SCA crisis; oxygen via cannula (B) addresses this first. ABGs (A), IV (C), and analgesics (D) follow to confirm hypoxia, hydrate, and manage pain.
The client receiving a unit of PRBCs begins to chill and develops hives. Which action should be the nurse’s first response?
- A. Notify the laboratory and health-care provider.
- B. Administer the histamine-1 blocker, Benadryl, IV.
- C. Assess the client for further complications.
- D. Stop the transfusion and change the tubing at the hub.
Correct Answer: D
Rationale: Chills/hives suggest a transfusion reaction; stopping the transfusion at the hub (D) prevents further reaction. Assessment (C), Benadryl (B), and notification (A) follow.