A charge nurse is precepting a newly licensed nurse who is to administer a transfusion of packed red blood cells (PRBC) to a client who has anemia. Which of the following actions by the new nurse should cause the charge nurse to intervene in this client's care immediately?
The nurse stays with the client for 15 minutes after beginning the transfusion.
The nurse primes the blood tubing with lactated ringers.
The nurse starts the infusion at a slow rate for the first 15 minutes.
The nurse witnesses the client sign the consent form for the blood transfusion.
The Correct Answer is B
A. The nurse stays with the client for 15 minutes after beginning the transfusion:
This action is appropriate as it ensures the nurse monitors the client closely for any immediate adverse reactions during the initial phase of the transfusion.
B. The nurse primes the blood tubing with lactated Ringer's solution:
This action is incorrect and potentially dangerous. Blood tubing should be primed with normal saline (0.9% sodium chloride) solution, not lactated Ringer's solution, to prevent potential adverse reactions or hemolysis of the blood products.
C. The nurse starts the infusion at a slow rate for the first 15 minutes:
This action is appropriate as it allows for the initial assessment of the client's tolerance to the transfusion and reduces the risk of adverse reactions.
D. The nurse witnesses the client sign the consent form for the blood transfusion:
This action is appropriate and ensures that the client has provided informed consent for the procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Take the iron with dairy products to enhance absorption: This statement is incorrect. Calcium-rich foods, such as dairy products, can inhibit iron absorption. It's recommended to take iron supplements with vitamin C-rich foods or beverages to enhance iron absorption.
B. Limit foods high in fiber due to the risk for diarrhea: While some individuals may experience gastrointestinal side effects such as constipation or diarrhea when taking iron supplements, it is not generally recommended to limit foods high in fiber. Adequate fiber intake is important for overall digestive health.
C. Increase the intake of vitamin E to enhance absorption: Vitamin E does not directly enhance iron absorption. Vitamin C is the nutrient that enhances iron absorption, so increasing intake of vitamin C-rich foods or taking vitamin C supplements along with iron supplements can improve iron absorption.
D. Iron will cause the stools to darken in color: This statement is correct. Iron supplements can cause stools to become dark or even black in color. This is a harmless side effect known as "iron stools" and is caused by the reaction of iron with substances in the digestive tract.
Correct Answer is D
Explanation
A. Ribs: Ribs are not typically used for bone marrow aspiration procedures due to the difficulty of accessing bone marrow in this area.
B. Humerus: While bone marrow aspiration can technically be performed in the humerus (upper arm bone), it is not commonly used as a primary site because other sites like the iliac crest offer easier access and a larger volume of bone marrow.
C. Femur: The femur (thigh bone) is a potential site for bone marrow aspiration, especially in certain situations or specific patient populations. However, it is less commonly used compared to the iliac crest.
D. Iliac crest: The iliac crest is a primary site for bone marrow aspiration due to its accessibility, the relatively low risk of complications, and the ability to obtain an adequate sample of bone marrow for diagnostic purposes.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.