A nurse is assessing a client who is receiving a blood transfusion. The nurse notes lung crackles, hypoxia, and distended neck veins. Which of the following actions should the nurse take? (Select all that apply.)

Place the client in high-Fowler's position.

Administer oxygen to the client.

Stop the transfusion.

Obtain a prescription for a diuretic.

Administer epinephrine to the client.

Answer and Explanation

Correct Answer : A,B,C

A.   Placing the client in high Fowler's position helps improve lung expansion and oxygenation.
B.   Administering oxygen helps address hypoxia and supports adequate oxygenation.
C.   Stopping the transfusion is crucial when signs of a transfusion reaction are present.
D.   Administering a diuretic is not typically indicated for transfusion reactions involving lung crackles, hypoxia, and distended neck veins.
E.   Epinephrine is not typically used to manage a blood transfusion reaction; it's more for severe allergic reactions like anaphylaxis.

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Correct Answer is C

Explanation

A. Involving the supervisor for a temporary password might not be necessary when other options for password recovery are available.
B. Asking another nurse to document on behalf of the newly licensed nurse might lead to issues related to accountability and accuracy.
C. Providing contact information for password recovery assistance is the most appropriate action.
D. Sharing passwords compromises security and violates policies and should be avoided.

A. Assist the client into semi-Fowler's position. B. Give the client's medications between meals. C. Encourage the client to use a straw to take the medications. D. Administer the client's medications one at a time.

Correct Answer is D

Explanation

A. Assisting the client into a semi-Fowler's position might be beneficial but doesn't directly address dysphagia while taking medications.
B. Timing medications between meals isn't directly related to improving medication intake for someone with dysphagia.
C. Using a straw might not be recommended as it could increase the risk of aspiration.
D. Administering medications one at a time allows for better control and observation of swallowing ability and reduces the risk of aspiration.

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A nurse is assessing a client who is receiving a blood transfusion. The nurse notes lung crackles, hypoxia, and distended neck veins. Which of the following actions should the nurse take? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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