A nurse is preparing to administer 2 units of packed RBCs to a client.

Which of the following actions should the nurse take?

Transfuse each unit of blood over 5 hr.

Change the IV tubing after each unit of blood is transfused.

Prime the tubing with 0.9% sodium chloride.

Administer the blood through a 22-gauge intravenous catheter.

Answer and Explanation

The Correct Answer is C

When administering packed RBCs, the tubing should be primed with 0.9% sodium chloride.
Transfusing each unit of blood over 5 hours (choice A) is not recommended as it may increase the risk of bacterial growth.
Packed RBCs should be transfused over 2 to 3 hours.
Changing the IV tubing after each unit of blood is transfused (choice B) is not necessary.
Administering the blood through a 22-gauge intravenous catheter (choice D) may not be appropriate as a larger gauge catheter is typically used for blood transfusions.

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Correct Answer is C

Explanation

Step 1: 100 mL ÷ 30 min

Step 2: (100 mL ÷ 30 min) × 60 min/hr

Step 3: 3.33 mL/min × 60 min/hr

Answer: 200 mL/hr

A. Apply an occlusive dressing. B. Turn and reposition the client every 4 hr. C. Support bony prominences with pillows. D. Massage the reddened areas three times daily.

Correct Answer is C

Explanation

The nurse should include this intervention in the plan of care because it can help relieve pressure on the reddened areas over the client’s bony prominences and prevent the development of pressure injuries.
Choice A is incorrect because applying an occlusive dressing to intact skin over bony prominences is not an appropriate intervention for preventing pressure injuries.
Choice B is incorrect because turning and repositioning the client every 4 hours may not be frequent enough to prevent the development of pressure injuries.
The client should be turned and repositioned more frequently, at least every 2 hours.
Choice D is incorrect because massaging reddened areas over bony prominences is not recommended as it can cause further damage to the skin and underlying tissues.

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A nurse is preparing to administer 2 units of packed RBCs to a client. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer piperacillin 3.375 g by intermittent IV bolus every 6 hr. Available in piperacillin 3.375 g in dextrose 5% in water (DsW) 100 mL to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr?

Correct Answer is C

Explanation

A nurse is completing an assessment of an older adult client and notes reddened areas over the bony prominences, but the client's skin is intact. Which of the following interventions should the nurse include in the plan of care?

Correct Answer is C

Explanation

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A nurse is preparing to administer 2 units of packed RBCs to a client.

Which of the following actions should the nurse take?