The nurse is performing the safety checks prior to initiating a packed red blood cell transfusion for a patient whose blood type is A positive. The nurse observes the unit is AB negative. What is the nurse's best first action?

Call the blood bark

Initiate the transfusion

Take and record the patients vital signs

Notify the physician

Answer and Explanation

The Correct Answer is A

A. The first action should be to call the blood bank to report the mismatch in blood type. The patient is A positive, and the blood unit is AB negative, which is not compatible and could lead to a serious transfusion reaction. The blood bank can provide the correct unit of blood.
B. Initiating the transfusion with the wrong blood type is dangerous and could cause a life-threatening reaction.
C. Taking and recording vital signs is important but should only occur after confirming the correct blood product. Starting a transfusion with the wrong blood is a safety hazard.
D. While notifying the physician is important, the immediate action is to contact the blood bank to resolve the blood type mismatch.

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Correct Answer is A

Explanation

A. Tanning beds significantly increase the risk of developing skin cancer, particularly melanoma. The UV radiation from tanning beds is a known carcinogen, and frequent use can damage the skin's DNA, leading to an increased risk of skin cancer. This individual is at high risk and should definitely follow up for skin cancer screenings.
B. While freckles can be a sign of sun exposure, they are not necessarily indicative of a higher risk of skin cancer. However, it is important for this individual to monitor for any changes in freckles (such as size, shape, or color) and to perform regular self-exams.
C. While sun exposure should be minimized, the risk of skin cancer is lower at 8 AM when UV rays are less intense. That said, the individual should still take precautions like wearing sunscreen and protective clothing, but their risk is not as elevated as that of someone using tanning beds.
D. Tanning sprays do not expose the skin to harmful UV radiation, so they do not increase the risk of skin cancer. However, it's important to note that this individual should still be mindful of overall skin health.

A. D-dimer fibrinogen and fibrin degradation products B. Complete blood count, platelets and prothrombin time C. Prothrombin time fibrin level and D-dimer D. Fibrin degradation products, lactic acid and complete blood count

Correct Answer is A

Explanation

A. The diagnostic workup for disseminated intravascular coagulation (DIC) typically includes the measurement of D-dimer, fibrinogen, and fibrin degradation products. D-dimer levels are elevated in DIC due to increased fibrin breakdown, and fibrinogen levels are usually decreased due to consumption. Fibrin degradation products (FDPs) are also elevated in DIC and provide evidence of abnormal clotting and fibrinolysis.

B. While a complete blood count (CBC) and platelet count are part of the evaluation of DIC, they are not sufficient on their own to confirm the diagnosis. The prothrombin time (PT) is helpful but does not provide the most specific information regarding fibrinolysis and clot breakdown, which are crucial in diagnosing DIC.

C. While prothrombin time (PT) and D-dimer are useful in the diagnosis of DIC, fibrin level is not a standard test. The focus is generally on fibrinogen and fibrin degradation products (FDPs) rather than fibrin levels.

D. Although fibrin degradation products and a complete blood count are part of the evaluation, lactic acid is not typically a key test in diagnosing DIC. Lactic acid levels may rise in conditions associated with hypoperfusion or shock but do not specifically diagnose DIC.

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The nurse is performing the safety checks prior to initiating a packed red blood cell transfusion for a patient whose blood type is A positive. The nurse observes the unit is AB negative. What is the nurse's best first action?

Nursing Test Bank

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