The nurse is preparing for a blood transfusion. Which of the following would be contraindicated to include in the prep for the procedure?

Obtaining a primary and secondary tubing set

Ensuring another licensed personnel is available

Obtaining 0.9% normal saline solution

Checking ABO and Rh status of the donor and recipient

Answer and Explanation

The Correct Answer is B

A) Obtaining a primary and secondary tubing set:
The primary tubing is used for the intravenous access, and the secondary tubing is attached for administering the blood product. This ensures that the blood transfusion will be delivered effectively, and it is a standard practice to use proper IV tubing for blood products to avoid contamination or complications.

B) Ensuring another licensed personnel is available:
. While it is required that two licensed healthcare professionals verify the blood product before starting the transfusion, this action itself is not contraindicated, it is required. Both individuals should independently check the patient's identification, blood type, and the matching of the blood product before administration. Therefore, the answer to the question should not be about ensuring availability of licensed personnel as this is actually a required safety measure, not contraindicated. The actual contraindications involve actions like using inappropriate fluids for transfusion or mismatching blood.

C) Obtaining 0.9% normal saline solution:
This is appropriate and necessary when preparing for a blood transfusion. Normal saline (0.9%) is the only compatible solution that should be used to flush the IV line before and after the transfusion or to prime the blood tubing. Other solutions, such as lactated Ringer's, can cause clotting when mixed with blood, making saline the only appropriate choice.

D) Checking ABO and Rh status of the donor and recipient:
This is essential and mandatory before administering a blood transfusion. It is critical to ensure that the ABO blood group and Rh factor of the donor and recipient are compatible to prevent hemolytic reactions. This compatibility check must be done every time before administering a transfusion, and it is an integral part of ensuring patient safety.

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Correct Answer is ["7"]

Explanation

Given:

Desired dose: Amoxicillin 350 mg PO

Available concentration: Amoxicillin 250 mg/5 ml

To find:

Volume to administer (in ml)

Step 1: Set up the proportion

We can use the following proportion to solve the problem:

(Desired dose) / (Available concentration) = Volume to administer

Step 2: Substitute the values

Plugging in the given values, we get:

(350 mg) / (250 mg/5 ml) = Volume to administer

Step 3: Simplify

To simplify, we can invert the denominator and multiply:

(350 mg) x (5 ml / 250 mg) = Volume to administer

The "mg" units cancel out, leaving us with:

(350 x 5 ml) / 250 = Volume to administer

Step 4: Calculate

Performing the multiplication and division, we get:

1750 ml / 250 = Volume to administer

1 ml = Volume to administer

A. Sedate the client with PRN medications so they stay in bed B. Implement the bed alarm and call light system C. Ensure all four side rails on the bed are up D. Avoid night lights in the client's room to promote sleep

Correct Answer is B

Explanation

A. Sedate the client with PRN medications so they stay in bed:
Sedating a client to prevent movement is not an appropriate intervention for fall prevention. This approach could have adverse effects, such as increased confusion, sedation, and even a greater risk for falls once the medication wears off. It may also contribute to a decreased level of independence and quality of life for the client. Non-pharmacological interventions such as environmental modifications and supportive devices should be prioritized.

B. Implement the bed alarm and call light system:
Implementing a bed alarm and call light system is an effective and appropriate strategy to prevent falls in an older adult client. The bed alarm alerts the healthcare team when the client attempts to get out of bed, reducing the risk of falls. The call light allows the client to request assistance before attempting to move independently, ensuring timely support and reducing fall risk. This intervention promotes safety while maintaining the client’s autonomy.

C. Ensure all four side rails on the bed are up:
While side rails may prevent a client from falling out of bed, raising all four side rails can increase the risk of injury. Clients may try to climb over the rails, which can lead to entrapment or falls. In addition, side rails can create a false sense of security and reduce the client's ability to mobilize independently. A more appropriate measure would be using one or two side rails or providing assistance with repositioning or transferring when necessary.

D. Avoid night lights in the client's room to promote sleep:
Avoiding night lights is not advisable for older adults, particularly those at risk for falls. A dark environment can increase confusion and disorientation, leading to unsafe movements. Providing soft night lights in the room can enhance visibility during nighttime hours, reducing the likelihood of accidents and falls when the client needs to get up to use the bathroom or reposition. Adequate lighting is a key aspect of fall prevention.

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The nurse is preparing for a blood transfusion. Which of the following would be contraindicated to include in the prep for the procedure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many mL should the nurse administer? (Round to the nearest whole number.)

Correct Answer is ["7"]

Explanation

The nurse is caring for an older adult client who is at risk for falls. Which of the following interventions should be included in the plan of care for this client?

Correct Answer is B

Explanation

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