The nurse is preparing to start a transfusion of packed red blood cells for a client with a hemoglobin of 5.4 g/dL. (normal Female: 11.7-15.5 g/dL; Male: 14-17.3 g/dL). Which IV site should the nurse use?

20-gauge catheter in the right wrist infusing IV antibiotics

18-gauge catheter infusing 20 mEq Potassium Chloride IV

22-gauge catheter in the left forearm infusing 0.9% Normal Saline

20-gauge catheter in the right forearm infusing 0.9% Normal Saline

Answer and Explanation

The Correct Answer is D

A.   The 20-gauge catheter in the right wrist is not ideal for blood transfusions, as wrist veins are smaller and may be less optimal for high-flow transfusions.
B.   An 18-gauge catheter is appropriate for blood transfusions, but the catheter is currently in use for potassium chloride, which would need to be discontinued. The best choice is a separate site.
C.   A 22-gauge catheter is not large enough for blood transfusion; it may cause hemolysis or slow the transfusion rate.
D.   The 20-gauge catheter in the right forearm is an appropriate size for a blood transfusion and is currently infusing normal saline, which does not interfere with the blood transfusion.

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Correct Answer is A

Explanation

A. Cyanosis, or a bluish discoloration of the skin, occurs when there is insufficient oxygen in the blood, which can result from decreased perfusion due to clotting in DIC. It is a sign of poor oxygenation and perfusion.
B. While petechiae (small red or purple spots) are a common manifestation of DIC due to microvascular clotting and bleeding, they are not a sign of decreased perfusion.
C. Epistaxis (nosebleeds) is another bleeding manifestation of DIC but is not indicative of decreased perfusion, which is more closely related to cyanosis.
D. Hematuria (blood in the urine) can occur in DIC due to clotting in the kidneys or urinary tract. However, it is more related to bleeding than to decreased perfusion.

A. prepare to place the client in a single room. B. ask the client if they wish to speak to a spiritual advisor. C. explore the possibility of suicidal thoughts with the client. D. explain to the client that they will not die for a long time.

Correct Answer is C

Explanation

A. While privacy may be important for a patient who is emotionally distressed, the priority is addressing
the client’s emotional state, not the physical environment.
B. This might be helpful later, but the priority is to explore the patient's feelings and concerns regarding their condition first. Immediate emotional support is more important at this stage.
C. When a patient expresses feelings of hopelessness, as in this case, the nurse must assess for potential suicidal ideation. This is a priority to ensure patient safety and to provide necessary psychological support or intervention.
D. While reassurance is important, providing false or unrealistic expectations can lead to further disappointment. The nurse should focus on addressing emotional distress and offering realistic support rather than giving definitive assurances.

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The nurse is preparing to start a transfusion of packed red blood cells for a client with a hemoglobin of 5.4 g/dL. (normal Female: 11.7-15.5 g/dL; Male: 14-17.3 g/dL). Which IV site should the nurse use?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client diagnosed with disseminated intravascular coagulation (DIC). When completing an assessment for decreased perfusion from clotting, the nurse would observe for which manifestation?

Correct Answer is A

Explanation

The physician has just informed a client with advanced heart failure that a left ventricular assist device (LVAD) will be needed. The client is crying and says to the nurse, "I just know that I am going to die. What's the point of treatment?" The priority nursing action is to:

Correct Answer is C

Explanation

The nurse is caring for a client in the coronary care unit and the monitor depicts the rhythm shown below. What is the nurse’s interpretation of this rhythm?

When using an ECG rhythm strip to quickly estimate the ventricular rate for a client, the nurse should:

The nurse is preparing to start a transfusion of packed red blood cells for a client with a hemoglobin of 5.4 g/dL. (normal Female: 11.7-15.5 g/dL; Male: 14-17.3 g/dL). Which IV site should the nurse use?

The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?

The nurse is caring for a client receiving a heparin infusion for disseminated intravascular coagulation (DIC). Which of the following lab results would indicate a sub-therapeutic level? An activated partial thromboplastin time (aPTT) of :……. (normal value: 25-35 seconds)

Upon assessment of the client's lungs, the nurse hears continuous, high-pitched, musical sounds. This should be documented as:

Which physical assessment findings would the nurse anticipate for a client with rapid atrial flutter?

The nurse is performing an admission assessment of an older adult client with a history of chronic heart failure. The client exhibits +2 pitting edema of the ankles and bibasilar crackles. Based on these findings what action should the nurse take next?