The nurse practitioner is caring for a 54-year-old male patient with a hemoglobin level of 4.4 who is ordered to receive 5 units of packed red blood cells. To avoid transfusion-associated circulatory overload (TACO), all but which one of the following actions are correct?
Administer supplemental oxygen to aid the patient’s breathing
Transfuse the blood quickly to avoid fatigue
Administer furosemide 20 mg intravenously in between each unit
Monitor the patient for signs and symptoms of hypoxia, edema, and fever
The Correct Answer is B
Choice A reason: Administering supplemental oxygen can support oxygenation in patients receiving transfusions and help manage symptoms of hypoxia, which may reduce the risk of complications.
Choice B reason: Rapid transfusion increases the risk of circulatory overload (TACO), particularly in patients with low hemoglobin and possible compromised cardiac function. Slower, controlled transfusion is recommended.
Choice C reason: Administering furosemide between units can help prevent fluid overload by promoting diuresis, especially in patients receiving multiple transfusions.
Choice D reason: Monitoring for signs of hypoxia, edema, and fever is essential to detect TACO or other transfusion reactions early, allowing timely intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is correct; most low back pain is nonspecific and does not require imaging unless there are red flags.
Choice B reason: Imaging may be indicated if pain persists despite conservative management or if there are neurologic deficits, making this statement accurate.
Choice C reason: Combining cognitive behavioral therapy with physical therapy is evidence-based and effective in improving outcomes for chronic low back pain.
Choice D reason: This is incorrect. Opioids are not first-line treatment due to risks of dependence, overdose, and limited efficacy. First-line management emphasizes non-pharmacologic strategies and non-opioid medications.
Correct Answer is C
Explanation
Choice A reason: Desensitization focuses on processing and reducing the emotional distress associated with traumatic memories, not on body scanning.
Choice B reason: Installation involves strengthening positive beliefs about the self while recalling the traumatic memory, but it does not include scanning the body for tension.
Choice C reason: This is correct. The body scan phase instructs the client to visualize the traumatic memory and a positive belief while identifying areas of residual tension or discomfort, integrating physical and emotional processing.
Choice D reason: Closure is the phase in which the client returns to a calm state at the end of the session, not performing body scans.
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