A client has a triple lumen subclavian central venous catheter (CVC) with D51/2NS infusing through one lumen (port) at 75 mL per hour. The nurse has an order to transfuse one unit of packed red blood cells (PRBCs). The nurse's safest action is to:

contact the prescriber to decrease the rate of the D51/2 NS during the blood transfusion

stop the D51/2NS, check the client's vitals & notify the prescriber.

Fluids cannot be given through a CVC.

Insert a 22 gauge peripheral IV to administer the transfusion

transfuse the unit of packed red blood cells through a separate lumen of the CVC

Answer and Explanation

The Correct Answer is E

A. contact the prescriber to decrease the rate of the D51/2NS during the blood transfusion: There's no need to alter the rate of maintenance fluids unless there's a fluid volume concern. Additionally, decreasing the rate would not address the need for a dedicated blood transfusion line if another lumen is available.

B. stop the D51/2NS, check the client's vitals & notify the prescriber: Stopping necessary fluids without cause may compromise fluid balance. Unless there's a compatibility issue or no other lumen, stopping the infusion is not the safest or most efficient action.

C. Fluids cannot be given through a CVC: Central venous catheters are routinely used for administering fluids, medications, and blood products, especially in critical care settings.

D. Insert a 22 gauge peripheral IV to administer the transfusion: While blood can be given through a peripheral IV, using an existing central venous catheter is safer and more efficient, especially when multiple lumens are available. Inserting a new IV unnecessarily increases infection and complication risks.

E. transfuse the unit of packed red blood cells through a separate lumen of the CVC: This is the safest and most appropriate action. Triple-lumen CVCs allow for simultaneous infusions through separate channels without mixing. Blood should be transfused through a dedicated lumen to avoid incompatibility or dilution by other fluids.

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Correct Answer is B

Explanation

A. Run of premature ventricular beats: While adenosine can occasionally provoke brief ventricular ectopy, this is not its primary or most expected effect. Premature ventricular contractions may occur transiently but are not the hallmark response to this medication.

B. Short period of asystole: Adenosine briefly blocks AV node conduction and can interrupt re-entry pathways, often resulting in a short period of asystole lasting a few seconds. This is an expected effect and reflects the drug’s mechanism in terminating supraventricular tachycardia by interrupting the reentrant pathway.

C. Brief seizure episode: Adenosine does not typically cause seizures. It acts primarily on cardiac tissue and has no significant pro-convulsant effects. A seizure would be an atypical and concerning adverse reaction rather than an expected response.

D. Dramatic increase in blood pressure: Adenosine causes transient vasodilation and may lead to a brief drop in blood pressure or flushing. A dramatic increase in blood pressure would not be expected and could suggest an alternate diagnosis or drug reaction.

A. gabapentin & acetaminophen B. extended release opioids C. sitting & leaning forward D. supine with head of bed 15 degrees

Correct Answer is C

Explanation

A. gabapentin & acetaminophen: While acetaminophen may help with pain relief, gabapentin is primarily used for neuropathic pain and not effective for the inflammatory chest pain associated with pericarditis. These medications do not address the positional nature of pericardial pain.

B. extended release opioids: Opioids may provide general pain relief but are not the standard treatment for pericarditis-related pain. They do not address the inflammatory cause and carry risks of sedation and respiratory depression without improving cardiac inflammation.

C. sitting & leaning forward: Pericarditis pain is classically relieved by having the patient sit up and lean forward. This position reduces pressure on the pericardium and decreases pain by allowing the inflamed pericardial layers to separate slightly, reducing friction.

D. supine with head of bed 15 degrees: Lying flat or even slightly elevated can worsen pericarditis pain because it increases pressure on the inflamed pericardium. Patients often report increased discomfort in the supine position, making it less favorable for symptom relief.

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WBC	8.5
Hemoglobin	17g/dL
Hematocrit	54%
BUN	28mg/dL
Creatinine	1.1 mg/dL
Potassium	4.9 mEq/L

A client has a triple lumen subclavian central venous catheter (CVC) with D51/2NS infusing through one lumen (port) at 75 mL per hour. The nurse has an order to transfuse one unit of packed red blood cells (PRBCs). The nurse's safest action is to:

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Naxlex Comprehensive Predictor Exams

A client is to receive an intravenous dose of adenosine. What immediate response to this medication should the nurse expect?

Correct Answer is B

Explanation

The nurse understands that chest pain related to pericarditis is classically relieved by

Correct Answer is C

Explanation

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The nurse is caring for a client immediately following the insertion of a permanent pacemaker. Which intervention should be included in the plan of care?

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