A nurse is caring for a client who is to receive a unit of packed RBCs. The nurse should prime the blood administration tubing using which of the following IV solutions?

Dextrose 5% in 0.45% sodium chloride

0.9% sodium chloride

Lactated Ringer's solution

Dextrose 5% in water

Answer and Explanation

The Correct Answer is B

Choice A reason: This is incorrect because dextrose 5% in 0.45% sodium chloride is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.

Choice B reason: This is correct because 0.9% sodium chloride is a isotonic solution that is compatible with blood products. It does not cause hemolysis or fluid shifts and maintains the osmotic pressure of the blood.

Choice C reason: This is incorrect because lactated Ringer's solution is a isotonic solution that contains electrolytes, such as potassium, calcium, and lactate, that can interfere with the blood products. It can also cause metabolic alkalosis due to the conversion of lactate to bicarbonate.

Choice D reason: This is incorrect because dextrose 5% in water is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.

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Correct Answer is C

Explanation

Choice A reason: A headache is not likely due to the anxiety about the chest pain, as anxiety usually causes other symptoms, such as palpitations, sweating, or trembling. A headache is more likely related to the vasodilating action of nitroglycerin, which causes increased blood flow to the brain.

Choice B reason: A headache does not indicate tolerance to the medication, as tolerance usually manifests as a reduced effect of the medication on relieving chest pain. A headache is more likely a sign of the medication's potency, as it indicates that the nitroglycerin is reaching the systemic circulation.

Choice C reason: A headache is an expected adverse effect of the medication, as nitroglycerin causes vasodilation of the cerebral vessels, which can result in increased intracranial pressure and pain. A headache is usually mild and transient, and can be relieved by taking analgesics, such as acetaminophen.

Choice D reason: A headache is not an indication of an allergy to the medication, as an allergic reaction usually causes other symptoms, such as rash, itching, swelling, or difficulty breathing. A headache is more likely a pharmacological effect of the medication, rather than an immunological response.

A. Ataxia B. Anorexia C. Photosensitivity D. Jaundice

Correct Answer is B

Explanation

Choice A reason: Ataxia is not a manifestation of digoxin toxicity, as it does not affect the coordination or balance of the client. Ataxia may be caused by other factors, such as cerebellar disorders, alcohol intoxication, or medication interactions.

Choice B reason: Anorexia is a manifestation of digoxin toxicity, as it affects the appetite and digestion of the client. Anorexia may be accompanied by nausea, vomiting, or abdominal pain, which are also signs of digoxin toxicity. Anorexia may lead to weight loss, dehydration, or electrolyte imbalance, which can worsen the condition of the client.

Choice C reason: Photosensitivity is not a manifestation of digoxin toxicity, as it does not affect the skin or the eyes of the client. Photosensitivity may be caused by other factors, such as sun exposure, allergies, or medication interactions.

Choice D reason: Jaundice is not a manifestation of digoxin toxicity, as it does not affect the liver or the bilirubin level of the client. Jaundice may be caused by other factors, such as liver disease, gallstones, or hemolysis.

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A nurse is caring for a client who is to receive a unit of packed RBCs. The nurse should prime the blood administration tubing using which of the following IV solutions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make?

Correct Answer is C

Explanation

A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity?

Correct Answer is B

Explanation

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