A nurse is caring for a client who refuses a blood transfusion. Which of the following actions should the nurse take?

Inform the client that the transfusion is mandatory.

Document the client's refusal in the medical record.

Notify risk management about the client's refusal.

Suggest that the client explore alternative therapies.

Answer and Explanation

The Correct Answer is B

A) Inform the client that the transfusion is mandatory: This approach is not appropriate, as it disregards the client's autonomy and right to make informed decisions about their own healthcare. Patients have the right to refuse treatment, including blood transfusions.

B) Document the client's refusal in the medical record: This is the correct action. It is essential to document the client's decision thoroughly, including the discussion surrounding the refusal and any information provided about the risks and benefits of the transfusion. This documentation protects both the client and the healthcare team.

C) Notify risk management about the client's refusal: While it may be necessary to inform risk management in certain cases, it is not a standard procedure for all refusals of treatment. The focus should be on respecting the client's wishes first and ensuring proper documentation.

D) Suggest that the client explore alternative therapies: While it is important to provide clients with information about their options, suggesting alternative therapies should not take precedence over respecting the client's decision. Instead, the nurse should ensure the client is fully informed about the implications of their refusal and provide support in understanding their choices.

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Correct Answer is D

Explanation

A) Acetaminophen: While acetaminophen can be effective for mild to moderate pain relief, it may not be the most appropriate choice for abdominal pain associated with cholelithiasis. Opioids or nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac are typically more effective for this type of pain.

B) Omeprazole: This medication is a proton pump inhibitor used primarily for reducing gastric acid secretion and is not indicated for pain management. It does not address the pain caused by cholelithiasis.

C) Metoclopramide: This medication is an antiemetic and prokinetic agent that may help with nausea and vomiting, but it does not directly alleviate pain. It would not be the first choice for pain management in this situation.

D) Ketorolac: This NSAID is effective for managing moderate to severe pain and is suitable for the type of pain associated with cholelithiasis. It has anti-inflammatory properties that can provide significant relief, making it the best option for the client's current symptoms.

A. Schedule nursing staff training for infection control produres. B. Identify possible precipitating factors related to the infections. C. Meet with providers to discuss measures to decrease the infections. D. Revise the current policy for catheter care.

Correct Answer is B

Explanation

A) Schedule nursing staff training for infection control procedures: While staff training is important for reducing infection rates, it is a secondary step. First, understanding the underlying factors contributing to the increase in catheter infections is crucial.

B) Identify possible precipitating factors related to the infections: This action should be the priority. By identifying the specific causes or trends associated with the increase in infections, the charge nurse can target interventions more effectively and implement changes based on evidence.

C) Meet with providers to discuss measures to decrease the infections: Engaging providers is important, but it should occur after identifying the root causes. Once the contributing factors are understood, a more focused discussion can take place.

D) Revise the current policy for catheter care: While policy revision may be necessary, it is essential to first assess the current situation to understand why the infections are occurring. Without identifying the factors first, changes made may not address the actual issues at hand.

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A nurse is caring for a client who refuses a blood transfusion. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer PRN pain medication to a client who has cholelithiasis and is experiencing moderate abdominal pain. Which of the following medications should the nurse plan to administer?

Correct Answer is D

Explanation

A charge nurse is concerned about a recent increase in facility-acquired catheter infections. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

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