A nurse is monitoring a client who reports having chills and back pain during a blood transfusion. Which of the following actions is nurse's priority?
Stopping the transfusion
Covering the client with a blanket
Assessing the client's skin for a rash
Notifying the provider
The Correct Answer is A
A. Stopping the transfusion is the priority action if the client is experiencing symptoms of a transfusion reaction.
B. Covering the client with a blanket may address chills but does not address the potential serious nature of the reaction.
C. Assessing the client's skin for a rash is important but should not delay the immediate action of stopping the transfusion.
D. Notifying the provider is important, but stopping the transfusion and addressing the immediate needs of the client take precedence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A: Educator involves providing information and teaching, which is not explicitly related to analyzing a clinical situation.
B: Advocate involves supporting and defending the client's rights but doesn't necessarily imply analyzing a clinical situation.
C: Mentor involves guiding and advising, but it's not directly related to analyzing a clinical situation.
D: Critical thinker involves using knowledge and experience to analyze and solve complex problems in clinical situations.
Correct Answer is B
Explanation
A. A decrease in systolic blood pressure is not directly related to dehydration.
Dehydration is more associated with fluid balance.
B. With aging, there is a natural decline in kidney function, including a decrease in the ability to concentrate urine. This can contribute to an increased risk of dehydration.
C. An increase in saliva production is not typically associated with dehydration.
D. With aging, there is actually a decrease in the percentage of body water, making older adults more susceptible to dehydration.
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