A nurse is preparing to administer 2 units of packed RBCs to a client.
Which of the following actions should the nurse take?
Transfuse each unit of blood over 5 hr.
Change the IV tubing after each unit of blood is transfused.
Prime the tubing with 0.9% sodium chloride.
Administer the blood through a 22-gauge intravenous catheter.
The Correct Answer is C
When administering packed RBCs, the tubing should be primed with 0.9% sodium chloride.
Transfusing each unit of blood over 5 hours (choice A) is not recommended as it may increase the risk of bacterial growth.
Packed RBCs should be transfused over 2 to 3 hours.
Changing the IV tubing after each unit of blood is transfused (choice B) is not necessary.
Administering the blood through a 22-gauge intravenous catheter (choice D) may not be appropriate as a larger gauge catheter is typically used for blood transfusions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The nurse’s priority assessment in the PACU (Post-Anesthesia Care Unit) should be the client’s respiratory status.
This is because the client is recovering from anesthesia and may have an altered respiratory function.
Choice B, assessing the surgical site, is not an answer because it is not the priority assessment for a client in the PACU.
Choice C, assessing the level of consciousness, is not an answer because it is not the priority assessment for a client in the PACU.
Choice D, assessing the pain level, is not an answer because it is not the priority assessment for a client in the PACU.
Correct Answer is A
Explanation
The nurse should instruct the client to obtain sterile lancets for blood glucose monitoring.
Lancets are small needles used to prick the skin to obtain a blood sample for testing blood glucose levels.
Choice B is wrong because compression stockings are not necessary for blood glucose monitoring.
Choice C is wrong because toenail clippers are not necessary for blood glucose monitoring.
Choice D is wrong because a hand mirror is not necessary for blood glucose monitoring.
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