The nurse is caring for a patient whose blood type is A-. The nurse knows that this patient can receive the following blood types:(SELECT ALL THAT APPLY)

A-

АB

O-

A-

O+

Answer and Explanation

Correct Answer : A,C,D

A.   A patient with blood type A- can receive A- blood, as it matches both the ABO blood group and Rh factor.
B.   A patient with A- blood cannot receive AB blood because the blood type is incompatible in terms of both ABO group and Rh factor. AB blood contains both A and B antigens, which could lead to an immune response in a type A patient.
C.   O- blood is a universal donor for all blood types, meaning it does not contain A or B antigens and does not have the Rh factor, so it can be given to an A- patient.
D.   As already noted, A- blood is compatible with an A- patient because both the ABO group and Rh factor are the same.
E.   O+ blood contains the Rh antigen, and since the patient is A-, they cannot receive Rh-positive blood, as this could cause an immune reaction.

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Correct Answer is D

Explanation

A. Instructing the client to remain quiet may reduce stress or activity but does not address the issue of the pacemaker not sensing properly.
B. Continuing to monitor without addressing the malfunction is inappropriate because this could lead to complications or inappropriate pacing.
C. Assessing blood pressure and pulse is important for patient safety but the priority is addressing the pacemaker's malfunction by notifying the healthcare provider.
D. The pacemaker should sense the client's intrinsic beats to avoid inappropriate pacing. If it is firing on the T wave or at inappropriate times, it indicates a sensing issue that needs to be addressed by the healthcare provider.

A. Teach family members to assist with all ADLS once discharged B. Cluster activities to a time when the client has the most energy C. Provide alternating activity and rest periods D. Limit self-care activities until symptoms subside

Correct Answer is C

Explanation

A. While family support is important, encouraging complete assistance with all activities of daily living (ADLs) is not an ideal intervention. The goal is to maintain as much independence as possible, even if that means modifying or pacing activities. Encouraging complete dependency can lead to deconditioning and further loss of function.
B. Clustering activities is not the best intervention for this problem. Clustering involves grouping multiple tasks together at once, which can overwhelm the patient and lead to fatigue. Instead, the nurse should encourage pacing and spreading out activities to avoid overexertion, even if the patient has energy.
C. Providing alternating periods of activity and rest is a fundamental strategy in managing activity intolerance due to chronic heart failure. This approach helps balance the energy demands of daily activities with rest to prevent fatigue and overexertion. By alternating activity and rest, the patient can perform necessary tasks while minimizing strain on the heart.
D. The goal in chronic heart failure is to help the patient maintain independence and function as much as possible. Limiting self-care could lead to increased dependency and reduced quality of life. Activity modifications and appropriate pacing are better strategies.

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The nurse is caring for a patient whose blood type is A-. The nurse knows that this patient can receive the following blood types:(SELECT ALL THAT APPLY)

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has had a temporary transvenous pacemaker inserted. The cardiac monitor shows pacemaker spikes occurring at various points in the client's own beats such as on the T wave. What action is the nurse's priority?

Correct Answer is D

Explanation

The client problem of Activity Intolerance related to decrease in cardiac reserve is identified for a client with chronic heart failure. Which intervention should the nurse include in the plan of care related to this problem?

Correct Answer is C

Explanation

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