The nurse is reviewing the client's medical record.

Procedures

Planned endoscopy at 1300.

The nurse is assisting with the care of the client prior to a blood transfusion. Which of the following actions should the nurse take?

Select all that apply.

Witness the client signing a consent for transfusion.

Obtain a large bore IV catheter.

Ensure two nurses confirm the information on the blood label.

Ensure the transfusion tubing is flushed with dextrose 5% in water.

Explain to the client that transfusion reactions are not serious.

Answer and Explanation

Correct Answer : A,B,C

A.   Correct. The nurse should witness the client signing a consent form for blood transfusion.
Informed consent is necessary for any medical procedure.
B.   Correct. A large bore IV catheter is required for blood transfusion to ensure the smooth flow of blood and prevent clotting.
C.   Correct. Two nurses should confirm the information on the blood label, including the client's identification and the blood type, to prevent errors.
D.   Incorrect. Transfusion tubing is typically flushed with normal saline before attaching it to the patient. Flushing with dextrose 5% in water is not necessary or recommended.
E.   Incorrect. It's important for the nurse to educate the client about potential transfusion reactions, as some reactions can indeed be serious. Providing accurate information helps the client understand the importance of monitoring for any signs of a reaction.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Correct. Pancre-lipase is an enzyme replacement therapy used in cystic fibrosis to improve digestion and absorption of fats. Reduction in fat in the stools indicates improved fat digestion.
B. Improved absorption of vitamins B and C might occur as a result of improved overall digestion, but it is not the primary therapeutic effect of pancre-lipase.
C. Improved respiratory function is not a direct effect of pancre-lipase.
D. Decreased sodium excretion is not a primary therapeutic effect of pancre-lipase.

A. "I will give this medication to my child once daily in the evening." B. "I can stop giving my child this medication if he is taking a steroid." C. "I will give this medication to my child every 2 hours if he is wheezing." D. "It takes 2 months of scheduled use before this medication is effective."

Correct Answer is A

Explanation

A. Correct. Montelukast is typically given once daily in the evening to manage asthma symptoms.
B. Montelukast is not a replacement for inhaled steroids. The parent should not stop the medication without consulting the healthcare provider.
C. Montelukast is not used for acute wheezing; it is a maintenance medication and not for immediate relief.
D. Montelukast can start to show benefits within a few days of starting, not necessarily 2 months.

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The nurse is reviewing the client's medical record. Procedures Planned endoscopy at 1300. The nurse is assisting with the care of the client prior to a blood transfusion. Which of the following actions should the nurse take? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A nurse is administering pancrelipase to a child who has cystic fibrosis. Which of the following outcomes should the nurse expect as a therapeutic effect of the treatment?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a parent of a child who has asthma about the administration of montelukast. Which of the following statements by the parent indicates an understanding of the teaching?

Correct Answer is A

Explanation

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The nurse is reviewing the client's medical record.

Procedures

Planned endoscopy at 1300.

The nurse is assisting with the care of the client prior to a blood transfusion. Which of the following actions should the nurse take?

Select all that apply.