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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Correct Answer is C

Explanation

A. A nutritionist might provide information about feeding options, but a case manager can assist with financial concerns.
B. While a pediatric nurse practitioner can provide health guidance, a case manager is better suited for addressing financial matters.
C. Correct. A case manager can help the client access resources and assistance programs to afford necessary items like baby formula.
D. The primary care provider's role is more focused on medical care, not financial assistance.

A. "I have to take this medication on an empty stomach." B. "I will need to remain upright for 1 hour after taking the medication." C. "I can take antacids at the same time as this medication." D. "I should expect to have diarrhea while taking this medication."

Correct Answer is B

Explanation

A. Incorrect. Pantoprazole is a proton pump inhibitor that is typically taken before meals. It does not necessarily need to be taken on an empty stomach.
B. Correct. Taking pantoprazole and remaining upright for at least 1 hour after taking the medication helps prevent reflux and ensures optimal absorption.
C. Incorrect. Antacids should not be taken at the same time as pantoprazole, as they can interfere with its effectiveness.
D. Incorrect. Diarrhea is not a common side effect of pantoprazole.

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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.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

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.