The nurse reviews the entries in the medical record.

Exhibits

The nurse is ready to begin the blood transfusion. For each potential nursing action, click to specify if the action is indicated or not indicated for the client.

Stay with the client for the first 15 min of the transfusion.

Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg.

Document the blood product transfusion in the client's medical record.

Obtain the first unit of packed RBCs from the blood bank.

Start an IV bolus of lactated Ringer's solution.

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}

Answer is… Stay with the client for the first 15 min of the transfusion and Document the blood product transfusion in the client’s medical record are indicated nursing actions for the client. Obtain the first unit of packed RBCs from the blood bank is also indicated, but it should be done before starting the transfusion. Titrate the rate of infusion to maintain the client’s blood pressure at least 90/60 mm Hg and Start an IV bolus of lactated Ringer’s solution are not indicated nursing actions for the client.

Explanation:.

Staying with the client for the first 15 min of the transfusion is indicated because this is when most adverse reactions occur and the nurse should monitor the client’s vital signs and symptoms closely.
Documenting the blood product transfusion in the client’s medical record is indicated because this is part of the legal and ethical responsibility of the nurse and it provides a record of the type, amount, duration, and outcome of the transfusion.
Obtaining the first unit of packed RBCs from the blood bank is indicated because this is part of the preparation for the transfusion and it ensures that the blood product is compatible, fresh, and available. However, this should be done before starting the transfusion, not after.
Titrating the rate of infusion to maintain the client’s blood pressure at least 90/60 mm Hg is not indicated because this may cause fluid overload or hemolysis in the client who already has a low blood pressure and a high heart rate. The rate of infusion should be based on the client’s condition, weight, and response to the transfusion, not on a fixed target.
Starting an IV bolus of lactated Ringer’s solution is not indicated because this may cause electrolyte imbalance or hemolysis in the client who already has a positive H. pylori test and a history of gastrointestinal bleeding. The only fluid that should be infused with blood products is 0.9% NaCl (normal saline) because it has a similar osmolarity and pH as blood and it prevents clotting or hemolysis.

Nursing Test Bank

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Correct Answer is C

Explanation

The leader allows the group to discuss whatever they would like to regarding their medications. This is because a laissez-faire leadership style is characterized by minimal guidance and direction from the leader, and maximum freedom and autonomy for the followers. The leader does not impose any rules or expectations on the group, and lets them decide how to manage their own learning and behavior.

Choice A is wrong because having group members vote on what they would like to learn about during the session is an example of a democratic leadership style, not a laissez-faire one.

A democratic leader solicits input and feedback from the group, and makes decisions based on consensus and majority rule.

Choice B is wrong because lecturing about medication adverse effects to the group members is an example of an authoritarian leadership style, not a laissez-faire one.

An authoritarian leader dictates what the group should do and how they should do it, without considering their opinions or preferences.

Choice D is wrong because encouraging group members to remain silent until questions are called for is an example of a paternalistic leadership style, not a laissez-faire one.

A paternalistic leader treats the group as if they are incapable of making their own decisions, and assumes a protective and nurturing role over them.

Normal ranges for leadership styles are not applicable in this context, as different styles may be more or less effective depending on the situation and the goals of the group.

However, some general advantages and disadvantages of each style are:

Laissez-faire: Advantages - fosters creativity, independence, and self-motivation; Disadvantages - may lead to chaos, confusion, and lack of accountability.
Democratic: Advantages - promotes participation, collaboration, and satisfaction; Disadvantages - may be time-consuming, inefficient, and conflict-prone.
Authoritarian: Advantages - provides clarity, direction, and control; Disadvantages - may cause resentment, resistance, and dependency.
Paternalistic: Advantages - creates trust, loyalty, and commitment; Disadvantages - may inhibit growth, development, and empowerment.

A. "You can drink beverages that contain caffeine.". B. "You should eat foods that are low in fat.". C. "Notify your provider if you experience vomiting or diarrhea.". D. "Limit alcohol intake to no more than one drink per day.". E. "You should eat foods high in protein.".

Correct Answer is ["B","C","E"]

Explanation

The nurse should include the following statements in the teaching:

You should eat foods that are low in fat. A low-fat diet can help reduce the amount of digestive enzymes your pancreas releases and prevent further inflammation and pain.
Notify your provider if you experience vomiting or diarrhea. These symptoms can lead to dehydration and malnutrition, which can worsen your condition and require hospitalization.
You should eat foods high in protein. Protein can help your body heal and repair damaged tissues. It can also prevent muscle wasting and weight loss, which are common complications of chronic pancreatitis.

Choice A is wrong because caffeine can stimulate the pancreas and increase pain and inflammation. Choice D is wrong because alcohol can damage the pancreas and trigger more attacks. People with chronic pancreatitis should avoid alcohol completely.

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The nurse reviews the entries in the medical record. Exhibits The nurse is ready to begin the blood transfusion. For each potential nursing action, click to specify if the action is indicated or not indicated for the client.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an acute care mental health facility is participating in a medication education group. The leader of the group uses a laissez-faire leadership style. Which of the following actions should the nurse expect from the leader during the session?

Correct Answer is C

Explanation

A nurse in an emergency department is caring for a client Exhibits The nurse is providing teaching to the client about self-care. Select the 3 statements the nurse should include in the teaching.

Correct Answer is ["B","C","E"]

Explanation

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A nurse is creating a plan of care for a female client who has recurrent urinary tract infections. Which of the following interventions should the nurse include in the plan?

The nurse reviews the entries in the medical record.

Exhibits

The nurse is ready to begin the blood transfusion. For each potential nursing action, click to specify if the action is indicated or not indicated for the client.