Nursing Elites

1. A healthcare professional is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare professional to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: Obtaining help from another healthcare professional to confirm the correct client and blood product is crucial in preventing an acute hemolytic reaction during a blood transfusion. This reaction occurs due to ABO or Rh incompatibility. Verifying the correct client and blood product reduces the risk of administering the wrong blood type, which could lead to a life-threatening reaction. Checking for patency of the IV line (Choice A) is important but does not directly prevent an acute hemolytic reaction. Monitoring vital signs (Choice C) is essential for detecting transfusion reactions but does not prevent them. Staying with the client (Choice D) is important for early recognition of adverse reactions but does not address the root cause of preventing an acute hemolytic reaction.

2. Which of the following is not a known effect of the drug Clozapine?

• A. Agranulocytosis
• B. Antipsychotic
• C. Used for Schizophrenia
• D. Hyperactivity

Correct answer: D

Rationale: Clozapine is associated with side effects like agranulocytosis (a serious blood condition), sedation (not hyperactivity), and is used as an antipsychotic to treat schizophrenia. Hyperactivity is not a typical effect of Clozapine, making it the correct answer in this context.

3. A healthcare professional is reviewing the medical record of a client with a new prescription for Epoetin Alfa. Which of the following findings should the professional report to the provider?

• A. The client has a history of hypertension.
• B. The client has a hemoglobin level of 10 g/dL.
• C. The client has a history of chronic kidney disease.
• D. The client has a blood pressure of 140/90 mm Hg.

Correct answer: C

Rationale: The correct answer is C. Chronic kidney disease is a contraindication for the use of Epoetin Alfa because it can worsen hypertension, increase the risk of cardiovascular events, and lead to adverse outcomes. Epoetin Alfa is used to treat anemia by stimulating red blood cell production, but in the presence of chronic kidney disease, it can exacerbate hypertension and contribute to cardiovascular complications. Choices A, B, and D are not directly related to the contraindication of Epoetin Alfa in the presence of chronic kidney disease.

4. What is the therapeutic use of Phenytoin?

• A. Replacement in hypothyroidism to restore normal hormonal balance
• B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux
• C. Diminished seizure activity, termination of ventricular arrhythmias
• D. Prevention of thrombus formation, prevention of extension of existing thrombi

Correct answer: C

Rationale: Phenytoin is primarily used to diminish seizure activity and is effective in terminating ventricular arrhythmias. It works by stabilizing neuronal membranes, reducing repetitive neuronal firing, and limiting the spread of seizure activity in the brain. While phenytoin does not have a direct role in preventing thrombus formation or extending existing thrombi, it is crucial in managing seizures and certain arrhythmias.

5. A client asks the nurse how Rituximab works, which the client is receiving to treat Non-Hodgkin's Leukemia. Which of the following should the nurse include?

• A. Blocks hormone receptors
• B. Increases immune response
• C. Binds with specific antigens on tumor cells
• D. Stops DNA replication during cell division

Correct answer: C

Rationale: Rituximab is a monoclonal antibody that binds with specific antigens on B-lymphocytes, leading to the destruction of cancer cells. In the context of Non-Hodgkin's Leukemia, Rituximab targets and destroys cancerous B-lymphocytes, which helps in treating the disease. Choices A, B, and D are incorrect. Rituximab does not block hormone receptors, increase immune response, or stop DNA replication during cell division. The primary mode of action of Rituximab is its binding with specific antigens on tumor cells, specifically B-lymphocytes, to elicit an immune response against cancerous cells.

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