Nursing Elites

1. A healthcare provider 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 provider 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: The correct answer is to obtain help from another healthcare provider to confirm the correct client and blood product. This action is crucial in preventing an acute hemolytic reaction, which is caused by ABO or Rh incompatibility. Verifying the correct client and blood product before the transfusion ensures that there are no errors in identification, reducing the risk of a potentially life-threatening reaction. Choices A, C, and D are important aspects of transfusion safety but are not directly related to preventing acute hemolytic reactions. Ensuring a patent IV line, monitoring vital signs, and staying with the client are all essential during transfusion but do not specifically address the risk of ABO or Rh incompatibility reactions.

2. A client has a new prescription for Propranolol. Which of the following statements should the nurse include in teaching the client?

• A. You may experience a rapid heart rate while taking this medication.
• B. Take the medication with food.
• C. Avoid sudden changes in position.
• D. Increase your intake of high-sodium foods.

Correct answer: C

Rationale: The correct statement to include when teaching a client about Propranolol is to avoid sudden changes in position. Propranolol, a beta-blocker, can lead to dizziness and lightheadedness, particularly when changing positions. Therefore, clients should be advised to change positions slowly to prevent falls and related injuries. Choice A is incorrect because Propranolol actually helps lower heart rate and blood pressure. Choice B is not a specific requirement for taking Propranolol. Choice D is also incorrect as increasing high-sodium foods is not recommended with Propranolol which can affect blood pressure control.

3. A healthcare provider is preparing to administer an Opioid agonist to a client who has acute pain. Which of the following complications should the healthcare provider monitor?

• A. Urinary retention
• B. Tachypnea
• C. Hypertension
• D. Irritating cough

Correct answer: A

Rationale: The correct answer is urinary retention. Opioid agonists like morphine can suppress the sensation of a full bladder, leading to urinary retention. Monitoring for this complication is crucial to prevent bladder distention and related issues. Choices B, C, and D are incorrect. Tachypnea (increased respiratory rate), hypertension (high blood pressure), and irritating cough are not typically associated with opioid agonist administration for pain management.

4. A client has been prescribed a Beta Blocker for hypertension. Which of the following findings should the nurse monitor as an adverse effect of this medication?

• A. Bradycardia
• B. Hypertension
• C. Hyperglycemia
• D. Hypernatremia

Correct answer: A

Rationale: Bradycardia is the correct answer. Beta Blockers work by slowing down the heart rate, which can lead to bradycardia as an adverse effect. Monitoring for bradycardia is essential to prevent complications. Choices B, C, and D are incorrect because Beta Blockers do not typically cause hypertension, hyperglycemia, or hypernatremia as adverse effects.

5. A client has a new prescription for Spironolactone. Which of the following findings should the nurse monitor as an adverse effect?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: Corrected Rationale: Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia as an adverse effect. Hyperkalemia can result in muscle weakness and cardiac dysrhythmias, making it essential for the nurse to monitor potassium levels closely when a client is on Spironolactone. Choice B, Hypoglycemia, is incorrect because Spironolactone is not known to cause low blood sugar levels. Choice C, Hypocalcemia, and Choice D, Hyponatremia, are also incorrect as Spironolactone is not associated with decreased levels of calcium or sodium.

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