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 diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?

• A. Colchicine
• B. Hydroxychloroquine
• C. Auranofin
• D. Duloxetine

Correct answer: D

Rationale: The correct answer is D, Duloxetine. Duloxetine is a serotonin-norepinephrine reuptake inhibitor commonly used to manage fibromyalgia. It helps in reducing pain and improving mood in individuals with this condition. Colchicine (Choice A) is primarily used to treat gout, while Hydroxychloroquine (Choice B) and Auranofin (Choice C) are medications used to manage conditions like rheumatoid arthritis and lupus, not fibromyalgia.

3. A client has a new prescription for Ondansetron for nausea and vomiting associated with chemotherapy. Which of the following statements should the nurse include?

• A. Take this medication one hour before chemotherapy.
• B. You may experience a headache while taking this medication.
• C. Increase your intake of potassium while taking this medication.
• D. This medication may cause temporary hearing loss.

Correct answer: B

Rationale: The correct statement the nurse should include is that the client may experience a headache while taking Ondansetron. Headache is a common side effect of this medication, and clients need to be informed about this potential adverse reaction to enhance their understanding and management of side effects. The other statements are incorrect because Ondansetron is usually taken 30 minutes before chemotherapy, not one hour before (choice A). There is no specific need to increase potassium intake while taking Ondansetron (choice C), and temporary hearing loss is not a common side effect associated with this medication (choice D).

4. A client has a new prescription for Labetalol. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid sudden discontinuation of the medication.
• C. Increase your intake of sodium-rich foods.
• D. Avoid drinking grapefruit juice.

Correct answer: B

Rationale: The correct instruction for a client on Labetalol is to avoid sudden discontinuation of the medication. Labetalol is a beta-blocker that, if abruptly stopped, can lead to rebound hypertension and other cardiac issues. It is essential for patients to taper off this medication under medical supervision to prevent adverse effects.

5. A client has a new prescription for Dabigatran. Which of the following instructions should be included?

• A. Take the medication with food.
• B. Store the capsules in a pill organizer.
• C. Crush the medication before swallowing.
• D. Expect frequent headaches while taking this medication.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication with food.' Taking Dabigatran with food is recommended to reduce gastrointestinal discomfort, a common side effect associated with this medication. Food can help minimize stomach irritation and improve tolerability. Choices B, C, and D are incorrect. Storing the capsules in a pill organizer (B) is a good practice for organization but not a specific instruction for this medication. Crushing the medication before swallowing (C) is not recommended for Dabigatran as it is available as a capsule and should be swallowed whole. Expecting frequent headaches while taking this medication (D) is not a common side effect of Dabigatran and should not be anticipated.

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