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 is being discharged with a new prescription for Atenolol. Which of the following instructions should the nurse include?

• A. Take this medication in the morning.
• B. Monitor your heart rate regularly.
• C. Avoid consuming foods high in potassium.
• D. Increase your fluid intake.

Correct answer: B

Rationale: The correct answer is B: 'Monitor your heart rate regularly.' Atenolol is a beta-blocker that can cause bradycardia (slow heart rate). Monitoring the heart rate regularly is crucial to promptly detect any significant decreases. This allows for timely intervention and adjustment of the medication regimen if needed, helping to prevent adverse effects associated with bradycardia. Choices A, C, and D are incorrect. Instructing the client to take the medication in the morning does not address the need for heart rate monitoring. Avoiding foods high in potassium is more relevant for medications like ACE inhibitors or potassium-sparing diuretics. Increasing fluid intake is not directly related to the use of Atenolol.

3. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?

• A. This medication can stain your contacts.
• B. This medication can cause your pupils to constrict.
• C. This medication can absorb into your contacts.
• D. This medication can slow your heart rate.

Correct answer: C

Rationale: The correct answer is C. Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove their contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid potential absorption of the medication by the lenses. Choices A, B, and D are incorrect because Brimonidine's main concern with contact lenses is its absorption into the lenses rather than staining contacts, causing pupil constriction, or affecting heart rate.

4. A client has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

• A. Increase intake of protein-rich foods.
• B. Expect muscle twitching to occur.
• C. Take this medication with food.
• D. Anticipate relief of manifestations in 24 hours.

Correct answer: C

Rationale: The correct instruction the nurse should include is to take Levodopa/Carbidopa with food. Taking this medication with food helps reduce gastrointestinal side effects. Instructing the client to take the medication with food promotes better tolerance and absorption of the drug. Choice A is incorrect because increasing protein-rich foods is not specifically related to the administration of this medication. Choice B is incorrect as muscle twitching is not a common side effect of Levodopa/Carbidopa. Choice D is incorrect because relief of manifestations may take longer than 24 hours to occur.

5. A client is receiving daily doses of Oprelvekin. Which of the following laboratory values should the nurse monitor to determine the effectiveness of this medication?

• A. Hemoglobin
• B. Absolute neutrophil count
• C. Platelet count
• D. Total white blood cell count

Correct answer: C

Rationale: The nurse should monitor the platelet count to determine the effectiveness of Oprelvekin. The expected outcome for this medication is a platelet count greater than 50,000/mm^3. Oprelvekin is a medication used to stimulate platelet production, making platelet count a crucial parameter to assess its effectiveness. Monitoring hemoglobin, absolute neutrophil count, or total white blood cell count is not specifically related to the action or effectiveness of Oprelvekin.

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