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A client is admitted to the hosiptal with a bleeding ulcer and is to receive 4 units of packed cells. Which nursing intervention is of PRIMARY importance in the administration of blood?
1. Checking the flow rate
2. Identifying the client
3. Monitoring the vital signs
4. Maintaining blood temperature
Answer:2
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Within 20minutes of the start of transfusion the client develops a sudden fever .What is the nurse's first reaction?
1. Force fluid
2. Continue to monitor the vital signs
3. Increase the flow rate of the IV fluids
4. Stop the transfusion
Answer:4
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A male client who is HIV positive us admitted to the hospital with a diagnosis of Pneumocystis carinii pneumonia. His live-in partner has accompanied him. During the history interview, the nurse is aware of feeling a negative attitude about the client's lifestyle, what action is most appropriate?
1. Share this feelings with the client
2. Develop a written interview form
3. Avoid eye contact with the client
4. Discuss the negative feelings with charge nurse
Answer:4
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What should the client atbrisk for developing AIDS be advised to do so?
1. Abstain from anal intercourse
2. Have a ELISA test for antibodies
3. Have a semen analysis done
4. Inform all sexual contacts
Answer:2
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A client who is HIV positive should have the moutj examined for which oral problem common associated with AIDS?
1. Halitosis
2. Carious teeth
3. Creamy white patches
4. Swollen lips
Answer:3
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The nurse is caring gor a vlient who us HIV positive . To prevent the spread of the HIV virus, what do thr Centere for Disease Control anf Prevention (CDC) recommend?
1. Universal blood and bloody fluid precaution
2. Laminar flow rooms during active infection
3. Body system isolation
4.Needle and syringe precautions
Answer:1
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An adult has been diagnosed with some type of anemia. The resultsnof his blood tests showed : decreased WBC, normal RBC, decrease HCT , decreased Hgb. Based on this data, which of the following nursing diagnoses should the nurse prioritize as being the most important?
1. Potential for infection
2. Alteration in nutrition
3. Self-care deficit
4. Fluid volume excess
Answer:1
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Which nursing intervention is appropriate for the nurse to take when setting up supplies for a client who requires blood transfusion?
1. Add any needed IV medication in the blood bag with one-half hour of planned infusion
2. Obtain blood bag from laboratory and leave at room temperature for atleast one hour prior to infusion
3. Prime tubing of blood administration set with 0.9% NS solution,completely filling filter
4. Use a small bag -bore catheter tomprevent rapid infusion of blood products that may lead to reaction.
Answer:4
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A client who is receiving a blood transfusion begins to experience chills, shortness of breath, nausea, excessive perspiration , and a vague sense of uneasiness. What is the nurse's first best action?
1. Report the sign and symptoms to the physician
2. Stop the transfusion
3. Monitor the client's vital signs
4. Assess respiratory status
Answer:2
