A 65-year-old smoker with painless hematuria, normal prostate. Most useful diagnostic test?

Correct Answer: D

Rationale: The correct answer is D: Cystoscopy and retrograde pyelography. This is the most useful test for evaluating painless hematuria in a 65-year-old smoker. Cystoscopy allows direct visualization of the bladder and can identify potential sources of bleeding. Retrograde pyelography helps assess the upper urinary tract for any abnormalities. The other choices are not as relevant in this context: A (urine culture) is used for diagnosing urinary tract infections, B (PSA) is for prostate cancer screening, and C (bladder scan) is used for assessing bladder volume, not for evaluating hematuria.

Correct Answer: B

Rationale: The correct answer is B: Donor antibodies vs. recipient. Since the woman developed pulmonary edema post-transfusion, it suggests an immune reaction due to donor antibodies targeting recipient antigens, leading to inflammation and increased vascular permeability. This immune response results in fluid leakage into the lungs, causing pulmonary edema. Volume overload (A) is unlikely as the patient had pulmonary edema, not generalized edema. Recipient antibodies vs. donor (C) is incorrect as the recipient's antibodies would not cause immediate pulmonary edema post-transfusion. Bacterial contamination (D) can lead to septic reactions but is less likely to cause pulmonary edema in this context.

Correct Answer: C

Rationale: The correct answer is C because priming the transfusion set with dextrose in lactated Ringer solution can cause hemolysis of the red blood cells due to the incompatibility between the solution and PRBCs. This can lead to serious complications for the patient. Choice A is incorrect because waiting 20 minutes before starting the infusion is a standard practice to allow for compatibility checks and patient assessment. Choice B is incorrect because starting an IV with a 22-gauge catheter is appropriate for blood transfusions. Choice D is incorrect because informing the patient about potential reactions is an essential part of the consent process and patient education.

Correct Answer: D

Rationale: The correct answer is D because a patient with neutropenia and fever is at high risk for infection, which can quickly become life-threatening. Assessing and addressing this patient's condition promptly is crucial for preventing sepsis. Choices A, B, and C, although important, do not pose an immediate threat to the patient's life like neutropenia with fever does. Thalassemia with low Hb, sickle cell crisis, and emotional distress in lymphoma are important but do not require immediate assessment compared to a potentially septic patient.

Correct Answer: D

Rationale: The correct answer is D because cleaning the skin with mild soap is within the nursing assistant's scope of practice and is essential for maintaining skin integrity in patients receiving radiation therapy. Checking skin for redness/peeling (A) and explaining skin care (C) involve assessment and education, which should be done by a registered nurse. Assisting with clothing choice (B) is not directly related to preventing impaired tissue integrity. In summary, choice D is correct as it addresses the immediate need for skin care within the nursing assistant's role, while the other choices involve tasks beyond their scope or not directly related to the issue at hand.