A child is to receive a blood transfusion, if an allergic reaction to the blood occurs, the nurse's first intervention should be:

Correct Answer: C

Rationale: In the scenario of a child experiencing an allergic reaction during a blood transfusion, the nurse's first intervention should always be to stop the blood immediately. This is crucial to prevent further complications and adverse reactions in the child. Pausing the transfusion allows for assessment of the allergic reaction's severity, immediate treatment initiation, and alerting the healthcare team for further management. Relieving symptoms with antihistamines or slowing the flow rate would not address the primary concern of stopping the allergen from entering the child's system. Therefore, stopping the blood immediately is the most appropriate and urgent action to take in this situation.

Correct Answer: B

Rationale: Severe and extensive hemolysis can lead to the destruction of a large number of red blood cells, causing a significant release of hemoglobin into the bloodstream. This excessive release of hemoglobin can overwhelm the body's ability to clear it, leading to the accumulation of toxic byproducts such as free hemoglobin and heme. These byproducts can lead to various complications, one of which is the potential for causing shock. Shock is a life-threatening condition characterized by inadequate tissue perfusion and oxygen delivery to vital organs due to a systemic vascular response to the circulating toxins and byproducts of hemolysis. It is a severe consequence of extensive hemolysis and requires immediate medical intervention to stabilize the patient.

Correct Answer: B

Rationale: Hemolytic anemias are characterized by the premature destruction of red blood cells. As a result, the lab values typically seen in hemolytic anemia include decreased red blood cell counts (RBC), increased bilirubin (due to the breakdown of red blood cells), decreased hemoglobin (Hgb) and hematocrit (Hct) levels, and increased reticulocytes (immature red blood cells released from the bone marrow in response to the increased demand for red blood cell production). Therefore, profile B aligns with the expected lab values consistent with hemolytic anemia.

Correct Answer: D

Rationale: The nurse should recommend a proctosigmoidoscopy for colorectal cancer screening in individuals over the age of 50. This procedure allows for the visualization of the lower part of the colon and rectum, which are common sites for precancerous and cancerous lesions to develop. Proctosigmoidoscopy can help identify abnormalities early on, allowing for prompt intervention and treatment. This screening method helps in detecting colorectal cancer or pre-cancerous polyps at an early stage when they are more easily treatable. Regular screening is essential for early detection and prevention of colorectal cancer. Other screening tests such as carcinoembryonic antigen (CEA) test, annual digital examination, and barium enema are not recommended as primary screening methods for colorectal cancer.

Correct Answer: B

Rationale: The nurse should first pick up the internal radioactive implant with long-handled forceps and place it in a lead-lined container. This action ensures the safety of the nurse and prevents further exposure to radiation. Handling the implant with forceps helps minimize direct contact, and placing it in a lead-lined container containing the radiation will effectively shield any further exposure. Once the implant is secured, proper authorities should be notified to take further action and ensure the client's safety.