A client is receiving a blood transfusion. If this client experiences an acute hemolytic reaction, which nursing intervention is the most important?

Correct Answer: D

Rationale: The correct answer is D: Immediately stop the transfusion, infuse normal saline solution, notify the blood bank. Rationale: 1. Stop the transfusion immediately to prevent further complications from the hemolytic reaction. 2. Infuse normal saline solution to maintain adequate hydration and support kidney function. 3. Notify the blood bank to report the adverse reaction and to return the blood products for further investigation and testing. Summary of other choices: A: Incorrect because infusing dextrose 5% in water (D5W) is not indicated for treating a hemolytic reaction. Calling the physician is important, but stopping the transfusion and notifying the blood bank are more critical. B: Incorrect because slowing the transfusion may not be sufficient to manage the acute hemolytic reaction effectively. C: Incorrect because administering antihistamines is not the appropriate treatment for a hemolytic reaction. Stopping the transfusion and notifying the blood bank are more urgent actions.

Correct Answer: A

Rationale: The correct answer is A because collecting urine 24-48 hrs after the client has received nonradioactive B12 is essential for the Schilling test to evaluate vitamin B12 absorption. Urine is collected to measure the excretion of radioactive B12, which helps in diagnosing pernicious anemia or malabsorption issues. Incorrect choices: B: Collecting blood samples is not necessary for the Schilling test as it primarily involves urine collection. C: Allowing oral fluid consumption is important to prevent dehydration and is not contraindicated after receiving nonradioactive B12. D: Making the client lie down in the supine position is unnecessary for the Schilling test and may not affect the test results.

Correct Answer: C

Rationale: The correct answer is C because jaundice is a common manifestation of sickle cell anemia due to the breakdown of red blood cells. The nurse should inspect the skin and sclera for the characteristic yellow discoloration indicating jaundice. This assessment is specific to identifying jaundice, which is directly related to the disease process. Choice A is incorrect as it relates to assessing neurological function, not jaundice. Choice B is incorrect as joint swelling is not a typical sign of jaundice in sickle cell anemia. Choice D is incorrect as a urine specimen is not used to assess jaundice; skin and sclera inspection are more appropriate.

Correct Answer: A

Rationale: Step-by-step rationale for the correct answer (A): 1. Increased RBC: Hemolytic anemia leads to increased RBC production as the body compensates for the destruction of red blood cells. 2. Decreased bilirubin: Bilirubin levels decrease due to the accelerated breakdown of red blood cells. 3. Decreased Hgb and Hct: Hemolysis causes a decrease in hemoglobin and hematocrit levels as red blood cells are destroyed. 4. Increased reticulocytes: Reticulocytes are immature red blood cells released by the bone marrow in response to increased RBC destruction. Summary: - Choice B is incorrect as hemolytic anemia would lead to increased, not decreased, bilirubin levels. - Choice C is incorrect as hemolytic anemia would lead to decreased, not increased, Hgb and Hct levels. - Choice D is incorrect as hemolytic anemia would not lead to increased levels of all parameters

Correct Answer: D

Rationale: The correct screening test for colorectal cancer is D: Proctosigmoidoscopy after age 50. This test allows direct visualization of the lower colon and rectum, aiding in the detection of polyps or tumors. It is recommended for individuals over 50 years old to screen for colorectal cancer. A: CEA test is not a primary screening tool but rather used for monitoring cancer progression. B: Annual digital examination is not sufficient for colorectal cancer screening. C: Barium enema is less effective compared to colonoscopy for detecting abnormalities in the colon.