A male patient needs to receive a unit of whole blood. What type of intravenous (IV) device should the nurse consider starting?

Correct Answer: C

Rationale: A large-bore catheter is recommended for whole blood transfusions to allow for the rapid administration of blood products and to prevent hemolysis. Smaller catheters may not accommodate the viscosity of whole blood and could increase the risk of complications. While patient comfort and past experiences are important, the primary consideration is the safe and effective delivery of the transfusion. Therefore, a large-bore catheter is the best choice.

Correct Answer: A

Rationale: Vancomycin's red man syndrome-flushing during infusion-is non-hypersensitivity mast cell degranulation . Rapid infusion triggers histamine release, not IgE-mediated allergy . Type II , III , and IV (E) involve immune mechanisms unrelated to this acute, rate-dependent reaction. Slowing infusion prevents it, distinguishing it from true hypersensitivity, aligning with vancomycin's pharmacology in MRSA treatment.

Correct Answer: B

Rationale: Heparin is an anticoagulant medication used to prevent blood clots. If a patient on heparin therapy experiences excessive bleeding or needs to quickly reverse the anticoagulant effects of heparin, the antidote is protamine sulfate. Protamine sulfate works by neutralizing the effects of heparin by forming a complex with it. It is important for healthcare providers to have protamine sulfate readily available when managing patients on heparin therapy to effectively reverse its anticoagulant effects in emergency situations.

Correct Answer: A

Rationale: Acetaminophen (Tylenol) is primarily metabolized in the liver. Hepatotoxicity is a serious potential side effect of acetaminophen overdose or excessive use. One of the markers for liver damage due to acetaminophen toxicity is an elevated blood urea nitrogen (BUN) level. Normal BUN levels range from 7 to 20 mg/dl, and a level of 60 mg/dl indicates kidney dysfunction, which can result from liver damage caused by acetaminophen toxicity. Therefore, an elevated BUN level would indicate a toxicity of acetaminophen in this client with Bell's palsy who is taking acetaminophen daily. The other laboratory values mentioned are not specific markers for acetaminophen toxicity.

Correct Answer: D

Rationale: Midazolam is a short-acting benzodiazepine widely used as an anesthetic due to its rapid onset and potent sedative effects. Its mechanism involves enhancing the activity of gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the brain, at GABA_A receptors—not GABA_B receptors, which are linked to different effects like muscle relaxation. By binding to a specific site on the GABA_A receptor, midazolam increases the frequency of chloride channel opening, leading to greater chloride ion conductance into neurons. This hyperpolarizes the neuron, making it less excitable and producing sedation, anxiolysis, and anesthesia. Dopamine enhancement is unrelated to its action, as is NMDA receptor blockade, which is a feature of drugs like ketamine. Partial agonism at serotonin (5HT) receptors also does not apply here. The facilitation of GABA-mediated chloride conductance is the precise mechanism that underpins midazolam's clinical utility as an anesthetic agent.