A nurse is preparing to transfuse a unit of packed red blood cells (RBCs) to a client who has anemia. Which of the following actions should the nurse take first?

Correct Answer: A

Rationale: The correct action is A: Witness the informed consent. This is the first step in the transfusion process to ensure the client's autonomy and understanding of the procedure. Without informed consent, the nurse cannot proceed with the transfusion. Checking the IV site (B) is important but not the first step. Verifying blood type (C) is crucial but can be done after obtaining consent. Priming the tubing (D) is necessary before starting the transfusion, but it comes after obtaining consent.

Correct Answer: A

Rationale: The correct answer is A because colchicine commonly causes gastrointestinal (GI) upset as a side effect. This is due to its mechanism of action on the gastrointestinal tract. Retinal damage (B), bone marrow suppression (C), and hepatotoxicity (D) are not commonly associated with colchicine use, making them incorrect choices. It's crucial to monitor patients for GI symptoms when taking colchicine to ensure their safety and manage any adverse effects promptly.

Correct Answer: A

Rationale: The correct answer is A: Celecoxib. Celecoxib is a selective COX-2 inhibitor, which has been associated with an increased risk of cardiac events, such as heart attacks and strokes. This is due to its mechanism of action, which can lead to elevated blood pressure and interfere with normal blood clotting. Celecoxib is specifically known to increase the risk of cardiovascular events compared to other nonsteroidal anti-inflammatory drugs (NSAIDs) like diclofenac, ibuprofen, and naproxen. Diclofenac, ibuprofen, and naproxen are traditional NSAIDs that can also have cardiovascular risks, but the risk is generally lower compared to celecoxib. In summary, celecoxib is associated with an increased risk of cardiac events due to its selective COX-2 inhibition, while the other choices are less likely to have as significant of an impact on cardiovascular health.

Correct Answer: C

Rationale: The correct answer is C: Painful, deformed small joints. This is consistent with systemic lupus erythematosus (SLE) as it can cause joint pain and inflammation, leading to joint deformities. A: Discoid rash on skin exposed to sunlight is a characteristic of cutaneous lupus, not systemic lupus. B: Urinalysis positive for casts and protein is more indicative of lupus nephritis, a complication of SLE affecting the kidneys. D: Pain on inspiration is more suggestive of pleurisy, a common symptom in SLE but not specific to the disease.

Correct Answer: C

Rationale: The correct answer is C: Deferoxamine. Thalassemia patients often require blood transfusions, leading to iron overload. Deferoxamine is an iron-chelating agent that helps remove excess iron from the body. Ferrous sulphate (A) is an iron supplement and would worsen iron overload. Hydroxycobalamin (B) is a form of vitamin B12 and is not indicated for iron overload. Iron dextran (D) is another form of iron supplement and would also exacerbate the iron overload in this patient. Therefore, the appropriate choice is C as it directly addresses the issue of high iron levels in thalassemia patients.