An older adult patient is receiving a transfusion of packed red blood cells after being injured in a car accident. On assessment, the nurse notes a new finding of bounding pulse, crackles, and increasing dyspnea. What should the nurse do first, after stopping the transfusion?

Correct Answer: B

Rationale: The correct answer is B: Raise the head of the bed. This action is crucial in managing the potential complication of fluid overload in the patient receiving a blood transfusion. Elevating the head of the bed helps reduce venous return to the heart, decreasing preload and cardiac workload. This can alleviate symptoms like dyspnea and crackles associated with fluid overload. Assessing vital signs (choice A) is important but should follow positioning the patient appropriately. Encouraging deep breathing and coughing (choice C) may exacerbate the patient's respiratory distress. Administering diphenhydramine (choice D) is not indicated for the symptoms described.

Correct Answer: D

Rationale: The correct answer is D. Having the patient lie on the left side for 1 hour after a bone marrow aspiration helps to prevent bleeding by applying pressure to the site. This position helps to promote clotting and reduces the risk of hematoma formation. Elevating the head of the bed (choice A) is not necessary for this procedure. Applying a sterile 2-inch gauze dressing (choice B) is important but does not address the immediate post-procedure care. Using a half-inch sterile gauze to pack the wound (choice C) is not recommended as it may disrupt the clotting process.

Correct Answer: D

Rationale: The correct answer is D. In chronic obstructive pulmonary disease (COPD), the lungs are unable to efficiently exchange oxygen and carbon dioxide, leading to tissue hypoxia. The body compensates for this by producing more red blood cells (polycythemia) to increase oxygen-carrying capacity. This helps deliver more oxygen to tissues. Choice A is incorrect because medications for bronchodilation do not directly cause polycythemia. Choice B is incorrect because overactive bone marrow is not the primary reason for polycythemia in COPD. Choice C is incorrect because polycythemia in COPD is not a response to combat anemia but rather to address tissue hypoxia.

Correct Answer: C

Rationale: The correct answer is C because a prothrombin time (PT) of 28 seconds indicates a prolonged clotting time, putting the client at risk for bleeding. This requires immediate assessment and intervention to prevent complications. Choice A (INR of 2.8) is within the therapeutic range for clients on anticoagulant therapy, so it does not require immediate attention. Choice B (platelet count of 128000/mm³) is low but not critically low enough to warrant immediate action unless there are signs of active bleeding. Choice D (red blood cell count of 5.1 million/L) is within normal limits and does not indicate an urgent issue.

Correct Answer: C

Rationale: Rationale: 1. Blinatumomab is designed to engage T cells to target CD19 antigen on B-lymphoblasts. 2. CD19 is a specific marker expressed on B cells, making it a target for Blinatumomab. 3. CD10 is not targeted by Blinatumomab and is commonly found on early B-cell precursors. 4. CD15 and CD20 are not targeted by Blinatumomab and have different functions unrelated to B-lymphoblasts. Summary: - CD19 is the correct answer as it is the specific target for Blinatumomab on B-lymphoblasts. - CD10, CD15, and CD20 are incorrect as they are not the targeted antigens for Blinatumomab and have different roles in immune function.