The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is 'too wet.' The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is which of the following?

Correct Answer: D

Rationale: The correct initial nursing action is D: Apply direct pressure above catheterization site. This is the correct answer because applying direct pressure above the catheterization site will help control the bleeding and prevent further blood loss. Here is a step-by-step rationale: 1. Direct pressure is the first-line intervention for controlling bleeding. 2. It helps to promote clot formation and stop the bleeding. 3. Placing the child in Trendelenburg position is not indicated and can potentially worsen the situation by increasing blood flow to the site. 4. Applying a new bandage with more pressure can disrupt any clot formation and is not recommended as the first action. 5. Notifying the physician is important but should not be the initial action when dealing with active bleeding.

Correct Answer: B

Rationale: The correct answer is B: Obtain a therapeutic drug level. The rationale for this is that digoxin has a narrow therapeutic range, and monitoring drug levels is crucial to prevent toxicity or subtherapeutic effects. By obtaining a drug level, the nurse can ensure that the infant is receiving the appropriate dose. A: Calling for a portable chest radiograph is not necessary for assessing the infant's heart rate in this scenario. C: Reassessing the heart rate in 30 minutes does not address the need to confirm the drug level for proper dosing. D: Administering digoxin immune Fab (Digibind) stat is a drastic measure for digoxin toxicity, which is not indicated based solely on the heart rate assessment at this time.

Correct Answer: B

Rationale: The correct answer is B: monocyte. Granulocytes are a type of white blood cell characterized by the presence of granules in their cytoplasm. Neutrophils, basophils, and eosinophils are all examples of granulocytes. Monocytes, on the other hand, are agranulocytes, lacking these granules. Monocytes are known for their role in immune response and inflammation. Therefore, monocyte does not belong to the category of granulocytes.

Correct Answer: B

Rationale: The correct answer is B because vaccination involves prior exposure to an infectious agent in an attenuated or weakened form. This exposure triggers the immune system to produce antibodies and memory cells, providing immunity against future infections. Choice A is incorrect as deliberately introducing a virulent strain can lead to severe disease instead of prevention. Choice C is incorrect as antibiotics are used to treat bacterial infections, not prevent viral diseases like vaccines. Choice D is incorrect as vaccines primarily stimulate adaptive immune responses, not innate immune responses.

Correct Answer: D

Rationale: The correct answer is D: infection. Neutrophils are a type of white blood cell responsible for fighting off infections. A low neutrophil count puts the client at risk for developing infections as their body's ability to fight off pathogens is compromised. Anemia (choice A) is related to low red blood cells, not white blood cells like neutrophils. Blood clots (choice B) and hemorrhage (choice C) are more related to platelets and clotting factors, not neutrophil count. Therefore, the correct answer is D as the primary concern with neutropenia is the increased susceptibility to infections.