The patient began receiving an intravenous (IV) infusion of packed red blood cells 30 minutes ago. The patient complains of difficulty of breathing, itching and a tight sensation in the chest. Which is the IMMEDIATE action of the nurse?

Correct Answer: D

Rationale: The symptoms described by the patient indicate a potential transfusion reaction, such as a hemolytic reaction or allergic reaction. The immediate action the nurse should take in such a situation is to stop the infusion of the packed red blood cells. This will help prevent further complications and ensure the safety of the patient. After stopping the infusion, the nurse should assess the patient's condition, monitor vital signs, and inform the healthcare team, including the physician, regarding the situation. Once the patient is stable, further investigations can be conducted to determine the cause of the reaction.

Correct Answer: B

Rationale: It is important for the nurse to have a direct and easily accessible means of communication with the patient who is expected to be in and out of the hospital due to their chronic illness like leukemia. By asking for the patient's phone number, the nurse can quickly reach out to them for updates, clarification, or any urgent matters that may arise. This direct communication line helps in ensuring continuity of care and addressing the patient's needs promptly. This approach is more practical and efficient compared to options such as asking the patient to call the hospital number listed in the yellow pages or relying on chart information which may not always be up to date. Writing down the number and giving it to the ward clerk may cause unnecessary delays in communication.

Correct Answer: B

Rationale: Acetaminophen (Tylenol) is given pre-operatively to decrease intra-operative anesthetic requirements and post-operative pain. It is a common analgesic that can help reduce the amount of intra-operative anesthesia needed and provide some pain relief during the surgery. Unlike drugs like Celebrex, Ibuprofen, and Demerol, Acetaminophen does not have anti-inflammatory properties, but it is effective in managing pain and can contribute to overall pain control before, during, and after surgery. This makes it a preferred choice for pre-operative medication in order to decrease the need for higher doses of anesthetics and reduce post-operative pain levels.

Correct Answer: B

Rationale: The extraneous variable in a study is a variable that is not the main focus of the study but could potentially impact the results. In this case, the length of stay is an extraneous variable because it is not directly related to the research question or objective of the study. The study is likely focused on factors such as patient age, complications, or date of admission, making the length of stay an irrelevant variable in this context.

Correct Answer: B

Rationale: Ella's statement "I will hang myself" directly indicates a desire and intent to commit suicide. This is classified as a suicidal intent, which is a serious concern that requires immediate attention and intervention. It is crucial to take any mention or indication of suicide seriously and seek help from mental health professionals or crisis intervention services.