Nursing Grad Questions

[R2K2NE1]

Hi I'm a new graduate in nursing and now preparing for board exam.

I have a few questions. I have been doing review questions and theres just some things I don't get so below ill be posting review questions that I do not understand. I was wondering if theres anyone there that can help me under why this certain answer is right above the rest.

Mr. A with Hepatitis A and was given injection for pain. What you will do with the needle ? If biohazard container is not there?

• Break the needle
  
• Leave the needle and wait for container to arrive
  
• Separate the needle from syringe and throw in the garbage cane
  
• Recapped the needle
  

In this questions the answer is B leave the needle and wait for the container to arrive. to me that sounded wrong because I have been thought to never leave needles in the room and should always be thrown in the sharps container but since in this situation there is no sharps container I thought the best way is to recap the needle(thought I know this isnt good to because of needle stick injuries). can someone clarify this questions to me thank you.

After delivery mother is fine back to ward V/S stable lochia normal c/o of severe episiotomy pain what will the nurse do?

• Apply analgesic cream
  
• Give an ice pack to the episostomy area
  
• Inform Doctor
  
• Tell her to liedown in supine position for a few hours
  

Now for this questions the answer is also B give an ice pack to the episostomy area. can someone explain to me why an ice pack would be applied the only thing i can think of is because it will numb the area so it doesnt hurt.

A client is on oxygen how will you know what is danger to her?

• The water tank in the humidifier is very low
  
• The oxygen tank has been taken out from the holder
  
• Patient in on comfortable position
  
• Nurse are monitoring the patient continuously
  

For this question the answer is a the water tank is in the humidifier is very low. I read in another book with the same question and it said the answer is the oxygen tank has been taken out from the holder was the right answer. so really which one is the real answer?

So i just wanted to clarify a few things about those questions (I have many more but I don't wanna be posting a whole bunch of questions). Thank You!

Here's another questions that confused me

Mr. Emanual is on blood transfusion after 1 hour he got reaction client complained of back pain nausea and vomiting chills. What should the nurse do?

A. Stop the transfusion and inform the RN

B. Stop the transfusion call the DR immediately

C. Stop the transfusion and flush with NS

D. Stop transfusion and monitor vital signs

The answer is b stop the transfusion call the dr immediately. I know that if an allergic reaction happens your suppose to stop the blood transfusion but for this my answer was stop it then flush with NS. usually all the blood transfusion questions I have done always said the right answer was stop the infusion and administer NS because Blood transfusion can only be done with NS. so why would NS not be the answer and call the dr immediately be the right one.

[CaregiverGrace]

water tank for humidifier being low only seems like a "danger" if the pt has had some severe dryness of the airways that requires constant humidification. But a portable O2 tank out of the holder is a real "danger" should it fall, get damaged, and rapidly decompress creating a projectile.

Depending on severity of episiotomy pain, I would think that contacting the Doc would not be unreasonable.

As far as the first question, it seems like putting the needle out of harms way until you can locate a sharps bin seems like the best answer.

[Sun0408, ASN, RN]

From the way things were explained to me for NCLEX, every department is always open so that sharps box would be on its way. Also all of the others answers have a greater risk of needle stick.

As for the pain, NCLEX wants to know what you will do, sometimes that is calling the MD (depending on the question) they don't want to know what the MD will do. So what can you do to help this pt NOW.. The med would need an order, calling the MD is not needed YET, everything else is WNL and pain is expected after birth.. So yes, the ice pack would be best.

As for the O2, I would think the immediate danger for her right now is the humidifier. Both answers are correct depending on how it is written..

[klone, MSN, RN]

If perineal area looks okay (no hematoma forming) then yes, apply ice packs (as well as Dermoplast and witch hazel) to the area.

[Sarah010101]

For question 1.. the first thing i thought of was to go to the biohazard container in the medroom and stick it in there. I would have flicked the safety cap and put it in there... i know thats not an answer on there, but is that actually wrong?

and after my psychiatric rotation i would never leave a needle laying around.. capped or not.

[MyLady23]

Your last question: You would NOT flush with saline, because then you would also inject the rest of the blood still in the line. Since you know it is a allergic reaction, you call the MD.

That's what I learned.

Good luck to you in your NCLEX, it sounds like you will do just fine!

[Sun0408, ASN, RN]

Yes for the last question you would not flush with NS because the tubing still has the blood product in it.. It take a few minutes of running NS to flush all the blood out of the tubing..

[Sarah010101]

for the last question you would not flush with NS because the tubing still has the blood product in it.. It take a few minutes of running NS to flush all the blood out of the tubing

Why then would you have a prepped NS line ready to go then.."just in case".. i always thought it was if a transfusion rx occurred.. you would switch over to NS

[R2K2NE1]

Yes for the last question you would not flush with NS because the tubing still has the blood product in it.. It take a few minutes of running NS to flush all the blood out of the tubing..

I totally forgot about that.THANKS!.But i've also been thought that some iv lines have two ports one for just blood to go into and the other is for flushing normal saline. I remember having this discussion with the class and the teacher. There was two teacher there at the time and both had different opinion and explanation but the one i can remember clearly is that there are some iv lines with two ports so it would be okay to insert the NS.

[R2K2NE1]

Why then would you have a prepped NS line ready to go then.."just in case".. i always thought it was if a transfusion rx occurred.. you would switch over to NS

This is what i thought also, because whats the point of having NS if your not going to administer it.

Because i've been thought before administering blood you must double check with another nurse and checking for clotting factors,rh, blood type, right client etc......

[Sarah010101]

This is what i thought also, because whats the point of having NS if your not going to administer it.

Because i've been thought before administering blood you must double check with another nurse and checking for clotting factors,rh, blood type, right client etc......

Hmm.. I will have to go look in my textbook again.. but I always was under the assumption that you had the NS on standby because it was there incase you had to switch over to it incase of a transf. rx... almost like a TKVO kinda thing..

And yes, where I am we need to have the administering RN plus 2 other RNs to check the information...

Hmm... can someone clairify this for us?

[tyvin, BSN, RN]

Seems all has been answered well except you want to know why the ice is applied; the reason you want to apply ice is to help prevent swelling (plus the numbing effect). If the area doesn't swell then then there is less pain with the healing process. It's usually a standing order and doesn't require any medication.