Deck 30: Blood Therapy

Question 1

The patient is to receive 1 unit of packed red blood cells (RBCs).The nurse obtains the blood from the blood bank and returns to the unit to find that the patient has been taken to radiology for a computed tomography (CT)scan and is expected to return in about an hour.What should the nurse do?

A) Go to radiology and administer the blood.
B) Keep the blood refrigerated until the patient returns.
C) Return the blood to the blood bank.
D) Hang the blood in the patient's room and start it when the patient returns.

Answer 1

Return the blood to the blood bank.

Question 2

The patient is to receive 2 units of packed red blood cells (RBCs).The units are cold,and the nurse is concerned that this could lead to arrhythmias and/or a reduction in core temperature.What action may the nurse take to prevent this?

A) Warm the blood in a microwave.
B) Warm the blood using hot water.
C) Warm the blood using a blood warmer.
D) Allow the blood to warm to room temperature before administering.

Answer 2

Warm the blood using a blood warmer.

Question 3

The patient is receiving a unit of packed red blood cells (RBCs).Fifteen minutes into the procedure,he complains of severe kidney pain,and his temperature increases by 1.6°C (3°F).The nurse stops the transfusion immediately,suspecting that which of the following reactions is occurring?

A) Delayed hemolytic transfusion reaction
B) Nonhemolytic febrile reaction
C) Acute hemolytic transfusion reaction
D) Severe allergic reaction

Answer 3

Acute hemolytic transfusion reaction

Question 4

The patient is scheduled to receive 1 unit of packed red blood cells (RBCs).She has small,fragile veins,and a 22-gauge intravenous (IV)patent catheter is in place.What should the nurse do?

A) Cancel the blood transfusion.
B) Insert a 16-gauge IV catheter into the antecubital fossa.
C) Use the IV catheter that is in place.
D) Transfuse the blood over 6 hours.

Question 5

The patient has received a total of 7 units of blood over the past 8 hours.The nurse assesses the patient's laboratory test results.Which of the following would be an expected complication?

A) Hypokalemia
B) Hyperkalemia
C) Hypercalcemia
D) Iron deficiency

Question 6

The patient is brought to the emergency department after a motor vehicle accident and has lost a large volume of blood.The patient's blood type is AB.Which blood type may this patient safely receive in transfusion?

A) Only type AB blood
B) Only type O blood
C) All blood types
D) Only type A blood

Question 7

A transfusion in which the donor is the patient is known as a(n)______________ transfusion.

A) allogenic
B) autologous
C) leukocyte
D) antibody

Question 8

The patient has received blood within the past 6 hours.The patient begins to feel short of breath and calls for the nurse.The nurse finds that the patient is dusky in colour with crackles throughout his lungs and is coughing up pink frothy sputum.The nurse calls the physician immediately,knowing that the patient is showing signs of _________________.

A) delayed hemolytic transfusion reaction
B) transfusion-related acute lung injury (TRALI)
C) nonhemolytic febrile reaction
D) severe allergic transfusion reaction

Question 9

The nurse is administering blood.What should the nurse do to detect a blood reaction as quickly as possible?

A) Remain with the patient during the first 15 minutes.
B) Transfuse the blood at 10 mL per minute.
C) Monitor vital signs q 1 hour.
D) Transfuse blood at 50 gtt per minute.

Question 10

A nurse is concerned about the type of blood that a patient is to receive.A patient with an O blood type may safely receive which type of blood?

A) Type A blood
B) Type B blood
C) Type AB blood
D) Type O blood

Question 11

The patient is scheduled to receive a blood transfusion.Preadministration laboratory tests are run to assess the level of which component in the patient's blood?

A) Sodium (Na)
B) Calcium (Ca)
C) Potassium (K)
D) Iron (Fe)

Question 12

When a patient's adverse reaction to a blood transfusion is differentiated,which of the following signs and symptoms indicates the presence of an anaphylactic response?

A) Wheezing and chest pain
B) Headache and muscle pain
C) Hypotension and tingling of the extremities
D) Crackles in the lungs and increased central venous pressure

Question 13

The patient has been home from the hospital for 10 days.On the last day of his hospitalization,he received 2 units of packed red blood cells (RBCs).This morning,he noticed that his skin had a yellow tint to it and his temperature was elevated.Which reaction might this patient be experiencing?

A) Delayed hemolytic transfusion reaction
B) Acute hemolytic transfusion reaction
C) Nonhemolytic febrile reaction
D) Severe allergic transfusion reaction

Question 14

What primary intervention should a nurse who is preparing a blood transfusion perform?

A) Set up the Y tubing.
B) Obtain 0.9% saline.
C) Verify the blood product and the patient.
D) Have the patient void or empty the urine drainage container.

Question 15

An appropriate technique for the nurse to implement for a blood transfusion is to

A) provide medication through the intravenous (IV)tubing with the blood.
B) regulate the flow of blood so that it infuses over 8 hours.
C) clear the IV tubing with normal saline after the blood infuses.
D) administer a blood product with clots through a filter line.

Question 16

The nurse is preparing to administer a unit of blood to a patient using blood tubing.On the blood product side of the Y tubing,the nurse will hang blood.What will be hung on the other side of the Y tubing?

A) Dextrose 5%
B) Normal saline
C) Dextrose 10%
D) Dextrose 5%/normal saline

Question 17

The specific blood product used for replacement of clotting factors and fibrinogen is

A) whole blood.
B) packed red blood cells (RBCs).
C) cryoprecipitate.
D) albumin,25% pooled.

Question 18

Under the ABO system,the blood type __________ can be given to any individual and is known as the "universal donor."

A) O positive
B) O negative
C) AB positive
D) AB negative

Question 19

The nurse is caring for a patient who needs a blood transfusion.The patient has been tested and was found to have blood type O.The nurse knows this means that which antigen is present on the surface of the red blood cells?

A) The type A antigen is present.
B) The type B antigen is present.
C) Neither type A nor type B antigens are present.
D) Both type A and type B antigens are present.

Question 20

The nurse is administering 1 unit of packed red blood cells as ordered by the primary care provider.While the nurse is measuring vital signs 15 minutes after starting the transfusion,the patient complains of chills and back pain.What is the nurse's first action?

A) Stop the blood transfusion and keep the vein patent by administering saline to infuse from the other side of the Y tubing.
B) Slow the blood transfusion and notify the charge nurse.
C) Disconnect the blood tubing from the catheter and replace it with an infusion of normal saline.
D) Stop the blood transfusion and notify the primary care provider.

Question 21

Transfusion therapy is the intravenous (IV)administration of which of the following? (Select all that apply.)

A) Whole blood
B) Plasma products
C) Red blood cells (RBCs)
D) Platelets
E) None of the above

Question 22

The patient is receiving blood when he suddenly complains of low back pain and develops diaphoresis and chills.The nurse should (Select all that apply.)

A) stop the transfusion.
B) start normal saline connected to the Y tubing.
C) notify the physician.
D) start normal saline using new intravenous (IV)tubing.

Question 23

What is the purpose of administering a transfusion? (Select all that apply.)

A) Restore intravascular volume.
B) Restore the oxygen-carrying capacity of blood.
C) Provide clotting factors.
D) Improve blood pressure.

Question 24

Symptoms that indicate an adverse reaction to blood products include which of the following? (Select all that apply.)

A) Fever
B) Skin rash
C) Hypotension
D) Cardiac arrest
E) None of the above

Question 25

The patient is to receive 2 units of packed red blood cells (RBCs).Before administering the blood,what does the nurse need to do? (Select all that apply.)

A) Insert an 18-gauge intravenous (IV)cannula.
B) Have the patient complete a consent form.
C) Obtain pretransfusion vital signs.
D) Notify the physician for a temperature of 37°C.