Deck 11: Transfusion Therapy

Question 1

A physician instructs a nurse to obtain a fluid warmer before implementing written orders for a client. The nurse obtains the fluid warmer knowing that it is used primarily for the administration of:

A)parenteral nutrition (PN).
B)solutions for the pediatric client.
C)blood.
D)solutions for the geriatric client.

Answer 1

C

Question 2

A nurse is preparing to administer a unit of packed red blood cells to a client. Which type of I.V. fluid should be used to facilitate the infusion of blood for this client?

A)Lactated Ringer's
B)Normal saline
C)5% dextrose in water
D)5% dextrose and normal saline

Answer 2

B

Question 3

A physician orders an infusion of fresh frozen plasma (FFP) for a client. A nurse administers the infusion knowing that FFP is used for which purposes? SELECT ALL THAT APPLY.

A)Platelet deficiencies
B)Demonstrated factor deficiencies
C)Warfarin sodium (Coumadin) drug reversal
D)Antithrombin III deficiency
Completion
Complete each statement.

Answer 3

B, C, D

Question 4

A nurse sends a client's blood specimen to the laboratory for a type and crossmatch. For which antigens in the blood system should the laboratory check? SELECT ALL THAT APPLY.

A)ABO blood groups
B)Rh factor
C)Immunoglobulin M (IgM)
D)Human leukocyte antigen (HLA)

Question 5

A unit of packed red blood cells (PRBCs) is ordered for a client with anemia. The physician does not specify a rate for the infusion, according to standards of practice. Thus, the nurse should set the transfusion drip rate so that the PRBCs will be infused within:

A)1/2 hour.
B)1 hour.
C)2 hours.
D)4 hours.

Question 6

A nurse obtains a blood specimen for type and cross match for a client suspected of having type A-positive blood. The nurse understands that A-positive blood contains which antibody in the plasma?

A)Anti-A
B)Anti-O
C)Anti-B
D)Anti-A and anti-B

Question 7

A client presents to a hospital laboratory wishing to make an autologous donation. An autologous donation is defined as the donation of:

A)bone marrow to be used for transplant.
B)blood by a donor to be used only by the donor.
C)blood directly from one donor to a specified recipient.
D)blood in a similar structure from a volunteer donor to a compatible recipient.

Question 8

A nurse is caring for a client diagnosed with post-transfusion hepatitis after a blood transfusion. Which virus is the primary cause of post-transfusion hepatitis?

A)Hepatitis A virus
B)Hepatitis B virus
C)Cytomegalovirus
D)HIV

Question 9

A maternal-child nurse is caring for a client who has type A-negative blood, received no prenatal care, and delivered a type A-positive fetus. The nurse is concerned for the client because previous exposure to an antigen through pregnancy or transfusion may cause the client to develop:

A)more antigens.
B)an antibody to an antigen.
C)tolerance to a transfusion.
D)alloimmunization to the antibody.

Question 10

A client is concerned about receiving donated blood for fear of contracting AIDS. A nurse reassures the client knowing that all transfusions are screened for which antibodies? SELECT ALL THAT APPLY.

A)Syphilis
B)HIV
C)Surface hepatitis B
D)Mononucleosis
E)T-lymphotrophic virus

Question 11

A physician orders 1 unit of packed red blood cells for a client diagnosed with anemia. A nurse correctly infuses the blood cells over a period of:

A)1 hour.
B)2 hours.
C)4 hours.
D)6 hours.

Question 12

A nurse is ordered to perform a type and cross match on a client scheduled for surgery. During the "type and cross," the laboratory technician tests the client's blood for the presence of which antigens? SELECT ALL THAT APPLY.

A)ABO
B)HLA
C)Rh
D)IgM

Question 13

A 25-year-old client who is a Jehovah's Witness was recently diagnosed with multiple myeloma. The client presents with a hemoglobin (Hgb) level of 6 g/dL. The client's physician orders a transfusion of 4 units of red blood cells, but the client refuses. Which is the most appropriate action by a nurse?

A)Do nothing.
B)Administer the transfusion as ordered.
C)Notify the physician of the client's refusal.
D)Convince the client to accept the transfusion.

Question 14

A nurse is caring for a client who is experiencing thrombocytopenia secondary to chemotherapy. Which laboratory test result would be consistent with thrombocytopenia from chemotherapy?

A)Low white blood cell count
B)Low platelet count
C)Low red blood cell count
D)High platelet count

Question 15

A nurse has transfused a unit of packed RBCs, which has a 250-mL bag of 0.9% sodium chloride attached. The follow-up I.V. order is to hang a 1000-mL bag of 5% dextrose in water. Which steps should be taken by the nurse after completing the transfusion and initiating the next I.V. order?

A)Aspirate the I.V.line before connecting the I.V.solution tubing.
B)Infuse the remaining sodium chloride before attaching the new primary I.V.administration set.
C)Flush the blood tubing with sodium chloride before changing to the primary I.V.administration set.
D)Disconnect the tubing while there is blood in the line and attach the primary I.V.administration set.

Question 16

A 90-year-old client is receiving 2 units of packed red blood cells. Furosemide (Lasix) 80 mg I.V. pyelography has been ordered after the first unit of blood has infused. The client asks a nurse why she is getting Lasix. The nurse's response should be based on the understanding that furosemide:

A)prevents pulmonary emboli.
B)prevents circulatory overload.
C)lowers the blood pressure.
D)counteracts the transfusion-induced hypercalcemia.

Question 17

A nurse is preparing to administer blood to a client. Before hanging a unit of blood, which information is a nurse responsible for verifying with another nurse? SELECT ALL THAT APPLY.

A)ABO and Rh
B)Client identification with two independent identifiers
C)Donor unit number
D)Expiration date
E)Client room number

Question 18

A nurse is caring for a client diagnosed with thrombocytopenia. Thrombocytopenia is an abnormally low number of:

A)platelets in the blood.
B)antibodies in the blood.
C)RBCs in the blood.
D)white blood cells in the blood.