Question 1

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.

Accepted Answer

A, B, C, E

Question 2

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

Accepted Answer

Thrombocytopenia is a condition characterized by an abnormally low number of platelets in the blood. Platelets are necessary for blood clotting, so thrombocytopenia can result in excessive bleeding or bruising.

Question 3

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:

Accepted Answer

A client with type A-negative blood who delivers a type A-positive fetus is at risk for developing antibodies to the D-antigen. This can occur when the fetus’s blood, which is usually not Rh-negative, enters the mother’s bloodstream during delivery. This exposure may cause the client to develop anti-D antibodies, which can cause hemolytic disease of the newborn in future pregnancies.

Question 4

A client who is to receive 4 units of whole blood has a hemoglobin (Hgb) level of 5 g/dL. A nurse should anticipate that the complete blood count after transfusion will reflect an Hgb of g/dL.

Accepted Answer

The answer of A client who is to receive 4...

Question 5

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

Accepted Answer

An autologous donation involves the donor giving their own blood to be used only by themselves at a later time. This is typically done prior to a planned medical procedure, such as surgery, to ensure a supply of compatible blood is available if needed. Autologous donations are not used for bone marrow transplants or for other patients, and they are not donated directly to a specified recipient.

Question 6

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:

Accepted Answer

A fluid warmer is primarily used for the administration of blood products in order to prevent hypothermia, which can occur when cold blood is infused into the body. PN and solutions for pediatric or geriatric clients do not typically require a fluid warmer.

Question 7

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?

Accepted Answer

As the client is a Jehovah's Witness, they may refuse blood transfusions based on religious beliefs. The nurse should notify the physician of the client's refusal and work with the healthcare team to find alternative treatments. Respect for the client's beliefs is essential, and the nurse should not attempt to convince them to accept the transfusion.

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?

Accepted Answer

Hepatitis B virus is the primary cause of post-transfusion hepatitis. It can be transmitted through blood transfusions, sexual contact, and sharing of needles. The other options are not commonly associated with post-transfusion hepatitis.

Question 9

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.

Accepted Answer

The answer of A nurse is ordered to perform a...

Question 10

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?

Accepted Answer

A-positive blood contains Anti-B antibodies in the plasma.

Question 11

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?

Accepted Answer

Normal saline is the preferred I.V. fluid for facilitating the infusion of blood products due to its isotonicity with blood. Lactated Ringer's and 5% dextrose in water are not recommended because they may cause hemolysis of the blood cells. 5% dextrose and normal saline may also be used, but normal saline alone is the preferred choice.

Question 12

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.

Accepted Answer

The laboratory should check for both ABO blood groups and Rh factor as part of the type and crossmatch procedure to ensure that the correct blood is given to the client. Immunoglobulin M and Human leukocyte antigen testing are not typically part of a routine type and crossmatch.

Question 13

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.

Accepted Answer

The answer of A physician orders an infusion of fresh...

Question 14

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:

Accepted Answer

Furosemide (Lasix) is a loop diuretic that promotes diuresis by inhibiting sodium and chloride reabsorption in the ascending loop of Henle. It is often given to prevent circulatory overload in clients receiving blood transfusions, as excess fluid can lead to complications such as heart failure and pulmonary edema.

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?

Accepted Answer

The blood tubing should be flushed with sodium chloride before changing to the primary I.V. administration set to prevent the mixing of incompatible fluids and to avoid blood incompatibility reactions. Aspirating the I.V. line before connecting the I.V. solution tubing is not necessary as the sodium chloride bag is compatible with the RBCs. Infusing the remaining sodium chloride before attaching the new primary I.V. administration set is also not necessary and may cause fluid overload. Disconnecting the tubing while there is blood in the line and attaching the primary I.V. administration set is not recommended as it can cause air embolism or contamination of the line.

Question 16

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?

Accepted Answer

Thrombocytopenia is a decrease in platelet count. In this scenario, the client is experiencing thrombocytopenia secondary to chemotherapy. Therefore, the laboratory test result that would be consistent with thrombocytopenia from chemotherapy is a low platelet count. Option A is incorrect because low white blood cell count would indicate leukopenia. Option C is incorrect because low red blood cell count would indicate anemia. Option D is incorrect because high platelet count is not consistent with thrombocytopenia.

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.

Accepted Answer

Before administering blood, the nurse should verify the ABO and Rh type, client identification with two independent identifiers, donor unit number, and expiration date with another nurse to ensure safety and accuracy. Client room number is not relevant to the administration of blood and does not need to be verified with another nurse.

Question 18

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:

Accepted Answer

The standard practice for infusing a unit of packed red blood cells (PRBCs) is to administer it over a period of approximately 4 hours. This timeframe helps minimize the risk of complications and allows for monitoring of any adverse reactions.

Question 19

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:

Accepted Answer

Generally, packed red blood cells are infused over a period of 2-4 hours. 1 unit of packed red blood cells is usually infused over 2-4 hours but not less than 2 hours or more than 4 hours. Therefore, the correct answer is C: 4 hours.

Quiz 11: Transfusion Therapy