med surg

1. On average, in a 70 kg adult, 1 unit of PRBCs incrases the hematrocrit (Hct) by: a. 3% b. 1 g/dl c. 10% d. 2 g/dl

A

1. The client has an order to receive 2 units of packed RBC's. The nurse begins to assess the client's knowledge of the procedure by asking which of the following initial questions? a. "Have you ever had a transfusion before?" b. "Have you ever gone into anaphylactic shock from a transfusion in the past?" c. "Can you tell me everything the doctor told you about why you need the transfusion?" d. "Does the idea of receiving blood frighten you in any way?"

A

1. The physician orders a STAT blood transfusion for a patient with GI bleeding. In the event of an emergency when un-crossmatched blood is used, which blood type to you expect to administer? a. O negative b. AB negative c. AB positive d. A negative

A

1. Which of the following infectious diseases may be transmitted from blood products? a. Cytomegalovirus b. Meningitis c. Mumps d. Rubella

A

The physician orders transfusion with packed red blood cells for a patient who has severe anemia resulting from a bleeding peptic ulcer. The most important action by the nurse to prevent a transfusion reaction when administering the blood is to: a. verify and document patient identification b. keep the blood chilled during administration c. administer the blood at a rate of no more than 2 ml/ min d. stay with the patient during the first 15 minutes of the transfusion

A

1. An adult female is admitted to the hospital with a bleeding ulcer. She is to receive 4 units of packed cells. Which nursing intervention is of primary importance in the administration of blood? a. Checking the flow rate b. Identifying the client c. Monitoring the vital signs d. Maintaining blood temperature

B

1. Within an hour after beginning to transfuse a unit of packed RBC's to an assigned client, the nures finds the client to be restless with complaints of chills and back pain. The nurse notes that there is dark-colored urine in the catheter drainage bag. The nurse interprets that the client is most likely experiencing which of the following reactions? a. delayed hemolytic b. acute hemolytic c. hyperkalemic d. Allergic

B

1. You should start a blood transfusion at a slow rate in order to: a. maintain blood volume b. observe for the effect of any transfusion reaction c. prevent clot formation at the tip of the venipuncture device d. allow the blood to warm to room temperature so the patient won't become chilled

B

A potential blood donor would be rejected if he or she: a. had a history of a sinus infection in the past 2 months b. received a tattoo in the last 6 months c. had donated blood 6 months ago d. had received a blood transfusion 12 months before the blood donation time

B

1. A new RN is preparing to administer packed red blood cells (PRBCs) to a patient whose anemia was caused by blood loss after surgery. Which action by the new RN requires that you, as charge nurse, intervene immediately? a. The new RN waits 20 minutes after obtaining the PRBCs before starting the infusion. b. The new RN starts an intravenous line for the transfusion using a 22-gauge catheter. c. The new RN primes the transfusion set using 5% dextrose in lactated Ringer's solution. d. The new RN tells the client that the PRBCs may cause a serious transfusion reaction

C

1. A patient has a hemoglobin of 8 gms/dl and receives two units of packed red blood cells. Which of the following lab results is expected when blood is drawn 6 hours later? a. Hg 8 gms/dl b. Hg 9 gms/dl c. Hg 10 gms/dl d. 11 gms/dl

C

1. A transfusion of PRBCs has been infusing for 5 minutes when the client becomes flushed and tachypneic and says "I am having chills. Please get me a blanket." Which action should you take first? a. Obtain a warm blanket for the client. b. Check the client's oral temperature. c. Stop the transfusion. d. Administer oxygen.

C

1. The nurse is monitoring blood administration to a trauma victim in shock. Which of the following assessments indicate a dangerous transfusion reaction? a. red raised areas (wheals) on the skin that itch b. an increase in body temperature by 3 degrees c. decreasing blood pressure and dyspnea d. increasing blood pressure and pulse

C

1. To expand plasma volume or to replace clotting factors, you would expect to give: a. platelets b. whole blood c. fresh frozen plasma d. albumin

C

1. Which nursing intervention is appropriate for the nurse to take when setting up supplies for a client who requires a blood transfusion? a. Add any needed IV medication in the blood bag within one half hour of planned infusion b. Obtain blood bag from laboratory and leave at room temperature for at least one hour prior to infusion c. Prime tubing and filter of blood administration set with 0.9% NS solution d. Use a small-bore catheter to prevent rapid infusion of blood products that may lead to a reaction

C

A nurse determines that a client receiving a unit of packed red blood cells (RBCs) is experiencing a transfusion reaction. The nurse promptly stops the blood transfusion and does which of the following next? a. Contact the physician b. Obtain a white blood cell count c. Run normal saline at keep vein open (KVO) rate d. Infuse a normal saline bolus

C

The nurse must insert an IV line to use for blood transfusion for an assigned patient on a medical unit. Which of the following catheters is the preferred size? a. 24 gauge b. 22 gauge c. 18 gauge d. 16 gauge

C

1. A man's blood type is AB and he requires a blood transfusion. To prevent complications of blood incompatabilities, the nurse knows that this client may receive: a. type A or B blood only b. type AB blood only c. type O blood only d. type A, B, AB, or O blood only

D

1. The client receiving a blood transfusion rings the call bell for the nurse. Upon entering the room, the nurse notes the client is flushed and dyspneic and is complaining of generalized itching. The nurse interprets the findings as: a. fluid overload b. bacteremia c. hypovolemic shock d. transfusion reaction

D

1. The client requiring upcoming surgery is extremely anxious about the need for possible blood transfusion during or after surgery. The nurse advises the client to do which of the following as the most effective way to eliminate the risk? a. take iron supplements before surgery to boost hemoglobin levels b. request that donated blood be screened twice by the blood bank c. ask a friend or family member to donate ahead of time d. donate autologous blood prior to the surgery

D

1. The client who was receiving a blood transfusion has experienced a transfusion reaction. The nurse should plan to send the blood bag to which of the following areas after discontinuing the unit from the client? a. risk management b. laboratory c. pharmacy d. blood bank

D

1. The nurse is checking a unit of blood with another nurse prior to initiating a transfusion. The nurse notes that the blood type, Rh, expiration date, and unit number on the bag match the requisition, but there is a discrepancy in the client's name. Which of the following actions should the nurse plan to take next? a. Hang the unit of blood since the blood information matches b. Cross out the incorrect name and write in the correct one c. Notify the physician that the client will not receive any blood d. Call the blood bank about the discrepancy

D

1. The nurse is preparing to infuse a unit of blood to an assigned client. The nurse asks which of the following members of the health care team to assist in checking the unit of blood immediately: a. Pharmacist b. Phlebotomist c. Nursing assistant d. Registered nurse

D

The nurse has transfused a unit of packed RBC's, which has a 250ml bag of 0.9% sodium chloride (normal saline) attached. The follow up IV order is to hang a 1000ml bag of 5% dextrose in water. Which of the following steps would the nurse take in the process of discontinuing the completed transfusion? a. Aspirate the IV line before connecting the IV solution tubing b. Disconnect the tubing while there is blood in the line and attach the new IV solution c. Infuse the rest of the normal saline before changing from the blood tubing to the new IV solution d. Flush the blood tubing with normal saline before changing to the new IV solution

D

Within 20 minutes of the start of transfusion, the client develops a sudden fever. The most appropriate initial response by the nurse is to: a. Force fluids b. Continue to monitor vital signs c. Increase the rate of IV fluids d. Stop the transfusion

D