Blood Transfusion Competency
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1.
A nurse is preparing to administer packed red blood cells (PRBCs). Which action is
most important immediately before initiating the transfusion?
A. Obtain the patient's temperature
B. Flush the IV catheter with dextrose 5% in water
C. Verify the blood product and patient identification with another authorized
clinician
D. Warm the blood to room temperature
Answer: C. Verify the blood product and patient identification with another
authorized clinician
Rationale: Accurate patient identification and blood-product verification are
critical safeguards against incompatible transfusion. The nurse should follow
institutional requirements for independent verification before starting the
blood.
2.
A patient develops chills, fever, flank discomfort, and hypotension 10 minutes
after PRBC administration begins. What is the nurse's priority action?
,A. Slow the transfusion
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Obtain a urine specimen
Answer: B. Stop the transfusion immediately
Rationale: These findings may indicate an acute hemolytic transfusion reaction.
The transfusion must be stopped immediately to prevent additional exposure to
the suspected incompatible blood.
3.
Which IV solution is compatible with administration of packed red blood cells?
A. Lactated Ringer's
B. Dextrose 5% in water
C. 0.9% sodium chloride
D. Dextrose 10% in water
Answer: C. 0.9% sodium chloride
Rationale: Normal saline is compatible with blood products. Dextrose-
containing solutions can cause red-cell hemolysis, while calcium-containing
solutions such as Lactated Ringer's may promote clotting.
4.
A patient receiving blood develops urticaria and itching but has no respiratory or
cardiovascular symptoms. Which reaction is most consistent with these findings?
A. Acute hemolytic reaction
B. Mild allergic reaction
C. Transfusion-associated circulatory overload
D. Septic transfusion reaction
Answer: B. Mild allergic reaction
,Rationale: Isolated itching and urticaria commonly indicate a mild allergic
reaction to plasma proteins. The transfusion should be stopped and the patient
assessed according to institutional protocol.
5.
Which blood component is most appropriate for a patient with symptomatic
anemia and inadequate oxygen-carrying capacity?
A. Fresh frozen plasma
B. Platelets
C. Packed red blood cells
D. Cryoprecipitate
Answer: C. Packed red blood cells
Rationale: PRBCs increase hemoglobin concentration and oxygen-carrying
capacity without providing the large plasma volume associated with whole
blood.
6.
A nurse notices that a patient's blood pressure has increased, oxygen saturation
has decreased, and the patient develops dyspnea and crackles during transfusion.
Which complication is most concerning?
A. TACO
B. TRALI
C. Mild allergic reaction
D. Delayed hemolytic reaction
Answer: A. TACO
Rationale: Transfusion-associated circulatory overload (TACO) results from
excessive intravascular volume and commonly causes hypertension, pulmonary
edema, dyspnea, and hypoxemia.
7.
, Which finding more strongly suggests transfusion-related acute lung injury (TRALI)
rather than TACO?
A. Hypertension and elevated jugular venous pressure
B. Positive fluid balance with peripheral edema
C. Acute hypoxemia without evidence of circulatory overload
D. Improvement after diuretic therapy
Answer: C. Acute hypoxemia without evidence of circulatory overload
Rationale: TRALI presents with acute pulmonary edema and hypoxemia that are
not primarily caused by circulatory overload. TACO more commonly features
hypertension and signs of volume excess.
8.
How should a unit of PRBCs generally be handled if it has been removed from
controlled blood-bank storage but cannot be started promptly?
A. Place it in the patient's room until needed
B. Return it promptly according to blood-bank policy
C. Store it in the medication refrigerator
D. Freeze it until administration
Answer: B. Return it promptly according to blood-bank policy
Rationale: Blood components require controlled storage conditions. If
administration is delayed, the product should be returned promptly according to
facility and blood-bank requirements.
9.
A patient has type O-negative blood. Which statement is correct?
A. The patient can safely receive any Rh-positive blood
B. The patient is considered a universal recipient
C. The patient has A and B antigens on red blood cells
D. The patient's red blood cells lack A, B, and Rh(D) antigens
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1.
A nurse is preparing to administer packed red blood cells (PRBCs). Which action is
most important immediately before initiating the transfusion?
A. Obtain the patient's temperature
B. Flush the IV catheter with dextrose 5% in water
C. Verify the blood product and patient identification with another authorized
clinician
D. Warm the blood to room temperature
Answer: C. Verify the blood product and patient identification with another
authorized clinician
Rationale: Accurate patient identification and blood-product verification are
critical safeguards against incompatible transfusion. The nurse should follow
institutional requirements for independent verification before starting the
blood.
2.
A patient develops chills, fever, flank discomfort, and hypotension 10 minutes
after PRBC administration begins. What is the nurse's priority action?
,A. Slow the transfusion
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Obtain a urine specimen
Answer: B. Stop the transfusion immediately
Rationale: These findings may indicate an acute hemolytic transfusion reaction.
The transfusion must be stopped immediately to prevent additional exposure to
the suspected incompatible blood.
3.
Which IV solution is compatible with administration of packed red blood cells?
A. Lactated Ringer's
B. Dextrose 5% in water
C. 0.9% sodium chloride
D. Dextrose 10% in water
Answer: C. 0.9% sodium chloride
Rationale: Normal saline is compatible with blood products. Dextrose-
containing solutions can cause red-cell hemolysis, while calcium-containing
solutions such as Lactated Ringer's may promote clotting.
4.
A patient receiving blood develops urticaria and itching but has no respiratory or
cardiovascular symptoms. Which reaction is most consistent with these findings?
A. Acute hemolytic reaction
B. Mild allergic reaction
C. Transfusion-associated circulatory overload
D. Septic transfusion reaction
Answer: B. Mild allergic reaction
,Rationale: Isolated itching and urticaria commonly indicate a mild allergic
reaction to plasma proteins. The transfusion should be stopped and the patient
assessed according to institutional protocol.
5.
Which blood component is most appropriate for a patient with symptomatic
anemia and inadequate oxygen-carrying capacity?
A. Fresh frozen plasma
B. Platelets
C. Packed red blood cells
D. Cryoprecipitate
Answer: C. Packed red blood cells
Rationale: PRBCs increase hemoglobin concentration and oxygen-carrying
capacity without providing the large plasma volume associated with whole
blood.
6.
A nurse notices that a patient's blood pressure has increased, oxygen saturation
has decreased, and the patient develops dyspnea and crackles during transfusion.
Which complication is most concerning?
A. TACO
B. TRALI
C. Mild allergic reaction
D. Delayed hemolytic reaction
Answer: A. TACO
Rationale: Transfusion-associated circulatory overload (TACO) results from
excessive intravascular volume and commonly causes hypertension, pulmonary
edema, dyspnea, and hypoxemia.
7.
, Which finding more strongly suggests transfusion-related acute lung injury (TRALI)
rather than TACO?
A. Hypertension and elevated jugular venous pressure
B. Positive fluid balance with peripheral edema
C. Acute hypoxemia without evidence of circulatory overload
D. Improvement after diuretic therapy
Answer: C. Acute hypoxemia without evidence of circulatory overload
Rationale: TRALI presents with acute pulmonary edema and hypoxemia that are
not primarily caused by circulatory overload. TACO more commonly features
hypertension and signs of volume excess.
8.
How should a unit of PRBCs generally be handled if it has been removed from
controlled blood-bank storage but cannot be started promptly?
A. Place it in the patient's room until needed
B. Return it promptly according to blood-bank policy
C. Store it in the medication refrigerator
D. Freeze it until administration
Answer: B. Return it promptly according to blood-bank policy
Rationale: Blood components require controlled storage conditions. If
administration is delayed, the product should be returned promptly according to
facility and blood-bank requirements.
9.
A patient has type O-negative blood. Which statement is correct?
A. The patient can safely receive any Rh-positive blood
B. The patient is considered a universal recipient
C. The patient has A and B antigens on red blood cells
D. The patient's red blood cells lack A, B, and Rh(D) antigens
