BSN 366 VCBC SCOTT BECKER UPPER GI BLEED | COMPLETE
HOURLY ROUNDS, ASSESSMENT, PRBC TRANSFUSION &
NURSING MANAGEMENT | 2026 UPDATE COMPLETE -
NIGHTINGALE COLLEGE.
90 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
BSN 366 VCBC SCOTT BECKER UPPER GI BLEED | COMPLETE HOURLY ROUNDS, ASSESSMENT, PRBC
TRANSFUSION & NURSING MANAGEMENT | 2026 UPDATE COMPLETE - NIGHTINGALE COLLEGE.. It
contains 90 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 90 Questions
Foundations - Application - BSN 366 VCBC Scott Becker Upper GI Bleed Complete Hourly Rounds
Assessment PRBC Transfusion & Nursing Management 2026 Update Complete - Nightingale College Nursing
Management OF Upper GI Bleed PRBC Transfusion AND Hourly Rounds Undergraduate YEAR 4 /
Pre-licensure BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Gastrointestinal Anatomy 1-15 Upper, Bleed, Transfusion, Finding, Blood
AND Physiology
Pathophysiology OF Upper 16-30 Upper, Bleed, Appropriate, Transfusion, Acute
GI Bleeding
RISK Factors AND Etiologies 31-45 Upper, Bleed, Hourly, Finding, Appropriate
OF Upper GI Bleeding
Clinical Manifestations AND 46-60 Transfusion, Upper, Bleed, Blood, Nursing
Diagnostic Assessment
Nursing Assessment AND 61-75 Upper, Bleeding, Transfusion, Acute, Hourly
Monitoring
Hourly Rounds AND Patient 76-90 Upper, Bleed, Blood, Acute, Appropriate
Safety
TOTAL 90 All questions include answers and detailed rationales
,Section A - Gastrointestinal Anatomy AND Physiology
Q1.
During hourly rounds, a patient with an upper GI bleed becomes diaphoretic and
confused. Which assessment finding most accurately indicates worsening perfusion
BEFORE a drop in blood pressure occurs?
A. Central venous oxygen saturation B. Urine output of 0.3 mL/kg/hr
(ScvO2) of 55%
C. Narrowing pulse pressure with D. Capillary refill of 4 seconds
tachycardia
Correct: C - Narrowing pulse pressure with tachycardia
Rationale:Narrowing pulse pressure and tachycardia are early compensatory signs of
hypovolemia, often preceding a measurable drop in systolic blood pressure. ScvO2 < 60%
indicates global tissue hypoxia but is not a bedside early sign; urine output and capillary refill
are later indicators. This reflects the body's compensatory mechanisms to maintain cardiac
output.
Why the other answers are wrong:
A. ScvO2 is a late indicator of inadequate oxygen delivery and not a typical early bedside sign.
B. Oliguria occurs later as renal perfusion is shunted; it is not as early as hemodynamic
changes.
D. Capillary refill is a less reliable early indicator in adults and can be affected by ambient
temperature.
Reference: Marx, J. (2026). Rosen's Emergency Medicine, 10th Ed., Ch. 21
Q2.
A patient with an upper GI bleed has a hemoglobin of 6.5 g/dL and is symptomatic. The
provider orders 2 units of PRBCs. Which action is most critical for the nurse to take
BEFORE initiating the transfusion?
A. Verify the patient's identity with two B. Obtain a signed informed consent for
identifiers and check the blood product transfusion
against the order
C. Administer a bolus of normal saline to D. Pre-medicate with acetaminophen and
maintain IV access diphenhydramine to prevent febrile reaction
Correct: A - Verify the patient's identity with two identifiers and check the blood product
against the order
Page 3
, Section A - Gastrointestinal Anatomy AND Physiology
Rationale: The most critical step is the final patient-product verification at the bedside, using
two identifiers, to prevent hemolytic transfusion reactions. Informed consent is typically
obtained by the provider, not the nurse; saline bolus is not a substitute for proper verification;
pre-medication is not routine and can mask reactions.
Why the other answers are wrong:
B. Informed consent is a provider responsibility; the nurse verifies that it is obtained but does
not obtain it for transfusion.
C. Saline bolus is not a substitute for the mandatory verification process and may worsen
bleeding.
D. Pre-medication is not standard for all transfusions and can mask early signs of a reaction.
Reference: AABB (2026). Standards for Blood Banks and Transfusion Services, 34th Ed., Standard 5.15
Q3.
A patient with cirrhosis and suspected variceal bleeding is started on octreotide. What is
the primary mechanism by which this drug controls bleeding?
A. Decreases portal venous pressure via B. Promotes platelet aggregation at the
splanchnic vasoconstriction bleeding site
C. Inhibits gastric acid secretion to stabilize D. Constricts the lower esophageal
the clot sphincter to tamponade varices
Correct: A - Decreases portal venous pressure via splanchnic vasoconstriction
Rationale:Octreotide is a somatostatin analog that selectively causes splanchnic
vasoconstriction, reducing portal blood flow and pressure, thereby decreasing variceal
bleeding. It does not directly affect platelets or gastric acid; it does not constrict the LES.
Why the other answers are wrong:
B. Octreotide does not have a direct effect on platelet function.
C. Acid suppression is adjunctive but not the primary mechanism of octreotide.
D. Octreotide does not cause mechanical tamponade of varices.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 47
Q4.
During a PRBC transfusion, a patient develops flushing, tachycardia, and a temperature of
38.9°C (102°F), 30 minutes after initiation. What is the priority nursing action?
A. Slow the transfusion and administer B. Stop the transfusion and keep the IV line
antipyretics open with normal saline
C. Continue the transfusion and monitor vital D. Disconnect the blood tubing and flush
signs every 15 minutes with saline to maintain patency
Correct: B - Stop the transfusion and keep the IV line open with normal saline
Page 4
HOURLY ROUNDS, ASSESSMENT, PRBC TRANSFUSION &
NURSING MANAGEMENT | 2026 UPDATE COMPLETE -
NIGHTINGALE COLLEGE.
90 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
BSN 366 VCBC SCOTT BECKER UPPER GI BLEED | COMPLETE HOURLY ROUNDS, ASSESSMENT, PRBC
TRANSFUSION & NURSING MANAGEMENT | 2026 UPDATE COMPLETE - NIGHTINGALE COLLEGE.. It
contains 90 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 90 Questions
Foundations - Application - BSN 366 VCBC Scott Becker Upper GI Bleed Complete Hourly Rounds
Assessment PRBC Transfusion & Nursing Management 2026 Update Complete - Nightingale College Nursing
Management OF Upper GI Bleed PRBC Transfusion AND Hourly Rounds Undergraduate YEAR 4 /
Pre-licensure BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Gastrointestinal Anatomy 1-15 Upper, Bleed, Transfusion, Finding, Blood
AND Physiology
Pathophysiology OF Upper 16-30 Upper, Bleed, Appropriate, Transfusion, Acute
GI Bleeding
RISK Factors AND Etiologies 31-45 Upper, Bleed, Hourly, Finding, Appropriate
OF Upper GI Bleeding
Clinical Manifestations AND 46-60 Transfusion, Upper, Bleed, Blood, Nursing
Diagnostic Assessment
Nursing Assessment AND 61-75 Upper, Bleeding, Transfusion, Acute, Hourly
Monitoring
Hourly Rounds AND Patient 76-90 Upper, Bleed, Blood, Acute, Appropriate
Safety
TOTAL 90 All questions include answers and detailed rationales
,Section A - Gastrointestinal Anatomy AND Physiology
Q1.
During hourly rounds, a patient with an upper GI bleed becomes diaphoretic and
confused. Which assessment finding most accurately indicates worsening perfusion
BEFORE a drop in blood pressure occurs?
A. Central venous oxygen saturation B. Urine output of 0.3 mL/kg/hr
(ScvO2) of 55%
C. Narrowing pulse pressure with D. Capillary refill of 4 seconds
tachycardia
Correct: C - Narrowing pulse pressure with tachycardia
Rationale:Narrowing pulse pressure and tachycardia are early compensatory signs of
hypovolemia, often preceding a measurable drop in systolic blood pressure. ScvO2 < 60%
indicates global tissue hypoxia but is not a bedside early sign; urine output and capillary refill
are later indicators. This reflects the body's compensatory mechanisms to maintain cardiac
output.
Why the other answers are wrong:
A. ScvO2 is a late indicator of inadequate oxygen delivery and not a typical early bedside sign.
B. Oliguria occurs later as renal perfusion is shunted; it is not as early as hemodynamic
changes.
D. Capillary refill is a less reliable early indicator in adults and can be affected by ambient
temperature.
Reference: Marx, J. (2026). Rosen's Emergency Medicine, 10th Ed., Ch. 21
Q2.
A patient with an upper GI bleed has a hemoglobin of 6.5 g/dL and is symptomatic. The
provider orders 2 units of PRBCs. Which action is most critical for the nurse to take
BEFORE initiating the transfusion?
A. Verify the patient's identity with two B. Obtain a signed informed consent for
identifiers and check the blood product transfusion
against the order
C. Administer a bolus of normal saline to D. Pre-medicate with acetaminophen and
maintain IV access diphenhydramine to prevent febrile reaction
Correct: A - Verify the patient's identity with two identifiers and check the blood product
against the order
Page 3
, Section A - Gastrointestinal Anatomy AND Physiology
Rationale: The most critical step is the final patient-product verification at the bedside, using
two identifiers, to prevent hemolytic transfusion reactions. Informed consent is typically
obtained by the provider, not the nurse; saline bolus is not a substitute for proper verification;
pre-medication is not routine and can mask reactions.
Why the other answers are wrong:
B. Informed consent is a provider responsibility; the nurse verifies that it is obtained but does
not obtain it for transfusion.
C. Saline bolus is not a substitute for the mandatory verification process and may worsen
bleeding.
D. Pre-medication is not standard for all transfusions and can mask early signs of a reaction.
Reference: AABB (2026). Standards for Blood Banks and Transfusion Services, 34th Ed., Standard 5.15
Q3.
A patient with cirrhosis and suspected variceal bleeding is started on octreotide. What is
the primary mechanism by which this drug controls bleeding?
A. Decreases portal venous pressure via B. Promotes platelet aggregation at the
splanchnic vasoconstriction bleeding site
C. Inhibits gastric acid secretion to stabilize D. Constricts the lower esophageal
the clot sphincter to tamponade varices
Correct: A - Decreases portal venous pressure via splanchnic vasoconstriction
Rationale:Octreotide is a somatostatin analog that selectively causes splanchnic
vasoconstriction, reducing portal blood flow and pressure, thereby decreasing variceal
bleeding. It does not directly affect platelets or gastric acid; it does not constrict the LES.
Why the other answers are wrong:
B. Octreotide does not have a direct effect on platelet function.
C. Acid suppression is adjunctive but not the primary mechanism of octreotide.
D. Octreotide does not cause mechanical tamponade of varices.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 47
Q4.
During a PRBC transfusion, a patient develops flushing, tachycardia, and a temperature of
38.9°C (102°F), 30 minutes after initiation. What is the priority nursing action?
A. Slow the transfusion and administer B. Stop the transfusion and keep the IV line
antipyretics open with normal saline
C. Continue the transfusion and monitor vital D. Disconnect the blood tubing and flush
signs every 15 minutes with saline to maintain patency
Correct: B - Stop the transfusion and keep the IV line open with normal saline
Page 4
