Education, Practice Questions with
Answers — comprehensive exam
preparation material
Introduction:
This document contains an extensive set of NCLEX-style
practice questions with detailed rationales focused on blood
transfusion therapy and hematologic nursing care. Topics
include transfusion reactions, blood compatibility, blood
products, nursing priorities, delegation, complications,
anemia, leukemia, sickle cell disease, and safe administration
of blood components. The material is designed to support
thorough NCLEX-RN exam preparation as well as clinical
nursing review.
Exam Questions and Detailed Answers:
The client with O+ blood is in need of an emergency
transfusion but the lab does not have any O+ blood available.
Which potential unit of blood could be given to the client?
1. 0- unit
,2. A+ unit
3. B+ unit
4. Any Rh+ unit" ---Correct Answer---1. 0- unit
1. O- negative blood is considered the universal donor because
it does not contain the antigens A, B, or Rh. (AB+ is considered
the universal recipient because a person with this blood type
has all the anti-gens on the blood).
2. A+ blood contains the antigen A that the client will react to,
causing the development of antibodies. The unit being Rh+
is compatible with the client.
3. B+ blood contains the antigen B that the client will react to,
causing the development of anti-bodies. The unit being Rh+
is compatible with the client.
4.This client does not have antigens A or B on the blood.
Administration of these types would cause an antigen/antibody
reaction within the client's body, resulting in a massive
hemolysis of the client's blood and death."
,About ten minutes after the nurse begins an infusion of packed
RBCs, the patient complains of chills, chest and back pain, and
nausea. His face is flushed, and he's anxious. Which is the
priority nursing action?
1. Administering antihistamines STAT for an allergic reaction.
2. Notifying the physician of a possible transfusion reaction.
3. Obtaining a urine and serum specimen to send to the lab
immediately.
4. Stopping hte transfusion and maintaining a patent IV
catheter. ---Correct Answer---4. Stopping the transfusion and
maintaining a patent IV catheter.
The patient is experiencing a transfusion reaction. The
immediate nursing action is to stop the transfusion and
maintain a patent IV line. The other options may be indicated
but aren't the priority in this case.
"The nurse is administering packed red blood cells (PRBCs) to
a client. The nurse should first:
"1. Discontinue the I.V. catheter if a blood transfusion reaction
occurs.
, 2. Administer the PRBCs through a percutaneously inserted
central catheter line with a 20-gauge needle.
3. Flush PRBCs with 5% dextrose and 0.45% normal saline
solution.
4. Stay with the client during the first 15 minutes of infusion. -
--Correct Answer---4. Stay with the client during the first 15
minutes of infusion.
The most likely time for a blood transfusion reaction to occur
is during the first 15 minutes or first 50 mL of the infusion. If
a blood transfusion reaction does occur, it is imperative to
keep an established I.V. line so that medication can be
administered to prevent or treat cardiovascular collapse in
case of anaphylaxis. PRBCs should be administered through a
19-gauge or larger needle; a peripherally inserted central
catheter line is not recommended, in order to avoid a slow
flow. RBCs will hemolyze in dextrose or lactated Ringer's
solution and should be infused with only normal saline
solution.
A unit of packed red blood cells has been prescribed for a
client with low hemoglobin and hematocrit levels. The nurse
notifies the blood bank of the order, and a blood specimen is
drawn from the client for typing and cross-matching. The
nurse receives a telephone call from the blood bank and is