ACE YOUR NUR 211 BLOOD TRANSFUSION NCEX EXAM:
COMPLETE STUDY GUIDE WITH COMPREHENSIVE QUESTIONS
AND ANSWERS LATEST 2026/2027
◉ The physician orders 2 units of packed RBCs to be administered to
the client. At 0600 the night shift nurse initiates the first unit's
transfusion before going off shift. At 1000 the day shift nurse notes the
IV line has clotted off and the transfusion has not been completed. The
nursing assessment revealed the transfusion was only approximately
75% complete. Which of the actions by the nurse is most appropriate?
A. Advise the blood bank about the delay for the next unit.
B. Restart another peripheral line with 0.9% NS and restart the blood
transfusion with the remaining blood unit C. Discontinue the
transfusion.
D. Document the amount infused thus far and continue the transfusion.
Answer: C. Discontinue the transfusion.
A unit of blood should be administered within a 4 hour period of time.
The nurse should discontinue the transfusion, document the findings and
notify the blood bank. The agency policy will need to be followed
concerning the documentation process and notification of appropriate
personnel. Continuing the transfusion with the "open" unit will expose
the client to an increase risk of injury.
◉ 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". 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.
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. Answer: 4.
Stay with the client during the first 15 minutes of infusion.
COMPLETE STUDY GUIDE WITH COMPREHENSIVE QUESTIONS
AND ANSWERS LATEST 2026/2027
◉ The physician orders 2 units of packed RBCs to be administered to
the client. At 0600 the night shift nurse initiates the first unit's
transfusion before going off shift. At 1000 the day shift nurse notes the
IV line has clotted off and the transfusion has not been completed. The
nursing assessment revealed the transfusion was only approximately
75% complete. Which of the actions by the nurse is most appropriate?
A. Advise the blood bank about the delay for the next unit.
B. Restart another peripheral line with 0.9% NS and restart the blood
transfusion with the remaining blood unit C. Discontinue the
transfusion.
D. Document the amount infused thus far and continue the transfusion.
Answer: C. Discontinue the transfusion.
A unit of blood should be administered within a 4 hour period of time.
The nurse should discontinue the transfusion, document the findings and
notify the blood bank. The agency policy will need to be followed
concerning the documentation process and notification of appropriate
personnel. Continuing the transfusion with the "open" unit will expose
the client to an increase risk of injury.
◉ 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". 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.
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. Answer: 4.
Stay with the client during the first 15 minutes of infusion.
