ATI Written Skills Study – Questions With Applicable
Solutions
When administering a transfusion of packed red blood cells, it is important
to... Correct Answer - Make sure the entire unit is transfused within 4
hours.
Rationale: Infusion times that exceed 4 hours increase the risk for bacterial
proliferation. Ideally, a unit of packed red blood cells is infused within 2 hours.
Patients at risk for fluid-volume excess will require slower rates, but the
entire transfusion must not exceed 4 hours.
A patient who is anticipating total hip replacement is considering autologous
transfusion. When teaching this patient about autologous transfusion, it is
important to emphasize that... Correct Answer - It reduces the risk of
mismatched blood.
Rationale: Mismatched blood can cause an immune response to another
person's antigens. Because the patient is her own donor, there is no risk of
exposure to another person's antigens.
A type of protein the immune system produces to neutralize a threat of some
kind, such as an incompatible substance in the blood, is called an... Correct
Answer - Antibody
Rationale: an antibody is a protein the immune system produces to neutralize
a threat. Antibodies are also called agglutinins.
You are caring for a patient with severe trauma whose blood type is A. A blood
transfusion is ordered stat. you know that the patient can safely receive blood
from blood group O because... Correct Answer - Type O blood contains
no A antigens.
Rationale: Type O blood contains no antigens at all, which is why people with
type O blood are considered universal donors - because their blood can be
transfused to people with any ABO-related type without putting them at risk
for an ABO compatibility. It is the specific antigens in the transfused blood
that trigger hemolytic reactions. Since type O has no antigens, it is safe for this
patient and for any other patient.
A patient is about to receive a unit of red blood cells. The unit of blood has
arrived and you are about to initiate the transfusion. Which of the following
, procedures will help you protect the patient against the possibility of a blood-
group incompatibility? Correct Answer - Comparing the ID numbers on
the blood unit with those on the order form and the wristband.
Rationale: After comparing the patient's identification from the hospital
wristband, the facility identification number, and a second patient identifier -
typically the patient's date of birth - with the blood order sheet, you must
check the barcode wristband, comparing the unique identification number
with the number on the order form and on the unit of blood. This helps ensure
that all documentation of the type of blood the patient is about to receive is
the correct type for that patient. Most facilities mandate that you have a
second qualified staff person check the patient's identifiers as well.
Prior to administering a blood transfusion, it is essential to explain to the
patient that... Correct Answer - He must immediately report any
subjective symptoms like chills, nausea, or itching.
Rationale: Although you can identify objective signs of a transfusion reaction
(changes in vital signs, flushing, cyanosis, coughing, and to some extent
dyspnea), you might not be able to tell if the patient is experiencing subjective
symptoms (chills, nausea, chest pain, headache, backache, muscle pain).
subjective signs are important clues, and you must be aware of them.
A patient about to receive a unit of packed RBCs states, "this is my third unit of
blood today. I don't want to get some disease from all this blood." Which of the
following would be your best response? Correct Answer - "Donated
blood is carefully screened for infectious diseases."
Rationale: This is the best response because it offers the patient some factual
information to help allay his concerns. You might continue to explain that the
approach to blood safety in the U.S. includes stringent donor selection
practices and the use of screening tests for HIV/AIDS, hepatitis B and C,
syphilis, and other infectious diseases. Infected blood and blood products are
safely discarded and are not used for transfusions.
Which is an essential nursing action prior to starting a blood transfusion?
Correct Answer - Ensure informed consent has been obtained.
Rationale: It is the responsibility of the prescribing healthcare provider to
answer the patient's questions about need, risks, and benefits, but a nurse can
witness the patient's signature indicating informed consent. This must be
done prior to obtaining or administering the blood.
Solutions
When administering a transfusion of packed red blood cells, it is important
to... Correct Answer - Make sure the entire unit is transfused within 4
hours.
Rationale: Infusion times that exceed 4 hours increase the risk for bacterial
proliferation. Ideally, a unit of packed red blood cells is infused within 2 hours.
Patients at risk for fluid-volume excess will require slower rates, but the
entire transfusion must not exceed 4 hours.
A patient who is anticipating total hip replacement is considering autologous
transfusion. When teaching this patient about autologous transfusion, it is
important to emphasize that... Correct Answer - It reduces the risk of
mismatched blood.
Rationale: Mismatched blood can cause an immune response to another
person's antigens. Because the patient is her own donor, there is no risk of
exposure to another person's antigens.
A type of protein the immune system produces to neutralize a threat of some
kind, such as an incompatible substance in the blood, is called an... Correct
Answer - Antibody
Rationale: an antibody is a protein the immune system produces to neutralize
a threat. Antibodies are also called agglutinins.
You are caring for a patient with severe trauma whose blood type is A. A blood
transfusion is ordered stat. you know that the patient can safely receive blood
from blood group O because... Correct Answer - Type O blood contains
no A antigens.
Rationale: Type O blood contains no antigens at all, which is why people with
type O blood are considered universal donors - because their blood can be
transfused to people with any ABO-related type without putting them at risk
for an ABO compatibility. It is the specific antigens in the transfused blood
that trigger hemolytic reactions. Since type O has no antigens, it is safe for this
patient and for any other patient.
A patient is about to receive a unit of red blood cells. The unit of blood has
arrived and you are about to initiate the transfusion. Which of the following
, procedures will help you protect the patient against the possibility of a blood-
group incompatibility? Correct Answer - Comparing the ID numbers on
the blood unit with those on the order form and the wristband.
Rationale: After comparing the patient's identification from the hospital
wristband, the facility identification number, and a second patient identifier -
typically the patient's date of birth - with the blood order sheet, you must
check the barcode wristband, comparing the unique identification number
with the number on the order form and on the unit of blood. This helps ensure
that all documentation of the type of blood the patient is about to receive is
the correct type for that patient. Most facilities mandate that you have a
second qualified staff person check the patient's identifiers as well.
Prior to administering a blood transfusion, it is essential to explain to the
patient that... Correct Answer - He must immediately report any
subjective symptoms like chills, nausea, or itching.
Rationale: Although you can identify objective signs of a transfusion reaction
(changes in vital signs, flushing, cyanosis, coughing, and to some extent
dyspnea), you might not be able to tell if the patient is experiencing subjective
symptoms (chills, nausea, chest pain, headache, backache, muscle pain).
subjective signs are important clues, and you must be aware of them.
A patient about to receive a unit of packed RBCs states, "this is my third unit of
blood today. I don't want to get some disease from all this blood." Which of the
following would be your best response? Correct Answer - "Donated
blood is carefully screened for infectious diseases."
Rationale: This is the best response because it offers the patient some factual
information to help allay his concerns. You might continue to explain that the
approach to blood safety in the U.S. includes stringent donor selection
practices and the use of screening tests for HIV/AIDS, hepatitis B and C,
syphilis, and other infectious diseases. Infected blood and blood products are
safely discarded and are not used for transfusions.
Which is an essential nursing action prior to starting a blood transfusion?
Correct Answer - Ensure informed consent has been obtained.
Rationale: It is the responsibility of the prescribing healthcare provider to
answer the patient's questions about need, risks, and benefits, but a nurse can
witness the patient's signature indicating informed consent. This must be
done prior to obtaining or administering the blood.
