Transfusion Therapy Chapter 11 7th Edition Test Bank

Chapter 11: Transfusion Therapy

Multiple Choice

Identify the choice that best completes the statement or answers the question.

1. A nurse has transfused a unit of packed RBCs, which has a 250-mL bag of 0.9% sodium chloride attached. The follow-up I.V. order is to hang a 1000-mL bag of 5% dextrose in water. Which steps should be taken by the nurse after completing the transfusion and initiating the next I.V. order?

A. Aspirate the I.V. line before connecting the I.V. solution tubing.

B. Infuse the remaining sodium chloride before attaching the new primary I.V. administration set.

C. Flush the blood tubing with sodium chloride before changing to the primary I.V. administration set.

D. Disconnect the tubing while there is blood in the line and attach the primary I.V. administration set.

2. A nurse obtains a blood specimen for type and cross match for a client suspected of having type A-positive blood. The nurse understands that A-positive blood contains which antibody in the plasma?

A. Anti-A

B. Anti-O

C. Anti-B

D. Anti-A and anti-B

3. A maternal-child nurse is caring for a client who has type A-negative blood, received no prenatal care, and delivered a type A-positive fetus. The nurse is concerned for the client because previous exposure to an antigen through pregnancy or transfusion may cause the client to develop:

A. more antigens.

B. an antibody to an antigen.

C. tolerance to a transfusion.

D. alloimmunization to the antibody.

4. A nurse is caring for a client diagnosed with thrombocytopenia. Thrombocytopenia is an abnormally low number of:

A. platelets in the blood.

B. antibodies in the blood.

C. RBCs in the blood.

D. white blood cells in the blood.

5. A client presents to a hospital laboratory wishing to make an autologous donation. An autologous donation is defined as the donation of:

A. bone marrow to be used for transplant.

B. blood by a donor to be used only by the donor.

C. blood directly from one donor to a specified recipient.

D. blood in a similar structure from a volunteer donor to a compatible recipient.

6. A unit of packed red blood cells (PRBCs) is ordered for a client with anemia. The physician does not specify a rate for the infusion, according to standards of practice. Thus, the nurse should set the transfusion drip rate so that the PRBCs will be infused within:

A. 1/2 hour.

B. 1 hour.

C. 2 hours.

D. 4 hours.

7. A 25-year-old client who is a Jehovah’s Witness was recently diagnosed with multiple myeloma. The client presents with a hemoglobin (Hgb) level of 6 g/dL. The client’s healthcare provider orders a transfusion of 4 units of red blood cells, but the client refuses. Which is the most appropriate action by a nurse?

A. Do nothing.

B. Administer the transfusion as ordered.

C. Provide information about autologous donation.

D. Convince the client to accept the transfusion.

8. A 90-year-old client is receiving 2 units of packed red blood cells. Furosemide 80 mg I.V. pyelography has been ordered after the first unit of blood has infused. The client asks a nurse why she is getting furosemide. The nurse’s response should be based on the understanding that furosemide:

A. prevents pulmonary emboli.

B. prevents circulatory overload.

C. lowers the blood pressure.

D. counteracts the transfusion-induced hypercalcemia.

9. A nurse is caring for a client diagnosed with post-transfusion hepatitis after a blood transfusion. Which virus is the primary cause of post-transfusion hepatitis?

A. Hepatitis A virus

B. Hepatitis B virus

C. Hepatitis C virus

D. HIV

10. A physician orders fresh frozen plasma (FFP) for a client diagnosed with hemophilia. How long does the nurse have to correctly infuse the plasma once thawed?

A. 4 hour.

B. 8 hours.

C. 16 hours.

D. 24 hours.

11. A nurse is preparing to administer a unit of packed red blood cells to a client. Which type of I.V. fluid should be used to facilitate the infusion of blood for this client?

A. Lactated Ringer’s

B. Normal saline

C. 5% dextrose in water

D. 0.45% normal saline

12. A nurse is caring for a client who is experiencing thrombocytopenia secondary to chemotherapy. Which laboratory test result would be consistent with thrombocytopenia from chemotherapy?

A. Low white blood cell count

B. Low platelet count

C. Low red blood cell count

D. High platelet count

13. A physician instructs a nurse to obtain a fluid warmer before implementing written orders for a client. The nurse obtains the fluid warmer knowing that it is used primarily for the administration of:

A. parenteral nutrition (PN).

B. solutions for the pediatric client.

C. blood.

D. solutions for the geriatric client.

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

1. A client is concerned about receiving donated blood for fear of contracting AIDS. A nurse reassures the client knowing that all transfusions are screened for which antibodies? (Select all that apply.)

A. Syphilis

B. HIV

C. Hepatitis B

D. Mononucleosis

E. T-lymphotrophic virus

2. A nurse sends a client’s blood specimen to the laboratory for a type and crossmatch. For which antigens in the blood system should the laboratory check? (Select all that apply.)

A. ABO blood groups

B. Rh factor

C. Immunoglobulin M (IgM)

D. Human leukocyte antigen (HLA)

E. HIV

3. A nurse is ordered to perform a type and cross match on a client scheduled for surgery. For which transfusion is a crossmatch necessary? (Select all that apply.)

A. PRBCs

B. Platelets

C. FFP

D. Albumin

E. Granulocytes

4. A nurse is preparing to administer blood to a client. Before hanging a unit of blood, which information is a nurse responsible for verifying with another nurse? (Select all that apply.)

A. ABO and Rh

B. Client identification with two independent identifiers

C. Donor unit number

D. Expiration date

E. Client room number

5. A health care provider orders an infusion of fresh frozen plasma (FFP) for a client. A nurse administers the infusion knowing that FFP is used for which purposes? (Select all that apply.)

A. Platelet deficiencies

B. Coagulation factor deficiencies

C. Warfarin drug reversal in the presence of bleeding

D. Disseminated intravascular coagulation (DIC)

E. Alternative to factor VIII

6. The nurse is preparing to administer blood to a 3-month old. What considerations does the nurse have to make when transfusing pediatric clients? (Select all that apply.)

A. Blood volume

B. Organ function

C. Vascular access

D. Blood typing

E. Rh factors

Completion

Complete each statement.

1. A client who is to receive 4 units of whole blood has a hemoglobin (Hgb) level of 5 g/dL. A nurse should anticipate that the complete blood count after transfusion will reflect an Hgb of ____ g/dL. Fill in the blank.

Chapter 11: Transfusion Therapy

Multiple Choice

Identify the choice that best completes the statement or answers the question.

1. A nurse has transfused a unit of packed RBCs, which has a 250-mL bag of 0.9% sodium chloride attached. The follow-up I.V. order is to hang a 1000-mL bag of 5% dextrose in water. Which steps should be taken by the nurse after completing the transfusion and initiating the next I.V. order?

A. Aspirate the I.V. line before connecting the I.V. solution tubing.

B. Infuse the remaining sodium chloride before attaching the new primary I.V. administration set.

C. Flush the blood tubing with sodium chloride before changing to the primary I.V. administration set.

D. Disconnect the tubing while there is blood in the line and attach the primary I.V. administration set.