2016 NCLEX Practice Questions on Blood Infusion 81-85

81. A client is brought to the emergency department having experienced blood loss related to an arterial laceration. Fresh-frozen plasma is prescribed and transfused to replace fluid and blood loss. The nurse understands that which is the rationale for transfusing fresh-frozen plasma to this client?

a) To treat the loss of platelets
b) To promote rapid volume expansion
c) Because a transfusion must be done slowly
d) Because it will increase the hemoglobin and hematocrit levels

82. The nurse who is about to begin a blood transfusion knows that blood cells start to deteriorate after a certain period of time. Which item is important to check regarding the age of blood cells before the transfusion is begun?

a) Expiration date
b) Presence of clots
c) Blood group and type
d) Blood identification number

83. A client requiring surgery is anxious about the possible need for a blood transfusion during or after the procedure. The nurse suggests to the client to take which action(s) to reduce the risk of possible transfusion complications? Select all that apply.

a) Ask a family member to donate blood ahead of time.
b) Give an autologous blood donation before the surgery.
c) Take iron supplements before surgery to boost hemoglobin levels.
d) Request that any donated blood be screened twice by the blood bank.
e) Take adequate amounts of vitamin C several days prior to the surgery date.

84. A client with severe blood loss resulting from multiple trauma requires rapid transfusion of several units of blood. The nurse asks another health team member to obtain which device for use during the transfusion procedure to help reduce the risk of cardiac dysrhythmias?

a) Infusion pump
b) Pulse oximeter
c) Cardiac monitor
d) Blood-warming device

85. A client has a prescription to receive a unit of packed red blood cells. The nurse should obtain which intravenous (IV) solution from the IV storage area to hang with the blood product at the client’s bedside?

1. Lactated Ringer’s
2. 0.9% sodium chloride
3. 5% dextrose in 0.9% sodium chloride
4. 5% dextrose in 0.45% sodium chloride





NCLEX Practice Questions
Answers and Rationale

81) B
- Rationale: Fresh-frozen plasma is often used for volume expansion as a result of fluid and blood loss. It does not contain platelets, so it is not used to treat any type of low platelet count disorder. It is rich in clotting factors and can be thawed quickly and transfused quickly. It will not specifically increase the hemoglobin and hematocrit level.

- Test-Taking Strategy: Focus on the subject of the question, the purpose for transfusing fresh frozen plasma. Note the relationship between the words experienced blood loss and the correct option.

82) A
- Rationale: The nurse notes the expiration date on the unit of blood to ensure that the blood is fresh. Blood cells begin to deteriorate over time, so safe storage usually is limited to 35 days. Careful notation of the expiration date by the nurse is an essential part of the verification process before hanging a unit of blood. The nurse also notes the blood identification (unit) number, blood group and type, and client’s name. The nurse also inspects the unit of blood for leaks, abnormal color, clots, and bubbles and returns the unit to the blood bank if clots are noted.

Test-Taking Strategy: Focus on the subject , measures to verify prior to blood administration. Note the word deteriorate . To answer this question correctly, you must know which part of the pretransfusion verification procedure relates to the freshness of the unit of blood. Keeping this in mind should direct you to the correct option.

83) A, B
- Rationale: A donation of the client’s own blood before a scheduled procedure is autologous. Donating autologous blood to be reinfused as needed during or after surgery reduces the risk of disease transmission and potential transfusion complications. The next most effective way is to ask a family member to donate blood before surgery. Blood banks do not provide extra screening on request. Preoperative iron supplements are helpful for iron deficiency anemia but are not helpful in replacing blood lost during the surgery. Vitamin C enhances iron absorption, but also is not helpful in replacing blood lost during surgery.

- Test-Taking Strategy: Focus on the subject , reducing the risk of possible transfusion complications. Recalling that an autologous transfusion is the collection of the client’s own blood and also that family donation of blood is usually effective will direct you to the correct options.

84) D
- Rationale: If several units of blood are to be administered, a blood warmer should be used. Rapid transfusion of cool blood places the client at risk for cardiac dysrhythmias. To prevent this, the nurse warms the blood with a blood-warming device. Pulse oximetry and cardiac monitoring equipment are useful for the early assessment of complications but do not reduce the occurrence of cardiac dysrhythmias. Electronic infusion devices are not helpful in this case because the infusion must be rapid, and infusion devices generally are used to control the flow rate. In addition, not all infusion devices are made to handle blood or blood products.

- Test-Taking Strategy: Note the words rapid and reduce the risk . These words tell you that the infusions will infuse quickly and that the correct option is the one that will minimize the risk of cardiac dysrhythmias. Eliminate the pulse oximeter and cardiac monitor first because these items are comparable or alike and are used to assess for rather than reduce the risk of complications. From the remaining options, use knowledge related to the complications of transfusion therapy and note the relationship between the words several units of blood in the question and blood-warming device in the correct option.

85) B
- Rationale: Sodium chloride 0.9% (normal saline) is a standard isotonic solution used to precede and follow infusion of blood products. Dextrose is not used because it could result in clumping and subsequent hemolysis of red blood cells. Lactated Ringer’s is not the solution of choice with this procedure.

- Test-Taking Strategy: Eliminate options that contain dextrose first because they are comparable or alike . From the remaining options, remember that normal saline is an isotonic solution and the solution compatible with red blood cells.


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