TEST III MATERIAL IV THERAPY
Blood Transfusion and TPN Knowledge Quiz
Test your knowledge on blood transfusions and total parenteral nutrition (TPN) with this comprehensive quiz. It consists of 45 carefully crafted questions designed to assess your understanding of critical nursing protocols, patient care, and transfusion reactions.
Challenge yourself with questions that cover topics such as:
- Blood product administration
- Transfusion reaction management
- TPN guidelines
- Working with patients with religious beliefs against transfusions
A patient comes to the clinic and presents with an uncontrollable bleeding disorder. The patient is a 34 year old woman who explains that she’s bleeding from her rectum, nose, and mouth. She says she hasn’t been able to stop it. Which blood product would she most likely receive?
Platelets
Albumin
Whole blood
Fresh Frozen Plasma
Why are blood transfusions typically ordered?
When a patient has decreased circulating blood and a potassium deficiency
When a patient presents with abnormal bleeding
When a patient has decreased circulating blood in the body or any blood components
When a patient has decreased platelets, amino acids, or potassium
When should vital signs be assessed if a patient is getting a blood transfusion?
Prior to the infusion and 15 minutes after the infusion
Prior to the infusion
15 minutes after the infusion
Vital signs do not need to be assessed for a blood transfusion
If more than one unit of blood is ordered, when should the Y tubing be changed?
After the 2nd unit of blood
After the 3rd unit of blood
After the 1st unit of blood
Y tubing should be changed every 4 hours
Which statement by the student nurse indicates a need for further teaching:
“Blood should not remain in the client care area for more than 15 minutes but it is acceptable for me to refrigerate the blood until I need to use it.”
Blood should not remain in the client care area for more than 30 minutes, if it is not to be used in that time frame the blood should be sent back to the blood bank.”
Blood should not remain in the client care area for more than 30 minutes so it is acceptable for me to refrigerate the blood until I need to use it.”
“Blood should not remain in the client care area for more than 60 minutes but it is acceptable for me to refrigerate the blood until I need to use it.”
Which of the following is the FIRST nursing action you would take if a patient was having a blood transfusion reaction?
Alert the charge nurse
Keep the vein open with Normal Saline
Inform the physician
Stop the infusion
A patient comes to the clinic and he makes it clear that his religion prohibits the practice of receiving blood transfusions. Which religion is the patient most likely a follower of?
Christian or Buddhism
Jehovah’s Witness or Christian Science
Catholic or Christian Science
Baptist or Catholic
After receiving a blood transfusion the patient begins to exhibit a blood transfusion reaction. It is characterized by hypotension, anxiety, and wheezing. What type of blood transfusion reaction is this?
Allergic
Febrile
Hemolytic
Phlebitis
If both anaerobic and aerobic blood cultures are to be obtained, in which order should the nurse obtain them?
Only obtain aerobic
Only obtain anaerobic
Aerobic first
Anaerobic first
Blood transfusion reactions usually occur:
In the first 30 minutes
In the first 15 minutes
Within an hour
Immediately after the transfusion
Which of the following are indicators that a blood transfusion reaction has occurred? [Select All That Apply]
Chills
Fever
Dyspnea
Tachycardia
Bradycardia
Hypertension
Hypotension
Cold extremities
Unsteady gait
Low back pain
Increased urine output
Decreased urine output
Anxiety
Wheezing
Crackles at the base of lungs
Itching
Emphysema
TPN tubing and solution bag is to be changed in how many hours and by whom?
36 hours/Physician
36-72 hours/RN
24 hours/RN
12-24 hours/Physician
Total Parenteral Nutrition is also know as Central Parenteral Nutrition
True
False
Which of the following is the universal donor?
Type AB
Type O
Type A
Type B
Which of the following patients would be candidates for the administration of TPN? [Select All That Apply]
Patient with cancer of the stomach
Patient experiencing fluid volume overload
Patient with major trauma or burns
Patient experiencing chronic vomiting and diarrhea
A severely malnourished female patient is admitted to the hospital and immediately administered a TPN solution specifically designed to help her meet her caloric needs. The nurse on duty is assigned to monitor the patient. She is the only nurse on the floor and because she is very busy she forgets to monitor the patient. After 8 hours she walks into the patient's room and sees signs that the patient is experiencing hyperglycemia. What did the nurse fail to do?
She failed to monitor the patient’s blood glucose levels every 6 hours
She failed to administer the patient’s insulin
She failed to stay with the patient for 15 minutes to ensure there was no adverse reaction
The nurse did nothing wrong
What is used to determine when a transfusion is necessary?
RBC level
Hematocrit level
Platelet count
Hemoglobin level
What has led some patients to being against receiving blood and blood products?
Lack of financial stability
Fear of HIV
Education status
Lack of trust for those in the medical field
What must be obtained before starting blood transfusion therapy?
Informed consent
Will
Charge Nurse’s consent
None of the above are correct
A patient is admitted to the hospital after being in a near fatal car accident. He is hemorrhaging and immediately put on blood transfusion therapy. Which type of blood product is he most likely to receive?
Platelet
Albumin
Whole blood
Fresh frozen plasma
When blood is administered faster than the circulation can accommodate what type of reaction can occur?
Circulatory overload
Febrile
Anaphylactic
Phlebitis
When administering blood or blood products, which of the following should be documented?
Physician signature
Family’s consent
Legal parameters
Date and time blood transfusion began
Where the IV site was
Vital signs and when they were taken
When administrating blood or blood products, which size gauge should be used?
20 gauge
18 gauge
30 gauge
25 gauge
Which of the following is a nursing intervention for a patient experiencing circulatory overload after the initiation of blood transfusion therapy?
Start a new transfusion line to counteract the negative affects
Administer a medication to lower the patient’s blood pressure
Place the client upright with feet dependent
Quickly place the client is a sitting position and so breathing exercises
Normal saline is not compatible with blood
True
False
A patient receiving blood transfusion therapy begins to have a reaction characterized by chest pain, apprehension, and a respiratory rate of 45/min. Which type of transfusion reaction is she most likely experiencing?
Allergic
Febrile
Non-hemolytic
Hemolytic
Which of the following are clinical signs of circulatory overload?
Cough
Wheezing
Nausea
Distending neck veins
Hypertension
Tachycardia
Which of the following is the reason that hemolytic reactions occur during blood transfusion therapy?
Blood administered at the wrong rate
Incompatibility of the donor’s and recipient’s blood
Blood products given at a severely elevated level
Microorganism invasion due to non-sanitary administration technique
When doing a blood draw the tourniquet should stay on for a maximum of:
5 minutes
2 minutes
1 minute
30-45 seconds
Nonhemolytic/febrile is the most commonly occurring reaction to blood and blood products administration.
True
False
Which of the following are appropriate nursing interventions when a blood transfusion reaction occurs? [Select All That Apply]
Stop the infusion
Slow the infusion
Keep the vein open with 5% dextrose
Keep the remaining blood product and bag and send to blood bank
Monitor vital signs and urine output every 15 minutes
Select the following equipment required for a blood draw. [Select All That Apply]
Tourniquet
Blood pressure cuff
Blood tubes
2x4 gauge pads
Tape
Gloves
Alcohol swab
Portable sharps container
Biohazard bag
Blood cultures usually come in:
Sharps container
Biohazard bag
High tempered glass flask
Bottle or tube
When initiating blood transfusion therapy who will specify the rate of the transfusion?
RN
Physician
Charge Nurse
Family
Patient
The same needle can be used when drawing blood AND when injecting the blood into the appropriate bottles.
True
False
Which of the following is the universal recipient?
Type O
Type AB
Type A
Type B
When TPN therapy ends the transfusion rate:
Is gradually decreased to prevent hypoglycemia
Is gradually increased to prevent potassium overload
Is gradually decreased to prevent an infection
None of the above
Which of the following is utilized when IV therapy is needed long term?
Total Parenteral Nutrition
PICC
Central Venous Access Device
Blood Transfusion Therapy
Blood transfusion reactions usually occur within:
The first 30 minutes
The first 10 minutes
The first 20 minutes
The first 15 minutes
The two person verification technique is essential in the initiation of blood transfusion therapy
True
False
When doing the two person verification technique the two nurses will: [Select All That Apply]
Check the blood against the order
Confirm the patient’s identity
Note the time and date the patient was admitted
Disregard the expiration of the blood or blood product
Inspect the blood for any unusual signs
Check patient’s blood type against type of blood to be infused
Central Venous Access Devices can be used to/for:
Administer fluids
Extract infections
Obtain blood samples
Hemodialysis
TPN is administered slowly to prevent: [Select All That Apply]
Circulatory overload
Phlebitis
Inflammation
Hyperglycemia/hypoglycemia
Hypertension
TPN can and should be infused by gravity
True
False
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