CRNI Blood Component Transfusion 4

Question 1

A patient with IgA deficiency requires a transfusion. Which blood product modification is most appropriate to prevent anaphylactic reaction?

Accepted Answer

Washed red blood cells

Answer

Washed red blood cells remove plasma proteins including IgA, preventing anaphylaxis in IgA-deficient patients who have anti-IgA antibodies.

Question 2

During a platelet transfusion, the patient develops rigors, fever of 38.9°C (102°F), and hypotension. What is the most likely cause?

Accepted Answer

Septic transfusion reaction

Answer

Hypotension combined with high fever and rigors during platelet transfusion is a hallmark of septic transfusion reaction, as platelets are stored at room temperature and are prone to bacterial contamination.

Question 3

A nurse is preparing to administer FFP. The FFP has been thawed for 26 hours. What action should the nurse take?

Accepted Answer

Discard it and request a new unit

Answer

Thawed FFP must be transfused within 24 hours; after 26 hours it should be discarded as labile coagulation factors V and VIII significantly degrade.

Question 4

Which of the following is the correct maximum infusion time for a single unit of packed red blood cells (PRBCs) to minimize risk of bacterial proliferation?

Accepted Answer

4 hours

Answer

Each unit of PRBCs must be infused within 4 hours of being removed from temperature-controlled storage to prevent bacterial proliferation.

Question 5

A patient receives a massive transfusion (>10 units PRBCs in 24 hours). Which electrolyte imbalance is most commonly anticipated?

Accepted Answer

Hypocalcemia

Answer

Citrate used as a preservative in banked blood chelates calcium, causing hypocalcemia during massive transfusion, especially when the liver cannot metabolize citrate fast enough.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Blood Component Transfusion 4