CRNI Blood Component Transfusion 5

Question 1

A patient develops back pain, hemoglobinuria, and hypotension shortly after beginning a red cell transfusion. Which action takes highest priority?

Accepted Answer

Stop the transfusion and maintain IV access with normal saline

Answer

These signs indicate an acute hemolytic transfusion reaction; the transfusion must be stopped immediately and IV access maintained with normal saline while notifying the blood bank and physician.

Question 2

Which of the following cryoprecipitate indications is considered most appropriate?

Accepted Answer

Replacement of factor VIII in hemophilia A when recombinant factor is unavailable

Answer

Cryoprecipitate is rich in factor VIII, fibrinogen, vWF, and factor XIII, making it appropriate for hemophilia A when recombinant or plasma-derived factor VIII is unavailable.

Question 3

Transfusion-related acute lung injury (TRALI) is most commonly associated with transfusion of which blood product?

Accepted Answer

Fresh frozen plasma from multiparous female donors

Answer

TRALI is most associated with plasma-containing products from multiparous donors who have developed HLA or HNA antibodies that react with recipient leukocytes.

Question 4

A patient with a platelet count of 48,000/µL is scheduled for a lumbar puncture. The physician orders prophylactic platelet transfusion. What is the generally accepted threshold for this procedure?

Accepted Answer

< 50,000/µL

Answer

A platelet count of at least 50,000/µL is the generally accepted threshold before invasive procedures such as lumbar puncture to minimize bleeding risk.

Question 5

During blood component administration, which solution is the ONLY acceptable co-infusion with blood products through the same IV line?

Accepted Answer

0.9% Normal saline

Answer

Only 0.9% normal saline is compatible with blood products; dextrose causes red cell hemolysis and calcium-containing solutions like LR can cause clotting.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Blood Component Transfusion 5