CRNI Blood Transfusion 4

Question 1

A patient receiving packed red blood cells develops flank pain, hypotension, and hemoglobinuria 30 minutes into the transfusion. Which reaction is most likely occurring?

Accepted Answer

Acute hemolytic transfusion reaction

Answer

Acute hemolytic transfusion reaction (AHTR) classically presents with flank pain, hypotension, and hemoglobinuria due to ABO incompatibility causing rapid intravascular hemolysis.

Question 2

What is the maximum allowable hang time for a unit of packed red blood cells once it leaves the blood bank?

Accepted Answer

4 hours

Answer

PRBCs must be infused within 4 hours of leaving the blood bank to prevent bacterial proliferation and product deterioration.

Question 3

A nurse is preparing to administer fresh frozen plasma (FFP). Which of the following is the correct administration filter to use?

Accepted Answer

Standard 170-260 micron blood filter

Answer

All blood products, including FFP, must be administered through a standard 170-260 micron filter to remove clots and cellular debris.

Question 4

Which blood product is MOST appropriate for a patient with thrombocytopenic purpura who is actively bleeding with a platelet count of 8,000/mcL?

Accepted Answer

Platelet concentrate

Answer

Platelet concentrate is indicated for active bleeding with severe thrombocytopenia (platelet count below 10,000/mcL).

Question 5

Transfusion-associated circulatory overload (TACO) is best distinguished from TRALI by which clinical feature?

Accepted Answer

Response to diuretics and elevated BNP

Answer

TACO improves with diuretics and is associated with elevated BNP/NT-proBNP, reflecting volume overload rather than the inflammatory mechanism of TRALI.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Blood Transfusion 4