CRNI Blood Transfusion 5 — Questions and Answers
Question 1: A patient's blood type is AB positive. Which donor blood type can they receive for red blood cell transfusions?
- O negative only
- A positive and B positive only
- Any ABO and Rh type (Correct answer)
- AB positive only
Correct answer: Any ABO and Rh type
AB positive patients are universal recipients for red blood cells because they have no anti-A, anti-B, or anti-Rh antibodies.
Question 2: Cryoprecipitate is PRIMARILY indicated for which coagulation deficiency?
- Factor II (prothrombin) deficiency
- Factor VIII and fibrinogen deficiency (Correct answer)
- Factor X deficiency
- Protein C deficiency
Correct answer: Factor VIII and fibrinogen deficiency
Cryoprecipitate is rich in fibrinogen, Factor VIII, Factor XIII, von Willebrand factor, and fibronectin, making it the treatment of choice for fibrinogen and Factor VIII deficiencies.
Question 3: A nurse notices a patient's urine has turned bright red during a blood transfusion. After stopping the transfusion, what is the NEXT priority nursing action?
- Restart the transfusion at a slower rate
- Notify the physician and blood bank immediately (Correct answer)
- Administer diphenhydramine IV
- Obtain a stat chest X-ray
Correct answer: Notify the physician and blood bank immediately
Hemoglobinuria (red urine during transfusion) signals acute hemolysis; the nurse must immediately notify the physician and blood bank and return the blood bag for analysis.
Question 4: When administering granulocytes, the nurse should anticipate that infusion should be completed within what timeframe?
- 1 hour (Correct answer)
- 2 hours
- 4 hours
- 8 hours
Correct answer: 1 hour
Granulocytes have a very short shelf life and must be infused within 1 hour of receipt because they rapidly lose viability at room temperature.
Question 5: Which documentation is MANDATORY before initiating a blood transfusion per CRNI standards?
- Patient's insurance authorization
- Two-nurse verification of patient identity and blood product compatibility (Correct answer)
- Physician presence at bedside
- Pharmacy reconciliation of all current medications
Correct answer: Two-nurse verification of patient identity and blood product compatibility
Two-nurse independent verification of patient identity (two identifiers) against the blood product label and crossmatch report is a mandatory safety check before transfusion.
Question 6: A patient develops urticaria and pruritus during the first 15 minutes of a platelet transfusion but has no fever, hypotension, or respiratory distress. What is the BEST initial action?
- Stop the transfusion permanently and discard the unit
- Slow the infusion rate and observe closely
- Stop the transfusion, administer diphenhydramine, and restart if symptoms resolve (Correct answer)
- Administer epinephrine immediately
Correct answer: Stop the transfusion, administer diphenhydramine, and restart if symptoms resolve
Mild allergic reactions (urticaria only) can be managed by stopping the transfusion, administering antihistamine, and restarting if symptoms resolve within 15-30 minutes.
Question 7: Massive transfusion protocol (MTP) is typically activated when a patient requires more than how many units of PRBCs within 24 hours?
- 4 units
- 6 units
- 10 units (Correct answer)
- 15 units
Correct answer: 10 units
Massive transfusion is defined as transfusion of 10 or more units of PRBCs within 24 hours, triggering MTP to address coagulopathy and hypothermia.
CRNI Blood Transfusion 5
A patient's blood type is AB positive.
Which donor blood type can they receive for red blood cell transfusions?