CRNI Blood Component Transfusion Questions and Answers

Question 1

A patient receiving a unit of packed red blood cells (PRBCs) begins to complain of flank pain, chills, and shortness of breath 20 minutes after the transfusion was initiated.
The CRNI notes the patient's temperature has risen to 101.5°F (38.6°C).
What is the CRNI's PRIORITY action?

Accepted Answer

Stop the transfusion immediately and disconnect the tubing.

Answer

Notify the provider of the symptoms.

Answer

Administer an ordered antipyretic for the fever.

Answer

Increase the rate of the concurrent normal saline infusion.

Question 2

A CRNI is preparing to administer a blood component. Which intravenous solution is the only one considered compatible for priming blood administration tubing and infusing concurrently with packed red blood cells?

Accepted Answer

0.9% Sodium Chloride

Answer

Lactated Ringer's solution

Answer

5% Dextrose in Water (D5W)

Answer

0.45% Sodium Chloride

Question 3

An elderly patient with a history of congestive heart failure is receiving a unit of PRBCs. The nurse assesses the patient and notes new onset of a dry cough, dyspnea, and bilateral crackles in the lung bases. The patient's blood pressure is 160/92 mmHg, an increase from 134/80 mmHg pre-transfusion. The CRNI should suspect which transfusion-related complication?

Accepted Answer

Transfusion-Associated Circulatory Overload (TACO)

Answer

Febrile non-hemolytic reaction

Answer

Anaphylactic reaction

Answer

Transfusion-Related Acute Lung Injury (TRALI)

Question 4

To mitigate the risk of a febrile non-hemolytic transfusion reaction (FNHTR) in a patient who has a history of such reactions, which type of blood component modification is most appropriate?

Accepted Answer

Leukoreduced

Answer

Irradiated

Answer

Washed

Answer

CMV-negative

Question 5

A CRNI is at the bedside with another licensed nurse to perform the final verification before starting a blood transfusion. They discover that the medical record number on the blood bag's compatibility tag does not exactly match the medical record number on the patient's identification band. What is the most appropriate action?

Accepted Answer

Do not start the transfusion and immediately return the unit to the blood bank.

Answer

Ask the patient to state their name and birthdate to resolve the discrepancy.

Answer

Begin the infusion at a very slow rate while a third nurse verifies the information.

Answer

Correct the number on the compatibility tag with a pen and have both nurses co-sign.

Question 6

Which of the following is a critical nursing consideration specific to the administration of platelets?

Accepted Answer

Using a dedicated administration set and infusing rapidly, typically over 30 to 60 minutes.

Answer

Administering the component through a micro-aggregate filter (20-40 microns).

Answer

Infusing the component slowly over a period of 3 to 4 hours.

Answer

Ensuring the component is warmed to body temperature prior to infusion to activate the platelets.

A patient receiving a unit of packed red blood cells (PRBCs) begins to complain of flank pain, chills, and shortness of breath 20 minutes after the transfusion was initiated.The CRNI notes the patient's temperature has risen to 101.5°F (38.6°C).What is the CRNI's PRIORITY action?

A patient receiving a unit of packed red blood cells (PRBCs) begins to complain of flank pain, chills, and shortness of breath 20 minutes after the transfusion was initiated.
The CRNI notes the patient's temperature has risen to 101.5°F (38.6°C).
What is the CRNI's PRIORITY action?