Nokea
A patient on the medical unit is receiving a unit of PRBCs. Difficult IV access has necessitated a slow infusion rate and the nurse notes that the infusion began 4 hours ago. What is the nurses most appropriate action?
- A. Apply an icepack to the blood that remains to be infused.
- B. Discontinue the remainder of the PRBC transfusion and inform the physician.
- C. Disconnect the bag of PRBCs, cool for 30 minutes and then administer.
- D. Administer the remaining PRBCs by the IV direct (IV push) route.
Correct Answer: B
Rationale: Because of the risk of infection, a PRBC transfusion should not exceed 4 hours. Remaining blood should not be transfused, even if it is cooled. Blood is not administered by the IV direct route.
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The nurse is describing normal RBC physiology to a patient who has a diagnosis of anemia. The nurse should explain that the RBCs consist primarily of which of the following?
- A. Plasminogen
- B. Hemoglobin
- C. Hematocrit
- D. Fibrin
Correct Answer: B
Rationale: Mature erythrocytes consist primarily of hemoglobin, which contains iron and makes up 95% of the cell mass. RBCs are not made of fibrin or plasminogen. Hematocrit is a measure of RBC volume in whole blood.
A patient undergoing a hip replacement has autologous blood on standby if a transfusion is needed. What is the primary advantage of autologous transfusions?
- A. Safe transfusion for patients with a history of transfusion reactions
- B. Prevention of viral infections from another persons blood
- C. Avoidance of complications in patients with alloantibodies
- D. Prevention of alloimmunization
Correct Answer: B
Rationale: The primary advantage of autologous transfusions is the prevention of viral infections from another persons blood. Other secondary advantages include safe transfusion for patients with a history of transfusion reactions, prevention of alloimmunization, and avoidance of complications in patients with alloantibodies.
A man suffers a leg wound which causes minor blood loss. As a result of bleeding, the process of primary hemostasis is activated. What occurs in primary hemostasis?
- A. Severed blood vessels constrict.
- B. Thromboplastin is released.
- C. Prothrombin is converted to thrombin.
- D. Fibrin is lysed.
Correct Answer: A
Rationale: Primary hemostasis involves the severed vessel constricting and platelets collecting at the injury site. Secondary hemostasis occurs when thromboplastin is released, prothrombin converts to thrombin, and fibrin is lysed.
A nurse is educating a patient about the role of B lymphocytes. The nurses description will include which of the following physiologic processes?
- A. Stem cell differentiation
- B. Cytokine production
- C. Phagocytosis
- D. Antibody production
Correct Answer: D
Rationale: B lymphocytes are capable of differentiating into plasma cells. Plasma cells, in turn, produce antibodies. Cytokines are produced by NK cells. Stem cell differentiation greatly precedes B lymphocyte production.
A patient is being treated for the effects of a longstanding vitamin B12 deficiency. What aspect of the patients health history would most likely predispose her to this deficiency?
- A. The patient has irregular menstrual periods.
- B. The patient is a vegan.
- C. The patient donated blood 60 days ago.
- D. The patient frequently smokes marijuana.
Correct Answer: B
Rationale: Because vitamin B12 is found only in foods of animal origin, strict vegetarians may ingest little vitamin B12. Irregular menstrual periods, marijuana use, and blood donation would not precipitate a vitamin B12 deficiency.