CCRN -- Immune/Hematology Questions and Correct Answers | Latest Update
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Course
CCRN
Institution
CCRN
A 52-year-old man returns to the hospital 2 weeks after being discharged from an
admission for upper gastrointestinal bleed. He has been vomiting bright red blood for the
past 24 hours. Laboratory parameters reveal a hemoglobin of 6 g/dL and a hematocrit of
20%. Vital signs are blood pressure...
CCRN -- Immune/Hematology Questions and
Correct Answers | Latest Update
A 52-year-old man returns to the hospital 2 weeks after being discharged from an
admission for upper gastrointestinal bleed. He has been vomiting bright red blood for the
past 24 hours. Laboratory parameters reveal a hemoglobin of 6 g/dL and a hematocrit of
20%. Vital signs are blood pressure 90/60 mm Hg; heart rate 120 beats/min and regular; and
respiratory rate 22 breaths/min and shallow. He has received two units of red blood cells
(RBCs) in the emergency department. The physician has ordered four more units of RBCs.
Which two lab values must be carefully monitored in this patient?
a. Calcium and potassium
b. BUN and Cr
c. Bilirubin and amylase
d. sodium and magnesium
✓ -:- a. Calcium and potassium
RATIONALE:
Patients receiving multiple transfusions must be monitored closely for hyperkalemia because
stored blood has a high potassium content resulting from aging and hemolysis of RBCs.
Hypocalcemia is a potential problem because citrate used as an anticoagulant in banked
d. check the patient's identification and blood type w/the blood identification and type
carefully
✓ -:- d. check the patient's identification and blood type w/the blood
identification and type carefully
RATIONALE:
To prevent a transfusion reaction, the nurse must ensure that the correctly typed and
crossmatched blood is administered.
TEST-TAKING STRATEGY:
The key phrase is to prevent a transfusion reaction. Option a would help to identify the
patient who would be more likely to have a transfusion reaction. Option b would aid in
early detection of a transfusion reaction. Option c would decrease the severity of a
transfusion reaction should it occur. Only ensuring that the correct blood is given to the
correct patient will prevent a reaction. Choose option d.
A 50-year-old patient is transferred to the critical care unit from the emergency
department. A rattlesnake bit him approximately 6 hours ago. He is having a severe reaction
to the venom, and antivenom is being flown to the hospital. The patient is bleeding from his
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