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NCLEX/ATI/HESI Exam Bank: Blood Transfusion & IV Therapy – Safe Administration and Complication Management

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Master blood transfusion and IV therapy skills with this focused exam bank for NCLEX, ATI, and HESI. Review evidence-based practices in safe IV insertion, transfusion procedures, patient monitoring, and managing complications like infiltration, phlebitis, or transfusion reactions. Includes clinically relevant questions and rationales to build safety and confidence.

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1



Comprehensive Exam Bank on Nursing Blood Transfusion and
Intravenous Therapy: Safe Administration, Monitoring, and
Complication Management




Table of Contents
Topic 1: Principles and Fundamentals of Blood Transfusion Therapy
(Questions 1–20)..............................................................................................2
Topic 2: Intravenous Fluid Therapy and Electrolyte Balance (Questions 21–40)
.........................................................................................................................8
Topic 3: Central Venous Access Devices and Infusion Techniques (Questions
41–60)............................................................................................................14
Topic 4: Blood Transfusion Reactions and Emergency Management (Questions
61–80)............................................................................................................20
Topic 5: Pediatric and Geriatric Considerations in IV and Transfusion Therapy
(Questions 81–100)........................................................................................26
Topic 6: Pharmacologic Agents and Compatibility in IV Therapy (Questions
101–120)........................................................................................................32
Topic 7: Infection Control and Aseptic Technique in IV and Blood Transfusion
Therapy (Questions 121–140)........................................................................38
Topic 8: Pediatric and Geriatric Considerations in IV and Transfusion Therapy
(Questions 141–160)......................................................................................44
Topic 9: Pharmacologic Compatibility, Additives, and IV Medication Safety
(Questions 161–180)......................................................................................50
Topic 10: Blood Component Handling, Storage, and Specialized Product Use
(Questions 181–200)......................................................................................56

, 2




Topic 1: Principles and Fundamentals of
Blood Transfusion Therapy (Questions 1–
20)

1. Which of the following blood products is most appropriate for a
patient with hemophilia A?
A. Cryoprecipitate
B. Fresh frozen plasma
C. Packed red blood cells
D. Platelet concentrate

Correct Answer: A. Cryoprecipitate
Rationale: Cryoprecipitate contains factor VIII, which is deficient in
hemophilia A. It is the preferred treatment for bleeding episodes in these
patients.



2. What is the maximum recommended time to transfuse a unit of
packed red blood cells?
A. 1 hour
B. 2 hours
C. 4 hours
D. 6 hours

Correct Answer: C. 4 hours
Rationale: To reduce the risk of bacterial growth, a unit of PRBCs should be
transfused within 4 hours of removal from refrigeration.



3. A nurse is preparing to administer a blood transfusion. Which of
the following actions should be taken first?
A. Obtain baseline vital signs
B. Prime IV tubing with 0.9% sodium chloride
C. Verify patient identification with another licensed staff
D. Hang the blood bag on the IV pole

Correct Answer: C. Verify patient identification with another
licensed staff

, 3


Rationale: Patient identification verification is the first and most critical
safety step to prevent transfusion errors.



4. What type of tubing is required when administering a blood
transfusion?
A. Extension tubing
B. Y-type tubing with a filter
C. Y-type tubing with a 170–260 micron filter
D. Straight-line IV tubing

Correct Answer: C. Y-type tubing with a 170–260 micron filter
Rationale: This tubing helps filter out clots and debris in blood products and
allows for administration with saline.



5. Which of the following would be a contraindication to blood
transfusion?
A. Iron-deficiency anemia
B. Hypovolemia
C. Patient refusal due to religious beliefs
D. Febrile neutropenia

Correct Answer: C. Patient refusal due to religious beliefs
Rationale: A competent adult has the right to refuse any medical treatment,
including blood transfusion, even in life-threatening situations.



6. Which solution is used to prime the tubing before a blood
transfusion?
A. Dextrose 5% in water
B. Lactated Ringer’s
C. 0.9% Normal Saline
D. Sterile water

Correct Answer: C. 0.9% Normal Saline
Rationale: Only normal saline is compatible with blood products; other
solutions may cause hemolysis.

, 4


7. How long should a nurse remain with a patient at the start of a
blood transfusion?
A. 5 minutes
B. 15 minutes
C. 30 minutes
D. Until the bag is half-empty

Correct Answer: B. 15 minutes
Rationale: Most transfusion reactions occur within the first 15 minutes; the
nurse should closely monitor the patient during this period.



8. Which laboratory test is most relevant before initiating a blood
transfusion?
A. Hemoglobin A1c
B. Type and crossmatch
C. BUN and creatinine
D. White blood cell count

Correct Answer: B. Type and crossmatch
Rationale: A type and crossmatch ensures blood compatibility and helps
prevent transfusion reactions.



9. A nurse receives a unit of blood but the transfusion is delayed.
What should be done?
A. Hang the blood in the patient’s room
B. Store it in the medication room refrigerator
C. Return it to the blood bank
D. Return it to the blood bank immediately

Correct Answer: D. Return it to the blood bank immediately
Rationale: Blood should only be kept at room temperature for a limited
time; returning it prevents degradation and contamination.



10. Which sign indicates a possible hemolytic transfusion reaction?
A. Bradycardia
B. Lower back pain
C. Cold extremities
D. Constipation

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