4:06:12 PM Wednesday, July 30, 2025
Medical-Surgical Nursing – Exam #3
Review NCLEX Practice Questions and
Answers
A female patient has a hemoglobin of 6.4 g/dL and is preparing to have a blood transfusion. Why
would it be important for the nurse to obtain information about the patient's history of pregnancy
prior to the transfusion?
A) a high number of pregnancies can increase the risk of reaction
B) if the patient has never been pregnant, it increases the risk of reaction
C) obtaining information about gravity and parity is routine information for all female patients
D) if the patient has been pregnant, she may have developed allergies
A
A patient will need a blood transfusion for the replacement of blood loss from the GI tract. The
patient states, "That stuff isn't safe!" What is the best response from the nurse?
A) I agree that you should be concerned with the safety of the blood but it's important that you
have this transfusion
B) the blood is carefully screened so there is no possibility of you contracting any illness or
disease from the blood
C) I understand your concern. The blood is carefully screened but is not completely risk free
D) you will have to decide if refusing the blood transfusion is worth the risk to your health
C
A patient with chronic anemia has had many blood transfusions over the last 3 years. What type
of transfusion reaction should the nurse monitor for that is commonly found in patients who
frequently receive blood transfusion?
A) allergic reactions
B) acute hemolytic reaction
C) circulatory overload
D) febrile nonhemolytic reactions
D
,4:06:12 PM Wednesday, July 30, 2025
The nurse is administering a blood transfusion to a patient over 4 hours. After 2 hours the patient
reports chills and has a fever of 101F and increase from a precious temp of 99.2F. What does the
nurse recognize is occurring with this patient?
A) the patient is having an allergic reaction to the blood
B) the patient is experiencing vascular collapse
C) the patient is having decrease in tissue perfusion from a shock state
D) the patient is having a febrile nonhemolytic reaction
D
The nurse is administering two units of PRBCs to an older adult patient with a bleeding duodenal
ulcer. The patient begins to experience difficulty breathing and the nurse assesses crackles in the
lung bases, JVD and an increase in blood pressure. What action by the nurse is necessary if the
reaction is severe? (select all that apply)
A) continue the infusion but slow the rate down
B) place the patient in an upright position with the feet dependent
C) administer diuretics as prescribed
D) discontinue the transfucion
E) administer oxygen
BCDE
A patient is receiving plasma develops transfusion-related acute lung injury (TRALI) 4 hours
after the transfusion. What type of aggressive therapy does the nurse anticipate the patient will
receive to prevent death from the injury? (select all that apply)
A) performance of serial chest x-rays
B) supplemental oxygen
C) provision of IV fluid support
D) intubation and mechanical ventilation
E)intra-aortic ballon pump
BCD
A patient who has long-term PRBC transfusions has developed symptoms of iron toxicity that
affect liver function. What immediate treatment should the nurse anticipate preparing the patient
for that may help prevent organ damage?
A) iron chelation therapy
, 4:06:12 PM Wednesday, July 30, 2025
B) oxygen therapy
C) therapeutic phlebotomy
D) anticoagulation therapy
A
A patient develops a hemolytic reaction to a blood transfusion. What actions should the nurse
take after this occurs? (select all that apply)
A) administer diphenhydramine
B) begin iron chelation therapy
C) collect a urine sample to detect hemoglobin
D) document the reaction according to policy
CDE
The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the
posterior superior iliac crest. What position will the nurse place the patient in?
A) lateral position with one leg flexed
B) lithotomy position
C) supine with head of the bed elevated 30 degrees
D) jackknife position
A
A patient with CKD has chronic anemia. What pharmacologic alternative to blood transfusion
may be used for the patient?
A) GM-CSF
B) erythropoietin
C) eltrombopag
D) thrombopoietin
B
A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse recognize is
the most likely clinical disorder the patient is being treated for?
A) essential thrombocythemia
B) extreme leukocytosis
Medical-Surgical Nursing – Exam #3
Review NCLEX Practice Questions and
Answers
A female patient has a hemoglobin of 6.4 g/dL and is preparing to have a blood transfusion. Why
would it be important for the nurse to obtain information about the patient's history of pregnancy
prior to the transfusion?
A) a high number of pregnancies can increase the risk of reaction
B) if the patient has never been pregnant, it increases the risk of reaction
C) obtaining information about gravity and parity is routine information for all female patients
D) if the patient has been pregnant, she may have developed allergies
A
A patient will need a blood transfusion for the replacement of blood loss from the GI tract. The
patient states, "That stuff isn't safe!" What is the best response from the nurse?
A) I agree that you should be concerned with the safety of the blood but it's important that you
have this transfusion
B) the blood is carefully screened so there is no possibility of you contracting any illness or
disease from the blood
C) I understand your concern. The blood is carefully screened but is not completely risk free
D) you will have to decide if refusing the blood transfusion is worth the risk to your health
C
A patient with chronic anemia has had many blood transfusions over the last 3 years. What type
of transfusion reaction should the nurse monitor for that is commonly found in patients who
frequently receive blood transfusion?
A) allergic reactions
B) acute hemolytic reaction
C) circulatory overload
D) febrile nonhemolytic reactions
D
,4:06:12 PM Wednesday, July 30, 2025
The nurse is administering a blood transfusion to a patient over 4 hours. After 2 hours the patient
reports chills and has a fever of 101F and increase from a precious temp of 99.2F. What does the
nurse recognize is occurring with this patient?
A) the patient is having an allergic reaction to the blood
B) the patient is experiencing vascular collapse
C) the patient is having decrease in tissue perfusion from a shock state
D) the patient is having a febrile nonhemolytic reaction
D
The nurse is administering two units of PRBCs to an older adult patient with a bleeding duodenal
ulcer. The patient begins to experience difficulty breathing and the nurse assesses crackles in the
lung bases, JVD and an increase in blood pressure. What action by the nurse is necessary if the
reaction is severe? (select all that apply)
A) continue the infusion but slow the rate down
B) place the patient in an upright position with the feet dependent
C) administer diuretics as prescribed
D) discontinue the transfucion
E) administer oxygen
BCDE
A patient is receiving plasma develops transfusion-related acute lung injury (TRALI) 4 hours
after the transfusion. What type of aggressive therapy does the nurse anticipate the patient will
receive to prevent death from the injury? (select all that apply)
A) performance of serial chest x-rays
B) supplemental oxygen
C) provision of IV fluid support
D) intubation and mechanical ventilation
E)intra-aortic ballon pump
BCD
A patient who has long-term PRBC transfusions has developed symptoms of iron toxicity that
affect liver function. What immediate treatment should the nurse anticipate preparing the patient
for that may help prevent organ damage?
A) iron chelation therapy
, 4:06:12 PM Wednesday, July 30, 2025
B) oxygen therapy
C) therapeutic phlebotomy
D) anticoagulation therapy
A
A patient develops a hemolytic reaction to a blood transfusion. What actions should the nurse
take after this occurs? (select all that apply)
A) administer diphenhydramine
B) begin iron chelation therapy
C) collect a urine sample to detect hemoglobin
D) document the reaction according to policy
CDE
The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the
posterior superior iliac crest. What position will the nurse place the patient in?
A) lateral position with one leg flexed
B) lithotomy position
C) supine with head of the bed elevated 30 degrees
D) jackknife position
A
A patient with CKD has chronic anemia. What pharmacologic alternative to blood transfusion
may be used for the patient?
A) GM-CSF
B) erythropoietin
C) eltrombopag
D) thrombopoietin
B
A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse recognize is
the most likely clinical disorder the patient is being treated for?
A) essential thrombocythemia
B) extreme leukocytosis
