NAME: May Jane C.

Diaz

YR & SECTION: 3 C

ASSIGNMENT: Answer the questions below and give their rationale. This serves as a review to prepare you for your
board exam in the future. Believe in yourself, you can do it. God bless!

BLOOD TRANSFUSION: https://quizizz.com/print/quiz/62425bb1d08daf001ee665e0

TOPIC: SUCTIONING

1. FILL IN THE BLANK. It is the removal of airway of secretions using negative pressure through catheter connected to a
suction machine.
Answer: SUCTIONING/AIRWAY SUCTIONING

Rationale: Suctioning is used to remove secretions from the airway. Suctioning of the oropharyngeal and nasopharyngeal
cavities is used when a patient can cough sufficiently but is unable to remove secretions through expectoration or
swallowing.

2. Nurse Leo was asked by a student about the time or seconds the patient should be suctioned. His best response will
be?

a. not more than 10 seconds

b. not more than 20 seconds
c. not more than 30 seconds
d. not more than 40 seconds

Rationale: Suctioning can cause bradycardia and hypoxia in the patient by stimulating the vagal nerve. After seconds of
suctioning, re-oxygenate the patient.

3. Nurse Cj knows that suctioning is, except,

a. an invasive procedure
b. prevents aspiration
c. prevents infection
d. should be carried out on a routine basis.

Rationale: Suction is an unpleasant procedure that should not be used frequently. Suctioning, on the other hand, is a
vital part of the care of an intubated or ventilated patient. Suctioning too often can cause secretory buildup.

4. Nurse Jericho is aware that the correct size of suction catheter for infant is:
a. Fr 3-5
b. Fr 5-8
c. Fr 8-10
d. Fr 12-18

Rationale: Fr. 5-8 refers to newborns, FR. 8-10 to adolescents, and Fr. 12-18 to adults.

5. Nurse Jonathan was assigned in Intensive Care Unit. He is caring for an adult comatose patient with pneumonia and
about to suction secretions visible in patient’s mouth. He then prepares suction catheter with size of:

a. Fr 8
b. Fr 10
c. Fr 14
d. Fr 5
Rationale: Fr. 5-8 refers to newborns, FR. 8-10 to adolescents, and Fr. 12-18 to adults.

6. Nurse Jonathan positions comatose patient in:

a. Semi-fowlers position
b. High fowlers position
c. Side lying position
d. Supine position

Rationale: The tongue might fall forward in this posture, preventing the catheter from becoming occluded during
insertion.

7. What is the best position for suctioning conscious patient?

a. Semi-fowlers position
b. High fowlers position
c. Side lying position
d. Supine position

Rationale: These settings make it easier to implant the catheter and reduce secretion aspiration.

8. Nurse April was asked by her supervisor to perform suctioning to her client who is 45 years old. As a nurse, she knows
that she needs to set the suction pressure to? (wall unit)
a. 100-120 mmHg
b. 200-300 mmHg
c. 140-160 mmHg
d. 98-100 mmHg

Rationale: 100-120 mmHg is the suggested pressure setting. This should be sufficient to remove secretions without
harming the bronchial mucosa. Negative pressures should not exceed 150 mmHg to avoid airway injury, hypoxia, or
atelectasis.

9. Side effects of suctioning includes all but one:

a. hypoxia
b. infection
c. trauma
d. bleeding
e. bradycardia

Rationale: In the event of an emergency, suctioning can prevent a number of disastrous effects and even save lives. As
with any medical procedure, it carries risks such as hypoxia, airway injury, psychological trauma, infection, and
bradycardia.

10. Hand hygiene is important to prevent cross contamination of microorganism causing infection. It is performed:

a. Before and after touching a patient.

b. After body fluid exposure risk.

c. After touching patient surroundings.

d. All of the above

Rationale: Infections are prevented by washing your hands and following ordinary measures.
PRELIMS

1. What is the most appropriate nursing intervention if your patient’s heart rate drops during suctioning?
A. Continue to suction.
B. Limit suctioning to 15 seconds.
C. Stop and reoxygenate the patient.
D. Notify the physician.

Rationale: If the patient’s heart rate drops while suctioning, the nurse should pause and re-oxygenate the patient before
continuing suctioning. The nurse should keep a close check on the patient during suctioning for any unwanted side
effects. If any unfavorable consequences occur, the patient should be re-oxygenated.

2. You are caring for a pregnant mother and you need to perform suctioning because of the presence of secretions. It is
important to follow which correct technique?
A. The suction pressure should be between 100 to 120 mmHg.
B. While advancing the suction catheter, occlude the Y-port of the catheter
C. Use intermittent suction in the airway for up to 20 seconds
D. Hyper-oxygenate the client before and after suctioning.

Rationale: To avoid aspiration, hyper-oxygenate the client before and after suctioning.

3. How long should as suction procedure last?

a. Approximately 40 seconds.
b. Approximately 30 seconds.
c. Approximately 15 seconds.
d. Approximately 5 seconds.
Rationale: To reduce the risk of problems such as vasovagal reaction or hypoxemia, suction should last about 15
seconds.

4. When during the suction procedure should suction be applied?

a. Only when withdrawing the suction catheter
b. Only when inserting the suction catheter.
c. Either during insertion or withdrawal, depending on when the patient coughs.
d. Only if the patient coughs.
Rationale: To avoid injuring the tracheal mucosa of the patient, suction should only be utilized when the suction catheter
is being withdrawn.

5. Which one of the following is a contraindication for inserting a nasopharyngeal airway?

a. The patient is able to tolerate an oropharyngeal airway
b. The patient a fractured base of skull.
c. The patient has hypoxaemia.
d. The patient has a chest infection.

Rationale: The nasopharyngeal airway should not be used if the patient has a suspected fractured base of the skull.

6. Which of the following are possible indications for performing suction?

a. Normal air entry on auscultation.
b. The patient has an effective cough.
c. Reduced oxygen saturation levels.
d. Normal respiratory rate.
Rationale: Because a drop in oxygen saturation levels could indicate that the patient has secretions impeding oxygen
intake from the lungs, which should be cleared as quickly as feasible.

7. Which of the following is true?

a. The dominant hand will need to remain sterile throughout the entire suctioning procedure.
b. The non-dominant hand will need to remain sterile throughout the entire suctioning procedure.
c. Do not hyperoxygenate the patient prior to suctioning.
d. Apply suction when inserting the catheter.
Rationale: Because a sterile hand is always a sterile hand, the dominant hand must remain sterile throughout the
suctioning technique.
8. Donated blood undergoes screening for which diseases?
a. HIV (the virus that causes AIDS
b. Viral hepatitis
c. Diabetes
d. A and B
Rationale: This is to prevent infectious blood and blood components from being released for clinical use.
9. Nurse Jonathan positions comatose patient in:

a. Semi-fowlers position
b. High fowlers position
c. Side lying position facing the nurse
d. Supine position

Rationale: The tongue might fall forward in this posture, preventing the catheter from becoming occluded during
insertion.

10. What is the best position for suctioning conscious patient?

a. Semi-fowlers position
b. High fowlers position
c. Side lying position
d. Supine position

Rationale: These settings make it easier to implant the catheter and reduce secretion aspiration.

11. Red blood cells are very vital for survival. Which statement below is NOT correct about red blood cells?
a. "Red blood cells help carry oxygen throughout the body with the help of the protein hemoglobin."
b. "Extreme loss of red blood cells can lead to a suppressed immune system and clotting problems."
c. "Red blood cells help remove carbon dioxide from the body."
d. "Red blood cells are suspended in the blood's plasma." 
Rationale: Shortness of breath, tachycardia, weariness, and other symptoms can be caused by anaemia, which is caused
by a substantial loss of red blood cells. Low white blood cells, or WBCs, can inhibit the immune system, whereas low
platelets might create clotting problems.
12. You're providing care to a 36 year old male. The patient experienced abdominal trauma and recently received 2 units
of packed red blood cells. You're assessing the patient's morning lab results. Which lab result below demonstrates that
the blood transfusion was successful?
A. Hemoglobin level 7 g/dL
B. Platelets 300,000 µl
C. Hemoglobin level 15 g/dL 
D. Prothrombin Time 12.5 seconds
Rationale: Hemoglobin levels determine the effectiveness of a blood transfusion. Haemoglobin levels in men should be
between 13.2 and 16.6 grams per decilitre. Women’s blood sugar levels range from 11. 6 to 15 grams per decilitre.
13. What blood type is known as the “universal donor”?
a. Type A
b. Type B
c. Type AB
d. Type O 
Rationale: Universal donors have type O- blood, which contains no antigens from the A, B, or Rh blood groups and can
thus be safely given to people of any blood group.

14. What blood type is known as the “universal recipient”?

a. Type A
b. Type B
c. Type AB
d. Type O 
Rationale: People with type AB+ blood can get red blood cells from any blood type donor because they have no
antibodies to A, B, or Rh in their blood.

15. A patient needs 2 units of packed red blood cells. The patient is typed and crossmatched. The patient has B+ blood.
As the nurse you know the patient can receive what type of blood?
a. A+, A-
b. B+, B-
c. O+, O-
d. Option b and c is correct

Rationale: A blood type O or B donor is required for the patient. Because the patient’s Rh factor is positive, they may
receive either negative or positive blood. As a result, the patient may receive B-, B+, O-, and O+ blood.

16. A donor has AB- blood. Which patient or patients below can receive this type of blood safely?
a. A patient with O- blood.
b. A patient with A- blood.
c. A patient with B- blood.
d. A patient with AB- blood.
Rationale: Donors with the AB blood type, or AB- blood in this case, can only give to people with the AB blood type. They
are universal recipients in the sense that they can accept blood from people of all blood kinds, but they can only donate
to people of the same blood type.

17. As the nurse you know that there is a risk of a transfusion reaction during the administration of red blood cells.
Which patient below it is at most RISK for a febrile (non-hemolytic) transfusion reaction?
a. A 38 year old male who has received multiple blood transfusions in the past year.
b. A 42 year old female who is immunocompromised. 
c. A 78 year old male who is B+ that just received AB+ blood during a transfusion.
d. A 25 year old female who is AB+ and just received B+ blood.
Rationale: In a febrile transfusion reaction, the recipient’s WBCs react with the donor’s WBCs. This results in the
production of antibodies. Patients who have had blood transfusions in the past are more likely to develop this illness.

18. Before a blood transfusion you educate the patient to immediately report which of the following signs and
symptoms during the blood transfusion that could represent a transfusion reaction
a. restlessness and cramps
b. pruritus, chills, chest pain, backpain
c. pruritus, cramps, shortness of breath
d. none of the above
Rationale: Sweating, chills, hives, headache, backpain, pruritus, shortness of breath, and nausea are all signs and
symptoms of blood transfusion reactions.

19. Your patient needs 1 unit of packed red blood cells. You've completed all the prep and the blood bank notifies you
the patient's unit of blood is ready. You send for the blood and the transporter arrives with the unit at 1200. You know
that you must start transfusing the blood within _________.
a. 5 minutes
b. 15 minutes
c. 30 minutes 
d. 1 hour
Rationale: Within 30 minutes, the blood must be started.

20. A patient is ordered to receive 2 units of packed red blood cells. The first unit was started at 1400 and ended at
1800. You send for the other bag of red blood cells. As the nurse you know it is priority to:
A. obtain signed informed consent for the second unit of blood from the patient
B. obtain a new y-tubing set or blood transfusion set for this unit of blood 
C. type and crossmatch the patient
D. hang a new bag of dextrose to transfuse with the blood
Rationale: One unit of blood has already been given to the patient, and another is required. The first unit of blood took 4
hours to transfuse, and the nurse will need to get new y-tubing for the next unit of blood. Sets of Y-tubing are only good
for 4 hours. With each unit transfusion or after 4 hours, some hospitals require fresh tubing sets.

21. Before starting a blood transfusion the nurse will perform a verification process with __________. This will include?

A. any available personnel; physician's order, patient's identification, blood bank's information, expiration date of blood
B. Only licensed personnel only (another RN); physician's order, patient's identification, blood bank's information,
patient's blood type and donor's type along with Rh factor, expiration date, assess the bag of blood for damage or
abnormal substances 
C. blood bank; patient's identification, blood bank's information, patient's blood type and donor's type along with Rh
factor, expiration date, bag of blood for damage or abnormal substances
D. licensed personnel only (another RN); blood compatibility, physician order, expiration date
Rationale: The nurse will double-check the physician’s order, the patient’s identification and blood bank information, the
patient’s blood type and donor’s blood type, as well as the Rh factor, expiration date, and assess the bag for damage or
abnormal substances with another licensed personnel before starting the transfusion.

22. Before initiating the blood transfusion, you obtain the patient's baseline vital signs, which are: heart rate 100, blood
pressure 115/72, respiratory rate 18, and temperature 38.0 degree celsius. Your next action is to:
A. Administer the blood transfusion as ordered. 
B. Hold the blood transfusion and reassess vital signs in 1 hour.
C. Notify the physician before starting the transfusion.
D. Administer 200 mL of the blood and then reassess the patient's vital signs

Rationale: The patient has an unusually high fever. Prior to blood injection, any temperature exceeding 100°F should be
reported to the doctor.

23. A patient started receiving their first unit of blood at 1000. It is now 1010 and the patient is reporting itching, chills,
and a headache. In addition, the patient's temperature is now 99.8'F from 98'F. Your next nursing action is:
A. Stop the transfusion 
B. Notify the physician
C. Decrease the rate of the transfusion
D. Reassure the patient that this is normal and will resolve in 30 minutes.

Rationale: The patient could be experiencing a transfusion response. After stopping the transfusion, the nurse should
unplug and replace the IV tubing at the access site. Regular saline should also be injected to keep the vein open. After
that, the nurse will inform the doctor and the blood bank.
24. A patient started receiving their first unit of blood at 1000. It is now 1010 and the patient is reporting itching, chills,
and a headache. In addition, the patient's temperature is now 99.8'F (37.7 degrees celsius) from 98'F (36.7 degrees
celsius). Your next nursing action is:
A. Stop the transfusion 
B. Notify the physician
C. Decrease the rate of the transfusion
D. Reassure the patient that this is normal and will resolve in 30 minutes.

Rationale: The patient could be experiencing a transfusion response. After stopping the transfusion, the nurse should
unplug and replace the IV tubing at the access site. Regular saline should also be injected to keep the vein open. After
that, the nurse will inform the doctor and the blood bank.
25. What solution or solutions below are compatible with red blood cells?
A. Normal Saline 
B. Dextrose Solutions
C. Any medications with normal saline
D. No solutions are compatible with blood

Rationale: Normal saline is the only solution that can be used with blood.
26. Your patient is having a transfusion reaction. You immediately stop the transfusion. Next you will:
A. Notify the physician.
B. Disconnect the blood tubing from the IV site and replace it with a new IV tubing set-up and keep the vein open with
normal saline 0.9%. 
C. Collect urine sample.
D. Send the blood tubing and bag to the blood bank.

Rationale: After the transfusion, the nurse must disconnect the blood tubing from the IV site and replace it with a fresh
IV tube set-up, keeping the vein open with normal saline 0.9 percent. As a result, more blood will be unable to reach the
patient’s system. After that, the nurse will inform the doctor and the blood bank.
27. Why are transfusions given?
a. To increase the amount of blood
b. To increase the blood's ability to carry oxygen
c. To decrease the risk of bleeding
d. All of the above
Rationale: Transfusions are used to replace different type of blood cells or blood components. A certain type of
transfusion can help with clotting problems.

28. Which parts of the blood can be transfused?

a. Whole blood
b. Platelets
c. Red blood cells
d. All of the above
Rationale: Everything discussed above. When possible, recipients are only given the blood components they need,
rather than the full blood.

29. What is the minimum you should weigh to donate blood?

a. 100 pounds
b. 110 pounds
c. 115 pounds
d.125 pounds
Rationale: A complete medical history is taken before a donor is approved. A drop of blood is then used to examine the
donor’s haemoglobin levels to see if they have enough to donate blood without jeopardizing their own health. You may
need additional height and weight measurements if you are under the age of 18.

30. How often can a donor give blood?

a. At any time
b. Every 2 months
c. Every 3 months
d. Every 6 months

Rationale: The time between two donations must be at least 12 weeks apart (3 months).