A nurse is caring for a patient who is receiving a unit of packed red blood cells. Fifteen minutes following the start of the transfusion, the nurse notes that the patient is febrile, with chills and red-tinged urine. Which of the following transfusion reactions should the nurse suspect?

Allergic

Hemolytic

Acute pain

Febrile

Answer and Explanation

The Correct Answer is B

A. Allergic – An allergic reaction typically presents with itching, rash, and wheezing rather than fever, chills, and hematuria.

B. Hemolytic – Correct Answer. A hemolytic reaction occurs when the immune system attacks transfused red blood cells due to incompatibility. Symptoms include fever, chills, hypotension, back pain, and hematuria (red-tinged urine). This is a medical emergency requiring immediate intervention.

C. Acute pain – Acute pain transfusion reaction is rare and mainly presents with severe chest, back, and joint pain, without fever or hematuria.

D. Febrile – Febrile reactions cause fever and chills but do not typically cause hematuria, which is indicative of hemolysis.

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Correct Answer is A

Explanation

A. Correct. The GCS assesses level of consciousness based on eye-opening, verbal response, and motor response.

B. Incorrect. Reflex activity is assessed separately using neurological reflex tests.

C. Incorrect. Sensory involvement is evaluated through different neurological exams, not the GCS.

D. Incorrect. Cognitive ability assessment requires specialized tests, such as the Mini-Mental State Examination (MMSE).

A. Check the patient's blood temperature. B. Administer an oral analgesic. C. Perform a complete blood count. D. Evaluate the patient's neurological status.

Correct Answer is A

Explanation

A. Check the patient’s blood temperature. – Correct Answer. A headache and stiff neck are classic signs of meningitis. Fever is another key symptom, so checking temperature helps confirm suspicion and guides urgent intervention.

B. Administer an oral analgesic. – Incorrect. Pain management is secondary. The priority is assessing for infection (meningitis).

C. Perform a complete blood count. – Incorrect. While a CBC may show elevated WBCs, immediate assessment is more urgent.

D. Evaluate the patient’s neurological status. – Incorrect. While neurological assessment is important, confirming fever as an infection indicator is the first step.

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A nurse is caring for a patient who is receiving a unit of packed red blood cells. Fifteen minutes following the start of the transfusion, the nurse notes that the patient is febrile, with chills and red-tinged urine. Which of the following transfusion reactions should the nurse suspect?

Nursing Test Bank

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