Free IV Fluids and Blood Transfusion MCQs with Answers
50 IV Fluids and Blood Transfusion MCQs from Nursing Pharmacology, each with the correct answer and a written explanation of why it is correct. Free and unlimited, with no account needed.
IV therapy covers crystalloid and colloid fluids, electrolyte replacement, maintenance and resuscitation fluids, infusion equipment and complications such as infiltration, phlebitis, fluid overload and electrolyte imbalance. Blood transfusion content includes compatibility, cross matching, administration precautions and recognition of haemolytic, febrile and allergic reactions, distinct from ordinary IV fluid reactions.
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50 questions · page 2 of 3
- A. 5% dextrose in water
- B. Lactated Ringer's solution
- C. 3% sodium chloride
- D. 20% human albumin
Explanation: Lactated Ringer's solution is a balanced isotonic crystalloid containing sodium, chloride, potassium, calcium and lactate.
Correct answer: Lactated Ringer's solution- A. Rapid expansion of intravascular volume
- B. Provision of free water and limited calories
- C. Correction of severe symptomatic hyponatraemia
- D. Replacement of large plasma protein losses
Explanation: Glucose is metabolised, leaving free water that distributes through body compartments, with a small carbohydrate contribution.
Correct answer: Provision of free water and limited calories- A. Slow the infusion and reassess the site
- B. Stop the infusion and remove the cannula
- C. Apply heat and continue the infusion
- D. Flush the cannula with normal saline
Explanation: These findings indicate infiltration, so the nurse stops the infusion and removes the cannula to prevent further leakage into tissue.
Correct answer: Stop the infusion and remove the cannula- A. Increase the programmed infusion rate
- B. Inspect the tubing and IV site for obstruction
- C. Silence the alarm and leave the infusion running
- D. Flush forcefully without checking the IV site
Explanation: The nurse should assess the tubing, clamps, connections and cannula site to find the obstruction before correcting it.
Correct answer: Inspect the tubing and IV site for obstruction- A. 21 drops per minute
- B. 42 drops per minute
- C. 63 drops per minute
- D. 84 drops per minute
Explanation: The calculation is 500 mL × 20 drops/mL ÷ 240 minutes = 41.7 drops/minute, rounded to 42 drops/minute.
Correct answer: 42 drops per minute- A. Add prescribed antibiotics to the blood bag
- B. Use the same tubing for several different units
- C. Administer other IV medicines through the blood line
- D. Use a separate line for medicines and blood products
Explanation: Medications must not be added to blood or administered through the blood tubing because they may cause incompatibility or harm the cells.
Correct answer: Use a separate line for medicines and blood products- A. A positive
- B. B positive
- C. AB positive
- D. AB negative
Explanation: A B-positive recipient can receive B-positive packed cells because the donor red cells carry the recipient's ABO and Rh antigens.
Correct answer: B positive- A. Febrile non-haemolytic reaction
- B. Acute haemolytic reaction
- C. Mild allergic reaction
- D. Transfusion-associated circulatory overload
Explanation: Fever and chills without evidence of red-cell destruction are typical of a febrile non-haemolytic transfusion reaction.
Correct answer: Febrile non-haemolytic reaction- A. Slow the transfusion and observe the patient
- B. Stop the transfusion and support the airway
- C. Give oral fluids and document the symptoms
- D. Restart the transfusion after changing the filter
Explanation: Wheezing, facial swelling and hypotension indicate a severe allergic or anaphylactic reaction, so the transfusion is stopped and airway…
Correct answer: Stop the transfusion and support the airway30. Which observation is most important during the first part of a packed red blood cell transfusion?
- A. Measure the patient's weight after one hour
- B. Remain with the patient and observe for an early reaction
- C. Ask the patient to walk to assess tolerance
- D. Restrict all oral fluids until transfusion ends
Explanation: Serious transfusion reactions can begin soon after the transfusion starts, so the nurse remains with the patient and observes closely…
Correct answer: Remain with the patient and observe for an early reaction- A. The pulse becomes faster and weaker
- B. Urine output increases and mentation improves
- C. Thirst becomes stronger and the mouth is dry
- D. Postural dizziness becomes more pronounced
Explanation: Improved urine output and mental status suggest better renal perfusion and circulating volume.
Correct answer: Urine output increases and mentation improves- A. Serum potassium level and renal function
- B. Capillary glucose level and bowel sounds
- C. Serum calcium level and skin turgor
- D. Haemoglobin level and pupil reaction
Explanation: The nurse checks the potassium level and renal function because impaired potassium excretion can cause dangerous hyperkalaemia.
Correct answer: Serum potassium level and renal function- A. Silence the alarm and continue the infusion
- B. Stop the pump and inspect the tubing for air
- C. Increase the infusion rate to clear the tubing
- D. Disconnect the tubing and flush it with saline
Explanation: The nurse stops the pump and examines the tubing before restarting the infusion.
Correct answer: Stop the pump and inspect the tubing for air- A. Force a saline flush through the catheter
- B. Lower the fluid bag and increase the pressure
- C. Stop the infusion and assess the catheter site
- D. Remove the dressing and massage the vein
Explanation: Resistance may indicate a kink, closed clamp, malposition, or an occluded catheter, so the infusion is stopped and the site and tubing are…
Correct answer: Stop the infusion and assess the catheter site- A. Continue the infusion and reassess in one hour
- B. Stop or slow the infusion and assess respirations
- C. Encourage oral fluids and apply a warm blanket
- D. Place the patient upright and offer a high-potassium meal
Explanation: Reduced reflexes and drowsiness can indicate magnesium toxicity, which may progress to respiratory depression.
Correct answer: Stop or slow the infusion and assess respirations- A. Clamp the line, stop the infusion, and give oxygen
- B. Restart the infusion rapidly to clear the line
- C. Flush the cannula forcefully with normal saline
- D. Place the patient flat and leave the line open
Explanation: The line is clamped and the infusion stopped to prevent further air entry, while oxygen and urgent assistance address the breathing…
Correct answer: Clamp the line, stop the infusion, and give oxygen- A. Changing the dressing only when it becomes loose
- B. Using hand hygiene and aseptic technique during access
- C. Covering the site with gauze after every assessment
- D. Flushing the catheter before checking the insertion site
Explanation: Hand hygiene and aseptic technique during insertion and every line access reduce the introduction of microorganisms.
Correct answer: Using hand hygiene and aseptic technique during access- A. Packed red blood cells
- B. Fresh frozen plasma
- C. Platelet concentrate
- D. Cryoprecipitate
Explanation: Platelet concentrate replaces platelets and is used when thrombocytopenia is associated with significant bleeding or a serious bleeding…
Correct answer: Platelet concentrate- A. Transfusion-related acute lung injury
- B. Delayed haemolytic transfusion reaction
- C. Mild allergic transfusion reaction
- D. Simple febrile transfusion reaction
Explanation: Transfusion-related acute lung injury causes acute respiratory distress and non-cardiogenic pulmonary oedema, usually without evidence of…
Correct answer: Transfusion-related acute lung injury- A. Warm the unit and begin it slowly
- B. Shake the unit gently before administration
- C. Do not use it and notify the blood bank
- D. Remove the clumps with a sterile needle
Explanation: Cloudiness, clumps, or abnormal discolouration may indicate contamination, haemolysis, or damage to the blood product.
Correct answer: Do not use it and notify the blood bank