NCLEX prep question: What's the right answer?

[Freedom42]

I'm struggling with this test question on my NCLEX test prep CD. What's the correct answer?

A client with pretransfusion hemoglobin and hematocrit values of 9 grams and 27 percent, respectively, received two units of packed red blood cells. The nurse determines the transfusions were effective when repeat laboratory tests indicate which of the following results?

A. 11 g, 33%

B. 12 g, 36%

C. 13 g, 30%

D. 15 g, 39%

I thought that each unit of PRBCs raised the hgb by 1 g and the hct by up to 3%, so I chose A. The CD says the correct answer is C, 13 g, 30%.

Am I insane? What am I doing wrong? Or is the disk wrong? I've come across this type of question several times and always come up with a different calculation than what the disk says is correct.

Thanks for your help.

[Freedom42]

bumpity bump

[goodstudentnowRN]

I'm struggling with this test question on my NCLEX test prep CD. What's the correct answer?

A client with pretransfusion hemoglobin and hematocrit values of 9 grams and 27 percent, respectively, received two units of packed red blood cells. The nurse determines the transfusions were effective when repeat laboratory tests indicate which of the following results?

A. 11 g, 33%

B. 12 g, 36%

C. 13 g, 30%

D. 15 g, 39%

I thought that each unit of PRBCs raised the hgb by 1 g and the hct by up to 3%, so I chose A. The CD says the correct answer is C, 13 g, 30%.

Am I insane? What am I doing wrong? Or is the disk wrong? I've come across this type of question several times and always come up with a different calculation than what the disk says is correct.

Thanks for your help.

I am almost sure that with each unit of PRBC the hemoglobin should raise by two units. I will check on it for you. If this is the case "C" would be the correct answer

[jadu1106]

:) Hi!

I also thought that 1 unit of RBC results in a hemoglobin increase of 1 unit or hematocrit increase of 3%.

I am curious to see what others say!

[mnf626]

The key to this question is: The nurse determines the transfusions were effective when repeat laboratory tests indicate which of the following results?

You do not need to know how much (numerically) packed RBCs increase the H/H but what a normal range of H/H is. This eliminates all the others and leaves the correct answer: C. Just do not think too much into the question..look for the key words.

[Freedom42]

The key to this question is: The nurse determines the transfusions were effective when repeat laboratory tests indicate which of the following results?

You do not need to know how much (numerically) packed RBCs increase the H/H but what a normal range of H/H is. This eliminates all the others and leaves the correct answer: C. Just do not think too much into the question..look for the key words.

I don't understand this. Thirty percent is not a normal hematocrit. I think this question is asking for the anticipated results based on the specific transfusion formula.

[ghillbert, MSN, NP]

I think it's A.

There are 2 reasons I think C is wrong:

1. Each unit of PRBC should raise Hb by 1

2. By the "rule of 3s", Hb x3 = Hct. C has a Hb of 13 but a crit of only 30% which doesn't make sense.

[Freedom42]

Thanks, ghillbert. I just double-checked my high-acuity text book. I'm thinking the disk is wrong, and you and the book have confirmed it.

[Daytonite, BSN, RN]

a client with pretransfusion hemoglobin and hematocrit values of 9 grams and 27 percent, respectively, received two units of packed red blood cells. the nurse determines the transfusions were effective when repeat laboratory tests indicate which of the following results?

a. 11 g, 33%

b. 12 g, 36%

c. 13 g, 30%

d. 15 g, 39%

the answer is "a. 11 g, 33%".

if you are getting this question from the saunders comprehensive review for the nclex-rn examination be aware that there are a lot of wrong answers to the questions on that disc.

i went to post #5 on the sticky thread any good iv therapy or nursing procedure web sites on the nursing student assistance forum and went on some of the websites listed for blood transfusions and found that indeed. . .

• http://classes.kumc.edu/son/nurs420/unit8/blood_transfusion_guide.htm - "1 unit [of packed rbcs] raises hgb 1 g and hct 3-4%."
  
• http://www.redcross.org/services/biomed/profess/pgbtscreen.pdf - page 10 "a dose of one unit of compatible red blood cells will increase the hemoglobin level in an average sized adult who is not bleeding or hemolyzing by approximately 1g/dl or hct by 3%"
  

[Freedom42]

Thanks, Daytonite. I am using Prentice Hall, if anyone has any experience with that disk. I've noticed a number of what I can only conclude are typos.

[kgh31386, BSN, MSN, RN]

yea the answer is A. 1g/ unit and 3%/unit...so 2 units, you end up with 11g and 33%