Clinical Nurse Leader Practice Exam

What is the immediate next step after a patient's hemoglobin drops significantly before a transfusion?

1. Research the patient's history of anemia

2. Assess the patient for signs and symptoms of bleeding

3. Call the physician to redraw the labs

4. Review the rest of the patient's lab values

The correct answer is: Assess the patient for signs and symptoms of bleeding

Assessing the patient for signs and symptoms of bleeding is a critical immediate next step when a patient experiences a significant drop in hemoglobin. This is due to the need for timely identification of any potential acute conditions that may be contributing to the drop in hemoglobin, such as hemorrhage or other types of bleeding. Observing for clinical signs such as pallor, increased heart rate, hypotension, changes in consciousness, or any visible signs of bleeding can provide essential information that influences patient management. In situations like this, addressing the most pressing concerns—like active bleeding—ensures that the appropriate interventions can be initiated promptly. Recognizing and responding to this can be lifesaving. Other options, while they may be relevant to the overall understanding of the patient's condition or treatment, do not address the need for immediate action in response to the dropped hemoglobin. For example, gathering more historical data or reviewing other lab values can be valuable in the long run but does not provide the urgent assessment needed to identify and manage potential complications right away.