一位病人正在接受輸血，並在輸血開始 15 分鐘後自訴下背痛和畏寒。護理師應首先採取哪項行動？
A client is receiving a blood transfusion and reports low back pain and chills 15 minutes after the infusion started. Which action should the nurse take first?
- ANotify the blood bank and the healthcare provider通知血庫和醫療提供者
- BSlow the infusion rate and monitor vital signs減慢輸注速度並監測生命徵象
- CStop the transfusion immediately✓ 正解立即停止輸血
- DAdminister acetaminophen for the chills給予乙醯胺酚以緩解畏寒
下背痛（Low back pain）、畏寒、發燒與低血壓是「急性溶血性輸血反應」（Acute hemolytic reaction）的典型徵兆，這是一種致命的免疫反應。處理任何疑似輸血反應的首要、最優先行動永遠是「立即停止輸血」。B 選項減慢速度無濟於事，只要微量的錯誤血型進入體內就足以致命；D 選項 acetaminophen 會掩蓋症狀；A 選項是後續步驟。在 NCLEX 的邏輯中，當危及生命的事情發生時，必須先執行物理上的停止動作（Stop the source），再進行後續通報與評估。這題考驗輸血安全與急症處理的優先順序。
Low back pain, chills, fever, and hypotension are classic signs of an acute hemolytic transfusion reaction, a life-threatening immune-mediated event. The first and highest-priority action for any suspected transfusion reaction is always to stop the transfusion immediately. Option B (slowing the rate) is inadequate because even a small amount of incompatible blood can be fatal; Option D (acetaminophen) only masks symptoms; Option A is a subsequent step. In NCLEX logic, when a life-threatening event occurs, the physical action of stopping the source must be performed first, followed by notification and further assessment. This question tests the priorities of transfusion safety and emergency response.
美國護理標準對於輸血反應有極嚴格的 SOP（Stop, Flush with NS, Vitals, Notify, Send bag back）。台灣雖然流程相似，但護理師在第一時間「果斷停藥」的自主性是考試強調的重點，不能等醫師看完才停。