病人正在接受輸血，隨後主訴背痛和發冷。護理師的首要行動為何？

背痛、發冷、發燒或低血壓是急性溶血性輸血反應（Acute Hemolytic Reaction）的典型特徵。這是一種醫療緊急狀況，可能導致急性腎衰竭、DIC 甚至死亡。護理師在懷疑任何輸血反應時，絕對的首要行動是立即「停止輸血」（Stop the transfusion）。之後才是更換生理食鹽水管路維持靜脈通路、評估生命徵象、通知醫師與血庫。減慢速度（C）無法停止免疫傷害；給予普拿疼（B）只是對症處理且可能掩蓋病情。及時停止暴露於抗原是減少致命風險的最有效方式。這是 NCLEX 考題中關於「安全」最經典的必考點之一。

Back pain, chills, fever, or hypotension are classic features of an acute hemolytic transfusion reaction. This is a medical emergency that can lead to acute renal failure, DIC, or even death. Whenever any transfusion reaction is suspected, the nurse's absolute first action is to immediately stop the transfusion. Then change tubing to normal saline to maintain IV access, assess vital signs, and notify the physician and blood bank. Slowing the rate (C) cannot stop the immune injury; administering acetaminophen (B) is symptomatic only and may mask the condition. Promptly stopping exposure to the antigen is the most effective way to reduce fatal risk. This is one of the most classic NCLEX safety questions.

在美國，輸血反應後需將剩餘血袋與所有管路一併送回血庫檢驗；台灣流程相似，但部分醫院要求需同時採集病人的第一套尿液檢體以確認是否有血紅素尿（溶血證據）。