Transfusion Practices
Exam Answer Key
Course Introduction
Transfusion Practices explores the principles, procedures, and policies involved in the safe and effective transfusion of blood and blood components. The course covers the indications and contraindications for transfusion, compatibility testing, adverse transfusion reactions, and strategies to minimize risks. Learners gain an understanding of donor selection, blood collection, storage, and the laboratory processes that ensure product quality and patient safety. Ethical considerations, regulatory standards, and innovations in transfusion medicine are also discussed, preparing students for practical decision-making in clinical and laboratory settings.
Recommended Textbook
Clinical Laboratory Blood Banking and Transfusion Medicine Practices 1st Edition by Gretchen Johns
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21 Chapters
420 Verified Questions
420 Flashcards
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Chapter 1: The Immune Process: the Origin and Interaction
Between Antigens and Antibodies
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Sample Questions
Q1) Optimal pH has not been determined for immunohematologic testing,but it is generally believed that testing should be performed within what pH range?
A)4.2-5.8
B)5.8-7.5
C)6.8-7.2
D)7.0-8.8
Answer: C
Q2) Which scientist proved that infections were caused by microorganisms?
A)Edward Jenner
B)Robert Koch
C)Louis Pasteur
D)Emil von Behring
Answer: B
Q3) What is the best description of cytokines?
A)Glycoproteins bound to red blood cell membranes
B)Proteins reLe sed by cells that affect the behavior of other cells
C)Small proteins that attract and cause the migration of cells
D)Substances that evoke an immune response
Answer: B
3
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Chapter 2: Immunogenetics: the Origin of Antigens
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Q1) Which term refers to the fact that human cells,except for sexual cells,contain two sets of chromosomes?
A)Diploid
B)Karyotype
C)Mitosis
D)Polymerase
Answer: A
Q2) What is the abbreviation for the amino acid glutamine?
A)Gln
B)Glu
C)Gly
D)Gtm
Answer: A
Q3) DNA is defined as
A)Deoxyribonucleic acid
B)Deoxyribonucleic alkali
C)Digoxin neural assessment
D)Diploid nucleotide analysis
Answer: A
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Page 4
Chapter 3: Blood Bank Applications of Antigenantibody
Reactions
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Sample Questions
Q1) Which of the following tests does not detect antibodies to red blood cell antigens?
A)Antibody screen
B)Antibody identification
C)Antigen typing
D)Crossmatch
Answer: C
Q2) The antihuman globulin technique is used to detect which isotype of antibody?
A)IgD
B)IgE
C)IgG
D)IgM
Answer: C
Q3) All of the following can cause false results in both an indirect (IAT)or direct (DAT)antiglobulin test except
A)Contaminated saline
B)Inadequate incubation
C)Interruption in testing
D)Improper centrifugation
Answer: B
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Chapter 4: Abo and Hh Blood Group Systems
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Q1) Mixed field reaction is commonly seen in the forward ABO test if a group _________ patient has received an emergency transfusion of group ____ cells.
A)A,A
B)A,B
C)A,O
D)O,O
Q2) Forward grouping
A)Identifies antibody by combining the unknown plasma with known ABO red blood cells
B)Identifies antigen by combining the unknown red blood cells with known antibody
C)Occurs when the results of the forward and reverse grouping do not correlate
D)Occurs when the results for the A and B antigen do not correlate
Q3) ABO discrepancies are categorized into ____ groups.
A)two
B)three
C)four
D)five
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Chapter 5: Rh, Rhag, and Lw Blood Group Systems
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Sample Questions
Q1) The RHD gene codes for the ____ antigen.
A)A
B)B
C)C
D)D
Q2) In people of European ethnicity,the most common Rh(D)-positive phenotype is ___ and the most common Rh(D)-negative phenotype is ____.
A)R1R1,r'r'
B)R2R2,r''r''
C)R1R2,r'r''
D)R1r,rr
Q3) Which chromosome carries the two Rh genes?
A)1
B)6
C)7
D)9
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Chapter 6: Other Blood Group Systems
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Q1) How many antigens are in the Cartwright blood group system?
A)2
B)3
C)4
D)5
Q2) The full expression of Lewis antigens is not reached until around ___ years of age.
A)3
B)5
C)7
D)9
Q3) How many antigens are there in the Duffy blood group system?
A)3
B)6
C)8
D)9
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8
Chapter 7: Pretransfusion and Compatibility Testing
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Q1) The ABO group of the neonate is determined only by typing red blood cells with
A)anti-A antiserum
B)anti-B antiserum
C)both anti-A and anti-B antisera
D)both anti-A and anti-O antisera
Q2) In most situations,patients who type as Rh(D)negative should receive
A)Rh(D)-negative red blood cells
B)Rh(D)-positive red blood cells
C)Rh(E)-negative red blood cells
D)Rh(E)-positive red blood cells
Q3) When blood components are ordered all of the following are true except
A)Name of the physician placing the order must be indicated
B)Orders should be placed to ensure sufficient time to perform complete testing
C)Requests must include the number and type of components required
D)Requests must only be made using a written request form
Q4) In order for patients to give informed consent,they must first
A)be educated about the risks and benefits
B)be scheduled for an appointment
C)have a diagnosis
D)sign a waiver
Page 9
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Chapter 8: Identification of Unexpected Antibodies
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Sample Questions
Q1) Which drug is not known to cause a positive direct antiglobulin test (DAT)?
A)Aldomet
B)Aspirin
C)Cephalosporin
D)Procainamide
Q2) Antibody screen is generally performed using ______ different reagent cells.
A)1-2
B)2-3
C)2-4
D)3-4
Q3) Which method is preferred for removing autoantibodies?
A)Autologous absorption
B)Allogenic absorption
C)Cutaneous absorption
D)Pathologic absorption
Q4) What is the most common sulfhydryl reagent used in transfusion medicine?
A)Bromelin
B)Chymotrypsin
C)Dithiothreitol
D)Papain
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Chapter 9: Donor Selection, Phlebotomy, and Required Testing
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Sample Questions
Q1) If platelets are to be manufactured,the whole blood donation should be placed in a container that will cool the blood down to what temperature?
A)33.8-50° F (1-10° C)
B)50-59° F (10-15° C)
C)68-75.2° F (20-24° C)
D)75.2-89.6° F (24-32° C)
Q2) The AABB Standards require a donor's systolic pressure to be less than or equal to
A)160 mm Hg
B)170 mm Hg
C)180 mm Hg
D)190 mm Hg
Q3) Which type of deferral means the prospective donor is unable to give blood to someone else for an unspecified period of time due to current regulatory requirements?
A)Flexible
B)Indefinite
C)Permanent
D)Temporary
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Chapter 10: Blood Products: Preparation, Storage, and Shipment
of Blood Components
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Q1) A single component of platelet-rich plasma produced from whole blood will contain a minimum of 5.5 × 1010 platelets and a total volume of _______ mL.
A)20-30
B)30-40
C)40-70
D)50-80
Q2) All of the following anticoagulants have been approved for blood bank use in the United States except A)ACD
B)CPD
C)CPDA-1
D)CP3D
Q3) Which of the following statements is true about granulocyte component production?
A)A whole blood unit generally yields 5 × 106 granulocytes.
B)Apheresis collection is used more often than whole blood separation.
C)Granulocyte units are stored at 68-75.2° F (20-24° C)for up to 5 days.
D)Hydroxyethel starch is added and then the blood is centrifuged.
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Page 12
Chapter 11: Component Therapy and Massive Transfusion
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Sample Questions
Q1) Whole blood transfusion achieves all of the following except
A)Improved cellular immune function
B)Improved tissue oxygenation
C)Replacement of fluid
D)Replacement of nonlabile coagulation factors
Q2) Which of the following do hematopoietic progenitor cell (HPC)donors routinely receive prior to donation?
A)Desmopressin
B)G-CSF
C)Recombinant EPO
D)Recombinant TPO
Q3) Where do the majority of hematopoietic progenitor cells (HPCs)reside?
A)bone marrow
B)lymphatic system
C)peripheral circulation
D)striated muscle
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13
Chapter 12: Adverse Reactions to Transfusion
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Q1) Regarding febrile,nonhemolytic transfusion reactions (FNHTR),all of the following statements are true except
A)After an initial reaction,recurrence is uncommon.
B)Onset of symptoms occurs during or up to 4 hours after transfusion.
C)Prestorage filtration has been shown to be effective in reducing incidences.
D)Symptoms cause discomfort but are not life-threatening.
Q2) All of the following statements about anaphylactoid transfusion reactions are true except
A)They are serious and life-threatening
B)They are triggered by IgE class antibodies that reLease mediators from mast cells
C)They can be caused by reaction between a protein allergen and its corresponding antibody
D)They can be caused by IgA in the transfused blood product reacting with anti-IgA in the patient's plasma
Q3) Hypothermia occurs when the body temperature drops below
A)92° F (33° C)
B)95° F (35° C)
C)98° F (37° C)
D)101° F (38° C)
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Page 14
Chapter 13: Transfusion-Transmitted Infections
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Sample Questions
Q1) Leukoreduction can reduce the risk of which transfusion-associated virus?
A)CMV (cytomegalovirus)
B)HBV (hepatitis B virus)
C)HCV (hepatitis C virus)
D)HIV (human immunodeficiency virus)
Q2) Nucleic acid amplification-based testing (NAT)reduced the window period for human immunodeficiency virus (HIV)to approximately how many days?
A)12
B)14
C)16
D)22
Q3) Which of the following infects red blood cells?
A)Epstein-Barr virus
B)Cytomegalovirus
C)Parvovirus B19
D)West Nile virus
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Chapter 14: Perinatal and Neonatal Transfusion Issues
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Q1) Which term refers to delivery of a live infant?
A)Gravid
B)Gravida
C)Para
D)Peri
Q2) All of the following are known to be IgM antibodies and have not been found to cause hemolytic disease of the fetus and newborn (HDFN)except
A)Anti-Le
B)Anti-Le
C)Anti-M
D)Anti-P1
Q3) In general,for the neonatal population,a platelet count of ___________ is considered the minimum to maintain hemostasis.
A)50 × 10³/µL (50 × 10 /L)
B)75 × 10³/µL (75 × 10 /L)
C)100 × 10³/µL (100 × 10 /L)
D)150 × 10³/µL (150 × 10 /L)
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Chapter 15: Autoimmune and Drug-Induced Immune
Hemolytic Anemias
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Q1) Which of the following is the most common autoimmune hemolytic anemia?
A)DAT-negative autoimmune hemolytic anemia
B)Drug-induced immune hemolytic anemia (DIIHA)
C)Mixed autoimmune hemolytic anemia (MAIHA)
D)Warm autoimmune hemolytic anemia (WAIHA)
Q2) Warm autoimmune hemolytic anemia (WAIHA)occurs most frequently in which age group?
A)Infants
B)Toddlers
C)Teenagers
D)Older adults
Q3) Which term refers to the destruction of autologous red blood cells during a hemolytic transfusion reaction that is destroying allogeneic cells?
A)Hemagglutination
B)Hemostasis
C)Hemoglobinuria
D)Hyperhemolysis
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Chapter 16: Platelet Refractory Patients
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Q1) The antibodies most commonly implicated in immune platelet refractoriness are directed against which group of antigens?
A)ABO
B)HLA
C)HPA
D)Rh
Q2) What is the first step to take when platelet refractoriness is suspected in a patient?
A)Confirm the response to the transfusion
B)Obtain a complete and accurate history
C)Screen the patient for HLA and/or HPA antibodies
D)Transfuse ABO-identical platelets
Q3) Transfusion of which blood component is most often associated with post-transfusion purpura (PTP)?
A)Plasma
B)Platelets
C)Red blood cells
D)White blood cells (granulocytes)
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Chapter 17: Transfusion Support of Selected Patient
Populations
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Q1) Red blood cell and platelet transfusions are used as supportive therapy in patients who have undergone a hematopoietic progenitor cell (HPC)transplant until when?
A)Chemotherapy is complete
B)CMV reactivation occurs
C)Engraftment occurs
D)Factor levels reach 70%
Q2) All of the following are common manifestations of cytomegalovirus (CMV)disease except
A)Anemia
B)Gastroenteritis
C)Hepatitis
D)Pneumonia
Q3) Sickle cells that occlude blood vessels cause all of the following except
A)Iron overload
B)Organ damage
C)Stroke
D)Tissue ischemia
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Page 19
Chapter 18: Human Histocompatibility
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Q1) Which of the following is the correct term used for "multiple genes expressed in an individual that produce similar products"?
A)Polymorphic
B)Polygenic
C)Polymerase
D)Pseudogene
Q2) When matching a recipient and potential donor for kidney transplant,all of the following antigens should be identified except
A)HLA-A
B)HLA-B
C)HLA-DQ
D)HLA-DR
Q3) All of the following are typical monitoring tests performed after a kidney transplant except
A)C4D staining and histological analysis
B)Serum creatinine level
C)Serum complement level
D)Urinary output
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Chapter 19: Methods in Parentage Testing
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Q1) VNTR refers to
A)variable nucleotide test result in DNA testing
B)variable number of tandem repeats in a DNA sequence
C)venous nucleotide type repeat in DNA sequence
D)very neutral transition reactions in DNA synthesis
Q2) Mendel's laws of genetics requires ________ of the alleles in the child's sample to be traceable to each parent.
A)one-half
B)one-third
C)one-quarter
D)one-sixth
Q3) How many loci are included in the core loci originally defined by the FBI for use in identification of individuals by genetic testing?
A)9
B)13
C)15
D)18
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21
Chapter 20: Transfusion Safety and Regulatory Issues
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Q1) Generally over-the-counter tests and some point-of-collection tests are classified as
A)Nonwaived
B)Waived
C)Moderate complexity
D)High complexity
Q2) Which code of federal regulations contains the rules for blood product safety?
A)CFR title 10
B)CFR title 21
C)CFR title 29
D)CFR title 42
Q3) Which law was the first American legislation to deal with biologics?
A)Biologics Control Act
B)Federal Food and Drugs Act
C)Public Health Service Act
D)Virus-Control Law
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22
Chapter 21: Quality Assurance
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Q1) A nonconformance event is defined as a
A)corrected error where the patient or product was not adversely affected
B)departure from policies
C)deviation from cGMP
D)failure to meet accreditation requirements
Q2) The definition for policy would be which of the following?
A)Document used to record data
B)Information that provides objective evidence that an activity was completed
C)Principle that guides decision making
D)Set of related steps that achieve a goal
Q3) The AABB Standards for Blood Banks and Transfusion Services are divided into how many quality system essentials?
A)10
B)13
C)21
D)23
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