Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking

Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

PART I Fundamental Concepts 6. What are the current storage time and storage c. 65%. a. 4 hours.
CHAPTER 1 temperature for platelet concentrates and apheresis d. 75%. b. 24 hours.
platelet components? c. 5 days.
Review Questions a. 5 days at 1°C to 6°C 13. What is the lowest allowable pH for a platelet d. 7 days.
1. What is the maximum volume of blood that can be b. 5 days at 24°C to 27°C component at outdate?
collected from a 110-lb donor, including samples for c. 5 days at 20°C to 24°C a. 6 20. Which of the following is the most common cause of
processing? d. 7 days at 22°C to 24°C b. 5.9 bacterial contamination of platelet products?
a. 450 mL c. 6.8 a. Entry of skin plugs into the collection bag
b. 500 mL 7. What is the minimum number of platelets required in d. 6.2 b. Environmental contamination during processing
c. 525 mL a platelet concentrate prepared from whole blood by c. Bacteremia in the donor
d. 550 mL centrifugation (90% of sampled units)? 14. Frozen and thawed RBCs processed in an open d. Incorrect storage temperature
a. 5.5 _ 1011 system can be stored for how many days/hours?
2. How often can a blood donor donate whole blood? b. 3 _ 1010 a. 3 days
a. Every 24 hours c. 3 _ 1011 b. 6 hours
b. Once a month d. 5.5 _ 1010 c. 24 hours
c. Every 8 weeks d. 15 days
d. Twice a year 8. RBCs can be frozen for:
a. 12 months. 15. What is the hemoglobin source for hemoglobin-
3. When RBCs are stored, there is a “shift to the left.” b. 1 year. based oxygen carriers in advanced clinical testing?
This means: c. 5 years. a. Only bovine hemoglobin
a. Hemoglobin oxygen affinity increases, owing to an d. 10 years. b. Only human hemoglobin
increase in 2,3-DPG. c. Both bovine and human hemoglobins
b. Hemoglobin oxygen affinity increases, owing to a 9. What is the minimum number of platelets required in d. None of the above
decrease in 2,3-DPG. an apheresis component (90% of the sampled units)?
c. Hemoglobin oxygen affinity decreases, owing to a a. 3 _ 1011
decrease in 2,3-DPG. b. 4 _ 1011
d. Hemoglobin oxygen affinity decreases, owing to an c. 2 _ 1011 16. Which of the following occurs during storage of red
increase in 2,3-DPG. d. 3.5 _ 1011 blood cells?
a. pH decreases
4. The majority of platelets transfused in the United 10. Whole blood and RBC units are stored at what b. 2,3-DPG increases
States today are: temperature? c. ATP increases
a. Whole blood–derived platelets prepared by the a. 1°C to 6°C d. plasma K+ decreases
platelet-rich plasma method. b. 20°C to 24°C
b. Whole blood–derived platelets prepared by the buffy c. 37°C 17. Nucleic acid amplification testing is used to test
coat method. d. 24°C to 27°C donor blood for which of the following infectious
c. Apheresis platelets. diseases?
d. Prestorage pooled platelets. 11. Additive solutions are approved for storage of red a. Hepatitis C virus
blood cells for how many days? b. Human immunodeficiency virus
5. Which of the following anticoagulant preservatives a. 21 c. West Nile virus
provides a storage time of 35 days at 1°C to 6°C for b. 42 d. All of the above
units of whole blood and prepared RBCs if an additive c. 35
solution is not added? d. 7 18. Which of the following is NOT an FDA-approved test
a. ACD-A for quality control of platelets?
b. CP2D 12. One criterion used by the FDA for approval of new a. BacT/ALERT
c. CPD preservation solutions and storage containers is an b. eBDS
d. CPDA-1 average 24-hour post-transfusion RBC survival of more c. Gram stain
than: d. Pan Genera Detection (PGD) test
a. 50%.
b. 60%. 19. Prestorage pooled platelets can be stored for:
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Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions c. The noncoding region of a gene. d. Inside the nucleolus of the cell.
CHAPTER 2 : Basic Genetics d. The enzymes used to cut DNA into fragments.
15. Meiosis is necessary to:
1. Which of the following statements best describes 8. PCR technology can be used to: a. Keep the N number of the cell consistent within
mitosis? a. Amplify small amounts of DNA. populations.
a. Genetic material is quadruplicated, equally divided b. Isolate intact nuclear RNA. b. Prepare RNA for transcription.
between four daughter cells c. Digest genomic DNA into small fragments. c. Generate new DNA sequences in daughter cells.
b. Genetic material is duplicated, equally divided d. Repair broken pieces of DNA. d. Stabilize proteins being translated on the ribosome.
between two daughter cells
c. Genetic material is triplicated, equally divided 9. Transcription can be defined as:
between three daughter cells a. Introduction of DNA into cultured cells.
d. Genetic material is halved, doubled, then equally b. Reading of mRNA by the ribosome.
divided between two daughter cells c. Synthesis of RNA using DNA as a template.
d. Removal of external sequences to form a mature RNA
2. When a recessive trait is expressed, it means that: molecule.
a. One gene carrying the trait was present.
b. Two genes carrying the trait were present.
c. No gene carrying the trait was present. 10. When a male possesses a phenotypic trait that he
d. The trait is present but difficult to observe. passes to all his daughters and none of his sons, the
trait is said to be:
3. In a pedigree, the “index case” is another name for: a. X-linked dominant.
a. Stillbirth. b. X-linked recessive.
b. Consanguineous mating. c. Autosomal dominant.
c. Propositus. d. Autosomal recessive.
d. Monozygotic twins.
11. When a female possesses a phenotypic trait that she
4. Which of the following nitrogenous bases make up passes to all of her sons and none of her daughters, the
DNA? trait is said to be:
a. Adenine, leucine, guanine, thymine a. X-linked dominant.
b. Alanine, cytosine, guanine, purine b. X-linked recessive.
c. Isoleucine, lysine, uracil, leucine c. Autosomal dominant.
d. Adenine, cytosine, guanine, thymine d. Autosomal recessive.

5. Proteins and peptides are composed of: 12. DNA is replicated:

a. Golgi bodies grouped together. a. Semiconservatively from DNA.
b. Paired nitrogenous bases. b. In a random manner from RNA.
c. Nuclear basic particles. c. By copying protein sequences from RNA.
d. Linear arrangements of amino acids. d. By first copying RNA from protein.

6. Which phenotype(s) could not result from the mating 13. RNA is processed:
of a Jk(a+b+) female and a Jk(a-b+) male? a. After RNA is copied from DNA template.
a. Jk(a+b–) b. After protein folding and unfolding on the ribosome.
b. Jk(a+b+) c. Before DNA is copied from DNA template.
c. Jk(a–b+) d. After RNA is copied from protein on ribosomes.
d. Jk(a–b-)
14. Translation of proteins from RNA takes place:
7. Exon refers to: a. On the ribosomes in the cytoplasm of the cell.
a. The part of a gene that contains nonsense mutations. b. On the nuclear membrane.
b. The coding region of a gene. c. Usually while attached to nuclear pores.
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 Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions a. Class I disease of the newborn?

Chapter 3 Fundamentals of Immunology b. Class II a. IgA 21. Which of the following terms refers to the net
c. Class III b. IgE negative charge surrounding red blood cells?
1. Which of the following is not involved in the acquired d. Class IV c. IgG a. Dielectric constant
or adaptive immune response? d. IgM b. Van der Waals forces
a. Phagocytosis 8. Which of the following MHC classes encodes c. Hydrogen bonding
b. Production of antibody or complement complement components? 15. Which of the following refers to the effect of an d. Zeta potential
c. Induction of immunologic memory a. Class I excess amount of antigen present in a test system?
d. Accelerated immune response upon subsequent b. Class II a. Postzone
exposure c. Class III b. Prozone
to antigen d. Class IV c. Zone of equivalence
d. Endzone
2. Which cells are involved in the production of 9. Which of the following immunoglobulins is most
antibodies? efficient at binding complement? 16. Which of the following refers to the presence of an
a. Dendritic cells a. IgA excess amount of antibody present in a test system?
b. T lymphocytes b. IgE a. Postzone
c. B lymphocytes c. IgG b. Prozone
d. Macrophages d. IgM c. Zone of equivalence
d. Endzone
3. Which of the following cells is involved in antigen 10. Which portion of the immunoglobulin molecules
recognition following phagocytosis? contains complement binding sites? 17. Which of the following refers to a state of
a. B lymphocytes a. Heavy chain variable region equilibrium in antigen-antibody reactions?
b. T lymphocytes b. Light chain variable region a. Postzone
c. Macrophages c. Heavy chain constant region b. Prozone
d. Granulocytes d. Light chain constant region c. Zone of equivalence
d. Endzone
4. The role of the macrophage during an antibody 11. Which complement pathway is activated by the
response is to: formation of antigen-antibody complexes? 18. Which one of the following properties of antibodies
a. Make antibody a. Classical is NOT dependent on the structure of the heavy chain
b. Lyse virus-infected target cells b. Alternative constant region?
c. Activate cytotoxic T cells c. Lectin a. Ability to cross the placenta
d. Process antigen and present it d. Retro b. Isotype (class)
c. Ability to fix complement
5. Which of the following immunoglobulins is produced 12. Which of the following is known as the “recognition d. Affinity for antigen
in the primary immune response? unit” in the classical complement pathway?
a. IgA a. C1q 19. Molecules that promote the update of bacteria for
b. IgE b. C3a phagocytosis are:
c. IgG c. C4 a. Opsonins
d. IgM d. C5 b. Cytokines
c. Haptens
6. Which of the following immunoglobulins is produced 13. Which of the following is known as the “membrane d. Isotypes
in the secondary immune response? attack complex” in the classical complement pathway?
a. IgA a. C1 20. Select the term that describes the unique
b. IgE b. C3 confirmation of the antigen that allows recognition by a
c. IgG c. C4, C2, C3 corresponding antibody:
d. IgM d. C5b, C6, C7, C8, C9 a. Immunogen
b. Epitope
7. Which of the following MHC classes are found on 14. Which of the following immunoglobulin classes is c. Avidity
antigen presenting cells? capable of crossing the placenta and causing hemolytic d. Clone
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Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions c. Can never be automated Review Questions d. Increase the antibody binding to antigen
Chapter 4 Concepts in Molecular Biology d. Is an enzymatic in vitro reaction PART II Blood Groups and Serologic Testing
Chapter 5 7. An in vitro phenomenon associated with a positive
1. The central dogma of molecular biology states that: 9. RFLP and SSP are techniques used for: IAT is:
a. DNA is the genetic material a. Protein isolation 1. A principle of the antiglobulin test is: a. Maternal antibody coating fetal RBCs
b. RNA is the genetic material b. RNA isolation a. IgG and C3d are required for RBC sensitization. b. Patient antibody coating patient RBCs
c. DNA is translated to mRNA c. DNA typing b. Human globulin is eluted from RBCs during saline c. Recipient antibody coating transfused donor RBCs
d. Proteins are transcribed from mRNA d. Protein typing washings. d. Identification of alloantibody specificity using a panel
c. Injection of human globulin into an animal engenders of reagent RBCs
2. Recombinant-DNA technology is possible because: 10. Recombinant DNA techniques: passive immunity.
a. Restriction endonucleases cut RNA a. Are not used in a clinical setting d. AHG reacts with human globulin molecules bound to 8. False-positive DAT results are most often associated
b. Restriction endonucleases cut proteins b. Are useful research tools RBCs or free in serum. with:
c. The genetic code is universal c. Are not used in blood banking a. Use of refrigerated, clotted blood samples in which
d. Bacteria are difficult to culture d. Are useful only for research 2. Polyspecific AHG reagent contains: complement components coat RBCs in vitro.
a. Anti-IgG. b. A recipient of a recent transfusion manifesting an
3. Agarose gel electrophoresis is a technique used for: 11. Transcription mediated amplification: b. Anti-IgG and anti-IgM. immune response to recently transfused RBCs.
a. DNA synthesis a. Requires thermostable DNA polymerase c. Anti-IgG and anti-C3d. c. Presence of heterophile antibodies from
b. RNA synthesis b. Is an isothermal procedure d. Anti-C3d. administration of globulin.
c. Separation of DNA molecules by size c. Is an obsolete method currently replaced by SSOP d. A positive autocontrol caused by polyagglutination.
d. Oligonucleotide synthesis d. Utilizes probes labeled with fluorescent tags 3. Monoclonal anti-C3d is:
a. Derived from one clone of plasma cells. 9. Polyethylene glycol enhances antigen-antibody
4. Restriction fragment length polymorphism (RFLP) is 12. Preseroconversion window: b. Derived from multiple clones of plasma cells. reactions by:
based on the use of the enzymes: a. Is the time when donors can be infected but do not c. Derived from immunization of rabbits. a. Decreasing zeta potential.
a. Reverse transcriptases yet test positive by serologic methods d. Reactive with C3b and C3d. b. Concentrating antibody by removing water.
b. Bacterial endonucleases b. May be narrowed by using molecular methods c. Increasing antibody affinity for antigen.
c. DNA polymerases c. Refers mainly to viral pathogens 4. Which of the following is a clinically significant d. Increasing antibody specificity for antigen.
d. RNA polymerases d. All of the above antibody whose detection has been reported in some
instances to be dependent on anticomplement activity 10. Solid-phase antibody screening is based on:
5. The polymerase chain reaction (PCR): 13. Red blood cell molecular antigen typing is useful in in polyspecific a. Adherence.
a. Is carried out in vivo all listed situations except: AHG? b. Agglutination.
b. Is used for peptide synthesis a. In screening RBC inventory for antigen-negative units a. Anti-Jka c. Hemolysis.
c. Requires RNA polymerase b. When reagent antibodies are weak or unavailable b. Anti-Lea d. Precipitation.
d. Is used for the amplification of DNA c. In quantitative gene expression analysis c. Anti-P1
d. When resolving ABO discrepancies d. Anti-H 11. A positive DAT may be found in which of the
6. Plasmids are: following situations?
a. Vectors used for molecular cloning 5. After the addition of IgG-coated RBCs (check cells) to a. A weak D-positive patient
b. Antibiotics a negative AHG reaction during an antibody screen, a b. A patient with anti-K
c. Enzymes negative result is observed. Which of the following is a c. HDN
d. Part of chromosomes correct interpretation? d. An incompatible crossmatch
a. The antibody screen is negative.
7. Some model organisms: b. The antibody screen needs to be repeated. 12. What do Coombs’ control cells consist of?
a. Simplify the study of human disease c. The saline washings were adequate. a. Type A-positive cells coated with anti-D
b. Are used to produce recombinant proteins d. Reactive AHG reagent was added. b. Type A-negative cells coated with anti-D
c. Are prokaryotes and some are eukaryotes c. Type O-positive cells coated with anti-D
d. All of the above 6. RBCs must be washed in saline at least three times d. Type O-negative cells coated with anti-D
before the addition of AHG reagent to:
8. DNA sequencing: a. Wash away any hemolyzed cells 13. Which of the following methods requires the use of
a. Is more difficult than peptide sequencing b. Remove traces of free serum globulins check cells?
b. Requires the use of RNA polymerase c. Neutralize any excess AHG reagent a. LISS
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 Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

b. Gel Review Questions 4+ 4+ Neg 2+ Neg

c. Solid-phase Chapter 6 : The ABO Blood Group System The reactions above may be seen in a patient who is:
d. Enzyme-linked a. A1 with acquired B
1. An ABO type on a patient gives the following b. A2B with anti-A1
14. Which factor can affect AHG testing, yet is reactions: c. AB with increased concentrations of protein in the
uncontrollable Patient Cells With Patient Serum With serum
in the lab? Anti-A Anti-B A1 cells B cells d. AB with an autoantibody
a. Temperature 4+ 4+ Neg Neg
b. Antibody affinity What is the patient’s blood type? 7. Which of the following ABO blood groups contains
c. Gravitational force in the centrifuge a. O the least amount of H substance?
d. Incubation time b. A a. A1B
c. B b. A2
15. If you had the authority to decide which primary d. AB c. B
AHG methodology to utilize at your lab, which method d. O
would you choose based on the knowledge that the 2. The major immunoglobulin class(es) of anti-B in a
majority of the staff are generalists? group 8. You are working on a specimen in the laboratory that
a. LISS A individual is (are): you believe to be a Bombay phenotype. Which of the
b. Polybrene a. IgM following reactions would you expect to see?
c. Solid phase or gel b. IgG a. Patient’s cells + Ulex europaeus = no agglutination
d. Enzyme-linked c. IgM and IgG b. Patient’s cells + Ulex europaeus = agglutination
d. IgM and IgA c. Patient’s serum + group O donor RBCs = no
agglutination
16. A 27-year-old group O mother has just given birth to 3. What are the possible ABO phenotypes of the d. Patient’s serum + A1 and B cells = no agglutination
abeautiful, group A baby girl. Since the mother has offspring from the mating of a group A to a group B
IgGanti-A in her plasma, it is likely that the baby is individual? 9. An example of a technical error that can result in an
experiencingsome in vivo red cell destruction. Which of a. O, A, B ABO discrepancy is:
thefollowing methods and tests would be most b. A, B a. Acquired B phenomenon.
c. A, B, AB b. Missing isoagglutinins.
effective atdetecting the anti-A on the baby’s RBCs?
d. O, A, B, AB c. Cell suspension that is too heavy.
a. DAT using common tube technique
d. Acriflavine antibodies.
b. DAT using gel|
c. IAT using common tube technique 4. The immunodominant sugar responsible for blood
group 10. An ABO type on a patient gives the following
d. IAT using gel reactions:
A specificity is:
a. L-fucose Patient Cells
b. N-acetyl-D-galactosamine With Patient Serum With
c. D-galactose Anti-A Anti-B A1 cells B cells O cells Autocontrol
d. Uridine diphosphate-N-acetyl-D-galactose 4+ Neg 2+ 4+ 2+ Neg
These results are most likely due to:
5. What ABH substance(s) would be found in the saliva a. ABO alloantibody.
of a group B secretor? b. Non-ABO alloantibody.
a. H c. Rouleaux.
b. H and A d. Cold autoantibody.
c. H and B
d. H, A, and B

6. An ABO type on a patient gives the following

reactions:
Patient Cells With Patient Serum With
Anti-A Anti-B Anti-A1 A1 cells B cells
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Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions
Chapter 7 : The Rh Blood Group System 8. Rh antibodies are primarily of which immunoglobulin 15. Which of the following most commonly causes an
class? individual to type RhD positive yet possess anti-D?
1. The Rh system was first recognized in a case report a. IgA a. Genetic weak D
of: b. IgM b. Partial D
a. A hemolytic transfusion reaction. c. IgG c. C in trans to RHD
b. Hemolytic disease of the fetus and newborn. d. IgD d. D epitopes on RhCE protein
c. Circulatory overload.
d. Autoimmune hemolytic anemia. 9. Rh antibodies have been associated with which of the 16. An individual has the following Rh phenotype:
following clinical conditions? D+C+E+c+e+. Using Fisher-Race terminology, what is
2. What antigen is found in 85% of the white population a. Erythroblastosis fetalis their most likely Rh genotype?
and is always significant for transfusion purposes? b. Thrombocytopenia a. DCE/Dce
a. d c. Hemophilia A b. DCE/dce
b. c d. Stomatocytosis c. DCe/dcE
c. D d. DCe/DcE
d. E 10. What do Rhnull cells lack?
a. Lewis antigens 17. Which of the following is the most common Rh
3. How are weaker-than-expected reactions with anti-D b. Normal oxygen-carrying capacity phenotype
typing reagents categorized? c. Rh antigens in African Americans?
a. Rhmod d. MNSs antigens a. Dce/dce
b. Weak D b. DcE/dce
c. DAT positive 11. What antigen system is closely associated c. DCe/dce
d. Dw phenotypically with Rh? d. Dce/dCe
a. McCoy
4. Cells carrying a weak-D antigen require the use of b. Lutheran
what test to demonstrate its presence? c. Duffy
a. Indirect antiglobulin test d. LW
b. Direct antiglobulin test
c. Microplate test 12. Anti-LW will not react with which of the following?
d. Warm autoadsorption test a. Rh-positive RBCs
b. Rh-negative RBCs
5. How are Rh antigens inherited? c. Rhnull RBCs
a. Autosomal recessive alleles d. Rh:33 RBCs
b. Sex-linked genes
c. Codominant alleles 13. Convert the following genotypes from Wiener
d. X-linked nomenclature to Fisher-Race and Rosenfield
nomenclatures, and list the antigens present in each
6. Biochemically speaking, what type of molecules are haplotype.
Rh antigens? a. R1r
a. Glycophorins b. R2R0
b. Simple sugars c. RzR1
c. Proteins d. ryr
d. Lipids
14. Which Rh phenotype has the strongest expression
7. Rh antibodies react best at what temperature (°C)? of D?
a. 22 a. R1r
b. 18 b. R1R1
c. 15 c. R2R2
d. 37 d. D–
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 Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions 13. Which of the following is the most common 20. Which antibody is most commonly associated with
Chapter 8 Blood Group Terminology and the Other 7. A type 1 chain has: antibody delayed hemolytic transfusion reactions?
Blood Groups a. The terminal galactose in a 1-3 linkage to subterminal seen in the blood bank after ABO and Rh antibodies? a. Anti-s
N-acetylglucosamine. a. Anti-Fya b. Anti-k
1. The following phenotypes are written incorrectly b. The terminal galactose in a 1-4 linkage to subterminal b. Anti-k c. Anti-Lua
except for: N-acetylglucosamine. c. Anti-Jsa d. Anti-Jka
a. Jka+ c. The terminal galactose in a 1-3 linkage to subterminal d. Anti-K
b. Jka+ N-acetylgalactosamine. 21. Anti-U will not react with which of the following
c. Jka(+) d. The terminal galactose in a 1-4 linkage to subterminal 14. Which blood group system is associated with RBCs?
d. Jk(a+) N-acetylgalactosamine. resistance to P. vivax malaria? a. M+N+S+s–
a. P b. M+N–S–s–
2. Which of the following characteristics best describes 8. Which of the following best describes Lewis antigens? b. Kell c. M–N+S–s+
Lewis antibodies? a. The antigens are integral membrane glycolipids c. Duffy d. M+N–S+s+
a. IgM, naturally occurring, cause HDFN b. Lea and Leb are antithetical antigens d. Kidd
b. IgM, naturally occurring, do not cause HDFN c. The Le(a+b–) phenotype is found in secretors 22. A patient with an M. pneumoniae infection will most
c. IgG, in vitro hemolysis, cause hemolytic transfusion d. None of the above 15. The null Ko RBC can be artificially prepared by which likely develop a cold autoantibody with specificity to
reactions of the following treatments? which antigen?
d. IgG, in vitro hemolysis, do not cause hemolytic 9. Which of the following genotypes would explain RBCs a. Ficin and DTT a. I
transfusion typed as group A Le(a+b–)? b. Ficin and glycine-acid EDTA b. i
reactions a. A/O Lele HH Sese c. DTT and glycine-acid EDTA c. P
b. A/A Lele HH sese d. Glycine-acid EDTA and sialidase d. P1
3. The Le gene codes for a specific glycosyltransferase c. A/O LeLe hh SeSe
that transfers a fucose to the N-acetylglucosamine on: d. A/A LeLe hh sese 16. Which antibody does not fit with the others with 23. Which antigen is destroyed by enzymes?
a. Type 1 precursor chain. respect to optimum phase of reactivity? a. P1
b. Type 2 precursor chain. 10. Anti-LebH will not react or will react more weakly a. Anti-S b. Jsa
c. Types 1 and 2 precursor chain. with which of the following RBCs? b. Anti-P1 c. Fya
d. Either type 1 or type 2 in any one individual but not a. Group O Le(b+) c. Anti-Fya d. Jka
both. b. Group A2 Le(b+) d. Anti-Jkb
c. Group A1 Le(b+) 17. Which of the following Duffy phenotypes is 24. The antibody to this high-prevalence antigen
4. What substances would be found in the saliva of a d. None of the above prevalent in blacks but virtually nonexistent in whites? demonstrates mixed-field agglutination that appears
group B secretor who also has Lele genes? a. Fy(a+b+) shiny and refractile under the microscope:
a. H, Lea 11. Which of the following best describes MN antigens b. Fy(a–b+) a. Vel
b. H, B, Lea and antibodies? c. Fy(a–b–) b. JMH
c. H, B, Lea, Leb a. Well developed at birth, susceptible to enzymes, d. Fy(a+b–) c. Jra
d. H, B, Leb generally saline reactive d. Sda
b. Not well developed at birth, susceptible to enzymes, 18. Antibody detection cells will not routinely detect
5. Transformation to Leb phenotype after birth may be generally saline reactive which antibody specificity? 25. Which of the following has been associated with
as follows: c. Well developed at birth, not susceptible to enzymes, a. Anti-M causing severe immediate HTRs?
a. Le(a–b–) to Le(a+b–) to Le(a+b+) to Le(a–b+) generally saline reactive b. Anti-Kpa a. Anti-JMH
b. Le(a+b–) to Le(a–b–) to Le(a–b+) to Le(a+b+) d. Well developed at birth, susceptible to enzymes, c. Anti-Fya b. Anti-Lub
c. Le(a–b+) to Le(a+b–) to Le(a+b+) to Le(a–b–) generally antiglobulin reactive d. Anti-Lub c. Anti-Vel
d. Le(a+b+) to Le(a+b–) to Le(a–b–) to Le(a–b+) d. Anti-Sda
12. Which autoantibody specificity is found in patients 19. Antibodies to antigens in which of the following
6. In what way do the Lewis antigens change during with paroxysmal cold hemoglobinuria? blood groups are known for showing dosage? 26. Which of the following antibodies would more likely
pregnancy? a. Anti-I a. I be found in a black patient?
a. Lea antigen increases only b. Anti-i b. P a. Anti-Cra
b. Leb antigen increases only c. Anti-P c. Kidd b. Anti-Ata
c. Lea and Leb both increase d. Anti-P1 d. Lutheran c. Anti-Hy
d. Lea and Leb both decrease d. All of the above
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Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions d. 7
27. Which of the following antigens is not in a blood Chapter 9 Detection and Identification of Antibodies
group system? 5. Anti-Sda has been identified in patient ALF. What
a. Doa 1. Based on the following phenotypes, which pair of substance would neutralize this antibody and allow
b. Vel cells would make the best screening cells? detection of other alloantibodies?
c. JMH a. Cell 1: Group A, D+C+c–E–e+, K+, Fy(a+b–), a. Saliva
d. Kx Jk(a+b–), M+N–S+s– b. Hydatid cyst fluid
Cell 2: Group O, D+C–c+E+e–, K–, Fy(a–b+), c. Urine
28. A weakly reactive antibody with a titer of 128 is Jk(a–b+), M–N+S–s+ d. Human breast milk
neutralized by plasma. Which of the following could be b. Cell 1: Group O, D–C–c+E–e+, K–, Fy(a–b+),
the specificity? Jk(a+b+), M+N–S+s+ 6. Patient JM appears to have a warm autoantibody.
a. Anti-JMH Cell 2: Group O, D+C+c–E–e+, K–, Fy(a+b–), She was
b. Anti-Ch Jk(a+b–), M–N+S–s+ transfused 2 weeks ago. What would be the next step
c. Anti-Kna c. Cell 1: Group O, D+C+c+E+e+, K+, Fy(a+b+), performed
d. Anti-Kpa Jk(a+b+), M+N–S+s+ to identify any alloantibodies that might be in her
Cell 2: Group O, D–C–c+E–e+, K–, Fy(a+b–), serum?
29. An antibody reacted with untreated RBCs and DTT Jk(a+b+), M+N+S–s+ a. Acid elution
treated RBCs but not with ficin-treated RBCs. Which of d. Cell 1: Group O, D+C+c–E–e+, K+, Fy(a–b+), b. Warm autoadsorption using autologous cells
the following antibodies could explain this pattern of Jk(a–b+), M–N+S–s+ c. Warm differential adsorption
reactivity? Cell 2: Group O, D- C–c+E+e–, K–, Fy(a+b–), d. RESt™ adsorption
a. Anti-JMH Jk(a+b–), M+N–S+s–
b. Anti-Yta 7. What is the titer and score for this prenatal anti-D
c. Anti-Kpb 2. Antibodies are excluded using RBCs that are titer?
d. Anti-Ch homozygous for the corresponding antigen because: (Refer to Figure 9–20.)
a. Antibodies may show dosage a. Titer = 64; score = 52
30. The following antibodies are generally considered b. Multiple antibodies may be present b. Titer = 1:32; score = 15
clinically insignificant because they have not been c. It results in a P value of .05 for proper identification c. Titer = 64; score = 21
associated with causing increased destruction of RBCs, of the antibody d. Titer = 32; score = 52
HDFN, or HTRs. d. All of the above
a. Anti-Doa and anti-Coa
b. Anti-Ge3 and anti-Wra 3. A request for 8 units of packed RBCs was received for
c. Anti-Ch and anti-Kna patient LF. The patient has a negative antibody screen,
d. Anti-Dib and anti-Yt but one of the 8 units was 3+ incompatible at the AHG
phase. Which of the following antibodies may be the
cause?
a. Anti-K
b. Anti-Lea
c. Anti-Kpa
d. Anti-Fyb

4. The physician has requested 2 units of RBCs for

patient DB, who has two antibodies, anti-L and anti-Q.
The frequency of antigen L is 45%, and the frequency of
antigen Q is 70% in the donor population.
Approximately how many units will need to be antigen-
typed for L and Q to fill the request?
a. 8
b. 12
c. 2
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 Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

c. Cell number 2 for the positive control and cell c. Employing the prewarm technique
number 4 for the negative control d. Decreasing the incubation temperature to 18°C

d. Cell number 4 for the positive control and cell

For Questions 8 through 10, refer to Figure 9–21. number 5 for the negative control

8. Select the antibody(ies) most likely responsible for 11. Which of the following methods may be employed
the reactions observed: to remove IgG antibodies that are coating a patient’s
a. Anti-E and anti-K red blood cells?
b. Anti-Fya a. Adsorption
c. Anti-e b. Elution
d. Anti-Jkb c. Neutralization
d. Titration
9. What additional cells need to be tested to be 95%
confident that the identification is correct? 12. A technologist has decided to test an enzyme-
a. Three e-negative cells that react negatively and one treated panel of RBCs against a patient’s serum. Which
additional e-positive cell that reacts positively of the following antibody pairs could be separated using
b. One additional E-positive cell to react positively and this technique?
one additional K-positive cell to react positively a. Anti-Jka and anti-Jkb
c. Two Jkb homozygous positive cells to react positively b. Anti-S and anti-Fya
and one Jkb heterozygous positive cell to react c. Anti-D and anti-C
negatively d. Anti-Jka and anti-Fya
d. No additional cells are needed 13. An antibody demonstrates weak reactivity at the
AHG phase when using a tube method with no
10. Using the panel in Figure 9–21, select cells that enhancement reagent and monospecific anti-IgG AHG
would make appropriate controls when typing for the C reagent. When repeating the test, which of the
antigen. following actions may increase the strength of the
a. Cell number 1 for the positive control and cell positive reactions?
number 2 for the negative control a. Adding an enhancement reagent, such as LISS or PEG
b. Cell number 1 for the positive control and cell b. Decreasing the incubation time from 30 minutes to
number 6 for the negative control 10 minutes
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Review Questions 6. Having checked the patient’s prior history after when unexpected antibodies are present. d. Antibody below detectable levels during
Chapter 10 Pretransfusion Testing having received the specimen and request, you: c. Maternal serum cannot be used for antibody pretransfusion
a. Do not have to repeat the ABO and Rh if the name detection. testing
1. Pretransfusion testing: and hospital number agree d. To determine the infant’s ABO group, RBCs must be
a. Proves that the donor’s plasma is free of all irregular b. Do not have to repeat the indirect antiglobulin test tested with reagent anti-A, anti-B, and anti-A,B.
antibodies (IAT) if the previous IAT was negative
b. Detects most irregular antibodies on the donor’s c. Have to perform a crossmatch only if one has not 12. A nurse just called to request additional RBC units
RBCs that are reactive with patient’s serum been done within the last 2 weeks for a patient for whom you performed compatibility
c. Detects most errors in the ABO groupings d. Have to compare the results of your ABO, Rh, and IAT testing 4 days ago. She would like you to use the
d. Ensures complete safety of the transfusion with the previous results original specimen, as you keep it for 7 days anyway.
Your most appropriate course of action would be to:
2. Which is not true of rouleaux formation? 7. The purpose of the immediate spin crossmatch is to: a. Check to see if there is enough of the original
a. It is a stacking of RBCs to form aggregates. a. Ensure survival of transfused RBCs specimen
b. It can usually be dispersed by adding saline. b. Determine ABO compatibility between donor and b. Perform the compatibility testing on the original
c. It can appear as an ABO incompatibility. recipient specimen
d. It cannot cause a false-positive immediate spin c. Detect cold-reacting unexpected antibodies c. Request more information in case the patient has
crossmatch. d. Meet computer crossmatch requirements developed
a clinically significant unexpected antibody
3. What type of blood should be given in an emergency 8. Which does not represent requirements set forth by d. Indicate that a new specimen is necessary because
transfusion when there is no time to type the recipient’s the AABB for the performance of a computer the patient has been recently transfused
sample? crossmatch?
a. O Rh0 (D)-negative, whole blood a. Computer system must be validated on-site. 13. A crossmatch is positive at AHG phase with
b. O Rh0 (D)-positive, whole blood b. Recipient antibody screen must be positive. polyspecific AHG reagent but is negative with
c. O Rh0 (D)-positive, packed cells c. Two determinations of the recipient ABO and Rh monospecific anti-IgG AHG reagent. This may indicate
d. O Rh0 (D)-negative, packed cells must be performed. the antibody:
d. Computer system must have logic. a. Is a weak anti-D
4. A patient developed an anti-Jka antibody 5 years ago. b. Is a clinically insignificant Lewis antibody
The antibody screen is currently negative. To obtain 9. You have just received a request and sample for c. Can cause decreased survival of transfused RBCs
suitable blood for transfusion, which procedures apply? pretransfusion testing. Which is the most appropriate to d. Is a Duffy antibody
a. Type the patient for the Jkb antigen as an added part do first?
to the crossmatch procedure. a. Perform the ABO grouping and Rh typing 14. The emergency room requests 6 units of packed
b. Crossmatch random donors with the patient’s serum, b. Complete the crossmatch RBCs for a trauma patient prior to collection of the
and release the compatible units for transfusion to the c. Perform the IAT to see if the patient is going to be a patient’s specimen. The most appropriate course of
patient. problem action is to:
c. Type the patient and donor units for the Jka antigen, d. Check the records for prior type and screen results a. Release group O RBCs to ER with trauma patient
and then crossmatch the Jka negative units with the on the patient identification on each unit sent
patient serum. b. Refuse to release units until you get a patient sample
d. Computer-crossmatch Jka negative donor units. 10. Blood donor and recipient samples used in c. Indicate necessity for signed patient waiver for
crossmatching must be stored for a minimum of how incomplete pretransfusion testing
5. A 26-year-old B Rh0 (D)-negative female patient many days following transfusion? d. Explain need of patient’s ABO group prior to issuing
requires a. 2 blood
a transfusion. No B Rh0 (D)-negative donor units are b. 5
available. Which should be chosen for transfusion? c. 7 15. Which is not an example of the most common form
a. B Rh0 (D)-positive RBCs d. 10 of error associated with fatal transfusion reactions?
b. O Rh0 (D)-negative RBCs a. Phlebotomist labels patient A tubes with patient B
c. AB Rh0 (D)-negative RBCs 11. Which is true regarding compatibility testing for the information
d. A Rh0 (D)-negative RBCs infant younger than 4 months old? b. Technologist enters results of patient A testing into
a. A DAT is required. patient B field
b. A crossmatch is not needed with the infant’s blood c. Wrong RBC unit is tagged for transfusion
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Review Questions 7. Which of the following is not an enhancement media Review Questions b. Standardization
Chapter 11 Overview of the Routine Blood Bank that may be used in antibody screening and Chapter 12 Other Technologies and Automation c. Use of IgG-coated control cells
Laboratory identification? d. Specialized equipment
a. Albumin 1. The endpoint of the gel test is detected by:
1. What is the shipping temperature requirement for b. Low ionic strength solution (LISS) a. Agglutination 9. A disadvantage for both gel and solid-phase
plasma? c. Normal saline b. Hemolysis technology is:
a. 1°F to 6°F or higher d. Polyethylene glycol c. Precipitation a. Decreased sensitivity
b. 1°C to 6°C or lower d. Attachment of indicator cells b. Inability to test hemolyzed, lipemic, or icteric samples
c. _18°F or higher 8. Which of the following methods may be useful in c. Inability to detect C3d complement–coated cells
d. _18°C or lower investigating a positive DAT? 2. The endpoint of the SPRCA test is detected by: d. Large sample requirement
a. Elution techniques a. Agglutination
2. Antibody serial titration studies are most often b. Removal of cell-bound antibody using chloroquine b. Hemolysis 10. A safety feature in the SPRCA test is:
associated with which of the following blood bank test diphosphate c. Precipitation a. Air bubble barrier
groupings? c. Drug studies d. Attachment of indicator cells b. Viscous barrier
a. Prenatal evaluation d. All of the above c. Color change of the LISS
b. Type and screen 3. The endpoint of the solid-phase protein A assay is: d. Use of IgG-coated control cells
c. Type and crossmatch a. Agglutination
d. Blood unit processing b. Hemolysis
c. Precipitation
3. The prewarm technique is most useful in d. Attachment of cells to microwell
investigating which types of blood bank problems?
a. ABO discrepancies 4. Protein A captures antibodies by binding to:
b. Rh discrepancies a. Fab portion of immunoglobulin
c. Warm antibodies b. Fc portion of immunoglobulin
d. Cold antibodies c. Surface of test cells
d. Surface of indicator cells
4. It is most important to perform weak-D testing in
which of the following blood bank test groupings? 5. The endpoint of the solid-phase immunosorbent
a. Type and screen assay (ELISA) is:
b. Type and crossmatch a. Agglutination
c. Cord blood evaluation b. Hemolysis
d. Prenatal evaluation c. Color change in the substrate
d. Attachment of indicator cells
5. Which of the following is a method for determining
approximate volume of fetal-maternal bleed? 6. Mixed-field reactions can be observed in:
a. Kleihauer-Betke test a. Gel
b. Eluate testing b. SPRCA
c. Nucleic acid amplification testing c. Protein A technology
d. Antibody screening d. Luminex

6. Which of the following may not be used as a patient 7. The endpoint of the luminex assay is change of:
identifier? a. Electrical charge on the RBCs
a. Patient’s full name b. Color of the liquid substrate
b. Patient’s date of birth c. Color of indicator on beads
c. Patient’s medical record number d. Density of the indicator substrate
d. Patient’s room number
8. An advantage for both gel and solid-phase technology
is:
a. No cell washing steps
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Review Questions d. Anti-HTLV I e. The expiration date is 25 days from the date of 18. Random-donor platelets that have been
Chapter 13 Donor Screening and Component e. Anti-CMV irradiation leukoreduced must contain less than ______
Preparation or the original outdate, whichever is sooner. leukocytes.
7. Which of the following lists the correct shelf-life for a. 8.3 × 105
1. Which of the following information is not required for the component? 12. Once thawed, FFP must be transfused within: b. 8 × 106
whole blood donors? a. Deglycerolized RBCs—24 hours a. 4 hours c. 5 × 106
a. Name b. RBCs (CPD)—35 days b. 6 hours d. 3 × 1011
b. Address c. Platelet concentrate—7 days c. 8 hours
c. Occupation d. FFP—5 years d. 12 hours 19. A single unit of FFP or PF24 should contain ______
d. Sex e. RBCs (CPDA-1)—21 days e. 24 hours mL of plasma.
e. Date of birth a. 100–150
8. Each unit of cryoprecipitate prepared from whole 13. Quality control for RBCs requires a maximum b. 200–400
2. Which of the following would be cause for deferral? blood should contain approximately how many units of hematocrit level of: c. 150–250
a. Temperature of 99.2°F AHF activity? a. 75% d. 50–150
b. Pulse of 90 beats per minute a. 40 IU b. 80%
c. Blood pressure of 110/70 mm Hg b. 80 IU c. 85% 20. Cryoprecipitate that has been pooled must be
d. Hematocrit level of 37% c. 120 IU d. 90% transfused within ______ hours.
e. None of the above d. 160 IU e. 95% a. 24
e. 180 IU b. 6
3. Which of the following would be cause for 14. AHF concentrates are used to treat: c. 4
permanent deferral? 9. Platelet concentrates prepared by apheresis should a. Thrombocytopenia d. 8
a. History of hepatitis after 11th birthday contain how many platelets? b. Hemophilia A
b. Positive hepatitis C test result a. 5.5 × 1010 c. Hemophilia B
c. Positive HTLV-I antibody b. 6 × 1010 d. von Willebrand disease
d. Positive anti-HBc test result c. 3 × 1011 e. Factor XIII deficiency
e. All of the above d. 5.5 × 1011
e. 6 × 1011 15. Prothrombin complex concentrates are used to
4. Immunization for rubella would result in a temporary treat which of the following?
deferral for: 10. The required storage temperature for frozen RBCs a. Factor IX deficiency
a. 4 weeks using the high-glycerol method is: b. Factor VIII deficiency
b. 8 weeks a. 4°C c. Factor XII deficiency
c. 6 months b. –20°C d. Factor XIII deficiency
d. 1 year c. –18°C e. Factor V deficiency
e. no deferral required d. –120°C
e. –65°C 16. How is the antibody screen test different for donors
5. Which of the following donors is acceptable? than for patients?
a. Donor who had a first-trimester therapeutic abortion 11. How does irradiation affect the shelf-life of red a. In donors, a 2-cell screen is used.
4 weeks ago blood cells? b. In donors, a 3-cell screen is used.
b. Donor whose husband is a hemophiliac who regularly a. Irradiation has no effect on the shelf-life. c. In donors, a pooled cell is used.
received cryoprecipitate before 1989 b. The expiration date is 28 days from the date of d. There is no difference in testing.
c. Donor who was treated for gonorrhea 6 months ago irradiation
d. Donor who had a needlestick injury 10 months ago or the original outdate, whichever is later. 17. RBCs that have been leukoreduced must contain
c. The expiration date is 28 days from the date of less than ______ and retain at least ______ of original
6. Which of the following tests is not required as part of irradiation RBCs.
the donor processing procedure for allogeneic or the original outdate, whichever is sooner. a. 8 × 106/85%
donation? d. The expiration date is 25 days from the date of b. 8 × 106/90%
a. ABO irradiation c. 5 × 106/85%
b. Rh or the original outdate, whichever is later. d. 5 × 106/80%
c. STS
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Review Questions a. Leukocytes. Review Questions d. Used for IgA-deficient recipient with history of severe
Chapter 14 Apheresis b. Macrophages. Chapter 15 Transfusion Therapy reaction
c. Hematopoietic progenitor cells.
1. The most common anticoagulant used for apheresis d. Platelets. 1. Leukocyte-reduced filters can do all of the following 8. Select the appropriate product for a bone marrow
procedures is: except: transplant patient with anemia:
a. Heparin. 8. The anticoagulant added to blood as it is removed a. Reduce the risk of CMV infection a. RBCs
b. Sodium fluoride. from a donor or patient during an apheresis procedure b. Prevent or reduce the risk of HLA alloimmunization b. Irradiated RBCs
c. Warfarin. acts by: c. Prevent febrile, nonhemolytic transfusion reactions c. Leukoreduced RBCs
d. Citrate. a. Binding calcium ions. d. Prevent TA-GVHD d. Washed RBCs
b. Increasing intracellular potassium.
2. Therapeutic cytapheresis has a primary role in c. Binding to antithrombin III. 2. Albumin should not be given for: 9. Which blood product should be selected for vitamin K
treatment of patients with: d. Inactivating factor V. a. Burns deficiency?
a. Sickle cell disease and acute chest syndrome. 9. Peripheral blood stem cells are: b. Shock a. Cryoprecipitate
b. Systemic lupus erythematosus to remove immune a. Responsible for phagocytosis of bacteria. c. Nutrition b. Factor VIII
complexes. b. Removed during erythrocytapheresis. d. Plasmapheresis c. Factor IX
c. Leukemia to help increase granulocyte production. c. Pluripotential hematopoietic precursors that circulate d. Plasma
d. Myasthenia gravis to increase antibody production. in the peripheral blood. 3. Of the following, which blood type is selected when a
d. Lymphocytes involved with the immune response. patient cannot wait for ABO-matched RBCs? 10. Which fluid should be used to dilute RBCs?
3. The minimum interval allowed between a. A a. 0.9% saline
plateletpheresis component collection procedures is: 10. Which of the following can be given to an apheresis b. B b. 5% dextrose and water
a. 1 day. donor to increase the number of circulating c. O c. Immune globulin
b. 2 days. granulocytes? d. AB d. Lactated Ringers solution
c. 7 days. a. DDAVP
d. 8 weeks. b. Hydroxyethyl starch (HES) 4. Which patient does not need an irradiated
c. Immune globulin component?
4. In plasma exchange, the therapeutic effectiveness is: d. G-CSF a. Bone marrow transplant recipient
a. Greatest with the first plasma volume removed b. Neonate weighing less than 1,200 g
b. Affected by the type of replacement fluid used c. Adult receiving an RBC transfusion
c. Enhanced if the unwanted antibody is IgG rather d. Adult receiving an RBC transfusion from a blood
than IgM relative
d. Independent of the use of concomitant
immunosuppressive therapy 5. RBC transfusions should be given:
a. Within 4 hours
5. The replacement fluid indicated during plasma b. With lactated Ringer’s solution
exchange for TTP is: c. With dextrose and water
a. Normal (0.9%) saline. d. With cryoprecipitate
b. Hydroxyethyl starch (HES).
c. FFP. 6. Which type of transplantation requires all cellular
d. Albumin (human) 5%. blood components to be irradiated?
a. Bone marrow
6. The most common adverse effect of plateletpheresis b. Heart
collection is: c. Liver
a. Allergic reaction. d. Kidney
b. Hepatitis.
c. Hemolysis. 7. Characteristics of deglycerolized RBCs include the
d. Citrate effect. following except:
a. Inexpensive
7. Apheresis technology can be used to collect each of b. 24-hour expiration date after thawing
the following components except: c. Used for rare antigen-type donor blood
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Review Questions d. Transfusion-associated allergic reaction a. Respiratory distress

Chapter 16 Adverse Effects of Blood Transfusion b. Severe hypoxemia and hypotension
8. A suspected transfusion-related death must be c. Fever
1. What component is most frequently involved with reported to? d. All of the above
transfusion-associated sepsis? a. AABB
a. Plasma b. Federal and Drug Administration (FDA) 15. Which of the following is characteristic of iron
b. Packed red blood cells c. College of American Pathologists (CAP) overload?
c. Platelets d. The Joint Commission (TJC) a. Delayed, nonimmune complication
d. Whole blood b. Chelating agents are used
9. Nonimmune hemolysis can be caused during c. Multiorgan damage may occur
2. Fatal transfusion reactions are mostly caused by? transfusion by: d. All of the above
a. Serologic errors a. Use of small bore size needle.
b. Improper storage of blood b. Use of an infusion pump.
c. Clerical errors c. Improper use of a blood warmer.
d. Improper handling of the product d. All of the above

3. Early manifestation of an acute hemolytic transfusion 10. Transfusion reactions are classified according to:
reaction can be confused with? a. Signs or symptoms presenting during or after
a. Allergic reaction 24 hours.
b. Febrile nonhemolytic reaction b. Immune or nonimmune.
c. Anaphylactic shock c. Infectious or noninfectious.
d. Sepsis d. All of the above

4. Pain at infusion site and hypotension are observed 11. With febrile nonhemolytic transfusion reactions:
with what type of reaction? a. They are self-limited.
a. Delayed hemolytic transfusion reaction b. Fever resolves within 2 to 3 hours.
b. Acute hemolytic transfusion reaction c. Treatment is required.
c. Allergic reaction d. A and B are correct
d. Febrile nonhemolytic reaction e. All of the above

5. Irradiation of blood is performed to prevent? 12. Absolute IgA deficiency is a classic example of a
a. Febrile nonhemolytic transfusion reaction severe allergic reaction. Results indicating an absolute
b. Delayed hemolytic transfusion reaction IgA deficiency:
c. Transfusion-associated graft-versus-host disease a. < 0.05 mg/dL
d. Transfusion-associated circulatory overload b. < 0.50 mg/dL
c. < 0.50 gm/dL
6. The only presenting sign most often accompanying a d. < 5 mg/dL
delayed hemolytic transfusion reaction is?
a. Renal failure 13. How are mild allergic transfusion reactions with
b. Unexplained decrease in hemoglobin isolated symptoms or hives and urticaria treated?
c. Active bleeding a. Transfusion is stopped and transfusion reaction
d. Hives workup is initiated.
b. Transfusion is stopped and antihistamines
7. Which transfusion reaction presents with fever, administrated; when symptoms improve, transfusion is
maculopapular rash, watery diarrhea, abnormal liver restarted.
function, and pancytopenia? c. Stop transfusion and prepare washed red cells.
a. Transfusion-associated sepsis d. Continue transfusion with a slower infusion rate.
b. Transfusion-related acute lung injury
c. Transfusion-associated graft-versus-host disease 14. TRALI presents with the following symptoms:
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Review Questions c. CD34. Review Questions b. NAT testing.

Chapter 17 Cellular Therapy d. CD59. Chapter 18 Transfusion-Transmitted Diseases c. Leukoreduction.
d. Minipool screening.
1. Which of the following terms describe an HPC 8. The recommended dose of gamma radiation 1. The fecal-oral route is common in transmitting which
transplant administered to a blood product to reduce the risk of of these hepatitis viruses? 8. HBV remains infectious on environmental surfaces for
where the donor and recipient may be unrelated? graft-versus-host disease is: a. HAV 1:
a. Allogeneic a. 1,500 cGy to any point within the canister. b. HBV a. Day.
b. Autologous b. 1,500 cGy to the midplane of the canister. c. HDV b. Week.
c. Syngeneic c. 2,500 cGy to the midplane of the canister. d. HCV c. Month.
d. Hematopoietic d. 2,500 cGy to any point within the canister. d. Year.
2. Which of the following is the component of choice for
2. Stem cells from HPC donors may be mobilized with: 9. During HPC processing, cultures must be performed: a low-birth-weight infant with a hemoglobin of 8 g/dL if 9. HBV is transmitted most frequently:
a. Plerixafor. a. At initial testing. the mother is anti-CMV negative? a. By needle sharing among IV drug users.
b. Granulocyte colony-stimulating factor (G-CSF). b. Before freezing. a. Whole blood from a donor with anti-CMV b. Through blood transfusions.
c. Chemotherapy. c. After thawing. b. RBCs from a donor who is anti-CMV negative c. By unknown methods
d. All of the above d. After infusion. c. Leukoreduced platelets d. By sexual activity
d. Solvent detergent–treated plasma
3. Which choice is an advantage of an HPC transplant 10. HPC products are required to be tested for: 10. Which of the following is the most common cause of
using umbilical cord blood? a. Hepatitis C. 3. Which of the following tests is useful to confirm that chronic hepatitis, cirrhosis, and hepatocellular
a. Recipient weight of no concern b. Epstein-Barr virus. a patient or donor is infected with HCV? carcinoma in the United States?
b. Donor screening and testing abbreviated c. Variant CJD. a. ALT + anti-HBc a. HAV
c. Higher risk of GVHD d. Herpes simplex virus. b. Anti-HIV 1/2 b. HBV
d. No significant risk to the donor or mother c. Lymph node biopsy c. HCV
11. Which of the following terms describe an HPC d. RIBA d. HDV
4. Graft-versus-host disease (GVHD) is primarily caused transplant where donor and recipient are the same
by: person? 4. Currently, which of the following does the AABB 11. The first retrovirus to be associated with human
a. Neutrophils. a. Allogeneic consider to be the most significant infectious threat disease was:
b. T lymphocytes. b. Autologous from transfusion? a. HCV
c. B lymphocytes. c. Syngeneic a. Bacterial contamination b. HIV
d. Monocytes. d. Hematopoietic b. CMV c. HTLV-I
c. Hepatitis d. WNV
5. The minimum number of CD34+ cells required in an 12. Which of the following terms describe an HPC d. HIV
HPC-apheresis collection to ensure timely engraftment transplant where donor and recipient are identical 12. All of the following statements are true concerning
is: twins? 5. Which of the following is the most frequently WNV except:
a. 2 × 102 CD34+ cells/kg. a. Allogeneic transmitted virus from mother to fetus? a. 1 in 150 infections results in severe neurologic
b. 2 × 104 CD34+ cells/kg. b. Autologous a. HIV disease.
c. 2 × 106 CD34+ cells/kg. c. Syngeneic b. Hepatitis b. Severe disease occurs most frequently in the over-50
d. 2 × 108 CD34+ cells/kg. d. Hematopoietic c. CMV age group.
d. EBV c. Deaths occur more often in those over 65 years who
6. The mother of a cord blood donor is tested for: present with encephalitis.
a. ABO. 6. Jaundice due to HAV is seen most often in the: d. Fatalities occur in approximately 38% of infected
b. HIV. a. Adolescent. individuals.
c. Antibody screen. b. Adult.
d. All of the above c. Child younger than 6 years old. 13. The primary host for WNV is:
d. Newborn. a. Birds.
7. The cellular marker used to quantify the collection of
HPCs is: 7. Currently, steps taken to reduce transfusion- b. Horses.
a. CD4. transmitted CMV include: c. Humans.
b. CD33. a. Plaque reduction neutralization test. d. Bats.

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14. Tests for WNV include all of the following except: d. NAT Review Questions d. Mothers who are Rh-negative.
a. ELISA. Chapter 19 Hemolytic Disease of the Fetus and
b. NAT. 21. The first form of pathogen inactivation was: Newborn (HDFN) 8. RhIG is given without regard for fetal Rh type in all of
c. Plaque reduction neutralization test. a. Chemical. the following conditions except:
d. Immunofluorescent antibody assay. b. Heat. 1. HDFN is characterized by: a. Ectopic pregnancy rupture.
c. Cold-ethanol fractionation. a. IgM antibody. b. Amniocentesis.
15. Individuals exposed to EBV maintain an d. Anion-exchange chromatography. b. Nearly always anti-D. c. Induced abortion.
asymptomatic c. Different RBC antigens between mother and father. d. Full-term delivery.
latent infection in: 22. What is the most common parasitic complication of d. Antibody titer less than 32.
a. B cells. transfusion? 9. A Kleihauer-Betke test or flow cytometry indicates
b. T cells. a. Babesia microti 2. The main difference between the fetus and the 10 fetal cells per 1,000 adult cells. For a woman with
c. All lymphocytes. b. Trypanosoma cruzi newborn is: 5,000 mL blood volume, the proper dose of RhIG is:
d. Monocytes. c. Plasmodium species a. Bilirubin metabolism. a. One regular-dose vial.
d. Toxoplasma gondii b. Maternal antibody level. b. Two regular-dose vials, plus one.
16. Fifth disease is caused by: c. Presence of anemia. c. One regular-dose vial, plus one.
a. CMV. 23. Which organism has a characteristic C- or U-shape d. Size of RBCs. d. Two microdose vials.
b. EBV. on stained blood smears?
c. Parvovirus B19. a. Trypanosoma cruzi 3. Kernicterus is caused by the effects of: 10. RhIG is indicated in which of the following
d. HTLV-II. b. Plasmodium vivax a. Anemia. circumstances?
c. Plasmodium falciparum b. Unconjugated bilirubin. a. Mother D-positive, infant D-positive
17. Transient aplastic crisis can occur with: d. Babesia microti c. Antibody specificity. b. Mother D-negative, infant D-positive
a. Parvovirus B19. d. Antibody titer. c. Mother D-positive, infant D-negative
b. WNV. 24. Which transfusion-associated parasite may have d. Mother D-negative, infant D-negative
c. CMV. asymptomatic carriers? 4. The advantages of cordocentesis include all of the
d. EBV. a. Babesia microti following except: 11. ABO HDFN is usually mild because:
b. Trypanosoma cruzi a. Allows measurement of fetal hemoglobin and a. ABO antigens are poorly developed in the fetus.
18. Reasons why syphilis is so rare in the United States c. Plasmodium species hematocrit levels b. ABO antibodies prevent the disease.
blood supply include all of the following except: d. All of the above b. Allows antigen typing of fetal blood c. ABO antibodies readily cross the placenta.
a. 4°C storage conditions. c. Allows direct transfusion of fetal circulation d. ABO incompatibility is rare.
b. Donor questionnaire. 25. Which disease is naturally caused by the bite of a d. Decreases risk of trauma to the placenta
c. Short spirochetemia. deer tick? 12. A woman without prenatal care delivers a healthy
a. Chagas’ disease 5. Middle cerebral artery-peak systolic velocity is used
d. NAT testing. to: term infant. A cord blood sample shows the infant is
b. Babesiosis A-positive with a positive DAT. The workup of the
c. Malaria a. Measure bilirubin.
19. Nucleic acid amplification testing for HIV was b. Determine fetal blood type. unexpected finding should include:
instituted in donor testing protocols to: d. Leishmaniasis a. Anti-C3 antiglobulin test.
c. Determine change in optical density.
a. Identify donors with late-stage HIV who lack d. Assess for anemia. b. ABO testing of the mother.
antibodies. c. Direct antiglobulin testing of the mother’s specimen.
b. Confirm the presence of anti-HIV in asymptomatic 6. Blood for intrauterine transfusion should be all of the d. ABO and Rh typing of the father.
HIV-infected donors. following except:
c. Reduce the window period by detecting the virus a. More than 7 days old.
earlier than other available tests. b. Screened for CMV.
d. Detect antibodies to specific HIV viral proteins, c. Gamma-irradiated.
including anti-p24, anti-gp41, and anti-gp120. d. Compatible with maternal serum.
20. Screening for HIV is performed using the following 7. RhIG is indicated for:
technique: a. Mothers who have anti-D.
a. Radio immunoassay b. Infants who are Rh-negative.
b. WB c. Infants who have anti-D.
c. Immunofluorescent antibody assay
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Review Questions a. Immunoglobulin class a. Penicillins a. 3 days

Chapter 20 Autoimmune Hemolytic Anemias b. Thermal amplitude b. Quinidine b. 3 weeks
c. Antibody specificity c. Alpha-methyldopa c. 6 weeks
1. Immune hemolytic anemias may be classified in d. DAT results on EDTA specimen d. Cephalosporins d. 3 months
which of the following categories?
a. Alloimmune 8. Cold AIHA is sometimes associated with infection by: 14. A patient is admitted with a hemoglobin of 5.6 g/dL.
b. Autoimmune a. Staphylococcus aureus Initial pretransfusion workup appears to indicate the
c. Drug-induced b. Mycoplasma pneumoniae presence of a warm autoantibody in the serum and
d. All of the above c. Escherichia coli coating his RBCs. His transfusion history indicates that
d. Group A Streptococcus he received 6 units of RBCs 2 years ago after an
2. When preparing cells for a cold autoadsorption automobile accident. Which of the following would be
procedure, it is helpful to pretreat the cells with which 9. Many warm reactive autoantibodies have a broad most helpful in performing antibody detection and
of the following? specificity within which of the following blood groups? compatibility testing procedures?
a. Dithiothreitol a. Kell a. Adsorb the autoantibody using the patient’s
b. Ficin b. Duffy enzymetreated cells.
c. Phosphate-buffered saline at pH 9 c. Rh b. Perform an elution and use the eluate for
d. Bovine albumin d. Kidd compatibility testing.
c. Crossmatch random units until compatible units are
3. The blood group involved in the autoantibody 10. Valid Rh typing can usually be obtained on a patient found.
specificity in PCH is: with WAIHA using all of the following reagents or d. Collect blood from relatives who are more likely to
a. P techniques except: be compatible.
b. ABO a. Slide and modified tube anti-D
c. Rh b. Chloroquine-treated RBCs 15. A patient who is taking Aldomet has a positive DAT.
d. Lewis c. Rosette test An eluate prepared from his RBCs would be expected
d. Monoclonal anti-D to:
4. Which of the following blood groups reacts best with a. React only with Aldomet-coated cells
an anti-H or anti-IH? 11. In pretransfusion testing for a patient with WAIHA, b. Be neutralized by a suspension of Aldomet
a. O the primary concern is: c. React with all normal cells
b. B a. Treating the patient’s cells with chloroquine for d. React only with Rhnull cells
c. A2 reliable antigen typing 16. One method that can be used to separate a
d. A1 b. Adsorbing out all antibodies in the patient’s serum to patient’s
be able to provide compatible RBCs RBCs from recently transfused donor RBCs is:
5. With cold reactive autoantibodies, the protein c. Determining the exact specificity of the autoantibody a. Chloroquine diphosphate treatment of the RBCs
coating the patient’s cells and detected in the DAT is: so that compatible RBCs can be found b. Reticulocyte harvesting
a. C3 d. Discovering any existing significant alloantibodies in c. EGA treatment
b. IgG the patient’s circulation d. Donath-Landsteiner testing
c. C4
d. IgM 12. Penicillin given in massive doses has been 17. Monoclonal antisera is valuable in phenotyping
associated with RBC hemolysis. Which of the classic RBCs with positive DATs because:
6. Problems in routine testing caused by cold reactive mechanisms is typically involved in the hemolytic a. Both polyspecific and monospecific antihuman serum
autoantibodies can usually be resolved by all of the process? can be used in antiglobulin testing
following except: a. Immune complex b. Anti-C3 serum can be used in antiglobulin testing
a. Prewarming b. Drug adsorption c. It usually does not require antiglobulin testing
b. Washing with warm saline c. Membrane modification d. It does not require enzyme treatment of the cells
c. Using anti-IgG antiglobulin serum d. Autoantibody formation prior to antiglobulin testing
d. Testing clotted blood specimens
13. Which of the following drugs has been associated 18. Autoadsorption procedures to remove either warm
7. Pathological cold autoagglutinins differ from common with complement activation and rapid intravascular or cold autoantibodies should not be used with a
cold autoagglutinins in: hemolysis? recently transfused patient. Recently means:
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Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions 8. What represents the association of the alleles on the Review Questions
Chapter 21 The HLA System two C6 chromosomes as determined by family studies? Chapter 22 Relationship Testing
a. Haplotype
1. The HLA genes are located on which chromosome? b. Genotype 1. Among the combinations of attributes described
a. 2 c. Phenotype below, select the one that would not be suitable for a
b. 4 d. Xenotype genetic system used in parentage testing analysis.
c. 6 a. The system has multiple alleles in Hardy-Weinberg
d. 8 equilibrium.
b. The system has a high mutation rate.
2. The majority of HLA antibodies belongs to what c. Databases of allele frequencies are available for all
immunoglobulin class? ethnic groups tested by the laboratory.
a. IgD d. All systems selected are genetically independent
b. IgE from each other.
c. IgG
d. IgM 2. In which of the following genetic systems is the allele
frequency distribution continuous (not discrete)?
3. What is the test of choice for HLA antigen testing? a. DNA polymorphisms by RFLP
a. Agglutination b. DNA polymorphisms by PCR
b. Molecular c. RBC antigens
c. Cytotoxicity d. RBC enzymes
d. ELISA
3. A false direct exclusion in RBC antigen genetic
4. Of the following diseases, which one has the highest systems can be caused by:
relative risk in association with an HLA antigen? a. A silent allele
a. Ankylosing spondylitis b. A lack of precursor substance
b. Juvenile diabetes c. An alternate untested allele
c. Narcolepsy d. Weak reagents
d. Rheumatoid arthritis
4. Among the following organizations, which one offers
5. Why is HLA matching not feasible in cardiac an accreditation program for parentage testing
transplantation? laboratories?
a. No HLAs are present on cardiac cells a. AABB
b. No donors ever have HLA antibodies b. ASCP
c. Total ischemic time is too long c. FDA
d. Total ischemic time is too short d. HCFA

6. DR52 molecules are the product of which alleles?

a. DRA and DRB1
b. DRA and DRB3
c. DRA and DRB4
d. DRA and DRB5

7. What is the molecular technique that detects

undefined alleles?
a. Restriction fragment length polymorphism
b. Sequence-specific primer typing
c. Sequence-specific oligonucleotide typing
d. Direct nucleotide sequencing

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 Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions c. Validation. Review Questions

Chapter 23 Quality Management d. Auditing. Chapter 24 Utilization Management 8. The blood utilization management program planning
team should include:
1. A QMS is: 9. The difference between the blood bank and 1. Which type of review does not require direct a. Nursing representatives.
a. Synonymous with compliance. laboratory QMSs is that: discussion between the ordering clinician and b. Representatives from the facility’s practicing
b. Active and continuous. a. The laboratory has a different path of workflow. transfusion service personnel? clinicians.
c. Part of quality control. b. The blood bank does not include computer systems. a. Discontinuous prospective c. The blood bank medical director.
d. An evaluation of efficiency. c. The QSEs are different. b. Targeted prospective d. All of the above.
d. The blood bank excludes testing. c. Concurrent
2. QSEs are applied to: d. Retrospective 9. Metrics should be:
a. Just the blood bank’s management staff. 10. The QSEs for the blood bank QMS can be used for a. Chosen to indicate progress during the process of
b. Blood bank quality control activities. the laboratory because: 2. Improper specimen labeling contributes to waste continuous improvement.
c. Only blood component manufacturing. a. The paths of workflow are identical. (muda) within the system by requiring rework and b. Tracked and disseminated only to members of the
d. The blood bank’s path of workflow. b. Both the laboratory and blood bank experience prolonging turnaround time. blood utilization management team.
accreditation inspections. a. True c. The same for all institutions.
3. cGMP refers to: c. The QSEs are universal. b. False d. Selected only by the transfusion service leadership.
a. Regulations pertaining to laboratory safety. d. The QSEs are required by international standards.
b. Validation of testing. 3. There is no value in a transfusion if the patient suffers 10. Perfect value with zero risk and no peril is attainable
c. Nonconformance reporting. any transfusion-related adverse event. for any facility willing to invest in a blood utilization
d. Manufacturing blood components. a. True management program.
b. False a. True
4. Internal and external failure costs are: b. False
a. Readily identifiable in facility reports. 4. To receive benefit from a transfusion the patient
b. Controlled through prevention and appraisal. must have:
c. Built into the facility’s operating budget. a. A hemoglobin level less than 8 g/dL.
d. Part of prevention and appraisal. b. An invasive procedure planned.
c. A pathological lesion or deficiency that can be
5. Which one statement below is correct? remedied by functioning stored components.
a. A process describes how to perform a task. d. A blood order signed by the attending physician.
b. A procedure simply states what the facility will do.
c. A procedure informs the reader how to perform a 5. All of the following regarding the transfusion
task. medicine value stream are true except:
d. A policy can be flowcharted. a. The patient is the customer.
b. Waste can be generated in any department.
6. A blank form is a: c. Transfusion guidelines are a form of standardization.
a. Record. d. Value is decreased when waste and peril are
b. Procedure. decreased.
c. Flowchart.
d. Document. 6. Continuous improvement (kaizen) is important only
when targeted or discontinuous prospective review is
7. An example of a remedial action is: utilized.
a. Applying the problem-solving process. a. True
b. Starting a process improvement team. b. False
c. Resolving the immediate problem.
d. Performing an internal audit. 7. All interventions are compatible with all utilization
review methods, and they can be utilized in any
8. The PDCA cycle is used for: combination.
a. Problem resolution. a. True
b. Process control. b. False
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Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions plan. Review Questions 7. Preventing the issue of an incompatible blood
Chapter 25 Transfusion Safety and Federal Regulatory c. The quality control unit must perform all the quality Chapter 26 Laboratory Information Systems component
Requirements functions. is an example of:
d. Blood and blood components do not have to be in 1. Components of an information system consist of all a. Inventory management.
1. Which of the following is responsible for overseeing compliance with the drug CGMP regulations. of the following except: b. Utilization review.
the safety of the nation’s blood supply? a. Hardware c. System security.
a. Joint Commission on Accreditation of Healthcare 7. A donor calls the blood bank and informs them that b. Software d. Control function.
Organizations within a year prior to his donation, he had intimate c. Validation
b. Food and Drug Administration contact with a person diagnosed with HIV. Which of the d. People 8. Information is stored in a collection of many different
c. College of American Pathologists (CAP) following action is NOT required by the FDA? files called the:
d. Occupational Safety and Health Administration a. Identify and quarantine all blood and blood 2. To be in compliance with regulatory and a. Database.
components produced from the blood supplied by the accreditation agency requirements for blood bank b. Configuration.
2. Where are the regulations for blood and blood donor information systems, blood banks must maintain SOPs c. Hardware.
components published? b. Report the biological product deviation to CBER if for all of the following except: d. Disk drive.
a. The AABB Technical Manual the product has already been distributed a. Vendor validation testing
b. CAP inspection checklist c. Enter the donor in a record so that he can be b. Computer downtime 9. Application software communicates with this type of
c. The Code of Federal Regulations identified and his product not be distributed while he is c. System maintenance software to retrieve data from the system disks:
d. State Inspectional Guidance Documents deferred d. Personnel training a. Interface
d. Notify the AABB b. Operating system
3. What was an important tragedy that prompted 3. A validation test case that assesses the system’s c. Security
Congress to enact the Public Health Service Act? 8. A patient dies following transfusion of ABO- ability to recognize an erroneous input is called: d. Program
a. Three patients contracted hepatitis C following incompatible blood. To whom should this event be a. Normal
transfusion reported? b. Boundary 10. Validation testing for software should consider all of
b. A child died following transfusion of hemolyzed red a. The Center for Biologics Evaluation and Research c. Stress the following items except:
blood cells b. Center for Medicare and Medicaid Services d. Invalid a. Data entry methods
c. A group O patient received group A blood c. The AABB central office b. Control functions
d. Thirteen children died after receiving diphtheria d. The Occupational Safety and Health Administration 4. An example of interface software functionality is: c. Performance of testing in production database
antitoxin contaminated with tetanus a. The entry of blood components into the blood bank d. Invalid data
9. Which federal agency has the responsibility to database
4. What is required to ship blood and blood routinely inspect an unregistered transfusion service b. The transmission of patient information from the HIS 11. Complete the truth table below for a negative
components across state lines (interstate)? that does not collect blood? into the blood bank system antibody screen using two screening cells (SCI, SCII) at
a. AABB accreditation a. Food and Drug Administration c. The printing of a workload report the immediate spin (IS), 37°C (37), and antihuman
b. State license b. Centers for Medicare and Medicaid Services d. Preventing access to the system by an unauthorized globulin (AHG) phases.
c. CMS certification c. Occupational Safety and Health Administration user Phase SCI SCII Interpretation
d. Approved Biologics License Application d. State health department IS
5. Which of the following government organizations 5. Backup copies of the information system: 37°C
inspect blood and blood component manufacturers? 10. Which of the following is NOT one of the FDA layers a. Can be used to restore the information system data AHG
a. CBER of safety? and software if the production system is damaged. CC
b. ORA a. Donor screening b. Are used to maintain hardware components.
b. Biologics License Application c. Are performed once a month. During validation testing, a computer user entered the
c. CMS following results for an antibody screen test:
d. All of the above c. Investigation of manufacturing problems d. Are created any time changes are made to the
d. Infectious disease testing system.
SCI IS 37 AHG CC Interpretation
6. Which of the following is true about CGMP? Result 0 0 0 + Negative
a. CGMP is the minimum current practice for methods 6. User passwords should be:
and facilities used to manufacture a drug to ensure a. Shared with others.
b. Kept confidential. 12. After the user verified the entries, the monitor
that it is safe, pure, and potent. displayed the following message: “Invalid test results.”
b. The FDA will approve a Biologics License Application c. Posted at each terminal.
d. Never changed. What caused the error message to display?
if the manufacturer does not have a quality control a. An invalid entry was made in the check cells (CC)
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 Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

column. 5. Printed reports will indicate relevant units were

b. The truth table was set up incorrectly. assigned transfused status
c. The interpretation does not correlate with the test Name of Section C. __________Test Cases________
entries.
d. The interface to the laboratory computer system is Section D
down. 1. Attempt to assign transfused status to the following
units:
13. The following test plan has been created to validate a. Quarantined blood component
the blood bank computer function used to update the b. Selected (but not issued) blood component
status of blood units that have been transfused. The c. Transfused blood component
test plan contains each of the sections, lettered A 2. Selection of units from issued inventory list
through H, required for a thorough test plan. Evaluate 3. Manual entry of issued blood components
each section and, using the list below, assign a name to Name of Section D. ___Documentation Method_____
each section.
Section Names Section E
• Acceptance 1. Operator will input blood component information
• Acceptance criteria and
• Control functions select blood components.
• Corrective action 2. Operator will input selected patient information.
3. Blood bank computer will update the patient and unit
Test Plan Function: Assigning Transfused Status record.
Section A Description: This function is used to change Name of Section E. ___Documentation Method___
the status of issued units to a transfused status. All
records pertaining to the unit and patient will be Section F
updated: The following screen displays and printed reports will be
Name of Section A. _________Control Functions_____ verified for accuracy: Screen Displays Printed Reports
Patient Information Patient History Report
Section B Unit Information Transfusion Listing
1. Preventing the assignment of transfused status to a Unit History
quarantined blood unit. Transfusion History
2. Preventing the assignment of transfused status to a Name of Section F. ___Result View____
blood unit that has already been transfused.
3. Preventing the assignment of transfused status to a Section G
blood component that has not been issued. The acceptability of the results of each test case will be
Name of Section B. ____Acceptance Criteria____ determined by the blood bank manager and
documented on the validation documentation form.
Section C Name of Section G. _______Corrective Action________
1. The computer will beep and display **Unit Has Not
Been Issued** when a blood unit number that has not Section H
been issued is entered. If the software does not perform as expected, the
2. The computer will beep and display **Unit Is in problem must be recorded on a computer problem
Quarantined Status** when a blood component that report and the supervisor alerted. A remedial action
is in quarantine status is entered. plan will be devised with the assistance of the blood
3. The computer will beep and display **Unit Has Been bank computer system vendor.
Transfused** when a blood component that has already Name of Section H. __________Acceptance______
been transfused is entered. Blood bank director signature:____
4. The Transfusion History screen display will indicate Date:_____________
the patient has been transfused and will display the Comments:
date of the last transfusion. _____________________________________
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Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions Harmening - Modern Blood Banking & Transfusion Practices 6th Edition Study Questions

Review Questions Review Questions 7. The medical director for the tissue bank can be:
Chapter 27 Medicolegal and Ethical Aspects of Providing Chapter 28 Tissue Banking: A New Role for the a. Any individual appointed by the hospital medical
Blood Collection and Transfusion Services Transfusion Service director.
b. The lead supervisor in the blood bank.
1. Transfusion-transmitted diseases can result in 1. Implant records must be kept for what duration? c. The head nurse/transplant coordinator from surgical
lawsuits claiming: a. Ten years after the tissue has been harvested nursing.
a. Battery. b. Indefinitely d. A qualified physician involved in tissue transplant or
b. Invasion of privacy. c. For a reasonable time to ensure that the recipient is blood banking.
c. Negligence. not still alive when records are destroyed
d. A, B, and C d. Ten years following the expiration of the tissue 8. Notification of a recipient of tissue that has been
recalled because of possible contamination should be
2. Laws applicable to blood banking and transfusion 2. FDA CFR 1270 and 1271 include all of the following conducted by:
medicine can arise: tissues EXCEPT: a. The tissue bank director only.
a. In state and federal courts. a. Cancellous bone chips. b. The patient’s transplanting surgeon.
b. In the U.S. Congress, state legislatures, and state and b. Blood vessels associated with vascular organs for c. The patient does not need to be told unless he
federal courts. transplant. develops an infection.
c. In state legislatures and courts. c. Cornea. d. The informed consent covers this contingency and
d. In state legislatures and the U.S. Congress. d. Heart valve. no further notification is necessary.

3. The reasons patients have sued for transfusion injury 3. Hospital tissue banks must register with the FDA if: 9. Tissue receipt records must include all of the
include: a. Tissue for transplant is stored. following EXCEPT:
a. Failure to perform surrogate testing. b. Autologous tissue is stored and issued. a. Unique tissue identification number.
b. Failure to properly test blood components. c. Tissue is transferred to another facility. b. Name and address of tissue supplier.
c. Failure to properly screen donors. d. The tissue bank is located outside the blood bank. c. Expiration date.
d. All of the above d. Tissue supplier’s FDA registration number.
4. The Joint Commission requires all of the following
4. Blood banking professionals may increase the threat EXCEPT: 10. Records that must be reviewed to determine donor
of litigation by: a. Hospital tissue banks must ensure that suppliers are eligibility by the tissue manufacturer include:
a. Following published regulations and guidelines. complying with applicable state laws. a. Donor family history.
b. Knowing the legal bases for liability. b. Tissue manufacturing establishments must register b. Records from any source pertaining to risk factors for
c. Disclosing all information about patients and donors. with the FDA. communicable diseases.
d. Practicing good medicine. c. Hospitals must assign responsibility for overseeing c. Interview of next-of-kin.
the tissue program throughout the organization. d. Consent to harvest tissue.
5. Issues about transfusion-transmitted diseases: d. Hospital tissue banks must verify supplier’s
a. Are evolving and will continue to result in litigation in registration with the FDA yearly.
the foreseeable future.
b. Frequently result in plaintiff verdicts. 5. The American Association of Tissue Banks (AATB) is:
c. Have all been litigated. a. A mandatory accrediting agency for all tissue banks.
d. Are known and avoidable. b. A voluntary accrediting agency for tissue-
manufacturing establishments.
c. An historic name for the U.S. Navy Tissue Bank.
d. A subdivision within the AABB.

6. Transmission of malignancy in tissue:

a. Is most likely to occur with the use of bone.
b. Is relatively common (1/10,000 cases)
c. Is more likely to occur in whole organ transplant.
d. Has never been reported in cornea transplant.

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