Modern Blood Banking and Transfusion Practices 6th Edition Harmening Test Bank

Modern Blood Banking and Transfusion
Practices 6th Edition Harmening Test

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Chapter 7. The Rh Blood Group System
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. What is an advantage of using chemically modified anti-D?

a. It provides a low-protein medium.
b. Rh control is not necessary.
c. Few false-negative results are obtained.
d. Du testing is eliminated.
____ 2. The Rh antibody agglutinates what percentage of RBCs?
a. 15% c. 50%
b. 85% d. 35%
____ 3. Why is determination of Rh status crucial for obstetric patients?
a. An Rh-positive mother can form anti-D, which will destroy D-positive red blood cells of
the fetus.
b. All Rh-positive mothers are possible candidates for Rh immune globulin.
c. All Rh-negative mothers are possible candidates for Rh immune globulin.
d. An Rh-negative mother can form anti-D if she gives birth to an Rh-negative baby.
____ 4. Which antigen represents Rh3 in Rosenfield terminology?
a. D c. C
b. E d. e
____ 5. G antigen is present on all of which type of red blood cells?
a. D-positive c. E-positive
b. C-positive d. e-positive
____ 6. What does Rh genotype refer to?
a. Antigens detected on a red blood cell by serologic methods
b. Antibodies detected in serum by serologic methods
c. Rh genes inherited from both parents
d. Rh genes inherited from the mother
____ 7. Where is the Rh antigen located relative to the red blood cell membrane?
a. Integrally c. Centrally
b. Peripherally d. None of the above
____ 8. Which of the following statements regarding anti-LW is true?
a. Anti-LW reacts poorly with cord cells.
b. Anti-LW reacts stronger with Rh-positive cells than with Rh-negative cells.
c. Rh-null individuals lack the LW gene.
d. The gene coding for LW is located on the same chromosome as the Rh genes.
____ 9. Of the three following categories of altered D antigen, in which variation of D antigen expression are you
more likely to encounter an allo-anti-D?
a. C in Trans to RhD c. Partial D
b. Weak D d. None of the above
____ 10. A cord blood sample was sent to the blood bank for a type and DAT. Cells were washed six times with saline
before testing. The forward grouping typed as an O. There was no agglutination with anti-D and washed cord
cells. The DAT was 3+ with polyspecific AHG. What is the Rh type of the baby?
a. Rh-negative c. Rh type cannot be determined
b. Rh-positive d. None of the above
____ 11. Which gene combination is expressed in the greatest frequency in the black population?
a. DCe c. Dce
b. dce d. DCE
____ 12. Which of the following genotypes is consistent with f antigen expression?
a. DcE/DCe c. DCe/DcE
b. Dce/DCE d. DCe/dCE
____ 13. How are the Rh antigens inherited?
a. X-linked recessive c. X-linked dominant
b. Codominant alleles d. None of the above
____ 14. All of the following may cause a false-negative reaction in Rh typing except:
a. omission of reagent. c. rouleaux.
b. immunoglobulin coating cells. d. cell suspension that is too heavy.
____ 15. In the Fisher-Race nomenclature what does "d" refer to?
a. Amorph c. Absence of D
b. Silent allele d. All of the above
____ 16. Which of the following genotypes would demonstrate the strongest expression of D antigen?
a. Dce/dCE c. dce/dce
b. DCe/dce d. dCe/dcE
____ 17. Most Rh antibodies are of what immunoglobulin class?
a. IgM c. IgA
b. IgG d. IgE
____ 18. What clinical manifestation may be associated with the Rh-null syndrome?
a. Reticulocytosis c. Low hemoglobin
b. Stomatocytosis d. All of the above
____ 19. Which IgG subclasses carry the most significance with regard to Rh antibodies?
a. IgG1/IgG4 c. IgG3/IgG4
b. IgG2/IgG4 d. IgG1/IgG3
____ 20. In which population is the genetic Du usually found?
a. White c. Black
b. Asian d. Native American
____ 21. What does hr' refer to in the Weiner nomenclature?
a. c c. C
b. e d. E
____ 22. All of the following may occur following an Rh-mediated hemolytic transfusion reaction except:
a. elevated fever. c. intravascular hemolysis.
b. increased bilirubin. d. positive DAT.
____ 23. All of the following are consistent with International Society of Blood Transfusion (ISBT) terminology
except:
a. A six-digit number specifies each blood group antigen.
b. 004 represents Rh group.
c. D is written as "R1."
d. All genes are written in bold print.
____ 24. Rh-immune globulin is effective is preventing which type of hemolytic disease of the newborn (HDN)?
a. Anti-c c. Anti-D
b. Anti-E d. Anti-C
____ 25. The biochemical structure of the Rh antigens is a nonglycosylated protein, meaning:
a. lipids are not attached to protein structure.
b. carbohydrates are not attached to protein structure.
c. glucose is attached to protein.
d. glycerol is attached to protein.
____ 26. The Rh testing on a blood donor was negative at immediate spin. The tube was incubated at 37°C for 15
minutes. The tube was centrifuged and read macroscopically. The test was negative at 37°C. The tube was
washed three times with saline, and two drops of AHG were added. After centrifugation, the tube yielded a 2+
reaction. How is this Rh type reported on the donor unit?
a. Rh-positive c. Du-positive
b. Rh-negative d. Rh-variable
____ 27. What does the term exalted D refer to?
a. Deletion of the D antigen
b. Stronger expression of Cc antigens when D is missing
c. Stronger expression of Ee antigens when D is missing
d. Stronger expression of D antigens when Cc and Ee are missing
____ 28. What does the "R" represent in Rh-Hr terminology?
a. Absence of D antigen c. Presence of C antigen
b. Presence of D antigen d. Presence of e antigen
____ 29. What is the basis of Rosenfield Rh terminology?
a. Each gene produces one product or antigen.
b. The positive (+) or negative (–) sign demonstrates the presence or absence of antigen on a
red blood cell.
c. The Rh gene produces at least three factors within an agglutinogen.
d. The Rh gene produces at least five factors within an agglutinogen.
____ 30. In the black population, a mosaic form of which antigen may be found?
a. c c. e
b. E d. C
____ 31. Which of the following Rh antigens is the most immunogenic?
a. D c. e
b. C d. E
____ 32. What protocol is put in place to validate Rh testing when high-protein reagents are used, especially when the
patient types as an AB-positive?
a. Wash cells before testing c. Add LISS to test system
b. Run a control with Rh test d. Use only saline reactive anti-D
____ 33. The Del phenotype is most commonly found in individuals of which ethnicity?
a. Asian c. Native American
b. Whites d. African
____ 34. Why must there be alpha designations in the Rosenfield system?
a. Nomenclature applies to other blood group systems besides Rh.
b. Rosenfield nomenclature is only used in the Rh blood system.
c. Weiner and Fisher-Race use alpha designations.
d. None of the above
____ 35. What is the frequency of E antigen in the general population?
a. 85% c. 98%
b. 15% d. 30%
____ 36. The Rh gene is located on which chromosome?
a. 1 c. 9
b. 7 d. 11
____ 37. What is the principle of the Rh-Hr (Weiner) terminology?
a. The Rh gene produces at least three factors within an agglutinogen.
b. Each gene (D, C, c, E, e) produces one product or antigen.
c. The Rh gene produces at least three factors within an agglutinin.
d. Each gene is independent of the others.
____ 38. Which of the following reagents or methods is best for categorizing partial D types?
a. Saline based anti-D
b. High protein anti-D
c. A combination of serological typing and molecular analysis
d. Monoclonal anti-D reagents
____ 39. All of the following are true regarding Rh antibodies except:
a. Rh antibodies can bind complement on the red blood cell membrane.
b. An individual with a low titer Rh antibody may experience a secondary immune response
on antigen exposure.
c. Rh antibodies may cause a delayed hemolytic transfusion reaction.
d. Red blood cell destruction is usually extravascular.
____ 40. On which chromosome are the genes that code for RH proteins, namely, RHD and RHCE located?
a. Chromosome 1 c. Chromosome 20
b. Chromosome 19 d. Chromosome 9
____ 41. When one or more D epitopes within the entire D protein is missing it is termed__________.
a. weak D c. Del
b. C in trans to Rh(D) d. partial D
____ 42. If an individual with a partial D expression is transfused with a normal Rh-positive unit of blood, a likely
result will be:
a. the patient will develop an anti-D antibody.
b. the patient will form an antibody to the portion of Rh(D) protein that they are missing.
c. the patient will have an acute hemolytic transfusion reaction.
d. the patient will experience no consequence of receiving Rh-positive blood.
____ 43. A male patient was seen in the emergency room with an acute bleed. The recommendation from the blood
supplier is to give O-positive RBCs as uncrossmatched blood. This patient has already been exposed to
Rh-positive blood after a previous accident. What is a possible outcome?
a. The patient may have a hemolytic transfusion reaction from an allo immunized anti-D.
b. Anti-D is not immunogenic, and the patient probably would not have formed an anti-D.
c. Anti-D is not hemolytic, and even with the circulating antibody there would be no danger
to the patient.
d. The anti-D would activate complement, and a strong intravascular transfusion reaction
would occur.
____ 44. Anti-LW will react most strongly with:
a. adult Rh-positive RBCs. c. Rh-null RBCs.
b. Rh-negative RBCs. d. Rh-negative cord blood.
____ 45. Which of the following statements is false?
a. Anti-D usually stimulates complement.
b. Anti-D is mostly IgG.
c. Anti-D can cause hemolytic disease of the newborn.
____ 46. When a patient has Rh-null syndrome, what kind of packed RBCs need to be transfused?
a. ABO compatible Rh-positive blood c. ABO compatible Rh-null blood
b. ABO compatible Rh-negative blood d. O-negative PRBCs
____ 47. What are the dangers of transfusing donor Rh-negative RBCs to an Rh-positive patient?
a. There are no dangers.
b. A hemolytic transfusion reaction will occur.
c. A patient will be sensitized and will develop an Anti-D.
d. Most Rh-negative blood is c- and e–positive, and because of their immunogenicity the
patient may form an antibody to those antigens.
____ 48. The antigen ceCF is known as:
a. Wrights antigen c. D mosaic
b. Crawford antigen d. V antigen
____ 49. An individuals of the dce/dce genotype given dCe/dce blood has an antibody response that appears to be
anti-C and anti-D. The most likely explanation for this is:
a. The antibody is anti-G.
b. The antibody is anti-partial D.
c. The antibody is anti-Cw.
d. There was an incorrect reading of the agglutination reactions.
____ 50. Why do false-negative Rh testing results occur in babies with severe hemolytic disease of the newborn due to
anti-D?
a. The cord cells may be contaminated with Wharton's jelly.
b. All D sites are covered by maternal anti-D, which blocks the reagent.
c. Antigens are not expressed yet.
____ 51. Which of the following Rh phenotypes invites Cw antigen testing?
a. C+c+ c. E-e+
b. E+e- d. C+c-
Chapter 7. The Rh Blood Group System
Answer Section
MULTIPLE CHOICE
1. ANS: A PTS: 1 KEY: Taxonomy Level: 2

2. ANS: B PTS: 1 KEY: Taxonomy Level: 1
3. ANS: C PTS: 1 KEY: Taxonomy Level: 3
15. ANS: D PTS: 1 KEY: Taxonomy Level: 1

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Modern Blood Banking and Transfusion Practices 6th Edition Harmening Test Bank

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Modern Blood Banking and Transfusion

Practices 6th Edition Harmening Test

____ 1. What is an advantage of using chemically modified anti-D?

1. ANS: A PTS: 1 KEY: Taxonomy Level: 2

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