REVIEW QUESTIONS (BB) c.

35
d. 7
CHAPTER 1
10. One criterion used by the FDA for approval of new
1. What is the maximum volume of blood that can be preservation solutions and storage containers is an
collected from a 110-lb donor, including samples for average 24-hour post-transfusion RBC survival of
processing? more than:
a. 450 mL a. 50%.
b. 500 mL b. 60%.
c. 525 mL c. 65%.
d. 550 mL d. 75%.

2. How often can a blood donor donate whole blood? 11. What is the lowest allowable pH for a platelet
a. Every 24 hours component at outdate?
b. Once a month a. 6
c. Every 8 weeks b. 5.9
d. Twice a year c. 6.8
d. 6.2
3. When RBCs are stored, there is a “shift to the left.”
This means: 12. Which of the following occurs during storage of red
a. Hemoglobin-oxygen affinity increases, owing to an blood cells?
increase in 2,3-DPG. a. pH decreases
b. Hemoglobin-oxygen affinity increases, owing to a b. 2,3-DPG increases
decrease in 2,3-DPG. c. ATP increases
c. Hemoglobin-oxygen affinity decreases, owing to a d. plasma K+ decreases
decrease in 2,3-DPG.
d. Hemoglobin-oxygen affinity decreases, owing to an 13. Which of the following is approved for bacterial
increase in 2,3-DPG. detection specific to extending the expiration of
apheresed
4. The majority of platelets transfused in the United platelets to 7 days?
States today are: a. BacT/ALERT
a. Whole blood–derived platelets prepared by the b. eBDS
platelet-rich plasma method. c. Gram stain
b. Whole blood–derived platelets prepared by the buffy d. Pan Genera Detection (PGD) test
coat method.
c. Apheresis platelets. 14. Which of the following is the most common cause
d. Prestorage-pooled platelets. of bacterial contamination of platelet products?
a. Entry of skin plugs into the collection bag
5. Which of the following anticoagulant preservatives b. Environmental contamination during processing
provides a storage time of 35 days at 1°C to 6°C for c. T in the donor
units of whole blood and prepared RBCs if an additive d. Incorrect storage temperature
solution is not added?
a. ACD-A 15. The INTERCEPT pathogen reduction system uses
b. CP2D which of the following methods?
c. CPD a. Riboflavin and UV light
d. CPDA-1 b. Amotosalen and UV light
c. Solvent/detergent treatment
6. What are the current storage time and storage d. Irradiation
temperature for platelet concentrates and apheresis
platelet components?
CHAPTER 2
a. 5 days at 1°C to 6°C
1. Which statement best describes the process of
b. 5 days at 24°C to 27°C
mitosis?
c. 5 days at 20°C to 24°C
a. Cell division by which only one-half of the daughter
d. 7 days at 22°C to 24°C
cells produced are identical to the parent cell
b. Cell division of germ cells by which two successive
7. RBCs can be frozen for:
divisions of the nucleus produce cells that contain half
a. 12 months.
the number of chromosomes of somatic cells
b. 1 year.
c. Cell division that produces four daughter cells
c. 5 years.
having the same number of chromosomes as the
d. 10 years.
parent
d. Cell division that produces two daughter cells with
8. Whole blood and RBC units are stored at what
the same number of chromosomes as the parent cell
temperature?
a. 1°C to 6°C
2. When a recessive trait is expressed:
b. 20°C to 24°C
a. One gene carrying the trait was present.
c. 37°C
b. Two genes carrying the trait were present.
d. 24°C to 27°C
c. No gene carrying the trait was present.
d. The gene is hemizygous.
9. Additive solutions are approved for storage of red
blood cells for how many days?
3. In a pedigree analysis, which statement about the
a. 21
symbols used is true?
b. 42
a. Deceased family members have a line crossed
through the symbol.
b. A consanguineous mating is indicated by a single
line between a male and female.
c. The propositus is always found in the last generation
on the pedigree.
d. A stillbirth is indicated by a triangle.
4. Which of the following nitrogenous bases make up
DNA?
a. Adenine, leucine, guanine, thymine
b. Alanine, cytosine, guanine, thymine
c. Adenine, lysine, uracil, guanine
d. Adenine, cytosine, guanine, thymine
5. Mutations can occur following DNA replication that
escapes the proofreading and repair systems. Which
statement about DNA mutations is true?
a. All mutations result in a phenotypic change.
b. A frameshift mutation at the beginning of the coding
sequence is most likely to result in a phenotypic
change.
c. A transversion always encodes for a stop codon.
d. A missense point mutation never encodes for a stop
codon.
6. Which phenotype would be expected from the
mating of a Jk(a+b–) female and a Jk(a–b+) male?
a. Jk(a+b–)
b. Jk(a+b+)
c. Jk(a–b+)
d. All of the above
7. Which statement describes an intron?
a. The part of a gene that contains nonsense mutations
b. The coding region of a gene
c. The noncoding region of a gene
d. The resting stage between cell divisions
8. Which statement about isolation of nucleic acids is
true?
a. All isolation methods involve the use of organic
solvents.
b. High protein concentration increases the DNA yield.
c. mRNA can be effectively isolated with the use of
poly-A–coated beads.
d. Silica particles bind DNA under high salt con -
centrations.
9. The purpose of transcription is to:
a. Produce a protein.
b. Read the mRNA by the ribosome.
c. Synthesize RNA using DNA as a template.
d. Replicate DNA.
10. When a male possesses a phenotypic trait that he
passes to all his daughters and none of his sons, the
trait is said to be:
a. X-linked dominant.
b. X-linked recessive.
c. Autosomal dominant.
d. Autosomal recessive.
11. When a female possesses a phenotypic trait that
she passes to all of her sons and none of her
daughters, the trait is said to be:
a. X-linked dominant.
b. X-linked recessive.
c. Autosomal dominant.
d. Autosomal recessive.
12. Which statement correctly describes DNA
replication in eukaryotes?
a. Semiconservative replication from RNA; requires
DNA polymerase
b. Bidirectional replication; requires RNA primer
c. Conservative replication from DNA; requires RNA
polymerase
d. Occurs at the replication fork; both strands
replicated in the same direction
13. How is tRNA different from other types of RNA?
a. It has a 3′ poly-T tail.
b. The immature form contains introns.
c. It has a 3′ methylated cap.
d. It recognizes amino acids and nucleic acids.
14. Which statement about translation of proteins is
false?
a. It occurs on the ribosomes in the cytoplasm of
the cell.
b. Post-translation processing can include
glycosylation.
c. mRNA delivers the amino acids to the growing
peptide chain during elongation.
d. The codon UAA would terminate translation.
15. The purpose of meiosis is to:
a. Generate two identical daughter cells after division.
b. Generate four identical daughter cells after division
with the same number of chromosomes as the parent
cells.
c. Generate gametes with a diploid number of
chromosomes.
d. Generate daughter cells that contain half the
number of chromosomes of somatic cells that contain
new DNA sequences.
16. The pattern of inheritance most commonly
expressed by
blood group genes is:
a. X-linked recessive.
b. Autosomal recessive.
c. Autosomal codominant.
d. X-linked codominant.
CHAPTER 3
1. Which of the following is not involved in the acquired
(adaptive) immune response?
a. Phagocytosis
b. Production of antibody or complement
c. Induction of immunologic memory
d. Accelerated immune response upon subsequent
exposure to antigen
2. Which cells are involved in the production of
antibodies?
a. Dendritic cells
b. T lymphocytes
c. B lymphocytes
d. Macrophages
3. Which of the following cells is involved in antigen
recognition following phagocytosis?
a. B lymphocytes
b. T lymphocytes
c. Macrophages
d. Granulocytes
4. The role of the macrophage during an antibody
response is to:
a. Make antibody.
b. Lyse virus-infected target cells.
c. Activate cytotoxic T cells.
d. Process antigen and present it. 15. Which of the following refers to the presence of an
5. Which of the following immunoglobulins is produced excess amount of antibody present in a test system?
in the primary immune response? a. Postzone
a. IgA b. Prozone
b. IgE c. Zone of equivalence
c. IgG d. Endzone
d. IgM
16. Which one of the following properties of antibodies
6. Which of the following immunoglobulins is produced is NOT dependent on the structure of the heavy chain
in the secondary immune response? constant region?
a. IgA a. Ability to cross the placenta
b. IgE b. Isotype (class)
c. IgG c. Ability to fix complement
d. IgM d. Affinity for antigen

7. Which of the following MHC classes encodes 17. Molecules that promote the update of bacteria for
complement components? phagocytosis are:
a. Class I a. Opsonins.
b. Class II b. Cytokines.
c. Class III c. Haptens.
d. Class IV d. Isotypes.

8. Which of the following immunoglobulins is most 18. Select the term that describes the unique
efficient at binding complement? confirmation of the antigen that allows recognition by
a. IgA a corresponding antibody.
b. IgE a. Immunogen
c. IgG b. Epitope
d. IgM c. Avidity
d. Clone
9. Which portion of the immunoglobulin molecules
contains complement binding sites? 19. Which of the following terms refers to the net
a. Heavy chain variable region negative charge surrounding red blood cells?
b. Light chain variable region a. Dielectric constant
c. Heavy chain constant region b. Van der Waals forces
d. Light chain constant region c. Hydrogen bonding
d. Zeta potential
10. Which complement pathway is activated by the
formation of antigen-antibody complexes? CHAPTER 4
a. Classical 1. The central dogma of molecular biology states that:
b. Alternative a. DNA is the genetic material.
c. Lectin b. RNA is the genetic material.
d. Retro c. DNA is translated to mRNA.
d. Proteins are transcribed from mRNA.
11. Which of the following is known as the “recognition
unit” in the classical complement pathway? 2. Recombinant-DNA technology is possible because:
a. C1q a. Restriction endonucleases cut RNA.
b. C3a b. Restriction endonucleases cut proteins.
c. C4 c. The genetic code is universal.
d. C5 d. Bacteria are difficult to culture.

12. Which of the following is known as the “membrane 3. Agarose gel electrophoresis is a technique used for:
attack complex” in the classical complement pathway? a. DNA synthesis.
a. C1 b. RNA synthesis.
b. C3 c. Separation of DNA molecules by size.
c. C4, C2, C3 d. Oligonucleotide synthesis.
d. C5b, C6, C7, C8, C9
4. Restriction fragment length polymorphism (RFLP) is
13. Which of the following immunoglobulin classes is based on the use of the enzymes:
capable of crossing the placenta and causing a. Reverse transcriptases.
hemolytic disease of the newborn? b. Bacterial endonucleases.
a. IgA c. DNA polymerases.
b. IgE d. RNA polymerases.
c. IgG
d. IgM 5. The polymerase chain reaction (PCR):
a. Is carried out in vivo.
14. Which of the following refers to the effect of an b. Is used for peptide synthesis.
excess amount of antigen present in a test system? c. Requires RNA polymerase.
a. Postzone d. Is used for the amplification of DNA.
b. Prozone
c. Zone of equivalence 6. Plasmids are:
d. Endzone a. Vectors used for molecular cloning.
b. Antibiotics.
c. Enzymes.
d. Part of chromosomes.
7. Some model organisms:
a. Simplify the study of human disease.
b. Are used to produce recombinant proteins.
c. Are prokaryotes and some are eukaryotes.
d. All of the above
8. DNA sequencing:
a. Is more difficult than peptide sequencing.
b. Requires the use of RNA polymerase.
c. Can never be automated.
d. Is an enzymatic in vitro reaction.
9. RFLP and SSP are techniques used for:
a. Protein isolation.
b. RNA isolation.
c. DNA typing.
d. Protein typing.
10. Recombinant DNA techniques:
a. Are not used in a clinical setting.
b. Are useful research tools.
c. Are not used in blood banking.
d. Are useful only for research.
11. Transcription-mediated amplification:
a. Requires thermostable DNA polymerase.
b. Is an isothermal procedure.
c. Is an obsolete method currently replaced by SSOP.
d. Utilizes probes labeled with fluorescent tags.
12. Preseroconversion window:
a. Is the time when donors can be infected but do not
yet test positive by serologic methods.
b. May be narrowed by using molecular methods.
c. Refers mainly to viral pathogens.
d. All of the above
13. Red blood cell molecular antigen typing is useful in
all listed situations except:
a. In screening RBC inventory for antigen-negative
units.
b. When reagent antibodies are weak or unavailable.
c. In quantitative gene expression analysis.
d. When resolving ABO discrepancies.
CHAPTER 5
1. A description of the antiglobulin test is:
a. IgG and C3d are required for RBC sensitization.
b. Human globulin is completely eluted from RBCs
during saline washings.
c. Human globulin is injected into an animal.
d. AHG reacts with human globulin molecules bound to
RBCs.
2. Polyspecific AHG reagent contains:
a. Anti-IgG and anti-IgA.
b. Anti-IgG and anti-IgM.
c. Anti-IgG and anti-C3d.
d. Anti-IgA and Anti-C3d.
3. Monoclonal anti-C3d is:
a. Derived from one clone of plasma cells.
b. Derived from multiple clones of plasma cells.
c. Derived from immunization of rabbits.
d. Reactive with C3b and C3d.
4. Which of the following is a clinically significant
antibody whose detection has been reported in some
instances to be dependent on anticomplement activ
ity in polyspecific AHG?
a. Anti-Jka
b. Anti-Lea
c. Anti-P1
d. Anti-H
5. After the addition of IgG-coated RBCs (check cells)
to a negative AHG reaction during an antibody
screen, a negative result is observed. Which of the
following is a correct interpretation based on these
findings?
a. The antibody screen is negative.
b. The antibody screen cannot be interpreted.
c. The saline washings were adequate.
d. AHG reagent was added.
6. RBCs must be washed in saline at least three times
before the addition of AHG reagent to:
a. Wash away any hemolyzed cells.
b. Remove traces of free serum globulins.
c. Neutralize any excess AHG reagent.
d. Increase the antibody binding to antigen.
7. An in vivo phenomenon associated with a positive
DAT is:
a. Passive anti-D detected in the maternal sample.
b. Positive antibody screen tested by LISS.
c. Identification of alloantibody specificity using a
panel of reagent RBCs.
d. Maternal antibody coating fetal RBCs.
8. False-positive DAT results are most often
associated
with:
a. Use of refrigerated, clotted blood samples in which
complement components coat RBCs in vitro.
b. A recipient of a recent transfusion manifesting an
immune response to recently transfused RBCs.
c. Presence of antispecies antibodies from adminis
tration of immune globulin (IVIG).
d. A positive autocontrol caused by polyagglutination.
9. Polyethylene glycol (PEG) enhances antigen
antibody reactions by:
a. Decreasing zeta potential.
b. Concentrating antibody by removing water.
c. Increasing antibody affinity for antigen.
d. Increasing antibody specificity for antigen.
10. Solid-phase antibody screening is based on:
a. Adherence.
b. Agglutination.
c. Hemolysis.
d. Precipitation.
11. A positive DAT may be found in which of the
following
situations?
a. A weak D-positive patient
b. A patient with anti-M
c. HDFN
d. An incompatible crossmatch
12. What do Coombs’ check cells consist of?
a. Type A-positive cells coated with anti-IgG
b. Type A-negative cells coated with anti-IgG
c. Type O-positive cells coated with anti-D
d. Type B-negative cells coated with anti-D
13. Which of the following IAT methods requires the
use of
check cells?
a. Manual tube method with albumin
b. Gel 6. An ABO type on a patient gives the following
c. Automated solid-phase analyzer reactions:
d. Enzyme-linked Patient Cells With Patient Serum With
14. Which uncontrollable factor can affect AHG testing? Anti-A Anti-B Anti-A1
a. Temperature A1 cells B cells
b. Antibody affinity 4+ 4+ Neg 2+ Neg
c. Gravitational force in the centrifuge The reactions above may be seen in a patient who is:
d. Incubation time a. A1 with acquired B.
b. A2B with anti-A1.
15. Which would be the most efficient method for a c. AB with increased concentrations of protein in the
labora serum.
tory staffed by medical laboratory technicians? d. AB with an autoantibody.
a. LISS
b. Polybrene 7. Which of the following ABO blood groups contains
c. Solid-phase or gel the least amount of H substance?
d. Enzyme-linked a. A1B
b. A2
16. A 27-year-old group O mother has just given birth c. B
to a d. O
group A baby. Since the mother has IgG anti-A, anti-B
and anti-A, B in her plasma, which of the following 8. You are working on a specimen in the laboratory
methods and tests would be most effective at that you believe to be a Bombay phenotype. Which of
detecting the following reactions would you expect to see?
the anti-A on the baby’s RBCs? a. Patient’s cells + Ulex europaeus = no agglutination
a. DAT using common tube technique b. Patient’s cells + Ulex europaeus = agglutination
b. DAT using gel c. Patient’s serum + group O donor RBCs = no
c. IAT using common tube technique agglutination
d. IAT using gel d. Patient’s serum + A1 and B cells = no agglutination

CHAPTER 6 9. An example of a technical error that can result in an

1. An ABO type on a patient gives the following ABO discrepancy is:
reactions: a. Acquired B phenomenon.
Patient Cells With Patient Serum With b. Missing isoagglutinins.
Anti-A Anti-B A1 cells B cells c. Cell suspension that is too heavy.
4+ d. Acriflavine antibodies.
4+ Neg Neg
What is the patient’s blood type? 10. An ABO type on a patient gives the following
a. O reactions:
b. A Patient Cells
c. B With
d. AB Patient Serum With
Anti-A Anti-B A1 cells B cells O cells Autocontrol
2. The major immunoglobulin class(es) of anti-B in a 4+ Neg 2+ 4+ 2+ Neg
group A individual is (are): These results are most likely due to:
a. IgM. a. ABO alloantibody.
b. IgG. b. Non-ABO alloantibody.
c. IgM and IgG. c. Rouleaux.
d. IgM and IgA. d. Cold autoantibody

3. What are the possible ABO phenotypes of the CHAPTER 7

offspring from the mating of a group A to a group B 1. The Rh system genes are:
individual? a. RHD and RHCE.
a. O, A, B b. RHD and LW.
b. A, B c. RHD and RHAG.
c. A, B, AB d. RHCE and RHAG.
d. O, A, B, AB
2. What Rh antigen is found in 85% of the Caucasian
4. The immunodominant sugar responsible for blood population and is always significant for transfusion
group purposes?
A specificity is: a. d
a. L-fucose. b. c
b. N-acetyl-D-galactosamine. c. D
c. D-galactose. d. E
d. Uridine diphosphate-N-acetyl-D-galactose.
3. How are weaker-than-expected reactions with anti-
5. What ABH substance(s) would be found in the saliva D typing reagents categorized?
of a group B secretor? a. Rhmod
a. H b. Weak D
b. H and A c. DAT positive
c. H and B d. Dw
d. H, A, and B
4. Cells carrying a weak D antigen require the use of 13. An individual has the following serologic reactions:
what test to demonstrate its presence? D+C+E+c+e+f–. What is the most probable genotype?
a. Indirect antiglobulin test a. R1R2
b. Direct antiglobulin test b. Rory
c. Microplate test c. Rzr
d. Warm autoadsorption test d. R1r

5. How are Rh antigens inherited? 14. Which of the following is the most common
a. Autosomal recessive alleles haplotype in the African American population?
b. Sex-linked genes a. DCe
c. Codominant alleles b. DcE
d. X-linked c. Dce
d. ce
6. Biochemically speaking, what type of molecules are 15. If a patient who is R1R1 is transfused with RBCs that
Rh antigens? are
a. Glycophorins Ror, which antibody is he most likely to produce?
b. Simple sugars a. Anti-D
c. Proteins b. Anti-c
d. Lipids c. Anti-e
d. Anti-G
7. Rh antibodies react best at what temperature (°C)?
a. 15
b. 18
CHAPTER 8
c. 22
1. The following phenotypes are written incorrectly
d. 37
except for:
a. Jka+
8. Rh antibodies are primarily of which
b. Jka+
immunoglobulin
c. Jka(+)
class?
d. Jk(a+)
a. IgA
b. IgD
2. Which of the following characteristics best
c. IgG
describes Lewis antibodies?
d. IgM
a. IgM, naturally occurring, cause HDFN
b. IgM, naturally occurring, do not cause HDFN
9. Rh antibodies have been associated with which
c. IgG, in vitro hemolysis, cause hemolytic transfusion
clinical condition?
reactions
a. Hemolytic disease of the fetus and newborn
d. IgG, in vitro hemolysis, do not cause hemolytic
b. Thrombocytopenia
transfusion reactions
c. Hemophilia A
d. Stomatocytosis
3. The Le gene codes for a specific glycosyltransferase
that transfers a fucose to the N-acetylglucosamine on:
10. What do Rhnull cells lack?
a. Type 1 precursor chain
a. Lewis antigens
b. Type 2 precursor chain
b. Normal oxygen-carrying capacity
c. Types 1 and 2 precursor chains
c. Rh antigens
d. Either type 1 or type 2 in any one individual but not
d. Hemoglobin
both
11. Convert the following genotypes from Wiener
4. What substances would be found in the saliva of a
nomenclature to Fisher-Race and Rosenfield
group B secretor who also has Lele genes?
nomenclatures, and list the antigens present in each
a. H, Lea
haplotype.
b. H, B, Lea
a. R1r
c. H, B, Lea, Leb
b. R2R0
d. H, B, Leb
c. RzR1
d. r r
5. Transformation to Leb phenotype after birth may be
as follows:
a. Le(a–b–) to Le(a+b–) to Le(a+b+) to Le(a–b+)
b. Le(a+b–) to Le(a–b–) to Le(a–b+) to Le(a+b+)
c. Le(a–b+) to Le(a+b–) to Le(a+b+) to Le(a–b–)
d. Le(a+b+) to Le(a+b–) to Le(a–b–) to Le(a–b+)

6. In what way do the Lewis antigens change during

pregnancy?
a. Lea antigen increases only
12. Which Rh phenotype has the strongest expression b. Leb antigen increases only
of D? c. Lea and Leb both increase
a. DCe/ce d. Lea and Leb both decrease
b. DCe/DCe 7. A type 1 chain has:
c. DcE/DcE a. The terminal galactose in a 1-3 linkage to
d. D– subterminal N-acetylglucosamine
b. The terminal galactose in a 1-4 linkage to
subterminal
N-acetylglucosamine b. Anti-P1
c. The terminal galactose in a 1-3 linkage to c. Anti-Fya
subterminal d. Anti-Jkb
N-acetylgalactosamine
d. The terminal galactose in a 1-4 linkage to 17. Which of the following Duffy phenotypes is
subterminal prevalent in blacks but virtually nonexistent in whites?
N-acetylgalactosamine a. Fy(a+b+)
b. Fy(a–b+)
8. Which of the following best describes Lewis c. Fy(a–b–)
antigens? d. Fy(a+b–)
a. The antigens are integral membrane glycolipids
b. Lea and Leb are antithetical antigens 18. Antibody detection cells will not routinely detect
c. The Le(a+b–) phenotype is found in secretors which antibody specificity?
d. None of the above a. Anti-M
b. Anti-Kpa
9. Which of the following genotypes would explain c. Anti-Fya
RBCs typed as group A Le(a+b–)? d. Anti-Lub
a. A/O Lele HH Sese
b. A/A Lele HH sese 19. Antibodies to antigens in which of the following
c. A/O LeLe hh SeSe blood groups are known for showing dosage?
d. A/A LeLe hh sese a. I
b. P
10. Anti-LebH will not react or will react more weakly c. Kidd
with which of the following RBCs? d. Lutheran
a. Group O Le(b+)
b. Group A2 Le(b+) 20. Which antibody is most commonly associated with
c. Group A1 Le(b+) delayed hemolytic transfusion reactions?
d. None of the above a. Anti-s
b. Anti-k
11. Which of the following best describes MN antigens c. Anti-Lua
and antibodies? d. Anti-Jka
a. Well developed at birth, susceptible to enzymes,
generally saline reactive 21. Anti-U will not react with which of the following
b. Not well developed at birth, susceptible to enzymes, RBCs?
generally saline reactive a. M+N+S+s–
c. Well developed at birth, not susceptible to enzymes, b. M+N–S–s–
generally saline reactive c. M–N+S–s+
d. Well developed at birth, susceptible to enzymes, d. M+N–S+s+
generally antiglobulin reactive
22. A patient with an M. pneumoniae infection will most
12. Which autoantibody specificity is found in patients likely develop a cold autoantibody with specificity to
with paroxysmal cold hemoglobinuria? which antigen?
a. Anti-I a. I
b. Anti-i b. i
c. Anti-P c. P
d. Anti-P1 d. P1

13. Which of the following is the most common 23. Which antigen is destroyed by enzymes?
antibody seen in the blood bank after ABO and Rh a. P1
antibodies? b. Jsa
a. Anti-Fya c. Fya
b. Anti-k d. Jka
c. Anti-Jsa
d. Anti-K CHAPTER 9
1. The antibody to this high-prevalence antigen demon
14. Which blood group system is associated with strates mixed-field agglutination that appears shiny
resistance to P. vivax malaria? and refractile under the microscope.
a. P a. Vel
b. Kell b. JMH
c. Duffy c. Jra
d. Kidd d. Sda

15. The null Ko RBC can be artificially prepared by 2. What red blood cell treatment can be used to
which of the following treatments? differentiate between anti-D and anti-LW?
a. Ficin and DTT a. Ficin
b. Ficin and glycine-acid EDTA b. Trypsin
c. DTT and glycine-acid EDTA c. DTT
d. Glycine-acid EDTA and sialidase d. Papain

16. Which antibody does not fit with the others with 3. Which of the following has been associated with
respect to optimum phase of reactivity? causing severe immediate HTRs?
a. Anti-S a. Anti-JMH
b. Anti-Lub 13. Which antigen when absent produces a null in the
c. Anti-Vel Dombrock system?
d. Anti-Sda a. Hy
4. Which of the following antibodies would more likely b. Joa
be found in a black patient? c. Dob
a. Anti-Cra d. Gya
b. Anti-Ata
c. Anti-Hy 14. Which antigens are strongly expressed on placental
d. All of the above tissue, allowing for the adsorption of antibodies?
5. Which of the following antigens is not in a blood a. Cromer
group system? b. Knops
a. Doa c. Diego
b. LKE d. Vel
c. JMH
d. Kx 15. Which antigen was returned to the 901 series
because there was no determined linkage to the SMIM1
6. A weakly reactive antibody with a titer of 128 is gene?
neutralized by plasma. Which of the following could be a. JMH
the specificity? b. Ata
a. Anti-JMH c. ABTI
b. Anti-Ch d. MAM
c. Anti-Kna
d. Anti-Kpa 16. The FORS blood group system was first thought to
be part of what system due to the addition of
7. An antibody reacted with untreated RBCs and DTT N-acetylgalactosamine (GalNAc) to the P antigen?
treated RBCs but not with ficin-treated RBCs. Which a. ABO
of the following antibodies could explain this pattern of b. Lewis
reactivity? c. P1PK
a. Anti-JMH d. Globoside
b. Anti-Yta
c. Anti-Cra 17. What glycophorin expresses the MN CHO collection
d. Anti-Ch antigens that are associated with altered levels of
sialic acid (NeuNAc) or GlcNAc?
8. The following antibodies are generally considered a. GPA
clinically insignificant because they have not been b. GPB
associated with causing increased destruction of RBCs, c. GPC
HDFN, or HTRs. d. GPD
a. Anti-Doa and anti-Coa
b. Anti-Ge3 and anti-Wra 18. What techniques can be used to remove the
c. Anti-Ch and anti-Kna reactivity of Bg antigens?
d. Anti-Dib and anti-Yt a. EDTA/glycine-HCL
b. Platelet adsorption
9. Which antigen is the receptor for Haemophilus c. Chloroquine treatment
influenza? d. All of the above
a. AnWj
b. PEL 19. ABTI was thought to be classified with which
c. FORS antigen prior to it gaining system status?
d. Kna a. Jra
b. FORS1
10. Which antigen is not absent or is weakened on c. Vel
RBCs of individuals with PNH? d. Lan
a. Yta
b. Cra 20. The Jr(a–) phenotype is found more commonly in:
c. CD59 a. Japanese.
d. Coa b. African Americans.
c. South American Indians.
11. Which of the following blood groups is carried on a d. Caucasians.
structure that helps to maintain the RBC membrane
integrity through interaction with protein band 4.1? CHAPTER 10
a. Di 1. Based on the following phenotypes, which pair of
b. Kn cells
c. Ge would make the best screening cells?
d. Vel a. Cell 1: Group A, D+C+c–E–e+, K+, Fy(a+b–), Jk(a+b–),
M+N–S+s–
12. What is the name of the Knops system serologic Cell 2: Group O, D+C–c+E+e–, K–, Fy(a–b+), Jk(a–b+),
null M–N+S–s+
phenotype? b. Cell 1: Group O, D–C–c+E–e+, K–, Fy(a–b+), Jk(a+b+),
a. Gregory M+N–S+s+
b. Leach Cell 2: Group O, D+C+c–E–e+, K–, Fy(a+b–), Jk(a+b–),
c. Helgeson M–N+S–s+
d. McLeod c. Cell 1: Group O, D+C+c+E+e+, K+, Fy(a+b+), Jk(a+b+),
M+N–S+s+
Cell 2: Group O, D–C–c+E–e+, K–, Fy(a+b–), Jk(a+b+), b. One additional E-positive, K-negative cell to react
M+N+S–s+ positively and one additional K-positive, E-negative
d. Cell 1: Group O, D+C+c–E–e+, K+, Fy(a–b+), Jk(a–b+), cell to react positively
M–N+S–s+ c. Two Jkb homozygous positive cells to react posi
Cell 2: Group O, D- C–c+E+e–, K–, Fy(a+b–), Jk(a+b–), tively and one Jkb heterozygous positive cell to react
M+N–S+s– negatively
d. No additional cells are needed
2. Antibodies are excluded using RBCs that are
homozygous for the corresponding antigen because: 10. Using the panel (Fig. 10–18), select cells that would
a. Antibodies may show dosage make appropriate controls when typing for the C
b. Multiple antibodies may be present antigen.
c. It results in a P value of 0.05 for proper identification a. Cell number 1 for the positive control and cell num
of the antibody ber 2 for the negative control
d. All of the above b. Cell number 1 for the positive control and cell num
3. A request for 8 units of RBCs was received for ber 6 for the negative control
patient LF. The patient has a negative antibody screen, c. Cell number 2 for the positive control and cell num
but 1 of the 8 units was 3+ incompatible at the AHG ber 4 for the negative control
phase. Which of the following antibodies may be the d. Cell number 4 for the positive control and cell num
cause? ber 5 for the negative control
a. Anti-K
b. Anti-Lea 11. Which of the following methods may be employed to
c. Anti-Kpa remove IgG antibodies that are coating a patient’s red
d. Anti-Fyb blood cells?
a. Adsorption
4. The physician has requested 2 units of RBCs for b. Elution
patient DB, who has two antibodies, anti-L and anti-Q. c. Neutralization
The frequency of antigen L is 45%, and the frequency of d. Titration
antigen Q is 70% in the donor population.
Approximately how many units will need to be 12. A technologist has decided to test an enzyme-
antigen-typed for L and Q to treated panel of RBCs against a patient’s serum. Which
fill the request? of the following antibody pairs could be separated
a. 8 using this technique?
b. 12 a. Anti-Jka and anti-Jkb
c. 2 b. Anti-S and anti-Fya
d. 7 c. Anti-D and anti-C
d. Anti-Jka and anti-Fya
5. Anti-Sda has been identified in patient ALF. What
substance would neutralize this antibody and allow 13. An antibody demonstrates weak reactivity at the
detection of other alloantibodies? AHG phase when the tube method is used with no
a. Saliva enhancement reagent and monospecific anti-IgG AHG
b. Hydatid cyst fluid reagent. When repeating the test, which of the
c. Urine following actions may increase the strength of the
d. Human breast milk positive reactions?
a. Adding an enhancement reagent, such as LISS or
6. Patient JM appears to have a warm autoantibody. PEG
She was transfused 2 weeks ago. What would be the b. Decreasing the incubation time from 30 minutes to
next step performed to identify any alloantibodies that 10 minutes
might be in her serum? c. Employing the prewarm technique
a. Acid elution d. Decreasing the incubation temperature to 18°C
b. Warm autoadsorption using autologous cells
c. Warm differential adsorption CHAPTER 11
d. RESt adsorption 1. Which is not included on a properly labeled
specimen?
7. What is the titer and score for this prenatal anti-D a. Two unique patient identifiers
titer? b. Date and time of draw
(Refer to Fig. 10–17.) c. Phlebotomist’s initials
a. Titer = 64; score = 52 d. Patient’s home address
b. Titer = 1:32; score = 15
c. Titer = 64; score = 21 2. How many days before a pretransfusion specimen
d. Titer = 32; score = 52 expires?
a. 3 days
8. Select the antibody(ies) most likely responsible for b. 7 days
the reactions observed. c. 14 days
a. Anti-E and anti-K d. 1 month
b. Anti-Fya
c. Anti-e 3. How many days must a pretransfusion specimen
d. Anti-Jkb and donor unit segments be retained post-transfusion?
a. 3 days
9. What additional cells need to be tested to be 95% b. 7 days
confident that the identification is correct? c. 14 days
a. Three e-negative cells that react negatively and one d. 1 month
additional e-positive cell that reacts positively 4. If a blood type cannot be resolved, what ABO group
should be selected for a red blood cell transfusion? c. Positive for sickling hemoglobin
a. Group A d. Irradiated
b. Group B
c. Group O 13. A patient with sickle cell disease is B-positive with
d. Group AB a positive antibody screen. The antibody identified is
anti-D, and the autocontrol is negative. What is a
5. Which antibody specificity is not required in antibody possible explanation?
detection tests? a. The patient is weak D-positive
a. K b. Autoantibody is present
b. Cw c. Patient possesses the partial D phenotype
c. Fya d. The patient has a positive DAT
d. S
CHAPTER 12
6. A patient has a history of anti-Jka. The antibody 1. The endpoint of the CAT test is detected by:
screen is currently negative. Which red blood cell unit a. Agglutination.
should be selected, and what type of crossmatch b. Hemolysis.
should be performed? c. Precipitation.
a. Jk(a-) red blood cells, computer crossmatch d. Attachment of indicator cells.
b. Jk(a-) red blood cells, antiglobulin crossmatch
c. Jk(a-) red blood cells, immediate spin crossmatch 2. The endpoint of the SPRCA test is detected by:
d. ABO-compatible because the antibody screen is a. Agglutination.
negative b. Hemolysis.
c. Precipitation.
7. Which is not true of rouleaux formation? d. Attachment of indicator cells.
a. Mimics agglutination
b. Appears like a “stacking of coins” 3. The endpoint of the solid-phase protein A assay is:
c. Can be seen in the antiglobulin test a. Agglutination.
d. Can be dispersed by saline b. Hemolysis.
c. Precipitation.
8. A patient’s blood type is AB-negative, but there are d. Attachment of cells to microwell.
no AB-negative red blood cell units available. What
donor units could be selected? 4. Protein A captures antibodies by binding to the:
a. A-negative a. Fab portion of immunoglobulin.
b. O-positive b. Fc portion of immunoglobulin.
c. B-positive c. Surface of test cells.
d. All of the above d. Surface of indicator cells.

9. A patient requires 15 units of thawed plasma for 5. Mixed-field reactions can be observed in:
an apheresis procedure. The patient’s blood type is a. Gel.
O-negative. What donor units could be selected? b. SPRCA.
a. O-negative c. Protein A technology.
b. AB-positive d. None of the automated technologies.
c. A-negative
d. All of the above 6. An advantage for both CAT and solid-phase
technology is:
10. The American College of Surgeons recommends a. No cell washing steps.
transfusion of red blood cells, thawed plasma, and b. Standardization.
platelets in what ratio for a massive transfusion? c. Use of IgG-coated control cells.
a. 2 units of red blood cells for every unit of platelets d. Specialized equipment.
b. 1 unit of red blood cells to 1 unit of thawed plasma
to 1 unit of platelets 7. A disadvantage for both CAT and solid-phase
c. 1 unit of red blood cells to 3 units of thawed plasma technology is:
d. It’s an emergency. Give the surgeon whatever she a. Decreased sensitivity.
wants b. Inability to test hemolyzed, lipemic, or icteric
samples.
11. A patient’s antibody screen was positive and an c. Inability to detect C3d complement–coated cells.
anti-c was identified. Antiglobulin crossmatches were d. Large sample requirement.
performed with c-negative units and 1 of the 6 units
was incompatible. What should be performed to 8. A safety feature in the SPRCA test is:
resolve the incompatible crossmatch? a. Air bubble barrier.
a. Give O-negative red blood cells b. Viscous barrier.
b. Retype the incompatible unit for the c antigen c. Color change of the LISS.
c. Perform a DAT on the incompatible unit d. Use of IgG-coated control cells
d. Perform additional identification testing to include
low-specificity antigens e. b, c, and d
CHAPTER 13
1. Which of the following information is not required for
12. A mother, 30 weeks’ pregnant, has anti-K with a
whole blood donation?
titer of 32. An intrauterine red blood cell transfusion is
a. Name
indicated. The donor unit selected should be all of the
b. Address
following except:
c. Transfusion history
a. O-negative
d. Sex
b. K-negative
e. Date of Birth
2. Which of the following would be cause for deferral c. A male who had sex with another male last month
for a male donor? d. A female who had sex with a male 9 months ago
a. Temperature of 99.2°F
b. Hematocrit of 37% 12. What does “infrequent” refer to when talking about
c. Spent 2 weeks in the United Kingdom in 1998 a plasmapheresis program?
d. Weighs 80 kg a. Donating no more frequently than once every 4
e. Received a blood transfusion 2 years ago weeks
b. Donating once a year
3. Which of the following would be cause for a c. Donating once every 6 months
permanent deferral? d. Donating no more frequently than once every 8
a. Received a dura mater graft 9 months ago weeks
b. Received hepatitis B immune globulin
c. Is currently on warfarin 13. A patient is having an exploratory laparotomy
d. Diagnosis of babesiosis performed and donated blood for use in the patient’s
e. Traveled to Senegal 2 years ago upcoming surgery. Three units were collected, with the
last unit collected 2 days before surgery. Given this
4. Immunization for rubella would result in a information, can the patient undergo surgery as
temporary deferral for: planned?
a. 4 weeks. a. Yes
b. 8 weeks. b. No
c. 6 months.
d. 1 year. 14. Which of the following refers to a temporary
e. 3 years. deferral?
a. Donor received varicella zoster live attenuated
5. Which of the following donors is acceptable? vaccine
a. Donor who had a first-trimester abortion 4 weeks b. Donor had a confirmed positive test for HBsAg
ago c. Donor has a history of CJD
b. Donor whose husband is a hemophiliac who regu d. Donor was diagnosed with babesiosis
larly received cryoprecipitate before 1989
c. Donor who was treated for gonorrhea 6 months ago 15. Which of the following carries a 12-month deferral?
d. Donor who had a needle-stick injury 10 months ago a. Donor received Hepatitis B immune globulin
b. Donor received pituitary growth hormone from
6. Which of the following tests is not required as part another human
of the donor-processing procedure for allogeneic c. Donor received the MMR vaccine
donation? d. Donor spent 10 years in Africa
a. ABO
b. Rh CHAPTER 14
c. STS 1. The fecal-oral route is common in transmitting
d. Anti-HTLV-I which of these hepatitis viruses?
e. Anti-CMV a. HAV and HEV
b. HBV and HCV
7. How long must a 2-unit RBC donor wait before c. HDV
donating red blood cells again? d. HGV
a. 8 weeks
b. 16 weeks 2. Which of the following is the component of choice
c. 6 months for a low-birth-weight infant with a hemoglobin of 8
d. 12 months g/dL if the mother is anti-CMV negative?
a. Whole blood from a donor with anti-CMV
8. What is the deferral period for Plavix? b. RBCs from a donor who is anti-CMV negative
a. 14 days after last dose c. Leukoreduced platelets
b. 1 month after last dose d. Solvent detergent–treated plasma
c. 12 months after last dose
d. 48 hours after last dose 3. Which of the following is an FDA-licensed screening
test for HCV?
9. All of the following records must be kept for 10 a. NAT + anti-HBc
years, except: b. RIBA
a. Unique ID of each unit. c. Lymph node biopsy
b. Donor consent. d. HCV RNA
c. Request for blood or blood component.
d. A signed statement from requesting physician for 4. Currently, which of the following does the AABB con
emergency release. sider to be the most significant infectious threat from
transfusion?
10. What is the causative agent of Chagas disease? a. Bacterial contamination
a. Trypanosoma cruzi b. CMV
b. Yersinia pestis c. Hepatitis
c. Treponema pallidum d. HIV
d. Plasmodium falciparum
5. Which of the following is the most frequently
11. Which of the following donors would be rejected for transmitted virus from mother to fetus?
whole blood donation? a. HIV
a. A male who had sex with another male in 1988 b. Hepatitis
b. A female who had sex with a male in 1992 c. CMV
d. EBV d. Monocytes

6. Jaundice due to HAV is seen most often in the: 16. Fifth disease is caused by:
a. Adolescent a. CMV
b. Adult b. EBV
c. Child younger than 6 years old c. Parvovirus B19
d. Newborn d. HTLV-II

7. Currently, steps taken to reduce transfusion- 17. Transient aplastic crisis can occur with:
transmitted CMV include: a. Parvovirus B19
a. Plaque reduction neutralization test b. WNV
b. NAT testing c. CMV
c. Leukoreduction d. EBV
d. Minipool screening
18. Reasons why syphilis is so rare in the U.S. blood
8. HBV remains infectious on environmental surfaces supply include all of the following except:
for 1: a. 4°C storage conditions
a. Day b. Donor questionnaire
b. Week c. Short spirochetemia
c. Month d. NAT testing
d. Year
19. Nucleic acid amplification testing for HIV was
9. HBV is transmitted most frequently: instituted in donor testing protocols to:
a. By needle sharing among IV drug users a. Identify donors with late-stage HIV who lack
b. Through blood transfusions antibodies
c. By unknown methods b. Confirm the presence of anti-HIV in asymptomatic
d. By sexual activity HIV-infected donors
c. Reduce the window period by detecting the virus
10. Which of the following is the most common cause earlier than other available tests
of chronic hepatitis, cirrhosis, and hepatocellular carci d. Detect antibodies to specific HIV viral proteins,
noma in the United States? including anti-p24, anti-gp41, and anti-gp120
a. HAV
b. HBV 20. Screening for HIV is performed using the following
c. HCV technique:
d. HDV a. Radio immunoassay
b. WB
11. The first retrovirus to be associated with human dis c. Immunofluorescent antibody assay
ease was: d. NAT
a. HCV
b. HIV 21. The first form of pathogen inactivation was:
c. HTLV-I a. Chemical
d. WNV b. Heat
c. Cold-ethanol fractionation
12. All of the following statements are true concerning d. Anion-exchange chromatography
WNV except:
a. 1 in 150 infections results in severe neurological 22. What is the most common parasitic complication of
disease transfusion?
b. Severe disease occurs most frequently in the over- a. Babesia microti
50 age group b. Trypanosoma cruzi
c. Deaths occur more often in those over 65 years who c. Plasmodium species
present with encephalitis d. Toxoplasma gondii
d. Fatalities occur in approximately 38% of infected
individuals 23. Which organism has a characteristic C- or U-shape
on stained blood smears?
13. The primary host for WNV is: a. Trypanosoma cruzi
a. Birds b. Plasmodium vivax
b. Horses c. Plasmodium falciparum
c. Humans d. Babesia microti
d. Bats
24. Which transfusion-associated parasite may have
14. Tests for WNV include all of the following except: asymp
a. ELISA tomatic carriers?
b. NAT a. Babesia microti
c. Plaque reduction neutralization test b. Trypanosoma cruzi
d. Immunofluorescent antibody assay c. Plasmodium species
d. All of the above
15. Individuals exposed to EBV maintain an
asymptomatic 25. Which disease is naturally caused by the bite of a
latent infection in: deer tick?
a. B cells a. Chagas disease
b. T cells b. Babesiosis
c. All lymphocytes c. Malaria
d. Leishmaniasis which of the following?
a. Factor IX deficiency
CHAPTER 15 b. Factor VIII deficiency
1. Which of the following lists the correct shelf life for c. Factor XII deficiency
the component? d. Factor XIII deficiency
a. Deglycerolized RBCs—24 hours e. Factor V deficiency
b. RBCs (CPD)—35 days
c. Platelet concentrate—10 days 10. RBCs that have been leukoreduced must contain
d. FFP—5 years less than ______ leukocytes and retain at least ______ of
e. RBCs (CPDA-1)—21 days original RBCs.
a. 8 × 106/85%
2. Each unit of cryoprecipitate prepared from whole b. 8 × 106/90%
blood should contain a minimum of how many units of c. 5 × 106/85%
AHF activity? d. 5 × 106/80%
a. 40 IU
b. 80 IU 11. Random-donor platelets that have been
c. 120 IU leukoreduced must contain less than ______ leukocytes.
d. 160 IU a. 8.3 × 105
e. 180 IU b. 8 × 106
c. 5 × 106
3. Platelet concentrates prepared by apheresis should d. 3 × 1011
contain how many platelets?
a. 5.5 × 1010 12. A single unit of FFP or PF24 should contain ______
b. 6 × 1010 mL of plasma.
c. 3 × 1011 a. 100–150
d. 5.5 × 1011 b. 200–400
e. 6 × 1011 c. 150–250
d. 50–150
4. The required storage temperature for frozen RBCs
using the high-glycerol method is: 13. Cryoprecipitate that has been pooled in an open
a. 4°C system must be transfused within ______ hours.
b. ≤–20°C a. 24
c. ≤–18°C b. 6
c. 4
d. ≤–120°C
d. 8
e. ≤–65°C

5. How does irradiation affect the shelf life of red blood CHAPTER 16
cells? 1. Leukocyte-reduced filters can do all of the following
a. Irradiation has no effect on the shelf life except:
b. The expiration date is 28 days from the date of irradi a. Reduce the risk of CMV infection
ation or the original outdate, whichever is later b. Prevent or reduce the risk of HLA alloimmunization
c. The expiration date is 28 days from the date of irradi c. Prevent febrile, nonhemolytic transfusion reactions
ation or the original outdate, whichever is sooner d. Prevent TA-GVHD
d. The expiration date is 25 days from the date of irradi
ation or the original outdate, whichever is later 2. Albumin should not be given for:
e. The expiration date is 25 days from the date of irradi a. Burns
ation or the original outdate, whichever is sooner b. Shock
c. Nutrition
6. Once thawed, FFP must be transfused within d. Plasmapheresis
__________ hours unless relabeled as thawed plasma:
a. 4 3. Of the following, which blood type is selected when
b. 6 a patient cannot wait for ABO-matched RBCs?
c. 8 a. A
d. 12 b. B
e. 24 c. O
d. AB
7. Quality control for nonadditive RBCs requires a maxi
mum hematocrit level of: 4. Which patient does not need an irradiated
a. 75% component?
b. 80% a. Bone marrow transplant recipient
c. 85% b. Neonate weighing less than 1,200 g
d. 90% c. Adult receiving an RBC transfusion
e. 95% d. Adult receiving an RBC transfusion from a blood
Relative
8. AHF concentrates are used to treat:
a. Thrombocytopenia 5. RBC transfusions should be given:
b. Hemophilia A a. Within 4 hours
c. Hemophilia B b. With lactated Ringer solution
d. von Willebrand’s disease c. With dextrose and water
e. Factor XIII deficiency d. With cryoprecipitate

9. Prothrombin complex concentrates are used to treat

6. Which type of transplantation requires all cellular b. Unexplained decrease in hemoglobin
blood components to be irradiated? c. Active bleeding
a. Bone marrow d. Hives
b. Heart
c. Liver 7. Which transfusion reaction presents with fever,
d. Kidney maculopapular rash, watery diarrhea, abnormal liver
function, and pancytopenia?
7. Characteristics of deglycerolized RBCs include the a. Transfusion-associated sepsis
following except: b. Transfusion-related acute lung injury
a. Inexpensive c. Transfusion-associated graft-versus-host disease
b. 24-hour expiration date after thawing d. Transfusion-associated allergic reaction
c. Used for rare antigen-type donor blood
d. Used for IgA-deficient recipient with history of 8. A suspected transfusion-related death must be
severe reaction reported to:
a. AABB
8. Select the appropriate product for a bone marrow b. Federal and Drug Administration (FDA)
transplant patient with anemia: c. College of American Pathologists (CAP)
a. RBCs d. The Joint Commission (TJC)
b. Irradiated RBCs
c. Leukoreduced RBCs 9. Nonimmune hemolysis can be caused during transfu
d. Washed RBCs sion by:
a. Use of small bore size needle
9. Which blood product should be selected for vitamin b. Use of an infusion pump
K deficiency? c. Improper use of a blood warmer
a. Cryoprecipitate d. All of the above
b. Factor VIII
c. Factor IX 10. Transfusion reactions are classified according to:
d. Plasma a. Signs or symptoms presenting during or after
24 hours
10. Which fluid should be used to dilute RBCs? b. Immune or nonimmune
a. 0.9% saline c. Infectious or noninfectious
b. 5% dextrose and water d. All of the above
c. Immune globulin
d. Lactated Ringer solution 11. With febrile nonhemolytic transfusion reactions:
a. They are self-limited
CHAPTER 17 b. Fever resolves within 2–3 hours
1. What component is most frequently involved with c. Treatment is required
transfusion-associated sepsis? d. a and b are correct
a. Plasma e. All of the above
b. Packed red blood cells
c. Platelets 12. Absolute IgA deficiency is a classic example of a
d. Whole blood severe allergic reaction. A result indicating an
absolute IgA deficiency is:
2. Fatal transfusion reactions are mostly caused by: a. <0.05 mg/dL
a. Serologic errors b. <0.50 mg/dL
b. Improper storage of blood c. <0.50 gm/dL
c. Clerical errors d. <5 mg/dL
d. Improper handling of the product
13. How are mild allergic transfusion reactions with
3. Early manifestation of an acute hemolytic isolated symptoms or hives and urticaria treated?
transfusion reaction can be confused with: a. Transfusion is stopped and transfusion reaction
a. Allergic reaction workup is initiated
b. Febrile nonhemolytic reaction b. Transfusion is stopped and antihistamines admin
c. Anaphylactic shock istrated; when symptoms improve, transfusion is
d. Sepsis restarted
c. Stop transfusion and prepare washed red blood
4. Pain at infusion site and hypotension are observed cells
with what type of reaction? d. Continue transfusion with a slower infusion rate
a. Delayed hemolytic transfusion reaction
b. Acute hemolytic transfusion reaction 14. TRALI presents with the following symptoms:
c. Allergic reaction a. Respiratory distress
d. Febrile nonhemolytic reaction b. Severe hypoxemia and hypotension
c. Fever
5. Irradiation of blood is performed to prevent: d. All of the above
a. Febrile nonhemolytic transfusion reaction
b. Delayed hemolytic transfusion reaction 15. Which of the following is characteristic of iron
c. Transfusion-associated graft-versus-host disease overload?
d. Transfusion-associated circulatory overload a. Delayed, nonimmune complication occurs
b. Chelating agents are used
6. The only presenting sign most often accompanying a c. Multiorgan damage may occur
delayed hemolytic transfusion reaction is: d. All of the above
a. Renal failure
 a. DDAVP
b. Hydroxyethyl starch (HES)
CHAPTER 18
c. Immune globulin
1. The most common anticoagulant used for apheresis
d. G-CSF
procedures is:
a. Heparin
b. Sodium fluoride CHAPTER 19
c. Warfarin 1. When an HPC donor is unrelated to the recipient of
d. Citrate an HPC transplantation, the transplant is categorized
as:
2. Therapeutic cytapheresis has a primary role in a. Allogeneic
treatment of patients with: b. Autologous
a. Sickle cell disease and acute chest syndrome c. Syngeneic
b. Systemic lupus erythematosus to remove immune d. Hematopoietic
complexes
c. Leukemia to help increase granulocyte production 2. Stem cells from HPC donors may be mobilized with:
d. Myasthenia gravis to increase antibody production a. Plerixafor
b. Filgrastim (GCSF)
3. The minimum interval allowed between c. Chemotherapy
plateletpheresis component collection procedures is: d. All of the above
a. 1 day
b. 2 days 3. Which is an advantage of an HPC transplant using
c. 7 days umbilical cord blood as the HPC source?
d. 8 weeks a. Recipient weight of no concern
b. Donor screening and testing abbreviated
4. In plasma exchange, the therapeutic effectiveness is: c. Higher risk of GVHD
a. Greatest with the first plasma volume removed d. No significant risk to the donor or mother
b. Affected by the type of replacement fluid used
c. Enhanced if the unwanted antibody is IgG rather 4. The recommended minimum number of CD34+ cells
than IgM required in an HPC-apheresis collection to ensure
d. Independent of the use of concomitant immunosup timely engraftment is:
pressive therapy a. 2 × 102 CD34+ cells/kg
b. 2 × 104 CD34+ cells/kg
5. The replacement fluid indicated during plasma c. 2 × 106 CD34+ cells/kg
exchange d. 2 × 108 CD34+ cells/kg
for TTP is:
a. Normal (0.9%) saline 5. The cellular marker used to quantify the collection
b. Hydroxyethyl starch (HES) of HPCs using flow cytometry is:
c. FFP a. CD4
d. Albumin (human) 5% b. CD33
c. CD34
6. The most common adverse effect of plateletpheresis d. CD59
collection is:
a. Allergic reaction 6. An A patient received an HPC transplant from a B
b. Hepatitis donor. What type of ABO mismatch does this represent?
c. Hemolysis a. Major
d. Citrate effect b. Minor
c. Bidirectional
7. Apheresis technology can be used to collect each of d. Any of the above
the following components except:
a. Leukocytes 7. Which of the following terms describe an HPC trans
b. Macrophages plant where donor and recipient are the same person?
c. Hematopoietic progenitor cells a. Allogeneic
d. Platelets b. Autologous
c. Syngeneic
8. The anticoagulant added to blood as it is removed d. Hematopoietic
from a donor or patient during an apheresis procedure
acts by: 8. Three weeks after sustaining a car accident that
a. Binding calcium ions required emergency transfusion of blood products for
b. Increasing intracellular potassium resuscitation, an allogeneic HPC transplant recipient
c. Binding to antithrombin III developed a fever, erythematous skin rash, diarrhea,
d. Inactivating factor V and cytopenias, which ultimately were fatal. What
intervention may have prevented this outcome?
9. Peripheral blood stem cells are: a. The use of leukoreduced blood products
a. Responsible for phagocytosis of bacteria b. The use of irradiated of blood products
b. Removed during erythrocytapheresis c. The use of CMV-negative blood products
c. Pluripotential hematopoietic precursors that d. The use of washed blood products
circulate in the peripheral blood
d. Lymphocytes involved with the immune response 9. What common cryoprotectant is added to HPC
products for freezing?
10. Which of the following can be given to an apheresis a. Dimethyl sulfoxide
donor to increase the number of circulating b. Polyethylene glycol
granulocytes? c. Glycerol
d. Normal saline b. ABO antibodies prevent the disease itself
c. ABO antibodies readily cross the placenta
10. An O patient received an HPC transplant from a B d. ABO incompatibility is rare
donor. What type of ABO mismatch does this represent?
a. Major 10. A woman without prenatal care delivers a healthy
b. Minor term infant. A cord blood sample shows the infant is
c. Bidirectional A-positive with a positive DAT. The workup of the
d. Any of the above unexpected finding should include:
a. Anti-C3 antiglobulin test
CHAPTER 20 b. ABO testing of the mother
1. The etiology of HDFN is characterized by: c. Direct antiglobulin testing of the mother’s specimen
a. IgM antibody d. ABO and Rh typing of the father
b. Nearly always anti-D
c. Different RBC antigens between mother and father CHAPTER 21
d. Antibody titer less than 32 1. Immune hemolytic anemias may be classified in
which of the following categories?
2. An important difference between the fetus and the a. Alloimmune
newborn physiology is: b. Autoimmune
a. Bilirubin metabolism c. Drug-induced
b. Maternal antibody level d. All of the above
c. Presence of anemia
d. Size of RBCs 2. When preparing cells for a cold autoadsorption
procedure, it is helpful to pretreat the cells with which
3. Kernicterus is caused by the effects of: of the following?
a. Anemia a. Dithiothreitol
b. Unconjugated bilirubin b. Ficin
c. Antibody specificity c. Phosphate-buffered saline at pH 9
d. Antibody titer d. Bovine albumin

4. The advantage of middle cerebral artery peak 3. The blood group involved in the autoantibody
systolic velocity Doppler (MCA-PSV) is that it is: specificity in PCH is:
a. Able to measure fetal hemoglobin and hematocrit a. P.
levels b. ABO.
b. Able to support antigen typing of fetal blood using c. Rh.
DNA d. Lewis.
c. Helpful for direct transfusion of fetal circulation
d. Noninvasive and decreases risk of adverse events 4. Which of the following blood groups reacts best with
an anti-H or anti-IH?
5. Blood for intrauterine transfusion (IUT) should be: a. O
a. Irradiated, leukocyte reduced, more than 7 days old, b. B
HbS negative c. A2
b. Irradiated, leukocyte reduced, less than 7 days old, d. A1
HbS positive
c. Irradiated, leukocyte reduced, less than 7 days old, 5. With cold-reactive autoantibodies, the protein
HbS negative coating the patient’s cells and detected in the DAT is:
d. Irradiated, leukocyte reduced, more than 7 days old, a. C3.
HbS positive b. IgG.
c. C4.
6. RhIG is indicated for: d. IgM.
a. Mothers who have anti-D due to allosensitization
b. Infants who are RhD-negative 6. Problems in routine testing caused by cold-reactive
c. Infants who have anti-D autoantibodies can usually be resolved by all of the
d. Mothers who are RhD-negative following except:
a. Prewarming.
7. RhIG is given to RhD-negative mothers without b. Washing with warm saline.
regard for fetal RhD type in all of the following c. Using anti-IgG antiglobulin serum.
conditions except: d. Testing clotted blood specimens.
a. Ectopic pregnancy rupture
b. Full-term delivery 7. Pathological cold autoagglutinins differ from
c. Amniocentesis common cold autoagglutinins in:
d. Induced abortion a. Immunoglobulin class.
b. Thermal amplitude.
8. A Kleihauer-Betke test or flow cytometry indicates c. Antibody specificity.
10 fetal cells per 1,000 adult cells. For a woman with d. DAT results on EDTA specimen.
5,000-mL blood volume, the proper dose of RhIG is:
a. One regular-dose (300 µg) vial 8. Cold AIHA is sometimes associated with infection by:
b. Two regular-dose vials a. Staphylococcus aureus.
c. Three regular-dose vials b. Mycoplasma pneumoniae.
d. Four regular-dose vials c. Escherichia coli.
d. Group A Streptococcus.
9. ABO HDFN is usually mild because:
a. ABO antigens are poorly developed in the fetus
9. Many warm-reactive autoantibodies have a broad
specificity within which of the following blood groups?
a. Kell.
b. Duffy.
c. Rh.
d. Kidd.
10. Valid Rh typing can usually be obtained on a patient
with WAIHA using all of the following reagents or tech
niques except:
a. Slide and modified tube anti-D.
b. Chloroquine-treated RBCs.
c. Rosette test.
d. Monoclonal anti-D.
11. In pretransfusion testing for a patient with WAIHA,
the primary concern is:
a. Treating the patient’s cells with chloroquine for reli
able antigen typing.
b. Adsorbing out all antibodies in the patient’s serum
to be able to provide compatible RBCs.
c. Determining the exact specificity of the autoantibody
so that compatible RBCs can be found.
d. Discovering any existing significant alloantibodies in
the patient’s circulation.
12. Penicillin given in massive doses has been
associated with RBC hemolysis. Which of the classic
mechanisms is typically involved in the hemolytic
process?
a. Immune complex.
b. Drug adsorption.
c. Membrane modification.
d. Autoantibody formation.
13. Which of the following drugs has been associated
with complement activation and rapid intravascular
hemolysis?
a. Penicillins.
b. Quinidine.
c. Alpha-methyldopa.
d. Cephalosporins.
14. A patient is admitted with a hemoglobin of 5.6 g/dL.
Initial pretransfusion workup appears to indicate the
presence of a warm autoantibody in the serum and
coating his RBCs. His transfusion history indicates that
he received 6 units of RBCs 2 years ago after an
automobile accident. Which of the following would be
most helpful in performing antibody detection and
compatibility testing procedures?
a. Adsorb the autoantibody using the patient’s enzyme
treated cells.
b. Perform an elution and use the eluate for
compatibility
testing.
c. Crossmatch random units until compatible units are
found.
d. Collect blood from relatives who are more likely to
be compatible.
15. A patient who is taking Aldomet has a positive DAT.
An eluate prepared from his RBCs would be expected
to:
a. React only with Aldomet-coated cells.
b. Be neutralized by a suspension of Aldomet.
c. React with all normal cells.
d. React only with Rhnull cells.
16. One method that can be used to separate a patient’s
RBCs from recently transfused donor RBCs is:
a. Chloroquine diphosphate treatment of the RBCs.
b. Reticulocyte harvesting.
c. EGA treatment.
d. Donath-Landsteiner testing.
17. Monoclonal antisera is valuable in phenotyping
RBCs with positive DATs because:
a. Both polyspecific and monospecific antihuman
serum can be used in antiglobulin testing.
b. Anti-C3 serum can be used in antiglobulin testing.
c. It usually does not require antiglobulin testing.
d. It does not require enzyme treatment of the cells
prior to antiglobulin testing.
18. Autoadsorption procedures to remove either warm
or cold autoantibodies should not be used with a
recently transfused patient. Recently means:
a. 3 days.
b. 3 weeks.
c. 6 weeks.
d. 3 months.
CHAPTER 22
1. Implant records must be kept for what duration?
a. Ten years after the tissue has been harvested
b. Indefinitely
c. For a reasonable time to ensure that the recipient is
not still alive when records are destroyed
d. Ten years following the disposition or expiration of
the tissue
2. FDA CFR 1270 and 1271 include all of the following
tissues except:
a. Cancellous bone chips
b. Blood vessels associated with vascular organs for
transplant
c. Cornea
d. Heart valve
3. Hospital tissue banks must register with the FDA if:
a. Tissue for transplant is stored
b. Autologous tissue is stored and issued
c. Tissue is transferred to another facility
d. The tissue bank is located outside the blood bank
4. The Joint Commission requires all of the following
except:
a. Hospital tissue banks must ensure that suppliers
are complying with applicable state laws
b. Tissue-manufacturing establishments must register
with the FDA
c. Hospitals must assign responsibility for overseeing
the tissue program throughout the organization
d. Hospital tissue banks must verify supplier’s
registration with the FDA yearly
5. The American Association of Tissue Banks (AATB) is:
a. A mandatory accrediting agency for all tissue banks
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
7. The medical director for the tissue bank can be:
a. Any individual appointed by the hospital medical
director
b. The lead supervisor in the blood bank
c. The head nurse/transplant coordinator from surgical 7. What is the molecular technique that detects
nursing undefined alleles?
d. A qualified physician involved in tissue transplant or a. Restriction fragment length polymorphism
blood banking b. Sequence-specific primer typing
c. Sequence-specific oligonucleotide typing
8. Notification of a recipient of tissue that has been d. Direct nucleotide sequencing
recalled because of possible contamination:
a. Should be conducted by the tissue bank director 8. What represents the association of the alleles on
only the two C6 chromosomes as determined by family
b. Should be conducted by the patient’s transplanting studies?
surgeon a. Haplotype
c. The patient does not need to be told unless an infec b. Genotype
tion develops c. Phenotype
d. The informed consent covers this contingency and d. Xenotype
no further notification is necessary
9. Which type of HSCT can be performed within a rela
9. Tissue receipt records must include all of the tively short period of time?
following except: a. Matched unrelated
a. Unique tissue identification number b. Cord blood
b. Name and address of tissue supplier c. Autologous
c. Expiration date d. HLA haploidentical
d. Tissue supplier’s FDA registration number
10. The SAB describes the amount of bound antibody
10. Records that must be reviewed to determine donor on each bead as:
eligibility by the tissue manufacturer include: a. MCS
a. Donor family history b. MFI
b. Records from any source pertaining to risk factors c. CDC
for d. AHG
communicable diseases
c. Interview of next-of-kin CHAPTER 24
d. Consent to harvest tissue 1. Among the combinations of attributes described
below, select the one that would not be suitable for a
CHAPTER 23 genetic system used in parentage testing analysis.
1. The HLA genes are located on which chromosome? a. The system has multiple alleles in Hardy-Weinberg
a. 2 equilibrium
b. 4 b. The system has a high mutation rate
c. 6 c. Databases of allele frequencies are available for all
d. 8 ethnic groups tested by the laboratory
d. All systems selected are genetically independent
2. The majority of HLA antibodies belong to what im from each other
munoglobulin class?
a. IgD 2. In which of the following genetic systems is the
b. IgE allele frequency distribution continuous (not discrete)?
c. IgG a. DNA polymorphisms by RFLP
d. IgM b. DNA polymorphisms by PCR
c. RBC antigens
3. What is the test of choice for HLA antigen testing? d. RBC enzymes
a. Agglutination
b. Molecular 3. A false direct exclusion in RBC antigen genetic
c. Cytotoxicity systems can be caused by:
d. ELISA a. A silent allele
b. A lack of precursor substance
4. Of the following diseases, which one has the highest c. An alternate untested allele
relative risk in association with an HLA antigen? d. Weak reagents
a. Ankylosing spondylitis
b. Juvenile diabetes 4. Among the following organizations, which one offers
c. Narcolepsy an accreditation program for parentage testing
d. Rheumatoid arthritis laboratories?
a. AABB
5. Why is HLA matching not feasible in cardiac b. ASCP
transplantation? c. FDA
a. No HLAs are present on cardiac cells d. HCFA
b. No donors ever have HLA antibodies CHAPTER 25
c. Total ischemic time is too long 1. A compliance program:
d. Total ischemic time is too short a. Evaluates how effectively the facility meets
regulatory requirements
6. DR52 molecules are the product of which alleles? b. Always identifies quality problems
a. DRA and DRB1 c. Is part of quality control
b. DRA and DRB3 d. Is an evaluation of efficiency
c. DRA and DRB4
d. DRA and DRB5 2. The quality system essentials are applied to:
a. The blood bank’s management staff
b. Blood bank quality control activities
c. Blood component manufacturing
d. The blood bank’s path of workflow
3. cGMP refers to:
a. Regulations pertaining to laboratory safety
b. Validation of testing
c. Nonconformance reporting
d. Manufacturing blood components
4. Internal and external failure costs are:
a. Readily identifiable in facility reports
b. Controlled through prevention and appraisal
c. Built into the facility’s operating budget
d. Part of prevention and appraisal
5. Which one statement below is correct?
a. A process describes how to perform a task
b. A procedure simply states what the facility will do
c. A procedure informs the reader how to perform a
task
d. A policy can be flowcharted
6. A blank form is a:
a. Record
b. Procedure
c. Flowchart
d. Document
7. An example of a remedial action is:
a. Applying the problem-solving process
b. Starting a process improvement team
c. Resolving the immediate problem
d. Performing an internal audit
8. The DMAIC methodology is used for:
a. Problem resolution
b. Process control
c. Validation
d. Auditing
9. ___________________________ is a set of planned
actions that ensure that systems and elements that in
fluence the quality of service are working as expected.
a. Quality control
b. Quality assurance
c. Quality indicator
d. Quality management system
10. The Centers for Medicare and Medicaid Services
(CMS) developed an alternative quality control option,
an individualized quality control plan (IQCP). How is
the minimum frequency of running quality controls
determined?
a. Through risk assessment
b. By the quality control plan
c. After quality assessment
d. By the manufacturer
CHAPTER 26
1. Which type of review does not require direct
discussion between the ordering clinician and
transfusion service personnel?
a. Discontinuous prospective
b. Targeted prospective
c. Concurrent
d. Retrospective
e. Prospective
2. Which of the following is the most important first
step in developing a comprehensive PBM/BUM
program?
a. Identification of a qualified transfusion safety officer
with excellent blood banking bench skills
b. Determination of patient populations within the hos
pital with the highest blood utilization
c. Creation of a multidisciplinary transfusion
committee to determine the category of blood
utilization review
d. Meet with key physician and nursing leadership to
facilitate the creation of a hospital-wide transfusion
guideline
e. Determine the estimated cost savings through the
implementation of an anemia clinic for elective
surgical patients
3. Optimal value as it relates to blood utilization is best
obtained by which of the following:
a. Development of standardized cost metric for blood
utilization
b. Reduction in variabilities in transfusion ordering
practice from evidence-based standards
c. Consistent reporting of outcome metrics such as
decreased sepsis or emergency room admissions
d. Decreasing peril and waste by encouraging
bloodless surgery and conversion to lower volume
phlebotomy tubes
e. Use of LEAN practices to improve value and prevent
waste by considering the ordering clinician as a
customer
4. To receive benefit from a transfusion the patient
must have:
a. A hemoglobin level less than 8 g/dL
b. An invasive procedure planned
c. A pathological lesion or deficiency that can be reme
died by functioning stored components
d. A blood order signed by the attending physician
e. Understood the risks, benefits and alternatives, and
given informed consent
5. Which of the following statements best describes
the most important reason for creating a PBM/BUM
program?
a. PBM/BUM decreases blood bank exposure to risk
management and litigation by promoting optimal docu
mentation of transfusion indication and expected
outcome within the electronic medical record
b. PBM/BUM reduces patient exposure to transfusion
associated acute lung injury (TRALI) through physician
education and by prospectively encouraging mitigation
strategies from the blood supplier
c. PBM/BUM improves patient safety by promoting
evidence-based transfusion, transfusion avoidance
strategies, and prevention of inappropriate transfusion
d. PBM/BUM are laboratory and hospital regulatory re
quirements that are essential for ensuring a hospital
culture that promotes patient safety through the peri
odic direct observation and assessment of transfusion
administration by nursing staff
e. PBM/BUM provides significant and substantial direct
and indirect cost savings to both patients and blood
banks by reducing the number of unnecessary or in
appropriate transfusions
6. Which of the following is an example of targeted
prospective review as it related to blood utilization?
a. Continuing education on the proactive use of iron to
correct anemia in presurgical patients
b. Viscoelastic testing to assess real-time platelet
need for cardiac surgery patients
c. Hematologist directed erythropoietin clinic for
anemic cancer patients prior to chemotherapy
d. Decision support pop-up restricted to routine orders
for two or more units of RBCs
e. Report of average RBC usage per patient for a
targeted
procedure or physician group
7. Which of the following pairs best describes an
intervention strategy that is best paired with a
utilization review category?
a. Minimize unnecessary phlebotomy loss,
discontinuous
prospective review
b. Periodic physician feedback, retrospective review
c. Annual continuing education for medical residents,
prospective review
d. Predictive modeling, retrospective review
e. Automatic cancellation of surgical blood orders, con
current review
8. The PBM program planning team should include:
a. Nursing representatives
b. Representatives from the facility’s practicing
clinicians
c. The blood bank medical director
d. A laboratorian who is knowledgeable in blood bank
policies and procedures
e. All of the above
9. Metrics should be:
a. Chosen to indicate progress during the process of
continuous improvement
b. Tracked and disseminated only to members of the
blood utilization management team
c. The same for all institutions
d. Selected only by the transfusion service leadership
e. Only qualitative in nature, since medical decision
making is a complex process
10. Which statement is most accurate regarding
continuous improvement as it relates to PBM/BUM?
a. Blood utilization metrics should be periodically con
verted to national standardized metrics
b. An example of an ideal PBM metric is the ratio of the
facility cost of one unit of RBCs divided by the re
gional red blood cell cost
c. Continuous improvement should be performed by a
different set of players than were used in the planning
process
d. Outcomes during prospective review should be lim
ited to the transfusion committee
e. Feedback loops and appropriate metrics are
required
to achieve long-term improvements
CHAPTER 27
1. Which of the following is responsible for overseeing
the safety of the nation’s blood supply?
a. Joint Commission on Accreditation of Healthcare
Organizations
b. Food and Drug Administration
c. College of American Pathologists (CAP)
d. Occupational Safety and Health Administration
2. Where are the regulations for blood and blood
components published?
a. The AABB Technical Manual
b. CAP inspection checklist
c. The Code of Federal Regulations
d. State Inspectional Guidance Documents
3. What was the important tragedy that led to the
regulation of biological products?
a. Three patients contracted hepatitis C following trans
fusion
b. A child died following transfusion of hemolyzed red
blood cells
c. A group O patient received group A blood
d. Thirteen children died after receiving diphtheria anti
toxin contaminated with tetanus
4. What is required to ship blood and blood
components across state lines (interstate)?
a. AABB accreditation
b. State license
c. CMS certification
d. Approved biologics license application
5. Which of the following government organizations in
spect blood and blood component manufacturers?
a. CBER
b. ORA
c. CMS
d. All of the above
6. Which of the following is true about CGMP?
a. CGMP is the minimum current practice for methods
and facilities used to manufacture a drug to ensure
that it is safe, pure, and potent
b. The FDA will approve a biologics license application
if the manufacturer does not have a quality control
plan
c. The quality control unit must perform all the quality
functions
d. Blood and blood components do not have to be in
compliance with the drug CGMP regulations
7. A donor calls the blood bank and informs them that
within a year prior to his donation, he had intimate con
tact with a person diagnosed with HIV. Which of the fol
lowing actions is not required by the FDA?
a. Identify and quarantine all blood and blood compo
nents produced from the blood supplied by the
donor
b. Report the biological product deviation to CBER if
the product has been distributed
c. Enter the donor in a record so that he can be identi
fied and his product not be distributed while he is
deferred
d. Notify the AABB
8. A patient dies following transfusion of ABO-
incompatible blood. To whom should this event be
reported?
a. The Center for Biologics Evaluation and Research
b. Center for Medicare and Medicaid Services
c. The AABB central office
d. The Occupational Safety and Health Administration
9. Which federal agency has the responsibility to
routinely inspect an unregistered transfusion service
that does not collect blood?
a. Food and Drug Administration
b. Centers for Medicare and Medicaid Services
c. Occupational Safety and Health Administration
d. State health department
10. Which of the following is not one of the FDA layers
of safety?
a. Donor screening
b. Biologics License Application
c. Investigation of manufacturing problems
d. Testing for relevant transfusion-transmitted 10. Validation testing for software should consider all
infections of the following items except:
a. Data entry methods
b. Control functions
c. Performance of testing in production database
CHAPTER 28
d. Invalid data
1. Components of an information system consist of all
of the following except:
a. Hardware CHAPTER 29
b. Software 1. Transfusion-transmitted diseases can result in
c. Validation lawsuits claiming:
d. People a. Battery
2. To be in compliance with regulatory and b. Invasion of privacy
accreditation agency requirements for blood bank c. Negligence
information systems, blood banks must maintain SOPs d. a, b, and c
for all of the following except: 2. Laws applicable to blood banking and transfusion
a. Vendor validation testing medicine can arise:
b. Computer downtime a. In state and federal courts
c. System maintenance b. In the U.S. Congress, state legislatures, and state
d. Personnel training and federal courts
c. In state legislatures and courts
3. A validation test case that assesses the system’s d. In state legislatures and the U.S. Congress
ability to recognize an erroneous input is called:
a. Normal 3. The reasons patients have sued for transfusion
b. Boundary injury include:
c. Stress a. Failure to perform surrogate testing
d. Invalid b. Failure to properly test blood components
c. Failure to properly screen donors
4. An example of interface software functionality is: d. All of the above
a. The entry of blood components into the blood bank
database 4. Blood banking professionals may increase the
b. The transmission of patient information from the HIS threat of litigation by:
into the blood bank system a. Following published regulations and guidelines
c. The printing of a workload report b. Knowing the legal bases for liability
d. Preventing access to the system by an unauthorized c. Disclosing all information about patients and donors
user d. Practicing good medicine

5. Backup copies of the information system: 5. Issues about transfusion-transmitted diseases:

a. Can be used to restore the information system data a. Are evolving and will continue to result in litigation
and software if the production system is damaged in the foreseeable future
b. Are used to maintain hardware components b. Frequently result in plaintiff verdicts
c. Are performed once a month c. Have all been litigated
d. Are created any time changes are made to the d. Are known and avoidable
system

6. User passwords should be:

a. Shared with others
b. Kept confidential
c. Posted at each terminal
d. Never changed

7. Preventing the issue of an incompatible blood

component is an example of:
a. Inventory management
b. Utilization review
c. System security
d. Control function

8. Information is stored in a collection of many

different files called the:
a. Database
b. Configuration
c. Hardware
d. Disk drive

9. Application software communicates with this type of

software to retrieve data from the system disks:
a. Interface
b. Operating system
c. Security
d. Program