1. A woman wants to donate blood.

Her physical examination reveals the following: weight-110 lbs,

pulse- 73 bpm, blood pressure-125/75 mmHg, Hematocrit- 35%. Which of the following exclusions
applies to the prospective donor?
A. Pulse to high
B. Weight too low
C. Hematocrit too low
D. Blood pressure too low

C. Hematocrit too low

2. A potential donor has no exclusions, but she weights only 95 pounds. What is the allowable amount of
blood (including samples) that can be drawn?
A. 367 mL
B. 378 mL
C. 454 mL
D. 473 mL

C. 454 mL

3. Donors who have received blood or blood products within 12 months of when they desire to donate
are deferred to protect the recipient because the:
A. Blood could have transmitted hepatitis or HIV
B. Blood may have two cell populations
C. Donor May not be able to tolerate the blood loss
D. Donor red cell hemoglobin level may be too low

A. Blood could have transmitted hepatitis or HIV

4. Which of the following conditions would contraindicate autologous pre-surgical donation?

A. Weight of 100 lbs
B. Age of 14 years
C. Hemoglobin of 12 g/dL
D. Mild bacteremia

D. Mild bacteremia

5. Which of the following donors would be deferred indefinitely?

A. History of syphilis
B. History of gonorrhea
C. Accutane treatment
D Recipient of human growth hormone

D Recipient of human growth hormone

6. Which of the following viruses resides exclusively in leukocytes?

A. CMV
B. HIV
C. HBV
D. HCV

A. CMV

7. A donor indicates that he has taken two aspirin tablets per day for the last 36 hours. The unit of
blood:
A. May not be used for pooled platelet concentrate preparation
B. Should not be drawn until 36 hours after cesation of aspirin ingestion
C. May be used for pooled platelet concentrate preparation
D. May be used for red blood cells and fresh-frozen plasma production, but the platelets should be
discarded

C. May be used for pooled platelet concentrate preparation

8. Which of the following best describes what must be done with a unit of blood drawn from a donor
who is found to be at high risk of contracting acquired immune deficiency syndrome (AIDS)?
A. Hold unit in quarantine until donor diagnosis is clarified
B. Use the blood for research dealing with AIDS
C. Properly dispose of unit by autoclaving or incineration
D. Use the plasma and destroy the red blood cells.

C. Properly dispose of unit by autoclaving or incineration

9. Which of the following is least likely to transmit hepatitis?

A. Cryoprecipiate
B. RBC
C. Plasma protein fraction (PPF)
D. Platelets

C. Plasma protein fraction (PPF)

10. A pooled sera product from 16 donors has a repeatedly positive nucleic acid test (NAT) for HCV. The
next action that should be taken is to:
A. Permanently exclude all the donors in the pool
B. Test each donor in the pool for HCV
C. Label all the donors as HCV positive
D. Confirm the positive using recombinant immunoblot assay (RIBA)

B. Test each donor in the pool for HCV

11. Allthough cryoprecipitate has primarily been used for treatment of hypofibrinogenemia and
hemophilia A, it contains other blood proteins useful in the treatment of coagulopathies. Which of the
following is not found in cryoprecipitate?
A. Fibronectin
B. Factor XIII
C. Factor VIII:vW
D. Antithrombin III
D. Antithrombin III

12. Even though it is properly collected and stored, which of the following will fresh-frozen plasma (FFP)
not provide?
A. Factor V
B. Factor VIII
C. Factor IX
D. Platelets

D. Platelets

13. Blood needs to be prepared for intrauterine transfusion of a fetus with severe HDN. The red blood
cell unit selected is compatible with the mother's serum and has been leuko-depleted. An additional
step that must be taken before transfusion is to:
A. Add pooled platelets and fresh-frozen plasma
B. Check that the RBC group is consistent with the father's
C. Irradiate the RBCs before infusion
D. Test the RBC unit with the neonate's eluate

C. Irradiate the RBCs before infusion

14. The addition of adenine in an anticoagulant-preservative formulation aids in:

A. Maintaining ATP levels for red cell viability
B. Maintaining platelet funciton in stored blood
C. Reducing the plasma K+ levels during storage
D. Maintaining 2,3-PBG levels for oxygen release to the tissue

A. Maintaining ATP levels for red cell viability

15.The pilot tubes for donor unit #3276 break in the centrifuge. You should:
A. Label the blood using the donor's previous records
B. Discard the unit because processing procedures cannot be performed
C. Discard the red cells and salvage the plasma for fractionation
D. Remove sufficient segments to complete donor processing procedures

D. Remove sufficient segments to complete donor processing procedures

16. A satellite bag containing 250 mL of fresh plasma is selected for quality control of cryoprecipitate
production. Cryoprecipitate is prepared according to standard operat-ing procedures. The final product
has a total volume of 10 mL. The factor VIII assays are 1 IU/mL before and 9 IU/mL after preparation.
What is the percent yield of factor VIII in the final cryoprecipitate?
A. 11%
B. 25%
C. 36%
D. 80

C. 36%
17. A satellite bag containing 250 mL of fresh plasma is selected for quality control of cryoprecipitate
production. Cryoprecipitate is prepared according to standard operat-ing procedures. The final product
has a total volume of 10 mL. The factor VIII assays are 1 IU/mL before and 9 IU/mL after preparation
Does this product meet AABB Standards for cryoprecipitate production?
A. Yes
B. No; the percent recovery is too low.
C. No; the final factor VIII level is too low.
D. Data are insufficient to calculate

A. Yes

18. What should be done with a unit of RBCs that was irradiated twice?
A. Change expiration date and then issue the unit.
B. Note on unit that it has been irradiated twice.
C. Discard the unit.
D. Issue immediately.

C. Discard the unit.

19. What is the expiration date/time of pooled cryoprecipitate?

A. 30 minutes
B. 2 hours
C. 4 hours
D. 8 hours

C. 4 hours

20. Which of the following is most accurate regarding platelet apheresis criteria?
A. The minimum platelet count must be 3.0 * 1011, pH must be Ú6.0.
B. The minimum platelet count must be 3.0 * 1010, pH must be ...6.2.
C. The minimum platelet count must be 3.0 * 1011, pH must be Ú6.2.
D. The minimum platelet count must be 5.5 * 1010, pH must be ...6.0.

C. The minimum platelet count must be 3.0 * 1011, pH must be Ú6.2.

21. Which of the following lists the correct shelf life?

A. Frozen RBCs at -65°C = 7 years
B. Fresh frozen plasma (FFP) at -18°C = 1 year
C. Fresh frozen plasma (FFP) at -65°C = 1 year D. Platelets at 6°C = 5 day

B. Fresh frozen plasma (FFP) at -18°C = 1 year

22. When 2,3-BPG levels drop in stored blood, which of the following occurs as a result?
A. RBC K+ increases.
B. RBC ability to release O2 decreases.
C. Plasma hemoglobin is stabilized.
D. ATP synthesis increases.

B. RBC ability to release O2 decreases.

23. The last unit of autologous blood for an elective surgery patient should be collected no later than
________________ hours before surgery. A. 24
B. 36
C. 48
D. 72

D. 72

24. For which of the following patients would autologous donation not be advisable?
A. Patients with an antibody against a high-incidence antigen
B. Patients with uncompensated anemia
C. Open heart surgery patients
D. Patients with multiple antibodies

B. Patients with uncompensated anemia

25. What marker is the first to appear in hepati-tis B virus infection?

A. HBsAg
B. Anti-HBc IgM
C. Anti-HBs IgG
D. Anti-HBc IgG

A. HBsAg

26. Biochemical changes occur during the shelf life of stored blood. Which of the follow-ing is a result of
this "storage lesion"?
A. Increase in pH
B. Increase in plasma K+
C. Increase in plasma Na+
D. Decrease in plasma hemoglobin

B. Increase in plasma K+

27. It has been determined that a patient has posttransfusion hepatitis and received blood from eight
donors. There is nothing to indicate that these donors may have been likely to transmit hepatitis. What
action must be taken initially?
A. Defer all donors indefinitely from fur-ther donations.
B. Repeat all hepatitis testing on a fresh sample from each donor.
C. Notify the donor center that collected the blood.
D. Interview all implicated donors.

C. Notify the donor center that collected the blood.

28. The temperature range for maintaining RBCs and whole blood during shipping is:
A. 0-4°C
B. 1-6°C
C. 1-10°C
D. 5-15°C
C. 1-10°C

29. Platelets play an important role in maintain-ing hemostasis. One unit of donor platelets derived from
whole blood should yield ______________ platelets.
A. 5.5 * 106
B. 5 * 108
C. 5.5 * 1010
D. 5 * 101

C. 5.5 * 1010

30. Which component is recommended for patients with anti-IgA antibodies?

A. Packed RBCs
B. Washed RBCs
C. Fresh plasma
D. Leukoreduced RBCs

B. Washed RBCs

31. During preparation of platelet concentrate, the hermetic seal of the primary bag is bro-ken. The red
blood cells:
A. must be discarded.
B. may be labeled with a 21-day expiration date if collected in CPD.
C. must be labeled with a 24-hour expira-tion date.
D. may be glycerolized within 6 days and stored frozen

C. must be labeled with a 24-hour expira-tion date.

32. The transfusion services' procedure manual must be:

A. revised annually.
B. revised after publication of each new edition of the AABB Standards.
C. reviewed prior to a scheduled inspection.
D. reviewed annually by an authorized individual.

D. reviewed annually by an authorized individual.

33. Previous records of patients' ABO and Rh types must be immediately available for comparison with
current test results for:
A. 6 months.
B. 12 months.
C. 10 years.
D. indefinitely.

B. 12 months.

34. Which of the following weak D donor units should be labeled Rh-positive?
A. Weak D due to transmissible genes
B. Weak D as position effect
C. Weak partial D
D. All choices are appropriate

D. All choices are appropriate

35. In order to meet the current AABB Stan-dards for leukocyte reduction to prevent human leukocyte
antigen (HLA) alloimmu-nization or CMV transmission, the donor unit must retain at least __________ of
the original RBCs and leukocytes must be reduced to less than ___________.
A. 85%, 5 * 108
B. 80%, 5 * 106
C. 75%, 5 * 105
D. 70%, 5 * 10

B. 80%, 5 * 106

36. Which of the following tests is not per-formed during donor processing?
A. ABO and Rh grouping
B. HbsAg
C. HIV-1-Ag
D. HBsAb

D. HBsAb

37. A 70-kg man has a platelet count of 15,000/μL, and there are no complicating factors such as fever
or HLA sensitization. If he is given a platelet pool of six units, what would you expect his posttransfusion
count to be?
A. 21,000-27,000/μL
B. 25,000-35,000/μL
C. 45,000-75,000/μL
D. 75,000-125,000/μL

C. 45,000-75,000/μL

38. Which of the following tests on donor RBCs must be repeated by the transfusing facility when the
blood was collected and processed by a different facility?
A. Confirmation of ABO group and Rh type of blood labeled D-negative
B. Confirmation of ABO group and Rh type
C. Weak D on D-negatives
D. Antibody screening

A. Confirmation of ABO group and Rh type of blood labeled D-negative

39. Red blood cells, liquid

A. 1-6°C

40. Red blood cells, frozen

D. −65°C or colder

41. Fresh-frozen plasma

C. −18°C or colder

42. Cryoprecipitate

C. −18°C or colder

43. Platelet concentrate

A. 1-6°C
B. 20-24°C
C. −18°C or colder
D. −65°C or colder

B. 20-24°C

44. Red blood cells in citrate phosphate dex-trose adenine-1 (CPDA-1)

C. 35 days

45. Fresh-frozen plasma

D. 1 year

46. Cryoprecipitate

D. 1 year

47. Fresh-frozen plasma, thawed

A. 24 hours

48. Platelet concentrate in PL-732 bags (with agitation)

A. 24 hours
B. 5 days
C. 35 days
D. 1 year

B. 5 days

49. Citrate phosphate dextrose (CPD)

A. 21 days

50. Citrate phosphate dextrose adenine (CPDA-1)

B. 35 days

51. AS-1 (Adsol®)

C. 42 days

52. EDTA
A. 21 days
B. 35 days
C. 42 days
D. Not an approved anticoagulant

D. Not an approved anticoagulant

53. A 65-year-old man whose birthday is tomorrow

D. Accept

54. A 45-year-old woman who donated a unit during a holiday appeal 54 days ago

A. Defer temporarily

55. A 50-year-old man who had sex with another man in 1980

C. Defer indefinitely

56. A 25-year-old man who says he had yellow jaundice right after he was born

D. Accept

57. An 18-year-old with poison ivy on his hands and face

D. Accept

58. A woman who had a baby 2 months ago

D. Accept

59. A 35-year-old runner (pulse 46 bpm)

A. Defer temporarily
B. Defer for 12 months
C. Defer indefinitely
D. Accept

D. Accept

60. Patients with warm autoimmune hemo-lytic anemia (AIHA) due to a-methyldopa (Aldomet®) with
hemoglobin of 8.5 g/dL or above

D. Transfusion not indicate

61. Patients requiring transfusion with RBCs that will not transmit cytomegalovirus (CMV)

C. Leukocyte-reduced RBCs

62. Patients with normovolemic anemia

B. RBC

63. Patients who are thrombocytopenic sec-ondary to the treatment of acute leukemia
A. Platelet concentrate
B. RBC
C. Leukocyte-reduced RBCs
D. Transfusion not indicate

A. Platelet concentrate

64. Most blood group antibodies are of which of the following immunoglobulin classes?
A. IgA and IgD
B. IgA and IgM
C. IgE and IgD
D. IgG and IgM

D. IgG and IgM

65. All other indications are that these children are both the products of this mating. Pos-sible
explanations for these results would include which of the following?
A. A dominant inhibitor gene has been passed to child 1.
B. Father has one k gene and one K0 gene.
C. Father has the McLeod phenotype.
D. Mother has a cis-Kk gene

B. Father has one k gene and one K0 gene.

66. Which of the following blood groups re-acts least strongly with an anti-H produced in an A1B
individual?
A. Group O
B. Group A2B
C. Group A2
D. Group A1

D. Group A1

67. How many genes encode the following Rh antigens: D, C, E, c, e?

A. One
B. Two
C. Three
D. Four

B. Two

68. The test results could be due to:

A. cold autoantibody.
B. inheritance of sese genes.
C. inheritance of hh genes.
D. Rouleaux

C. inheritance of hh genes.

69. If the patient's RBCs were tested against anti-H lectin and did not react, this person would be
identified as a(an):
A. acquired B.
B. Oh phenotype.
C. secretor.
D. subgroup of A.

B. Oh phenotype.

70. If a person has the genetic makeup Hh, AO, LeLe, sese, which of the following substance will be
found in the secretions?
A. A substance
B. H substance
C. Lea substance D. Lea substance

C. Lea substance

71. The laboratory scientist suspects that this is a case of an acquired B antigen. Which of the following
would support this suspicion?
A. A positive autocontrol test
B. Secretor studies show that the patient is a nonsecretor.
C. A patient diagnosis of leukemia
D. The patient's RBCs give a negative result with a monoclonal anti-B reagent lacking the ES-4 clone.

D. The patient's RBCs give a negative result with a monoclonal anti-B reagent lacking the ES-4 clone.

72. Which antibody binds to RBCs at cold tem-peratures and causes lysis as the tempera-ture rises
through movement in peripheral circulation?
A. Auto anti-P
B. Anti-H
C. Anti-I
D. Auto non-specific antibody

A. Auto anti-P

73. Which of the following sugars must be present on a precursor substance for A and B antigenic
activity to be expressed?
A. d-Galactose
B. N-Acetylgalactosamine
C. Glucose
D. l-Fucose

D. l-Fucose

74. An antigen-antibody reaction alone does not cause hemolysis. Which of the follow-ing is required for
RBC lysis?
A. Albumin
B. Complement
C. Glucose-6-phosphate dehydrogenase (G6PD)
D. Antihuman globulin (AHG

B. Complement
75. A Caucasian American female's RBCs gave the following reactions upon phenotyp-ing: D+ C+ E− c+
e+. Which of the following is the most probable Rh geno-type?
A. DCe/Dce
B. DCe/dce
C. DCe/DcE
D. Dce/dCe

B. DCe/dce

76. An African American patient has the fol-lowing Rh phenotype: D+ C+ E+ c+ e+. Which of the following
genotypes is the least probable? A. DCE/dce
B. DCe/DcE
C. DCe/dcE
D. DcE/dCe

C. DCe/dcE

77. An individual of the dce/dce genotype given dCe/dce blood has an antibody response that appears
to be anti-C plus anti-D. What is the most likely explanation for this?
A. The antibody is anti-G.
B. The antibody is anti-partial D.
C. The antibody is anti-Cw.
D. The reactions were read incorrectly.

A. The antibody is anti-G.

78. If a patient has the Rh genotype DCe/DCe and receives a unit of RBCs from a DCe/dce individual,
what Rh antibody might the patient develop?
A. Anti-C
B. Anti-c
C. Anti-d
D. Anti-E

A. Anti-C

79. What percentage of this couple's offspring can be expected to be D-negative?

A. 0%
B. 25%
C. 50%
D. 75%

C. 50%

80. Which of the following conclusions regard-ing the family typing is most likely?
A. The husband is not the infant's father.
B. The husband is proved to be the infant's father.
C. The husband cannot be excluded from being the infant's father.
D. The D typing on the infant is a false positive.
C. The husband cannot be excluded from being the infant's father.

81. Which, if any, of the three individuals be-low, can make anti-D?
A. Husband
B. Husband and wife
C. Wife
D. Child

C. Wife

82. What is the primary difference between weak D and partial D individuals?
A. Weak D phenotype results from decreased epitopes of D antigens.
B. Partial D phenotypes can make antibodies to D antigens.
C. Partial D phenotype results from decrease expression of D antigens.
D. Weak D phenotypes should be categorized as D negative

B. Partial D phenotypes can make antibodies to D antigens.

83. An antibody screen is positive in the AHG phase in all three screen cells. The autocontrol is negative.
What is the most likely explanation for these results?
A. Auto antibody
B. Cold antibody
C. Excess protein
D. Alloantibody(ies

D. Alloantibody(ies

84. A victim of an auto accident arrives in the emergency department (ED) as a transfer from a hospital
in a rural area. The patient has been in that facility for several weeks and has received several units of
RBCs during that time. The ED resident orders two units of RBCs for transfusion. The sample sent to
transfusion services is centrifuged and the cell-serum interface is not discernable. A sub-sequent sample
produces the same appear-ance. You would suspect that the patient has:
A. autoimmune hemolytic anemia.
B. Anti-Fya.
C. Anti-Jka.
D. paroxysmal nocturnal hemoglobinuria

C. Anti-Jka.

85. Which of the following is a characteristic of the Xga blood group system?
A. The Xga antigen has a higher frequency in women than in men.
B. The Xga antigen has a higher frequency in men than in women.
C. The Xga antigen is enhanced by enzymes.
D. Anti-Xga is usually a saline-reacting antibody

A. The Xga antigen has a higher

86. Testing on a patient sample needs to be done with a rarely used antiserum. The ap-propriate steps
to take in using this antise-rum include following the manufacturer's procedure and:
A. performing a cell panel to be sure that the antiserum is performing correctly.
B. performing the testing on screen cells.
C. testing in duplicate to ensure the repeat-ability of the results.
D. testing a cell that is negative for the antigen and one that is heterozygous for the antigen

D. testing a cell that is negative for the antigen and one that is heterozygous for the antigen

87. Which of the following is a characteristic of Kidd system antibodies?

A. Usually IgM antibodies
B. Corresponding antigens are destroyed by enzymes.
C. Usually strong and stable during storage
D. Often implicated in delayed hemolytic transfusion reactions

D. Often implicated in delayed hemolytic transfusion reactions

88. Which procedure would help to distinguish between anti-c and Fyb in a mixed antibody panel?
A. Increase the pH of the serum.
B. Use a thiol reagent (e.g., dithiothreitol). .
C. Run a cold "mini" panel.
D. Run an enzyme panel

D. Run an enzyme panel

89. What is the primary difference between a patient with anti-S and a patient with anti-M?
A. Anti-S is never clinically significant.
B. Anti-S is similar to anti-M as both are naturally occurring.
C. Anti-S requires patient to receive antigen-negative blood.
D. Anti-S is cold-reacting and anti-M reacts at body temperatur

C. Anti-S requires patient to receive antigen-negative blood.

90. Which of the following statements is not true about anti-U?

A. Is clinically significant
B. Is only found in African American individuals C. Only occurs in S−s− individuals
D. Only occurs in Fy(a−b−) individual

D. Only occurs in Fy(a−b−) individual

91. A patient had an anti-E identified in his serum 5 years ago. His antibody screening test is now
negative. To obtain suitable blood for transfusion, what is the best procedure to use? A. Type the
patient for the E antigen as an added part to the crossmatch proce-dure.
B. Type the donor units for the E antigen and crossmatch the E-negative units.
C. Crossmatch donors with the patient's serum and release the compatible units for transfusion.
D. Perform the crossmatch with enzyme-treated donor cells, because enzyme-treated RBCs react better
with Rh antibodies.

B. Type the donor units for the E antigen and crossmatch the E-negative units.

92. A patient's RBCs are being typed for the Fya antigen. Which of the following is the proper cell type of
choice for a positive control of the anti-Fya reagent?
A. Fy(a+ b−)
B. Fy(a+ b+)
C. Fy(a−b+)
D. Fy(a−b−

B. Fy(a+ b+)

93. What should be done if HDN is caused by anti-K?

A. Give prophylactic immune globulin.
B. Monitor mother's antibody titer.
C. K is a low-frequency antigen so not likely an issue.
D. Neutralize the antibody

B. Monitor mother's antibody titer.

94. Which of the following antibodies would require additional testing in order to be ruled out?
A. Anti-E, anti-K, anti-Kpa, anti-Jsa, anti-Jkb
B. Anti-E, anti-S, anti-Leb, anti-K, anti-Kpa, anti-Fya
C. Anti-E, anti-S, anti-Lea, anti-K, anti-Kpa, anti-Jsa, anti-Fya, anti-Jka
D. Anti-E, anti-Lea, anti-K, anti-Kpa, anti-Jsa, anti-Fyb, anti-Jka, anti-Jk

A. Anti-E, anti-K, anti-Kpa, anti-Jsa, anti-Jkb

95. The most likely antibody(ies) in the pa-tient's serum is(are):

A. anti-S and anti-E.
B. anti-E and anti-K.
C. anti-Fyb showing dosage.
D. anti-K, anti-Jsa, and anti-Lea

B. anti-E and anti-K.

96. From the cells in panel chart 2, choose a selected cell panel to help identify the antibody(ies) in the
patient described in question 95.
A. 1, 2, 5, 9, 10
B. 2, 6, 7, 10
C. 1, 4, 7
D. 2, 3, 4, 6, 9

C. 1, 4, 7

97. Often when trying to identify a mixture of antibodies, it is useful to neutralize one of the known
antibodies. Which one of the following antibodies is neutralizable?
A. Anti-D
B. Anti-Jka
C. Anti-Lea
D. Anti-M

C. Anti-Lea
98. Which of the following antibodies does not match the others in terms of optimal reac-tive
temperature?
A. Anti-Fya
B. Anti-Jkb
C. Anti-N
D. Anti-U

C. Anti-N

99. A recently transfused patient's serum has a positive antibody screen. The panel per-formed at
immediate spin (IS), in low-ionic-strength saline (LISS) at 37°C, and at AHG shows a strong anti-Fya and a
weak possible anti-C. To confirm the anti-C, you would perform an:
A. elution.
B. absorption.
C. antigen typing.
D. enzyme panel.

D. enzyme panel.

100. The antiglobulin test does not require washing or the addition of IgG-coated cells in which of the
following antibody detec-tion methods?
A. Solid-phase RBC adherence assays
B. Gel test
C. Affinity column technology
D. Polyethylene glycol technique

B. Gel test

101. Which set of antibodies could you possibly find in a patient with no history of transfu-sion or
pregnancy?
A. Anti-I, anti-s, anti-P1
B. Anti-Leb, anti-A1, anti-D
C. Anti-M, anti-c, anti-B
D. Anti-P1, anti-Lea, anti-I

D. Anti-P1, anti-Lea, anti-I

102. Lymphocytotoxicity testing can be used to detect the presence of antibodies to:
A. Wra and Wrb.
B. HLA antigens.
C. Bga, Bgb, and Bgc.
D. JMH antigen

B. HLA antigens.

103. In which of the following instances can mixed-field agglutination be observed?

A. Direct antiglobulin test (DAT) result of patient undergoing delayed hemolytic transfusion reaction
B. Indirect antiglobulin test (IAT) result of patient who has anti-Lea
C. DAT result of patient on high doses of a-methyldopa
D. Typing result with anti-A of patient who is A2 subgrou

A. Direct antiglobulin test (DAT) result of patient undergoing delayed

104. The antibody produced during the second-ary response to a foreign antigen is usually
A. IgM.
B. a product of T lymphocytes.
C. produced a month or more after the second stimulus.
D. present at a higher titer than after a primary response

D. present at a higher titer than after a primary response

105. Which of the following causes ABO re-verse typing discrepancies?

A. Acquired B antigen in a group A person
B. IgM alloantibody at IS
C. Bone marrow transplant recipient
D. Polyagglutinable RBCs

B. IgM alloantibody at IS

106. A group A, D-negative obstetric patient with anti-D (titer 256) is carrying a fetus who needs an
intrauterine transfusion. Which of the following units should be chosen?
A. Group A, D-negative RBC
B. Group A, D-negative whole blood
C. Group O, D-negative RBC
D. Group O, D-negative whole blood

B. Group A, D-negative whole blood

107. Which of the following is generally detect-ed with the antiglobulin phase of testing?
A. Anti-Jka
B. Anti-M
C. Anti-P1
D. Anti-I

A. Anti-Jka

108. Which of the blood group systems is as-sociated with antibodies that are generally IgM?
A. Rh
B. Duffy
C. Kell
D. Lewis

D. Lewis

109. Some antigens that are primarily found on white blood cells can occur on erythro-cytes. Which of
the following are the RBC equivalents of HLAs?
A. Lea, Leb
B. Bga, Bgb, Bgc
C. Kpa, Kpb, Kpc
D. Doa, Dob

B. Bga, Bgb, Bgc

110. Which of the following statements is true? The alleged father:

A. is excluded by the ABO system.
B. is excluded by the Rh system.
C. is excluded by the HLA system.
D. cannot be ruled out.

C. is excluded by the HLA system.

111.A patient with an acquired antigen due to infection with gram-negative bacteria

C. Anti-A +, Anti-B +, A1 cells 0, B cells +, O cells -

112. A patient with multiple myeloma

A. Anti-A +, Anti-B +, A1 cells +, B cells +, O cells +

113. A newborn

D. Anti-A 0, Anti-B 0, A1 cells 0, B cells 0, O cells 0

114. An A2 individual making an anti-A1

B. Anti-A +, Anti-B 0, A1 cells +, B cells +, O cells -

115. A patient with antibodies to acriflavin (a yellow dye)

C. Anti-A +, Anti-B +, A1 cells 0, B cells +, O cells -

116. A patient who is immunodeficient

D. Anti-A 0, Anti-B 0, A1 cells 0, B cells 0, O cells 0

117. A patient with an unexpected IgM antibody in his serum

A. Anti-A +, Anti-B +, A1 cells +, B cells +, O cells +

118. A patient with cold hemagglutinin disease (CHD)

A. Anti-A +, Anti-B +, A1 cells +, B cells +, O cells +

119. Found predominantly in Caucasian Ameri-cans

C. Kpa

120. Associated with weak Kell system antigenic expression

A. McLeod phenotype

121. Associated with the presence of chronic granulomatous disease

A. McLeod phenotype

122. Linked with MN

D. Ss

123. A rare allele of M and N

A. McLeod phenotype
B. Mg
C. Kpa
D. Ss

B. Mg

124. The ethnicity of the donor of cell #3 is most likely of which descent?
A. African American
B. Inuit or Yupik
C. Asian
D. Caucasian American

A. African American

The donor of cell #5 is homozygous for which combination of the following genes?
A. Ce, P1, M, s, k, Jka, Fya, Leb
B. Ce, P1, s, k, Jka, Fya, Leb
C. Ce, s, k, Jka, Fya, Leb,P1
D. Ce, s, k, Jka, Fya

D. Ce, s, k, Jka, Fya

126. After testing a patient's serum with the panel, one observes there are no reactions at IS or 37°C
with cells #1-8. There is a 1+ AHG reaction with cells #1 and #6 and a 3+ AHG reaction with cells #4 and
#5. All other cells, #2, #3, #7, and #8, are negative at AHG. Which of the following statements is true?
A. Anti-Fya appears to be present.
B. Anti-Fya is present as well as an anti-body that is reacting with an undeter-mined antigen on Cells #4
and #5.
C. Ficin will enhance the reactions of the antibody(ies) present.
D. Anti-Fya is present but can be ignored because most people are Fy(a−b−).

A. Anti-Fya appears to be present.

127. The serum of a patient tested with the reagent RBC panel using an LISS additive demonstrates 3+
reactivity with cells #1-8 at the antiglobulin phase. The autocontrol is negative. This pattern of reactivity
is most likely due to:
A. rouleaux formation.
B. warm autoantibody.
C. alloantibody directed against a high-frequency antigen.
D. antibody directed against a preservative present in LISS.

C. alloantibody directed against a high-frequency antigen.

128. A patient's serum reacts with all the panel cells except cell #7 in the antiglobulin phase only. Which
of the following techniques would be most helpful at this point?
A. Treat the panel cells with a proteolytic enzyme and repeat the panel with un-treated serum.
B. Treat the panel cells with dithiothreitol (DTT) and repeat the panel with un-treated serum.
C. Treat the patient's serum with DTT and repeat the panel with treated serum.
D. Treat the patient's serum with a proteo-lytic enzyme and repeat the panel with treated serum.

B. Treat the panel cells with dithiothreitol (DTT) and repeat the panel with un-treated serum.

129. From the reactions given, it appears that there is(are):

A. one antibody reacting.
B. one antibody reacting that shows dosage.
C. "cold" and "warm" antibodies reacting.
D. two "warm" antibodies reacting.

C. "cold" and "warm" antibodies reacting.

130. The antibody that reacts at IS is most likely: A. anti-D.

B. anti-P1.
C. anti-Lea.
D. anti-Leb.

C. anti-Lea.

131. The antibody that reacts at 37°C and with AHG is: A. anti-C.
B. anti-D.
C. anti-CD.
D. anti-K.

B. anti-D.

132. What should be done to increase the prob-ability that an antibody identification is correct?
A. Make an eluate.
B. Do saliva testing.
C. Run an additional panel.
D. Type the patient's cells for the corresponding antigens.

D. Type the patient's cells for the corresponding antigens.

133. The following results were obtained upon testing a specimen of a patient, being admitted after a
car accident, who had no recent history of transfusion or medical problems. ABO group: A Rh type: D-
positive Antibody screening test: Positive, one screening cell only Direct antiglobulin test: Negative
Antibody identification: Anti-K identi-fied; 3 K+ cells that reacted with the patient serum and 3 K− cells
that did not react with the patient serum were on the panel. Patient's cell phenotyping: K+
What is the most likely cause of the discrepant results?
A. Failure to read panel at antiglobulin phase B. Failure to use positive and negative controls with anti-K
C. Panel cell reactions interpreted incorrectly D. Patient has circulating donor cells that are K+

B. Failure to use positive and negative controls with anti-K

134. False negative results at the antiglobulin phase of an antibody screening test are most likely due to:
A. excessive washing of the red cells.
B. inadequate washing of the red cells.
C. warm autoantibody present in the patient's serum.
D. failure to allow the blood to clot properly

B. inadequate washing of the red cells.

135. What is the process of removing an anti-body from the RBC membrane called?
A. Absorption
B. Adsorption
C. Elution
D. Immunization

C. Elution

136. At the end of an antiglobulin test, IgG-coated control cells are added to the negative tests and
centrifuged. What does it mean if no agglutination occurs?
A. Test is valid.
B. Antiglobulin reagent was working properly. C. Cells were not washed thoroughly.
D. Control cells are contaminated.

C. Cells were not washed thoroughly.

137. The crossmatch is performed using:

A. donor's serum and recipient's RBCs.
B. donor's RBCs and recipient's serum.
C. donor's serum and reagent red cells.
D. recipient's serum and reagent red cells.

B. donor's RBCs and recipient's serum.

138. A male trauma victim whose blood type is group AB, D-negative has a negative antibody screening
test. He has been transfused with both of the group AB, D-negative units in inventory within the last
hour. He is now in surgery and expected to need large amounts of blood. Of the following available units
in inventory, which type should be given next?
A. 30 units of group O, D-positive
B. 26 units of group A, D-positive
C. 10 units of group O, D-negative
D. 5 units of group A, D-negative

B. 26 units of group A, D-positive

139. Which of the following will the crossmatch do?

A. Prevent immunization
B. Prevent delayed transfusion reactions
C. Guarantee normal survival of the RBCs
D. Frequently verify donor ABO compatibility
D. Frequently verify donor ABO compatibility

140. Given that a patient's antibody screening test is negative, which of the following may cause a false
positive result in a compatibility test?
A. Incorrect ABO typing of the donor or patient
B. An alloantibody against a low-frequency antigen on the donor cells
C. Prior coating of IgG antibody on the donor cells
D. Centrifuging for 15 sec

C. Prior coating of IgG antibody on the donor cells

141. Which of the following will be incompat-ible in the crossmatch?

C. Group AB, D+ Donor with Group A, D+ recipient

142. A resident physician hand-delivers a blood sample, drawn by the attending physician, for
pretransfusion testing from a patient who is difficult to draw. The sample is unla-beled. One should:
A. discard the sample and request that the resident obtain a new sample, adhering to proper guidelines
for labeling.
B. label the specimen with the information the resident provides.
C. label the specimen with information from the accompanying transfusion request form.
D. request the sample be returned to the nursing station to be labeled.

A. discard the sample and request that the resident obtain a new sample, adhering to proper guidelines
for labeling.

143. A specimen of blood is received in transfu-sion services with request slips initialed by the
phlebotomist. The tube has the patient's first and last name and medical records identification number
on the label. What else must be on the tube label as required by AABB Standards?
A. Patient's room number
B. Date of phlebotomy
C. Initials of phlebotomist
D. Attending physician's name

B. Date of phlebotomy

144. A physician calls transfusion services and wants an additional unit of RBC cross-matched for a
patient. Several specimens from that patient are identified that have been drawn over the past month.
Which of the following available samples is the oldest acceptable specimen that may be used for
crossmatching? A. 1 day old
B. 4 days old
C. 1 week old
D. 1 month old

A. 1 day old

145. A patient has a hematocrit level of 21%. The surgeon wants to raise the hematocrit to 30% before
surgery. How many units of RBCs need to be administered to this patient to raise the hemoglobin to the
re-quired level?
A. 1
B. 2
C. 3
D. 4

C. 3

146. A patient with an anti-K and an anti-Jka in her plasma needs two units of RBC for surgery. How
many group-specific units would need to be screened to find two units of RBC? The frequency of Jk(a+)
is 77%; the K+ frequency is 10%.
A. 6
B. 10
C. 20
D. 36

B. 10

147. How many bags (units) should be thawed and pooled to provide 2 g of fibrinogen?
A. 2
B. 4
C. 8
D. 10

C. 8

148. The patient types as group A. Which cryo-precipitate units would most appropriately be used to
treat this patient?
A. Group A only
B. Group AB only
C. Group A and group O
D. Group A and group AB

D. Group A and group AB

149. If 98% of the RBCs are viable in a unit of blood at the time of transfusion, what percentage of RBCs
will remain viable 28 days posttransfusion?
A. 10%
B. 30%
C. 50%
D. 70

D. 70%

150. What is the component of choice for someone who needs an RBC transfusion when there is a
history of febrile transfu-sion reactions?
A. RBCs less than 5 days old
B. Leukocyte-reduced RBCs
C. RBCs 30 to 35 days old
D. Frozen RBCs that have been thawed and deglycerolized
B. Leukocyte-reduced RBCs

151. Which of the following is the component of choice when a physician is concerned about
restoring or maintaining oxygen carrying capacity?
A. Albumin
B. Cryoprecipitate
C. Whole blood
D. Red blood cells

D. Red blood cells

152. The serum of a patient contains an antibody that reacts with all random donor cells and
panel cells that have been tested. The best possibility to find compatible blood would be to test
A. Grandparents
B. Parents
C. Siblings
D. Spouse

C. Siblings

153. A resident physician on the trauma team runs a pretransfusion blood sample from a male
trauma victim to the blood bank and wants 6 units of blood to be issued immediately. He
indicates that he is willing to sign for uncrossmatched blood. He also indicates that he wants 6
units ready at all times. The patient has been admitted to the institution previously GI bleed.
The resident says the victim has a donor card in his walled indicating a group B, D-positive
blood type. What should be done immediately?
A. Issue 6 units of uncrossmatched group B, D-positive whole blood
B. Check patient and donor records to confirm the blood type, then issue 6 units of
uncrossmatched group B, D-positive blood
C. Withhold blood units until ABO compatability testing are completed
D. Issue 6 units of uncrossmatched group O RBCs.

D. Issue 6 units of uncrossmatched group O RBCs

154. A resident physician on the trauma team runs a pretransfusion blood sample from a male
trauma victim to the blood bank and wants 6 units of blood to be issued immediately. He
indicates that he is willing to sign for uncrossmatched blood. He also indicates that he wants 6
units ready at all times. The patient has been admitted to the institution previously GI bleed.
What should be the next step in the work-up of this emergency department patient?
A. Prepare 6 units uncrossmatched group B, D-positive whole blood
B. Check blood bank records for any previous patient information
C. Type and screen the patient sample
D. Prepare 6 more units of uncrossmatched group O blood

B. Check blood bank records for any previous patient information

155. Four units of fresh-frozen plasma have been ordered to correct factor V deficiency in a
group O patient. One should thaw and issue ________ plasma
A. Group O only
B. Group O and/or group A
C. Group O and/or group AB
D. Any blood group available

D. Any blood group available

156. Which of the following is acceptable to be given intravenously with a blood transfusion?
A. 5% dextrose in water
B. Physiologic saline
C. Ringer's solution
D. Potassium chloride in saline

B. Physiologic saline

157. Hemolytic transfusion reactions are the most serious type of reactions to blood transfusion.
The majority of hemolytic transfusion reactions are caused by _____________ erros.
A. Blood typing
B. Antibody identification
C. Clerical
D. Crossmatching

C. Clerical

158. What type of transfusion reaction is often diagnosed by a positve DAT and a gradual drop
in the patient's hemoglobin level?
A. Anaphylactic
B. Febrile
C. Delayed hemolytic
D. Acute hemolytic

C. Delayed hemolytic

159. What antibody, labile both in stored serum and the patient's plasma, is a frequent cause of
delayed hemolytic transfusion reactions?
A. Anit-A
B. Anti-D
C. Anti-Jka
D. Anti-K

C. Anti-Jka

160. Occasionally, patients have an anyphylactic reaction to a specific immunoglobulin class

during a transfusion. Which immunoglobulin class is most often implicated?
A. IgA
B. IgD
C. IgE
D. IgG

A. IgA

161. A transfusion of which of the following is least likely to transmit HIV, HCV, or HBV?
A. Pooled plasma, solvent/detergent treated
B. Cryoprecipitate
C. Leukocyte-reduced RBCs
D. Platelets

A. Pooled plasma, solvent/detergent treated

162. A transfusion reaction is reported by the nursing unit on patient A. D. The nurse reports that
the patient had chills, fever, and back pain within a few minutes of starting the unit. The nurse
asks what she should do. You tell the nurse to immediately
A. Collect posttransfusion blood samples
B. Monitor the pulse and blood pressure
C. Discontinue the unit, keep the line open
D. Page the patient's physician for instructions

C. Discontinue the unit, keep the line open

163. A transfusion reaction is reported by the nursing unit on patient A. D. The nurse reports that
the patient had chills, fever, and back pain within a few minutes of starting the unit. The nurse
asks what she should do. Which of the following directives would not be included in the
additional activities you would request the nurse to do?
A. Return the unit to the blood bank
B. Obtain a posttransfusion blood sample in EDTA
C. Obtain a posttransfusion urine sample
D. Obtain a fresh unit from the blood bank for immediate infusion

D. Obtain a fresh unit from the blood bank for immediate transfusion

164. A transfusion reaction is reported by the nursing unit on patient A. D. The nurse reports that
the patient had chills, fever, and back pain within a few minutes of starting the unit. The nurse
asks what she should do. All paperwork checks on this transfusion reaction are OK. The
pretransfusion sample has straw-colored plasma. The posttransfusion sample has red-tinged
plasma. This is indiciative of a(an)
A. Uncomplicated transfusion
B. Intravascular transfusion reaction
C. Error in which drugs have been infused with the blood
D. Febrile transfusion reaction
B. Intravascular transfusion reaction

165. Although use of autologous blood transfusions generally has several advantages, which of
the following is not avoidable?
A. Transmission of disease
B. Clerical error
C. Allergic reaction
D. Graft-versus-host disease

B. Clerical error

166. Before blood is issued for transfusion, a patient's previous blood bank records must be
reviewed. Which of the following is not included in this review process?
A. ABO group and Rh type
B. Clinically significant antibodies
C. Serious adverse reactions
D. Hepatitis testing

D. Hepatitis testing

167. Which of the following would not cause a positive hemagglutination reaction in the
crossmatch?
A. Incorrect ABO grouping of the donor
B. Unexpected antibodies in the recipient serum
C. A positive DAT on the recipient red cells
D. A positive DAT on the donor red cells

C. A positive DAT on the recipient red cells

168. Which of the following blood types neccessitates that a separate Rh control tube be set up
when using a monoclonal anti-D reagent?
A. Group O, D-positive
B. Group A, D-positive
C. Group B, D-positive
D. Group AB, D-positive

D. Group AB, D-positive

169. Six units of blood were ordered stat for a young female patient who has the following tube
typing results. The physician has just called requesting emergency release of 2 units of RBCs.
Anti-A: 2+
Anti-B: 4+
Anti-D: 3+
Rh control: 2+
A cells: 4+
B cells: 4+

Which of the following should be done first?

A. Perform a DAT on the patient's red cells
B. Tell the physician that no blood can be released until a full work-up has been done
C. Begin the antibody screening test
D. Select 2 units of group O, D-negative RBCs for emergency release.

D. Select 2 units of group O, D-negative RBCs for emergency release

170. Referring to the tube typing results in question 169,

Anti-A: 2+
Anti-B: 4+
Anti-D: 3+
Rh control: 2+
A cells: 4+
B cells: 4+
the most probable cause of the patient's positive Rh control test is that the patient has
A. A positive DAT result with anti-IgG
B. A cold autoantibody
C. Leukemia
D. Multiple myeloma

B. A cold autoantibody