TEST BANK
Modern Blood Banking and Transfusion Practices
Denise M. Harmening
7th Edition
,Table of Contents
Chapter 01 Red Blood Cells and Platelet Preservation-Historical Perspectives and Current
Trends 1
Chapter 02 Basic Genetics 9
Chapter 03 Fundamentals of Immunology 16
Chapter 04 Concepts in Molecular Biology 28
Chapter 05 The Antiglobulin Test 37
Chapter 06 The ABO Blood Group System 45
Chapter 07 The Rh Blood Group System 57
Chapter 08 Blood Group Terminology and Common Blood Groups 66
Chapter 09 Uncommon Blood Groups 97
Chapter 10 Detection and Identification of Antibodies 108
Chapter 11 Pre-Transfusion Testing 122
Chapter 12 Blood Bank Technologies and Automation 128
Chapter 13 Donor Selection 133
Chapter 14 Transfusion-Transmitted Diseases 142
Chapter 15 Component Preparation 150
Chapter 16 Transfusion Therapy 159
Chapter 17 Adverse Effects of Blood Transfusion 176
Chapter 18 Apheresis 192
Chapter 19 Cellular Therapy in the Transplant Setting 203
Chapter 20 Hemolytic Disease of the Fetus and Newborn 214
Chapter 21 Autoimmune Hemolytic Anemias 224
Chapter 22 Tissue Banking as Part of the Transfusion Service 236
Chapter 23 The HLA System 241
Chapter 24 Relationship Testing 250
Chapter 25 Quality Management 257
Chapter 26 Patient Blood Management 267
Chapter 27 Transfusion Safety and Federal Regulatory Requirements 272
Chapter 28 Laboratory Information Systems in the Blood Bank 279
Chapter 29 Medicolegal and Ethical Aspects of Providing Blood Collection and
Transfusion Services 286
,______________________________________________________________________________________________
Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
Chapter 1. Red Blood Cells and Platelet Preservation: Historical Perspectives and
Current Trends
MULTIPLE CHOICE
1. Which metabolic pathway is responsible for generating 90% of the ATP for the RBC?
a. Pentose phosphate shunt
b. Luebering-Rapoport shunt
c. Glycolysis
d. Methemoglobin reductase
ANS: C KEY: Taxonomy Level: 1 LO: 1-3
2. A unit of blood was returned to the blood bank before it was spiked. Apparently the
patient’s IV failed. The unit of blood was outside the blood bank for 35 minutes. Which of
the statements below is most accurate?
a. The unit of blood should be discarded immediately.
b. The unit of blood can be returned to inventory.
c. The unit of blood must be transfused within 4 hours or be discarded at the end of
that time.
d. The unit of blood must be transfused with 24 hours.
ANS: C KEY: Taxonomy Level: 3 LO: 1-6
3. What effect does storage have on platelets?
a. Shrinking
b. Lysis
c. Repulsion
d. All of these.
ANS: B KEY: Taxonomy Level: 1 LO: 1-14
4. In the normal hemoglobin-oxygen dissociation curve, what percentage of oxygen is released
to the tissues when PO2 averages 40 mm Hg?
a. 75%
b. 25%
c. 100%
d. 50%
ANS: B KEY: Taxonomy Level: 2 LO: 1-4
5. What factors are known to influence platelet metabolism and function?
a. Storage temperature
b. Initial pH
c. Platelet count
d. All of the above
ANS: D KEY: Taxonomy Level: 2 LO: 1-14
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1|Page
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Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
6. Which of the following red blood cell morphologies may be present on the peripheral blood
smear as a result of loss of RBC membrane?
a. Spherocytes
b. Target cells
c. Burr cells
d. Schistocytes
ANS: A KEY: Taxonomy Level: 2 LO: 1-7
7. What does the term autologous transfusion refer to?
a. A parent donating blood for his or her child
b. An individual donating blood for a friend
c. An individual donating blood for a relative
d. An individual donating blood for his or her own transfusion
ANS: D KEY: Taxonomy Level: 1 LO: 1-1
8. What is the primary function of hemoglobin?
a. Iron metabolism
b. Porphyrin synthesis
c. Oxygen transport
d. Signal transduction
ANS: C KEY: Taxonomy Level: 1 LO: 1-2
9. All of the following areas of red blood cell biology are crucial for normal erythrocyte
survival except:
a. cellular metabolism.
b. RBC membrane.
c. site of the ABO antigen attachment.
d. hemoglobin structure.
ANS: C KEY: Taxonomy Level: 1 LO: 1-2
10. What is the correct biochemical composition of the RBC membrane?
a. 52% protein, 40% lipid, 8% carbohydrate
b. 40% protein, 8% lipid, 52% carbohydrate
c. 8% protein, 52% lipid, 40% carbohydrate
d. 8% lipid, 40% carbohydrate, 52% protein
ANS: A KEY: Taxonomy Level: 2 LO: 1-2
11. All of the following biochemical changes are associated with loss of red blood cell viability
upon storage except:
a. decreased pH.
b. loss of red blood cell function.
c. increased ATP level.
d. decreased glucose consumption.
ANS: C KEY: Taxonomy Level: 1 LO: 1-7
12. Which red blood cell preservative has a storage time of 35 days?
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Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
a. ACD
b. CPDA-1
c. AS-1
d. CPD
ANS: B KEY: Taxonomy Level: 1 LO: 1-9
13. The RBC membrane is relatively permeable to all of the following except:
a. chloride.
b. sodium.
c. bicarbonate.
d. water.
ANS: B KEY: Taxonomy Level: 1 LO: 1-2
14. Red blood cells frozen using the high-concentration glycerol technique are usually stored at
a. 0oC
b. -20oC
c. -65oC
d. -80oC
ANS: C KEY: Taxonomy Level: 1 LO: 1-6
15. What is the major biochemical consideration in platelet storage?
a. Glucose metabolism
b. Oxygen supply
c. Production of carbon dioxide
d. Regulation of pH
ANS: D KEY: Taxonomy Level: 2 LO: 1-14
16. What would the hemoglobin-oxygen dissociation curve depict in a patient exhibiting clinical
signs of alkalosis?
a. Normal
b. Shift to the left
c. Shift to the right
d. None of the above
ANS: B KEY: Taxonomy Level: 3 LO: 1-5
17. Name the main lipid components of a red blood cell membrane.
a. Phospholipid
b. Sphingomyelin
c. Glycolipid
d. Glycophorin A
ANS: A KEY: Taxonomy Level: 1 LO: 1-2
18. The ABO blood groups were discovered in 1901 by whom?
a. Charles Drew
b. Karl Landsteiner
c. Loutit and Mollison
______________________________________________________________________________________________
3|Page
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Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
d. Edward Lindeman
ANS: B KEY: Taxonomy Level: 1 LO: 1-1
19. A standing order of platelets was shipped to your facility by your supplier. It was
inadvertently left in the corner of the department until discovered 36 hours later. What
would the appropriate action be for the blood banker?
a. If the temperature in the box was 22 ± 2°C and the platelet swirl seemed OK, it
would be OK to accept the unit into inventory.
b. The platelets have fallen outside the supplier’s quality assurance. The unit should
be discarded because the pH has probably dropped too low and platelet activation
has been compromised.
c. If the temperature was 1°C to 6°C and the platelet swirl seemed OK, it would be
OK to accept the unit into inventory.
d. If the platelets appeared OK and passed the platelet swirl test after being placed on
the agitator, they could be accepted into the inventory.
ANS: B KEY: Taxonomy Level: 3 LO: 1-16
20. Which metabolic pathway permits the accumulation of 2,3 diphosphoglycerate (2,3-DPG)?
a. Glycolysis
b. Luebering-Rapoport shunt
c. Pentose phosphate shunt
d. Methemoglobin reductase
ANS: B KEY: Taxonomy Level: 1 LO: 1-8
21. All of the following are consistent with a "shift to the right" of the hemoglobin-oxygen
dissociation curve except:
a. increased 2,3-DPG.
b. 50% O2 saturation to tissues.
c. decreased 2,3-DPG.
d. decreased hemoglobin affinity for O2.
ANS: C KEY: Taxonomy Level: 2 LO: 1-4
22. Why are platelet transfusions performed?
a. Therapeutically to stop bleeding
b. Prophylactically to prevent bleeding
c. Both reasons.
d. Neither reason.
ANS: C KEY: Taxonomy Level: 1 LO: 1-15
23. What cryoprotective agent is added to red blood cells upon freezing?
a. Dextrose
b. Adsol
c. Glycerol
d. All of the above
ANS: C KEY: Taxonomy Level: 1 LO: 1-11
______________________________________________________________________________________________
4|Page
,______________________________________________________________________________________________
Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
24. If platelets are to be stored for 5 days on a rotator, what is the optimal storage temperature?
a. 1°C to 6°C
b. 20°C to 24°C
c. 35°C to 37°C
d. 1°C to 10°C
ANS: B KEY: Taxonomy Level: 2 LO: 1-16
25. Platelets are transfused to play which role in hemostasis?
a. Maintenance of vascular integrity
b. Initial arrest of bleeding by platelet plug formation
c. Stabilization of the hemostatic plug
d. All of the above
ANS: D KEY: Taxonomy Level: 1 LO: 1-15
26. Which of the following best describes "integral" membrane proteins?
a. Reside at the cytoplasmic surface of membrane
b. Span the entire membrane surface
c. Form the red blood cell cytoskeleton
d. None of the above
ANS: B KEY: Taxonomy Level: 2 LO: 1-2
27. How is stroma-free hemoglobin solution prepared?
a. Outdated red blood cells are concentrated, and stroma is removed.
b. Outdated red blood cells are diluted with saline, and stroma is removed.
c. Outdated red blood cells are lysed, and stroma is removed.
d. None of the above
ANS: C KEY: Taxonomy Level: 2 LO: 1-10
28. What is the normal life span of an RBC?
a. 100 days
b. 120 days
c. 120 hours
d. 2 days
ANS: B KEY: Taxonomy Level: 1 LO: 1-2
29. Regarding loss of RBC membrane deformability, all of the following are true except:
a. increase in ATP level.
b. decrease in ATP level.
c. increase in calcium level.
d. decrease in spectrin phosphorylation level.
ANS: A KEY: Taxonomy Level: 2 LO: 1-3
30. One of the most important controls of hemoglobin's affinity for oxygen is:
a. glucose.
b. 2,3-diphosphoglycerate (2,3-DPG).
c. K+.
______________________________________________________________________________________________
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Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
d. Ca++.
ANS: B KEY: Taxonomy Level: 2 LO: 1-4
31. The normal position of the oxygen dissociation curve depends on three ligands normally
found within the RBC. Which one of the following is not one of these ligands?
a. H+ ions
b. CO2
c. 2,3-diphosphoglycerate (2,3-DPG)
d. Na+
ANS: D KEY: Taxonomy Level: 2 LO: 1-4
32. Which of the following events does not occur while RBCs are stored?
a. 2,3-DPG levels increase.
b. Potassium levels increase.
c. Hgb has a decreased affinity for oxygen carrying capacity.
d. 2,3-DPG and potassium levels increase.
ANS: A KEY: Taxonomy Level: 2 LO: 1-5
33. In order to maintain ATP levels in stored blood, ____________ can be added to CPD to
extend the shelf-life of stored RBCs from 21 days to 35 days. This new preservative is
designated as CPDA-1.
a. mannitol
b. adenine saline
c. adenine and glucose
d. Rejuvenix
ANS: C KEY: Taxonomy Level: 1 LO: 1-5
34. Which type of blood storage container is no longer available for use in the United States
because it may limit the viability of RBCs?
a. Glass bottles
b. PVC plastic bags with DEHP
c. DEHP-free polyolefin containers
d. Latex-free plastic containers
ANS: A KEY: Taxonomy Level: 1 LO: 1-9
35. A rare unit of blood became outdated 48 hours ago but is needed for a patient. Which of the
following concepts applies to this situation?
a. The blood could be rejuvenated by adding Rejuvesol, being washed appropriately,
and being transfused within 48 hours.
b. The blood could be rejuvenated with Rejuvesol, washed, and given immediately to
the patient.
c. Once a unit is outdated, it is no longer available for use.
d. The unit can be rejuvenated immediately, washed, and stored in the appropriate
refrigerator until needed later in the week.
ANS: B KEY: Taxonomy Level: 3 LO: 1-12
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Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
36. FDA-approved rejuvenation solution contains all of the following EXCEPT:
a. adenine
b. glycerin
c. inosine
d. phosphate
ANS: B KEY: Taxonomy Level: 1 LO: 1-13
37. Rejuvenated RBCs may be prepared up to three days after expiration when stored in all of
these EXCEPT:
a. ACD
b. AS-1
c. CPD
d. CPDA-1
ANS: A KEY: Taxonomy Level: 2 LO: 1-13
38. When is the corrected count increment (CCI) of platelets is usually determined?
a. Immediately prior to transfusion.
b. During the transfusion procedure.
c. Ten to 60 minutes after transfusion.
d. One to two days after transfusion.
ANS: C KEY: Taxonomy Level: 3 LO: 1-15
39. Generally, the quality control measurements required by various accreditation organizations
for platelet concentrates include:
a. platelet concentrate volume and platelet count.
b. leukocyte count if claims of leukoreduction are made.
c. pH of the unit.
d. All of the above
ANS: D KEY: Taxonomy Level: 1 LO: 1
40. Which of the following is not a major factor that influences platelet shape and activation
while the platelet is in storage?
a. pH
b. Volume
c. Agitation
d. Temperature
ANS: B KEY: Taxonomy Level: 1 LO: 1-18
41. Proper agitation of platelets while they are being stored is:
a. important because when not agitated properly the platelets will stick together and
not perform properly when transfused.
b. important because the pH of the stored platelets will increase and the platelets will
lose functionality.
c. important because the pH of the stored platelets will decrease and the platelets will
lose functionality.
d. not important because it has been deemed unnecessary by the FDA.
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Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
ANS: C KEY: Taxonomy Level: 2 LO: 1-17
42. Which of the following is not a commercial system approved by the FDA for screening for
bacterial contamination in platelet collections?
a. BacT/ALERT
b. eBDS
c. BACTEC
d. Scansytems
ANS: C KEY: Taxonomy Level: 1 LO: 1-19
43. Which of the following is a possible future method in pathogen reduction to treat platelet
components?
a. UV light and amotosalen
b. Amphotericin B
c. Vitamin B12 and UV light
d. Penicillin
ANS: A KEY: Taxonomy Level: 2 LO: 1-19
44. Which of the following is licensed additive solutions approved for the storage of red blood
cells for 42 days?
a. Adsol (AS-1)
b. Nutricel (AS-3)
c. Optisol (AS-5)
d. All of the above
ANS: D KEY: Taxonomy Level: 2 LO: 1-20
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8|Page
Modern Blood Banking and Transfusion Practices
Denise M. Harmening
7th Edition
,Table of Contents
Chapter 01 Red Blood Cells and Platelet Preservation-Historical Perspectives and Current
Trends 1
Chapter 02 Basic Genetics 9
Chapter 03 Fundamentals of Immunology 16
Chapter 04 Concepts in Molecular Biology 28
Chapter 05 The Antiglobulin Test 37
Chapter 06 The ABO Blood Group System 45
Chapter 07 The Rh Blood Group System 57
Chapter 08 Blood Group Terminology and Common Blood Groups 66
Chapter 09 Uncommon Blood Groups 97
Chapter 10 Detection and Identification of Antibodies 108
Chapter 11 Pre-Transfusion Testing 122
Chapter 12 Blood Bank Technologies and Automation 128
Chapter 13 Donor Selection 133
Chapter 14 Transfusion-Transmitted Diseases 142
Chapter 15 Component Preparation 150
Chapter 16 Transfusion Therapy 159
Chapter 17 Adverse Effects of Blood Transfusion 176
Chapter 18 Apheresis 192
Chapter 19 Cellular Therapy in the Transplant Setting 203
Chapter 20 Hemolytic Disease of the Fetus and Newborn 214
Chapter 21 Autoimmune Hemolytic Anemias 224
Chapter 22 Tissue Banking as Part of the Transfusion Service 236
Chapter 23 The HLA System 241
Chapter 24 Relationship Testing 250
Chapter 25 Quality Management 257
Chapter 26 Patient Blood Management 267
Chapter 27 Transfusion Safety and Federal Regulatory Requirements 272
Chapter 28 Laboratory Information Systems in the Blood Bank 279
Chapter 29 Medicolegal and Ethical Aspects of Providing Blood Collection and
Transfusion Services 286
,______________________________________________________________________________________________
Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
Chapter 1. Red Blood Cells and Platelet Preservation: Historical Perspectives and
Current Trends
MULTIPLE CHOICE
1. Which metabolic pathway is responsible for generating 90% of the ATP for the RBC?
a. Pentose phosphate shunt
b. Luebering-Rapoport shunt
c. Glycolysis
d. Methemoglobin reductase
ANS: C KEY: Taxonomy Level: 1 LO: 1-3
2. A unit of blood was returned to the blood bank before it was spiked. Apparently the
patient’s IV failed. The unit of blood was outside the blood bank for 35 minutes. Which of
the statements below is most accurate?
a. The unit of blood should be discarded immediately.
b. The unit of blood can be returned to inventory.
c. The unit of blood must be transfused within 4 hours or be discarded at the end of
that time.
d. The unit of blood must be transfused with 24 hours.
ANS: C KEY: Taxonomy Level: 3 LO: 1-6
3. What effect does storage have on platelets?
a. Shrinking
b. Lysis
c. Repulsion
d. All of these.
ANS: B KEY: Taxonomy Level: 1 LO: 1-14
4. In the normal hemoglobin-oxygen dissociation curve, what percentage of oxygen is released
to the tissues when PO2 averages 40 mm Hg?
a. 75%
b. 25%
c. 100%
d. 50%
ANS: B KEY: Taxonomy Level: 2 LO: 1-4
5. What factors are known to influence platelet metabolism and function?
a. Storage temperature
b. Initial pH
c. Platelet count
d. All of the above
ANS: D KEY: Taxonomy Level: 2 LO: 1-14
______________________________________________________________________________________________
1|Page
,______________________________________________________________________________________________
Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
6. Which of the following red blood cell morphologies may be present on the peripheral blood
smear as a result of loss of RBC membrane?
a. Spherocytes
b. Target cells
c. Burr cells
d. Schistocytes
ANS: A KEY: Taxonomy Level: 2 LO: 1-7
7. What does the term autologous transfusion refer to?
a. A parent donating blood for his or her child
b. An individual donating blood for a friend
c. An individual donating blood for a relative
d. An individual donating blood for his or her own transfusion
ANS: D KEY: Taxonomy Level: 1 LO: 1-1
8. What is the primary function of hemoglobin?
a. Iron metabolism
b. Porphyrin synthesis
c. Oxygen transport
d. Signal transduction
ANS: C KEY: Taxonomy Level: 1 LO: 1-2
9. All of the following areas of red blood cell biology are crucial for normal erythrocyte
survival except:
a. cellular metabolism.
b. RBC membrane.
c. site of the ABO antigen attachment.
d. hemoglobin structure.
ANS: C KEY: Taxonomy Level: 1 LO: 1-2
10. What is the correct biochemical composition of the RBC membrane?
a. 52% protein, 40% lipid, 8% carbohydrate
b. 40% protein, 8% lipid, 52% carbohydrate
c. 8% protein, 52% lipid, 40% carbohydrate
d. 8% lipid, 40% carbohydrate, 52% protein
ANS: A KEY: Taxonomy Level: 2 LO: 1-2
11. All of the following biochemical changes are associated with loss of red blood cell viability
upon storage except:
a. decreased pH.
b. loss of red blood cell function.
c. increased ATP level.
d. decreased glucose consumption.
ANS: C KEY: Taxonomy Level: 1 LO: 1-7
12. Which red blood cell preservative has a storage time of 35 days?
______________________________________________________________________________________________
2|Page
,______________________________________________________________________________________________
Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
a. ACD
b. CPDA-1
c. AS-1
d. CPD
ANS: B KEY: Taxonomy Level: 1 LO: 1-9
13. The RBC membrane is relatively permeable to all of the following except:
a. chloride.
b. sodium.
c. bicarbonate.
d. water.
ANS: B KEY: Taxonomy Level: 1 LO: 1-2
14. Red blood cells frozen using the high-concentration glycerol technique are usually stored at
a. 0oC
b. -20oC
c. -65oC
d. -80oC
ANS: C KEY: Taxonomy Level: 1 LO: 1-6
15. What is the major biochemical consideration in platelet storage?
a. Glucose metabolism
b. Oxygen supply
c. Production of carbon dioxide
d. Regulation of pH
ANS: D KEY: Taxonomy Level: 2 LO: 1-14
16. What would the hemoglobin-oxygen dissociation curve depict in a patient exhibiting clinical
signs of alkalosis?
a. Normal
b. Shift to the left
c. Shift to the right
d. None of the above
ANS: B KEY: Taxonomy Level: 3 LO: 1-5
17. Name the main lipid components of a red blood cell membrane.
a. Phospholipid
b. Sphingomyelin
c. Glycolipid
d. Glycophorin A
ANS: A KEY: Taxonomy Level: 1 LO: 1-2
18. The ABO blood groups were discovered in 1901 by whom?
a. Charles Drew
b. Karl Landsteiner
c. Loutit and Mollison
______________________________________________________________________________________________
3|Page
,______________________________________________________________________________________________
Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
d. Edward Lindeman
ANS: B KEY: Taxonomy Level: 1 LO: 1-1
19. A standing order of platelets was shipped to your facility by your supplier. It was
inadvertently left in the corner of the department until discovered 36 hours later. What
would the appropriate action be for the blood banker?
a. If the temperature in the box was 22 ± 2°C and the platelet swirl seemed OK, it
would be OK to accept the unit into inventory.
b. The platelets have fallen outside the supplier’s quality assurance. The unit should
be discarded because the pH has probably dropped too low and platelet activation
has been compromised.
c. If the temperature was 1°C to 6°C and the platelet swirl seemed OK, it would be
OK to accept the unit into inventory.
d. If the platelets appeared OK and passed the platelet swirl test after being placed on
the agitator, they could be accepted into the inventory.
ANS: B KEY: Taxonomy Level: 3 LO: 1-16
20. Which metabolic pathway permits the accumulation of 2,3 diphosphoglycerate (2,3-DPG)?
a. Glycolysis
b. Luebering-Rapoport shunt
c. Pentose phosphate shunt
d. Methemoglobin reductase
ANS: B KEY: Taxonomy Level: 1 LO: 1-8
21. All of the following are consistent with a "shift to the right" of the hemoglobin-oxygen
dissociation curve except:
a. increased 2,3-DPG.
b. 50% O2 saturation to tissues.
c. decreased 2,3-DPG.
d. decreased hemoglobin affinity for O2.
ANS: C KEY: Taxonomy Level: 2 LO: 1-4
22. Why are platelet transfusions performed?
a. Therapeutically to stop bleeding
b. Prophylactically to prevent bleeding
c. Both reasons.
d. Neither reason.
ANS: C KEY: Taxonomy Level: 1 LO: 1-15
23. What cryoprotective agent is added to red blood cells upon freezing?
a. Dextrose
b. Adsol
c. Glycerol
d. All of the above
ANS: C KEY: Taxonomy Level: 1 LO: 1-11
______________________________________________________________________________________________
4|Page
,______________________________________________________________________________________________
Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
24. If platelets are to be stored for 5 days on a rotator, what is the optimal storage temperature?
a. 1°C to 6°C
b. 20°C to 24°C
c. 35°C to 37°C
d. 1°C to 10°C
ANS: B KEY: Taxonomy Level: 2 LO: 1-16
25. Platelets are transfused to play which role in hemostasis?
a. Maintenance of vascular integrity
b. Initial arrest of bleeding by platelet plug formation
c. Stabilization of the hemostatic plug
d. All of the above
ANS: D KEY: Taxonomy Level: 1 LO: 1-15
26. Which of the following best describes "integral" membrane proteins?
a. Reside at the cytoplasmic surface of membrane
b. Span the entire membrane surface
c. Form the red blood cell cytoskeleton
d. None of the above
ANS: B KEY: Taxonomy Level: 2 LO: 1-2
27. How is stroma-free hemoglobin solution prepared?
a. Outdated red blood cells are concentrated, and stroma is removed.
b. Outdated red blood cells are diluted with saline, and stroma is removed.
c. Outdated red blood cells are lysed, and stroma is removed.
d. None of the above
ANS: C KEY: Taxonomy Level: 2 LO: 1-10
28. What is the normal life span of an RBC?
a. 100 days
b. 120 days
c. 120 hours
d. 2 days
ANS: B KEY: Taxonomy Level: 1 LO: 1-2
29. Regarding loss of RBC membrane deformability, all of the following are true except:
a. increase in ATP level.
b. decrease in ATP level.
c. increase in calcium level.
d. decrease in spectrin phosphorylation level.
ANS: A KEY: Taxonomy Level: 2 LO: 1-3
30. One of the most important controls of hemoglobin's affinity for oxygen is:
a. glucose.
b. 2,3-diphosphoglycerate (2,3-DPG).
c. K+.
______________________________________________________________________________________________
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Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
d. Ca++.
ANS: B KEY: Taxonomy Level: 2 LO: 1-4
31. The normal position of the oxygen dissociation curve depends on three ligands normally
found within the RBC. Which one of the following is not one of these ligands?
a. H+ ions
b. CO2
c. 2,3-diphosphoglycerate (2,3-DPG)
d. Na+
ANS: D KEY: Taxonomy Level: 2 LO: 1-4
32. Which of the following events does not occur while RBCs are stored?
a. 2,3-DPG levels increase.
b. Potassium levels increase.
c. Hgb has a decreased affinity for oxygen carrying capacity.
d. 2,3-DPG and potassium levels increase.
ANS: A KEY: Taxonomy Level: 2 LO: 1-5
33. In order to maintain ATP levels in stored blood, ____________ can be added to CPD to
extend the shelf-life of stored RBCs from 21 days to 35 days. This new preservative is
designated as CPDA-1.
a. mannitol
b. adenine saline
c. adenine and glucose
d. Rejuvenix
ANS: C KEY: Taxonomy Level: 1 LO: 1-5
34. Which type of blood storage container is no longer available for use in the United States
because it may limit the viability of RBCs?
a. Glass bottles
b. PVC plastic bags with DEHP
c. DEHP-free polyolefin containers
d. Latex-free plastic containers
ANS: A KEY: Taxonomy Level: 1 LO: 1-9
35. A rare unit of blood became outdated 48 hours ago but is needed for a patient. Which of the
following concepts applies to this situation?
a. The blood could be rejuvenated by adding Rejuvesol, being washed appropriately,
and being transfused within 48 hours.
b. The blood could be rejuvenated with Rejuvesol, washed, and given immediately to
the patient.
c. Once a unit is outdated, it is no longer available for use.
d. The unit can be rejuvenated immediately, washed, and stored in the appropriate
refrigerator until needed later in the week.
ANS: B KEY: Taxonomy Level: 3 LO: 1-12
______________________________________________________________________________________________
6|Page
,______________________________________________________________________________________________
Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
36. FDA-approved rejuvenation solution contains all of the following EXCEPT:
a. adenine
b. glycerin
c. inosine
d. phosphate
ANS: B KEY: Taxonomy Level: 1 LO: 1-13
37. Rejuvenated RBCs may be prepared up to three days after expiration when stored in all of
these EXCEPT:
a. ACD
b. AS-1
c. CPD
d. CPDA-1
ANS: A KEY: Taxonomy Level: 2 LO: 1-13
38. When is the corrected count increment (CCI) of platelets is usually determined?
a. Immediately prior to transfusion.
b. During the transfusion procedure.
c. Ten to 60 minutes after transfusion.
d. One to two days after transfusion.
ANS: C KEY: Taxonomy Level: 3 LO: 1-15
39. Generally, the quality control measurements required by various accreditation organizations
for platelet concentrates include:
a. platelet concentrate volume and platelet count.
b. leukocyte count if claims of leukoreduction are made.
c. pH of the unit.
d. All of the above
ANS: D KEY: Taxonomy Level: 1 LO: 1
40. Which of the following is not a major factor that influences platelet shape and activation
while the platelet is in storage?
a. pH
b. Volume
c. Agitation
d. Temperature
ANS: B KEY: Taxonomy Level: 1 LO: 1-18
41. Proper agitation of platelets while they are being stored is:
a. important because when not agitated properly the platelets will stick together and
not perform properly when transfused.
b. important because the pH of the stored platelets will increase and the platelets will
lose functionality.
c. important because the pH of the stored platelets will decrease and the platelets will
lose functionality.
d. not important because it has been deemed unnecessary by the FDA.
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Test Bank - Modern Blood Banking and Transfusion Practices, 7th Edition (Harmening, 2019)
ANS: C KEY: Taxonomy Level: 2 LO: 1-17
42. Which of the following is not a commercial system approved by the FDA for screening for
bacterial contamination in platelet collections?
a. BacT/ALERT
b. eBDS
c. BACTEC
d. Scansytems
ANS: C KEY: Taxonomy Level: 1 LO: 1-19
43. Which of the following is a possible future method in pathogen reduction to treat platelet
components?
a. UV light and amotosalen
b. Amphotericin B
c. Vitamin B12 and UV light
d. Penicillin
ANS: A KEY: Taxonomy Level: 2 LO: 1-19
44. Which of the following is licensed additive solutions approved for the storage of red blood
cells for 42 days?
a. Adsol (AS-1)
b. Nutricel (AS-3)
c. Optisol (AS-5)
d. All of the above
ANS: D KEY: Taxonomy Level: 2 LO: 1-20
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