Test Bank For Basic & Applied Concepts of Blood Banking
Practices 5th Edition – By Paula Howard
| Verified Chapter's 1 - 16 | Complete
,Table of Contents Qg Qg
Part I: Quality and Safety Issues
Qg Qg Qg Qg Qg
1. Quality Assurance and Regulation of the Blood Industry: Safety Issues in the Blood Bank……
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Qg II: Foundations: Basic Sciences and Reagents
Qg Qg Qg Qg Qg
2. Immunology: Basic Principles and Applications in the Blood Bank ………………………………………………
Qg Qg Qg Qg Qg Qg Qg Qg Qg
3. Blood Banking Reagents: Overview and Applications……………………………………………………………
Qg Qg Qg Qg Qg
Principles in Blood Banking……………………………………………………………………………………….18
Qg Qg Qg Qg Q g Part
Qg Major Blood Groups
Qg Qg
5. ABO and H Blood Group Systems and Secretor Status……………………………………………………………
Qg Qg Qg Qg Qg Qg Qg Qg Qg
Group System……………………………………………………………………………………………………26
Qg Qg
7. Other Red Cell Blood Group Systems, Human Leukocyte Antigens, and Platelet Antigens…………
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Qg IV: Essentials of Pretransfusion Testing
Qg Qg Qg Qg
8. Antibody Qg Qg Q g Detection Qg Qg Q g and Qg Qg Q g Identification………………………………………………………………………………
Qg Compatibility Qg Qg Qg Qg Q g Testing………………………………………………………………………………………………………38
10. Blood Bank Automation for Transfusion Services……………………………………………………………………
Qg Qg Qg Qg Qg
Qg Considerations in Immunohematology Qg Qg
11. Adverse Complications of Transfusions………………………………………………………………………………….46
Q
g Qg Q
g
12. Hemolytic Disease of the Fetus and Newborn…………………………………………………………………………
Qg Qg Qg Qg Qg Qg
Qg Collecting and Testing Qg Qg
13. Donor Selection and Phlebotomy………………………………………………………………………………………….55
Qg Qg Qg Qg
Blood…………………………………………………………………………………………………….60
Qg Q g Part VII: Blood Comp
Qg Qg Qg
Qg Transfusion Therapy Qg
15. Blood Component Preparation and Therapy…………………………………………………………………………….63
Qg Qg Qg Qg
16. Transfusion Therapy in Selected Patients……………………………………………………………………………….. 66
Qg Qg Qg Qg Qg
,Chapter 01: Quality Assurance and Regulation of the Blood Industry and Safety Issues in the B
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
Q g Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
MULTIPLE CHOICE Qg
1. Biosafety levels determine: Qg Qg
a. on what floor certain infectious disease testing can be performed.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
b. the degree of risk for certain areas of a health care facility to
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
exposure to infectious diseases.
Qg Qg Q g Qg
c. the amount of ventilation required in a transfusion service.
Qg Qg Qg Qg Qg Qg Qg Qg
d. how many biohazardous waste containers a laboratory must have.
Qg Qg Qg Qg Qg Qg Qg Qg
ANS: B Qg
OSHA defines biosafety levels based on potential exposure to infectious material.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
2. A laboratory technologist decided she would like to bring her lab coat home for laundering b
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
wrinkles when
Qg Qg
it was returned by the laboratory’s laundry service. Is this practice acceptable?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Yes, if she uses 10% bleach
Qg Qg Qg Qg Qg
b. Yes, if she clears it with her supervisor
Qg Qg Qg Qg Qg Qg Qg
c. Yes, as long as she removes the coat and does not wear it home
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
d. No, because the laboratory is a biosafety level 2, and lab coats
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
may not be removed
Qg Qg Qg Q g
ANS: D Qg
Methods of transporting the lab coat and the risk of contamination do not permit health care
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
home for cleaning.
Qg Qg Q g
DIF: Level 2 Qg
3. Personal protective equipment includes:
Qg Qg Qg
a. safety glasses. Qg
b. splash barriers. Qg
c. masks.
d. All of the above Qg Qg Qg
ANS: D Qg
Safety glasses, splash barriers, and masks are types of personal protective devices.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
4. At what point in the employment process should safety training take place?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. During orientation and training Qg Qg Qg
b. Following lab training when employees are more familiar with
Qg Qg Qg Qg Qg Qg Qg Qg
their responsibilities
Qg Q g
c. Following the employees’ first evaluation Qg Qg Qg Qg
d. Before independent work is permitted and annually thereafter
Qg Qg Qg Qg Qg Qg Qg
ANS: D Qg
The Occupation Safety and Health Administration requires safety training before independent w
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
annually
Qg thereafter. Q g
DIF: Level 1 Qg
, 7. Which of the following is true regarding good manufacturing practices (GMPs)?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. GMPs are legal requirements established by the Food and Drug Administration.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
b. GMPs are optional guidelines written by the AABB.
Qg Qg Qg Qg Qg Qg Qg
c. GMPs are required only by pharmaceutical companies.
Qg Qg Qg Qg Qg Qg
d. GMPs are part of the quality control requirements for blood products.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
ANS: A Qg
Good manufacturing practices are requirements established by the Food and Drug Administratio
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
8. Which of the following is an example of an unacceptable record-keeping procedure?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Using dittos in columns to save time Qg Qg Qg Qg Qg Qg
b. Recording the date and initials next to a correction Qg Qg Qg Qg Qg Qg Qg Qg
c. Not deleting the original entry when making a correction
Qg Qg Qg Qg Qg Qg Qg Qg
d. Always using permanent ink on all records Qg Qg Qg Qg Qg Qg
ANS: A Qg
All records must be clearly written. Dittos are unacceptable.
Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
9. A technologist in training noticed that the person training her had not recorded the results of
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
helpful, she carefully
Qg recorded the results she saw at a later time, using the technologist’s
Qg Qg Q g Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
acceptable procedure?
Qg Qg
a. Yes; all results must be recorded regardless of who did the test.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
b. No; she should have brought the error to the technologist’s attention.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
c. Yes; because she used the other technologist’s initials.
Qg Qg Qg Qg Qg Qg Qg
d. Yes; as long as she records the result in pencil.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
ANS: B Qg
This is an example of poor record keeping; results must be recorded when the test is perform
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
doing the test.
Qg Qg Qg
DIF: Level 3 Qg
10. Unacceptable quality control results for the antiglobulin test performed in test tubes may be n
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. preventive maintenance has not been performed on the cell washer.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
b. the technologist performing the test was never trained.
Qg Qg Qg Qg Qg Qg Qg
c. the reagents used were improperly stored.
Qg Qg Qg Qg Qg
d. All of the above Qg Qg Qg
ANS: D Qg
Training, equipment maintenance, and reagent quality can affect quality control.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 2 Qg
11. All of the following are true regarding competency testing except:
Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. it must be performed following training.
Qg Qg Qg Qg Qg
b. it must be performed on an annual basis.
Qg Qg Qg Qg Qg Qg Qg
c. it is required only if the technologist has no experience.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
d. retraining is required if there is a failure in competency testing.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
ANS: C Qg
All employees must have competency testing following training and annually thereafter. If ther
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
competency testing,
Qg retraining is required. Qg Q g Qg Qg
DIF: Level 2 Qg
,14. The standard operating procedure is a document that:
Qg Qg Qg Qg Qg Qg Qg
a. helps achieve consistency of results.
Qg Qg Qg Qg
b. may be substituted with package inserts.
Qg Qg Qg Qg Qg
c. is necessary only for training new employees.
Qg Qg Qg Qg Qg Qg
d. must be very detailed to be accurate.
Qg Qg Qg Qg Qg Qg
ANS: A Qg
Standard operating procedures are written procedures that help achieve consistency and should
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 2 Qg
15. Employee training takes place: Qg Qg Qg
a. after hiring and following implementation of new procedures.
Qg Qg Qg Qg Qg Qg Qg
b. following competency assessment. Qg Qg
c. only for new inexperienced employees.
Qg Qg Qg Qg
d. as procedures are validated.
Qg Qg Qg
ANS: A Qg
Training occurs with all new employees regardless of their experience and following implemen
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
16. Plans that provide the framework for establishing quality assurance in an organization are:
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. current good manufacturing practices. Qg Qg Qg
b. standard operating procedures. Qg Qg
c. change control plan. Qg Qg
d. continuous quality improvement plan. Qg Qg Qg
ANS: D Qg
The total quality management or continuous quality improvement plan are part of the quality
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Q
organization.
Qg
DIF: Level 1 Qg
17. A facility does not validate a refrigerator before use. What is a potential outcome?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. The facility is in violation of current good manufacturing practices and
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
could be
Qg Qg Q g cited Qg by the Food and
Qg Qg Qg Qg Drug Administration.
Qg
b. The facility Qg is in
Qg Qg Qg compliance if the Qg Qg Qg equipment functions properly. Qg Qg
c. The facility Qg is in
Qg Qg Qg compliance if the Qg Qg Qg blood products stored in it are not transfused.
Qg Qg Qg Qg Qg Qg Qg
d. The facility Qg is in
Qg Qg Qg violation of AABB Qg Qg Qg and may no longer be members.
Qg Qg Qg Qg Qg
ANS: A Qg
Validation of equipment is a current good manufacturing practice, which is a legal requirement
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Food and Drug
Qg Administration.
Qg Qg Q g
DIF: Level 2 Qg
MULTIPLE RESPONSE Qg
1. In a routine audit of a facilities blood collection area, the quality assurance department found
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
bags used on that
Qg Qg particular day had expired. What is the appropriate course of action? (
Qg Qg Q g Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
apply.)
Qg
a. Initiate a root cause analysis and quarantine the blood collected in the
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
expired bags.
Qg Q g
b. Notify the FDA since the expired bags were distributed.
Qg Qg Qg Qg Qg Qg Qg Qg
c. Change the expiration date on the bags to avoid legal issues.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
d. Fire the donor room supervisor, and discard the blood collected in the
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
,MATCHING
Match the government or accrediting agencies with the description that best fits their purpose
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Ensures safe and healthful working conditions
Qg Qg Qg Qg Qg
b. Ensures the safety and efficacy of biologics, drugs, and devices
Qg Qg Qg Qg Qg Qg Qg Qg Qg
c. Provides peer-reviewed accreditation for hospital laboratories
Qg Qg Qg Qg Qg
d. Professional organization that accredits blood banks and transfusion services
Qg Qg Qg Qg Qg Qg Qg Qg
e. Makes recommendations to the Occupational Safety and Health
Qg Qg Qg Qg Qg Qg Qg
Administration regarding the prevention of disease transmission
Qg Q g Qg Qg Qg Qg Qg
1. FDA
2. OSHA
3. CDC
4. AABB
5. CAP
1. ANS: B DIF: Level 1
Qg
2. ANS: A DIF: Level 1
Qg
3. ANS: E DIF: Level 1
Qg
4. ANS: D DIF: Level 1
Qg
5. ANS: C DIF: Level 1
Qg
Match the following descriptions with the appropriate terms.
Qg Qg Qg Qg Qg Qg Qg
a. The CAP survey is an example
Qg Qg Qg Qg Qg
b. Systematic evaluations to determine whether procedures are being followed
Qg Qg Qg Qg Qg Qg Qg Qg
c. Testing to determine the accuracy and precision of reagents and equipment
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
d. Process of standardizing an instrument against a known value
Qg Qg Qg Qg Qg Qg Qg Qg
e. Removal of products from the market that might compromise the
Qg Qg Qg Qg Qg Qg Qg Qg Qg
safety of the recipient
Qg Qg Qg Q g
f. Degree to which a measurement represents the true value
Qg Qg Qg Qg Qg Qg Qg Qg
g. Establishing that a specific process produces an expected result
Qg Qg Qg Qg Qg Qg Qg Qg
h. Evaluation of an employee’s ability to perform a specific skill
Qg Qg Qg Qg Qg Qg Qg Qg Qg
i. Investigation and identification of the factors that contributed to an error
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
j. Maximizes the duration of equipment and increases the reliability
Qg Qg Qg Qg Qg Qg Qg Qg
of the equipment
Qg Qg Q g
k. System to plan and implement changes to prevent problems
Qg Qg Qg Qg Qg Qg Qg Qg
6. Root cause analysis
Qg Qg
7. Recall
8. Accuracy
9. Validation
10. Calibration
11. Quality control Qg
12. Proficiency test Qg
13. Competency assessment Qg
14. Change control Qg
15. Audit
16. Preventive maintenance Qg
6. ANS: Qg Q g I DIF: Level 1
Qg
7. ANS: Qg Q g E DIF: Level 1
Qg
8. ANS: Qg Q g F DIF: Level 1
Qg
9. ANS: Qg Q g G DIF: Level 1
Qg
10. ANS: Qg Q g D DIF: Level 1
Qg
11. ANS: Qg Q g C DIF: Level 1
Qg
,3. Quality control is the same as quality assurance.
Qg Qg Qg Qg Qg Qg Qg
ANS: F Qg
Quality control is performed on reagents and equipment; quality assurance is a system to ens
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
effective products.
Qg Qg
DIF: Level 1 Qg
,Chapter 02: Immunology: Basic Principles and Applications in the Blood Bank
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
MULTIPLE CHOICE Qg
1. Select the cell involved in humoral immunity.
Qg Qg Qg Qg Qg Qg
a. Neutrophils
b. T lymphocytesQg
c. B lymphocytesQg
d. Monocytes
ANS: C Qg
B lymphocytes have the ability to transform into plasma cells to produce antibodies, which is
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Q
response.
Qg
DIF: Level 2 Qg
2. What process is described by opsonization?
Qg Qg Qg Qg Qg
a. Lysis of cells Qg Qg
b. Binding to cells or antigens Qg Qg Qg Qg
c. Ingestion of cells Qg Qg
d. Phagocytosis
ANS: B Qg
Opsonization promotes phagocytosis by binding to cells or antigens.
Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
3. Select the term that describes cells or tissue from a genetically different individual within the
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Allogeneic
b. Autologous
c. Xenogeneic
d. Autograft
ANS: A Qg
Allogeneic cells or tissue come from a genetically different individual within the same species.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
4. Select the substance that regulates the activity of other cells by binding to specific receptors.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Cytokines
b. Complement
c. Immunoglobulins
d. Anaphylatoxin
ANS: A Qg
Cytokines are proteins secreted by cells that regulate the activity of other cells by binding to
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Q
DIF: Level 1 Qg
5. Which of the following is responsible for the activation of the classic pathway of complement?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Bacteria
b. Foreign proteins Qg
c. Virus
d. Antibody bound to antigen Qg Qg Qg
ANS: D Qg
,ANS: B Qg
The five distinctive heavy-chain molecules distinguish the class or isotype. Each heavy chain im
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
features, which
Qg permit them to have unique biological functions.
Qg Q g Qg Qg Qg Qg Qg Qg
DIF: Level 2 Qg
, 8. Select the immunoglobulin class produced first in the primary immune response.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. IgG
b. IgE
c. IgA
d. IgM
ANS: D Qg
IgM antibodies are produced first, followed by the production of IgG antibodies.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
9. In a serologic test, the term prozone is also known as:
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. equivalence.
b. antigen excess. Qg
c. antibody excess. Qg
d. serum-to-cell ratio. Qg
ANS: C Qg
Antibody excess is termed prozone, often leading to a false-negative reaction.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
10. What is the potential effect in a tube agglutination test if a red cell suspension with a concen
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Qg used?
a. False negatives Qg
b. False positives Qg
c. Hemolysis
d. No effect Qg
ANS: A Qg
Antigen excess is termed postzone and will lessen the reaction, causing a false-negative.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 3 Qg
11. After adding antigen and antibody to a test tube, one large agglutinate was observed. How sh
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
graded?
Qg
a. 2+
b. 3+
c. 4+
d. 0
ANS: C Qg
One large agglutinate is graded a 4+ reaction.
Qg Qg Qg Qg Qg Qg Qg
DIF: Level 2 Qg
12. Select the portion of the antibody molecule that imparts the antibody’s unique class function.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Constant region of the heavy chain Qg Qg Qg Qg Qg
b. Constant region of the light chain Qg Qg Qg Qg Qg
c. Variable region of the heavy chain Qg Qg Qg Qg Qg
d. Variable region of the light chain Qg Qg Qg Qg Qg
ANS: A Qg
The heavy-chain constant region has the function of the class.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
13. What portion of the antibody molecule binds to receptors on macrophages and assists in the
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Practices 5th Edition – By Paula Howard
| Verified Chapter's 1 - 16 | Complete
,Table of Contents Qg Qg
Part I: Quality and Safety Issues
Qg Qg Qg Qg Qg
1. Quality Assurance and Regulation of the Blood Industry: Safety Issues in the Blood Bank……
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Qg II: Foundations: Basic Sciences and Reagents
Qg Qg Qg Qg Qg
2. Immunology: Basic Principles and Applications in the Blood Bank ………………………………………………
Qg Qg Qg Qg Qg Qg Qg Qg Qg
3. Blood Banking Reagents: Overview and Applications……………………………………………………………
Qg Qg Qg Qg Qg
Principles in Blood Banking……………………………………………………………………………………….18
Qg Qg Qg Qg Q g Part
Qg Major Blood Groups
Qg Qg
5. ABO and H Blood Group Systems and Secretor Status……………………………………………………………
Qg Qg Qg Qg Qg Qg Qg Qg Qg
Group System……………………………………………………………………………………………………26
Qg Qg
7. Other Red Cell Blood Group Systems, Human Leukocyte Antigens, and Platelet Antigens…………
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Qg IV: Essentials of Pretransfusion Testing
Qg Qg Qg Qg
8. Antibody Qg Qg Q g Detection Qg Qg Q g and Qg Qg Q g Identification………………………………………………………………………………
Qg Compatibility Qg Qg Qg Qg Q g Testing………………………………………………………………………………………………………38
10. Blood Bank Automation for Transfusion Services……………………………………………………………………
Qg Qg Qg Qg Qg
Qg Considerations in Immunohematology Qg Qg
11. Adverse Complications of Transfusions………………………………………………………………………………….46
Q
g Qg Q
g
12. Hemolytic Disease of the Fetus and Newborn…………………………………………………………………………
Qg Qg Qg Qg Qg Qg
Qg Collecting and Testing Qg Qg
13. Donor Selection and Phlebotomy………………………………………………………………………………………….55
Qg Qg Qg Qg
Blood…………………………………………………………………………………………………….60
Qg Q g Part VII: Blood Comp
Qg Qg Qg
Qg Transfusion Therapy Qg
15. Blood Component Preparation and Therapy…………………………………………………………………………….63
Qg Qg Qg Qg
16. Transfusion Therapy in Selected Patients……………………………………………………………………………….. 66
Qg Qg Qg Qg Qg
,Chapter 01: Quality Assurance and Regulation of the Blood Industry and Safety Issues in the B
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
Q g Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
MULTIPLE CHOICE Qg
1. Biosafety levels determine: Qg Qg
a. on what floor certain infectious disease testing can be performed.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
b. the degree of risk for certain areas of a health care facility to
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
exposure to infectious diseases.
Qg Qg Q g Qg
c. the amount of ventilation required in a transfusion service.
Qg Qg Qg Qg Qg Qg Qg Qg
d. how many biohazardous waste containers a laboratory must have.
Qg Qg Qg Qg Qg Qg Qg Qg
ANS: B Qg
OSHA defines biosafety levels based on potential exposure to infectious material.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
2. A laboratory technologist decided she would like to bring her lab coat home for laundering b
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
wrinkles when
Qg Qg
it was returned by the laboratory’s laundry service. Is this practice acceptable?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Yes, if she uses 10% bleach
Qg Qg Qg Qg Qg
b. Yes, if she clears it with her supervisor
Qg Qg Qg Qg Qg Qg Qg
c. Yes, as long as she removes the coat and does not wear it home
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
d. No, because the laboratory is a biosafety level 2, and lab coats
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
may not be removed
Qg Qg Qg Q g
ANS: D Qg
Methods of transporting the lab coat and the risk of contamination do not permit health care
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
home for cleaning.
Qg Qg Q g
DIF: Level 2 Qg
3. Personal protective equipment includes:
Qg Qg Qg
a. safety glasses. Qg
b. splash barriers. Qg
c. masks.
d. All of the above Qg Qg Qg
ANS: D Qg
Safety glasses, splash barriers, and masks are types of personal protective devices.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
4. At what point in the employment process should safety training take place?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. During orientation and training Qg Qg Qg
b. Following lab training when employees are more familiar with
Qg Qg Qg Qg Qg Qg Qg Qg
their responsibilities
Qg Q g
c. Following the employees’ first evaluation Qg Qg Qg Qg
d. Before independent work is permitted and annually thereafter
Qg Qg Qg Qg Qg Qg Qg
ANS: D Qg
The Occupation Safety and Health Administration requires safety training before independent w
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
annually
Qg thereafter. Q g
DIF: Level 1 Qg
, 7. Which of the following is true regarding good manufacturing practices (GMPs)?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. GMPs are legal requirements established by the Food and Drug Administration.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
b. GMPs are optional guidelines written by the AABB.
Qg Qg Qg Qg Qg Qg Qg
c. GMPs are required only by pharmaceutical companies.
Qg Qg Qg Qg Qg Qg
d. GMPs are part of the quality control requirements for blood products.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
ANS: A Qg
Good manufacturing practices are requirements established by the Food and Drug Administratio
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
8. Which of the following is an example of an unacceptable record-keeping procedure?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Using dittos in columns to save time Qg Qg Qg Qg Qg Qg
b. Recording the date and initials next to a correction Qg Qg Qg Qg Qg Qg Qg Qg
c. Not deleting the original entry when making a correction
Qg Qg Qg Qg Qg Qg Qg Qg
d. Always using permanent ink on all records Qg Qg Qg Qg Qg Qg
ANS: A Qg
All records must be clearly written. Dittos are unacceptable.
Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
9. A technologist in training noticed that the person training her had not recorded the results of
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
helpful, she carefully
Qg recorded the results she saw at a later time, using the technologist’s
Qg Qg Q g Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
acceptable procedure?
Qg Qg
a. Yes; all results must be recorded regardless of who did the test.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
b. No; she should have brought the error to the technologist’s attention.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
c. Yes; because she used the other technologist’s initials.
Qg Qg Qg Qg Qg Qg Qg
d. Yes; as long as she records the result in pencil.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
ANS: B Qg
This is an example of poor record keeping; results must be recorded when the test is perform
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
doing the test.
Qg Qg Qg
DIF: Level 3 Qg
10. Unacceptable quality control results for the antiglobulin test performed in test tubes may be n
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. preventive maintenance has not been performed on the cell washer.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
b. the technologist performing the test was never trained.
Qg Qg Qg Qg Qg Qg Qg
c. the reagents used were improperly stored.
Qg Qg Qg Qg Qg
d. All of the above Qg Qg Qg
ANS: D Qg
Training, equipment maintenance, and reagent quality can affect quality control.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 2 Qg
11. All of the following are true regarding competency testing except:
Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. it must be performed following training.
Qg Qg Qg Qg Qg
b. it must be performed on an annual basis.
Qg Qg Qg Qg Qg Qg Qg
c. it is required only if the technologist has no experience.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
d. retraining is required if there is a failure in competency testing.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
ANS: C Qg
All employees must have competency testing following training and annually thereafter. If ther
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
competency testing,
Qg retraining is required. Qg Q g Qg Qg
DIF: Level 2 Qg
,14. The standard operating procedure is a document that:
Qg Qg Qg Qg Qg Qg Qg
a. helps achieve consistency of results.
Qg Qg Qg Qg
b. may be substituted with package inserts.
Qg Qg Qg Qg Qg
c. is necessary only for training new employees.
Qg Qg Qg Qg Qg Qg
d. must be very detailed to be accurate.
Qg Qg Qg Qg Qg Qg
ANS: A Qg
Standard operating procedures are written procedures that help achieve consistency and should
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 2 Qg
15. Employee training takes place: Qg Qg Qg
a. after hiring and following implementation of new procedures.
Qg Qg Qg Qg Qg Qg Qg
b. following competency assessment. Qg Qg
c. only for new inexperienced employees.
Qg Qg Qg Qg
d. as procedures are validated.
Qg Qg Qg
ANS: A Qg
Training occurs with all new employees regardless of their experience and following implemen
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
16. Plans that provide the framework for establishing quality assurance in an organization are:
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. current good manufacturing practices. Qg Qg Qg
b. standard operating procedures. Qg Qg
c. change control plan. Qg Qg
d. continuous quality improvement plan. Qg Qg Qg
ANS: D Qg
The total quality management or continuous quality improvement plan are part of the quality
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Q
organization.
Qg
DIF: Level 1 Qg
17. A facility does not validate a refrigerator before use. What is a potential outcome?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. The facility is in violation of current good manufacturing practices and
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
could be
Qg Qg Q g cited Qg by the Food and
Qg Qg Qg Qg Drug Administration.
Qg
b. The facility Qg is in
Qg Qg Qg compliance if the Qg Qg Qg equipment functions properly. Qg Qg
c. The facility Qg is in
Qg Qg Qg compliance if the Qg Qg Qg blood products stored in it are not transfused.
Qg Qg Qg Qg Qg Qg Qg
d. The facility Qg is in
Qg Qg Qg violation of AABB Qg Qg Qg and may no longer be members.
Qg Qg Qg Qg Qg
ANS: A Qg
Validation of equipment is a current good manufacturing practice, which is a legal requirement
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Food and Drug
Qg Administration.
Qg Qg Q g
DIF: Level 2 Qg
MULTIPLE RESPONSE Qg
1. In a routine audit of a facilities blood collection area, the quality assurance department found
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
bags used on that
Qg Qg particular day had expired. What is the appropriate course of action? (
Qg Qg Q g Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
apply.)
Qg
a. Initiate a root cause analysis and quarantine the blood collected in the
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
expired bags.
Qg Q g
b. Notify the FDA since the expired bags were distributed.
Qg Qg Qg Qg Qg Qg Qg Qg
c. Change the expiration date on the bags to avoid legal issues.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
d. Fire the donor room supervisor, and discard the blood collected in the
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
,MATCHING
Match the government or accrediting agencies with the description that best fits their purpose
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Ensures safe and healthful working conditions
Qg Qg Qg Qg Qg
b. Ensures the safety and efficacy of biologics, drugs, and devices
Qg Qg Qg Qg Qg Qg Qg Qg Qg
c. Provides peer-reviewed accreditation for hospital laboratories
Qg Qg Qg Qg Qg
d. Professional organization that accredits blood banks and transfusion services
Qg Qg Qg Qg Qg Qg Qg Qg
e. Makes recommendations to the Occupational Safety and Health
Qg Qg Qg Qg Qg Qg Qg
Administration regarding the prevention of disease transmission
Qg Q g Qg Qg Qg Qg Qg
1. FDA
2. OSHA
3. CDC
4. AABB
5. CAP
1. ANS: B DIF: Level 1
Qg
2. ANS: A DIF: Level 1
Qg
3. ANS: E DIF: Level 1
Qg
4. ANS: D DIF: Level 1
Qg
5. ANS: C DIF: Level 1
Qg
Match the following descriptions with the appropriate terms.
Qg Qg Qg Qg Qg Qg Qg
a. The CAP survey is an example
Qg Qg Qg Qg Qg
b. Systematic evaluations to determine whether procedures are being followed
Qg Qg Qg Qg Qg Qg Qg Qg
c. Testing to determine the accuracy and precision of reagents and equipment
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
d. Process of standardizing an instrument against a known value
Qg Qg Qg Qg Qg Qg Qg Qg
e. Removal of products from the market that might compromise the
Qg Qg Qg Qg Qg Qg Qg Qg Qg
safety of the recipient
Qg Qg Qg Q g
f. Degree to which a measurement represents the true value
Qg Qg Qg Qg Qg Qg Qg Qg
g. Establishing that a specific process produces an expected result
Qg Qg Qg Qg Qg Qg Qg Qg
h. Evaluation of an employee’s ability to perform a specific skill
Qg Qg Qg Qg Qg Qg Qg Qg Qg
i. Investigation and identification of the factors that contributed to an error
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
j. Maximizes the duration of equipment and increases the reliability
Qg Qg Qg Qg Qg Qg Qg Qg
of the equipment
Qg Qg Q g
k. System to plan and implement changes to prevent problems
Qg Qg Qg Qg Qg Qg Qg Qg
6. Root cause analysis
Qg Qg
7. Recall
8. Accuracy
9. Validation
10. Calibration
11. Quality control Qg
12. Proficiency test Qg
13. Competency assessment Qg
14. Change control Qg
15. Audit
16. Preventive maintenance Qg
6. ANS: Qg Q g I DIF: Level 1
Qg
7. ANS: Qg Q g E DIF: Level 1
Qg
8. ANS: Qg Q g F DIF: Level 1
Qg
9. ANS: Qg Q g G DIF: Level 1
Qg
10. ANS: Qg Q g D DIF: Level 1
Qg
11. ANS: Qg Q g C DIF: Level 1
Qg
,3. Quality control is the same as quality assurance.
Qg Qg Qg Qg Qg Qg Qg
ANS: F Qg
Quality control is performed on reagents and equipment; quality assurance is a system to ens
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
effective products.
Qg Qg
DIF: Level 1 Qg
,Chapter 02: Immunology: Basic Principles and Applications in the Blood Bank
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Howard: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 5th Edition
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
MULTIPLE CHOICE Qg
1. Select the cell involved in humoral immunity.
Qg Qg Qg Qg Qg Qg
a. Neutrophils
b. T lymphocytesQg
c. B lymphocytesQg
d. Monocytes
ANS: C Qg
B lymphocytes have the ability to transform into plasma cells to produce antibodies, which is
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Q
response.
Qg
DIF: Level 2 Qg
2. What process is described by opsonization?
Qg Qg Qg Qg Qg
a. Lysis of cells Qg Qg
b. Binding to cells or antigens Qg Qg Qg Qg
c. Ingestion of cells Qg Qg
d. Phagocytosis
ANS: B Qg
Opsonization promotes phagocytosis by binding to cells or antigens.
Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
3. Select the term that describes cells or tissue from a genetically different individual within the
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Allogeneic
b. Autologous
c. Xenogeneic
d. Autograft
ANS: A Qg
Allogeneic cells or tissue come from a genetically different individual within the same species.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
4. Select the substance that regulates the activity of other cells by binding to specific receptors.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Cytokines
b. Complement
c. Immunoglobulins
d. Anaphylatoxin
ANS: A Qg
Cytokines are proteins secreted by cells that regulate the activity of other cells by binding to
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Q
DIF: Level 1 Qg
5. Which of the following is responsible for the activation of the classic pathway of complement?
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Bacteria
b. Foreign proteins Qg
c. Virus
d. Antibody bound to antigen Qg Qg Qg
ANS: D Qg
,ANS: B Qg
The five distinctive heavy-chain molecules distinguish the class or isotype. Each heavy chain im
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
features, which
Qg permit them to have unique biological functions.
Qg Q g Qg Qg Qg Qg Qg Qg
DIF: Level 2 Qg
, 8. Select the immunoglobulin class produced first in the primary immune response.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. IgG
b. IgE
c. IgA
d. IgM
ANS: D Qg
IgM antibodies are produced first, followed by the production of IgG antibodies.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
9. In a serologic test, the term prozone is also known as:
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. equivalence.
b. antigen excess. Qg
c. antibody excess. Qg
d. serum-to-cell ratio. Qg
ANS: C Qg
Antibody excess is termed prozone, often leading to a false-negative reaction.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
10. What is the potential effect in a tube agglutination test if a red cell suspension with a concen
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
Qg used?
a. False negatives Qg
b. False positives Qg
c. Hemolysis
d. No effect Qg
ANS: A Qg
Antigen excess is termed postzone and will lessen the reaction, causing a false-negative.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 3 Qg
11. After adding antigen and antibody to a test tube, one large agglutinate was observed. How sh
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
graded?
Qg
a. 2+
b. 3+
c. 4+
d. 0
ANS: C Qg
One large agglutinate is graded a 4+ reaction.
Qg Qg Qg Qg Qg Qg Qg
DIF: Level 2 Qg
12. Select the portion of the antibody molecule that imparts the antibody’s unique class function.
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
a. Constant region of the heavy chain Qg Qg Qg Qg Qg
b. Constant region of the light chain Qg Qg Qg Qg Qg
c. Variable region of the heavy chain Qg Qg Qg Qg Qg
d. Variable region of the light chain Qg Qg Qg Qg Qg
ANS: A Qg
The heavy-chain constant region has the function of the class.
Qg Qg Qg Qg Qg Qg Qg Qg Qg
DIF: Level 1 Qg
13. What portion of the antibody molecule binds to receptors on macrophages and assists in the
Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg Qg
