Question 1

Which of the following products may lead to sepsis in a patient when contaminated with Escherichia coli?

Accepted Answer

A)  Packed red blood cells 
B)  Normal saline 
C)  Platelets 
D)  All of the above 
A)  Packed red blood cells 
B)  Normal saline 
C)  Platelets 
D)  All of the above

Question 2

The plasma level of unconjugated bilirubin is elevated in:

Accepted Answer

A)  intravascular hemolysis. 
B)  extravascular hemolysis. 
C)  intravascular and extravascular hemolysis. 
D)  none of the above. 
A)  intravascular hemolysis. 
B)  extravascular hemolysis. 
C)  intravascular and extravascular hemolysis. 
D)  none of the above.

Question 3

What should be done in the transfusion process when the patient temperature spikes from 37.5°C to 38.5°C within 30 minutes of transfusion?

Accepted Answer

A)  Continue the transfusion. 
B)  Stop the transfusion and keep the intravenous line open. 
C)  Treat with diphenhydramine (Benadryl). 
D)  Affix a leukocyte filter to transfusion line. 
A)  Continue the transfusion. 
B)  Stop the transfusion and keep the intravenous line open. 
C)  Treat with diphenhydramine (Benadryl). 
D)  Affix a leukocyte filter to transfusion line.

Question 4

What is the most frequent cause of circulatory overload?

Accepted Answer

A)  Transfusion of a unit at too slow a rate 
B)  Massive transfusion of blood components 
C)  Transfusion of a unit at too fast a rate 
D)  Transfusion of a partially deglycerolized unit 
A)  Transfusion of a unit at too slow a rate 
B)  Massive transfusion of blood components 
C)  Transfusion of a unit at too fast a rate 
D)  Transfusion of a partially deglycerolized unit

Question 5

All of the following are diseases that can mimic a transfusion reaction except:

Accepted Answer

A)  AML. 
B)  hemoglobin C disease. 
C)  G6PD deficiency. 
D)  PNH. 
A)  AML. 
B)  hemoglobin C disease. 
C)  G6PD deficiency. 
D)  PNH.

Question 6

A 35-year-old woman was transfused with 1 unit of packed red blood cells. The nurse monitoring the transfusion noticed hives on the patient's arm and an increase in body temperature. What is the choice of treatment for this patient?

Accepted Answer

A)  Leukopoor blood products 
B)  Antihistamines 
C)  Premedication with aspirin 
D)  None of the above 
A)  Leukopoor blood products 
B)  Antihistamines 
C)  Premedication with aspirin 
D)  None of the above

Question 7

What is the physiologic mechanism of histamine?

Accepted Answer

A)  Histamine is released when the allergen-reagin complex attaches to the surface of basophils, increasing vascular dilation and permeability 
B)  Histamine is released when the allergen-reagin complex attaches to the surface of tissue mast cells, increasing vascular dilation and permeability 
C)  Histamine is released when the allergen-reagin complex attaches to the surface of eosinophils, increasing vascular dilation and permeability 
D)  Histamine is released when the allergen-reagin complex attaches to the surface of tissue mast cells, decreasing vascular dilation and permeability 
A)  Histamine is released when the allergen-reagin complex attaches to the surface of basophils, increasing vascular dilation and permeability 
B)  Histamine is released when the allergen-reagin complex attaches to the surface of tissue mast cells, increasing vascular dilation and permeability 
C)  Histamine is released when the allergen-reagin complex attaches to the surface of eosinophils, increasing vascular dilation and permeability 
D)  Histamine is released when the allergen-reagin complex attaches to the surface of tissue mast cells, decreasing vascular dilation and permeability

Question 8

Which of the following should be collected immediately from a patient exhibiting signs of a septic reaction to blood products?

Accepted Answer

A)  DAT 
B)  Complete blood count (CB
C)  
C)  Urine sample 
D)  Blood cultures 
A)  DAT 
B)  Complete blood count (CB
C)  
C)  Urine sample 
D)  Blood cultures

Question 9

All of the following are symptoms of an allergic reaction except:

Accepted Answer

A)  pruritus. 
B)  local erythema. 
C)  anemia. 
D)  hives. 
A)  pruritus. 
B)  local erythema. 
C)  anemia. 
D)  hives.

Question 10

A negative direct antiglobulin test (DAT) is found in all of the following transfusion reactions except:

Accepted Answer

A)  Acute nonimmune hemolytic transfusion reaction 
B)  Febrile nonhemolytic transfusion reaction 
C)  Acute immune hemolytic transfusion reaction 
D)  Transfusion-associated sepsis 
A)  Acute nonimmune hemolytic transfusion reaction 
B)  Febrile nonhemolytic transfusion reaction 
C)  Acute immune hemolytic transfusion reaction 
D)  Transfusion-associated sepsis

Question 11

Persons with a documented history of anaphylactic reactions should be transfused with blood products.

Accepted Answer

A)  IgE-deficient 
B)  leukodepleted 
C)  washed 
D)  irradiated 
A)  IgE-deficient 
B)  leukodepleted 
C)  washed 
D)  irradiated

Question 12

How could a potential alloimmunizaton due to anti-K be prevented?

Accepted Answer

A)  Matching of donor and recipient red blood cell phenotype 
B)  Use of third-generation bedside leukocyte filters 
C)  Use of washed red blood cells 
D)  Use of apheresed platelets 
A)  Matching of donor and recipient red blood cell phenotype 
B)  Use of third-generation bedside leukocyte filters 
C)  Use of washed red blood cells 
D)  Use of apheresed platelets

Question 13

Immediate transfusion reaction procedures consist of all of the following except:

Accepted Answer

A)  clerical check. 
B)  DAT. 
C)  serum haptoglobin. 
D)  visual check. 
A)  clerical check. 
B)  DAT. 
C)  serum haptoglobin. 
D)  visual check.

Question 14

Circulatory overload is cause by which of the following?

Accepted Answer

A)  Excessive transfused fluid 
B)  Rapid rate of infusion 
C)  decreased cardiac capacity 
D)  All of these 
A)  Excessive transfused fluid 
B)  Rapid rate of infusion 
C)  decreased cardiac capacity 
D)  All of these

Question 15

A patient transfused with 2 units of packed red blood cells demonstrated signs of a transfusion reaction just before the second unit was completely infused. Hypotension, fever, and back pain are the immediate symptoms. Blood work reveals a 3% drop in hematocrit and prolonged PT. What therapy is given to correct the PT?

Accepted Answer

A)  FFP 
B)  Dopamine 
C)  Platelet concentrates 
D)  Mannitol 
A)  FFP 
B)  Dopamine 
C)  Platelet concentrates 
D)  Mannitol

Question 16

Which of the following best describes a transfusion reaction?

Accepted Answer

A)  An urticarial response to blood products occurring 1 to 2 hours after infusion 
B)  A physiologic response to a blood product transfused 5 to 10 days before host symptoms 
C)  Any unfavorable transfusion-related event occurring in a patient during or after transfusion of blood components 
D)  None of the above 
A)  An urticarial response to blood products occurring 1 to 2 hours after infusion 
B)  A physiologic response to a blood product transfused 5 to 10 days before host symptoms 
C)  Any unfavorable transfusion-related event occurring in a patient during or after transfusion of blood components 
D)  None of the above

Question 17

What is the most common preventable error occurring among the nursing and medical staff that results in a transfusion-related death?

Accepted Answer

A)  Alloantibody misidentified 
B)  Improper patient identification 
C)  Specimen mislabeled 
D)  Incorrect crossmatch procedure 
A)  Alloantibody misidentified 
B)  Improper patient identification 
C)  Specimen mislabeled 
D)  Incorrect crossmatch procedure

Question 18

What is the pathophysiological cause surrounding anaphylactic and anaphylactoid reactions?

Accepted Answer

A)  Antibody in patient serum is detected 3 to 7 days after transfusion, reacting with donor red blood cells 
B)  Donor plasma has reagins (IgE or Ig
A)  that combine with allergens in patient plasma 
C)  A patient who is deficient in IgE develops IgE antibodies via sensitization from transfusion or pregnancy 
D)  A patient who is deficient in IgA develops IgA antibodies via sensitization from transfusion or pregnancy 
A)  Antibody in patient serum is detected 3 to 7 days after transfusion, reacting with donor red blood cells 
B)  Donor plasma has reagins (IgE or Ig
A)  that combine with allergens in patient plasma 
C)  A patient who is deficient in IgE develops IgE antibodies via sensitization from transfusion or pregnancy 
D)  A patient who is deficient in IgA develops IgA antibodies via sensitization from transfusion or pregnancy

Question 19

What groups are at risk for graft-versus-host disease (GVHD) as a result of transfusion?

Accepted Answer

A)  Polycythemia vera patients undergoing a therapeutic phlebotomy 
B)  Fetuses receiving an intrauterine transfusion 
C)  Patients receiving a directed donation from a first-degree relative 
D)  Options B and C 
A)  Polycythemia vera patients undergoing a therapeutic phlebotomy 
B)  Fetuses receiving an intrauterine transfusion 
C)  Patients receiving a directed donation from a first-degree relative 
D)  Options B and C

Question 20

Which mechanism may play a role in fever development in an FNHTR?

Accepted Answer

A)  Release of pyrogens from transfused white blood cells 
B)  The production of interleukin-6 by the complement system 
C)  Synthesis of prostaglandins (PGE±) in hypothalamic cells by interleukin-6 
D)  None of the above 
A)  Release of pyrogens from transfused white blood cells 
B)  The production of interleukin-6 by the complement system 
C)  Synthesis of prostaglandins (PGE±) in hypothalamic cells by interleukin-6 
D)  None of the above

Exam 17: Adverse Effects of Blood Transfusion

Which of the following products may lead to sepsis in a patient when contaminated with Escherichia coli?

The plasma level of unconjugated bilirubin is elevated in:

What should be done in the transfusion process when the patient temperature spikes from 37.5°C to 38.5°C within 30 minutes of transfusion?

What is the most frequent cause of circulatory overload?

All of the following are diseases that can mimic a transfusion reaction except:

A 35-year-old woman was transfused with 1 unit of packed red blood cells. The nurse monitoring the transfusion noticed hives on the patient's arm and an increase in body temperature. What is the choice of treatment for this patient?

What is the physiologic mechanism of histamine?

Which of the following should be collected immediately from a patient exhibiting signs of a septic reaction to blood products?

All of the following are symptoms of an allergic reaction except:

A negative direct antiglobulin test (DAT) is found in all of the following transfusion reactions except:

Persons with a documented history of anaphylactic reactions should be transfused with blood products.

How could a potential alloimmunizaton due to anti-K be prevented?

Immediate transfusion reaction procedures consist of all of the following except:

Circulatory overload is cause by which of the following?

Which of the following best describes a transfusion reaction?

What is the most common preventable error occurring among the nursing and medical staff that results in a transfusion-related death?

What is the pathophysiological cause surrounding anaphylactic and anaphylactoid reactions?

What groups are at risk for graft-versus-host disease (GVHD) as a result of transfusion?

Which mechanism may play a role in fever development in an FNHTR?

Red Blood Cells and Platelet Preservation: Historical Perspectives and Current Trends

Basic Genetics

Fundamentals of Immunology

Concepts in Molecular Biology

The Antiglobulin Test

The Abo Blood Group System

The Rh Blood Group System

Blood Group Terminology and Common Blood Groups

Uncommon Blood Groups

Detection and Identification of Antibodies

Pre-Transfusion Testing

Blood Bank Technologies and Automation

Donor Selection

Transfusion-Transmitted Diseases

Component Preparation

Transfusion Therapy

Apheresis

Cellular Therapy in the Transplant Setting

Hemolytic Disease of the Fetus and Newborn

Autoimmune Hemolytic Anemias

Tissue Banking As Part of the Transfusion Service

The Hla System

Relationship Testing

Quality Management

Patient Blood Management

Transfusion Safety and Federal Regulatory Requirements

Laboratory Information Systems in the Blood Bank

Medicolegal and Ethical Aspects of Providing Blood Collection and Transfusion Services

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