4.7 Components

Question 1

A male patient with cancer was admitted to the hospital with acute abdominal pain and a hemoglobin level of 6 g/dL. Small bowel resection was indicated, but the attending physician wanted to raise the patient’s hemoglobin level to 12 g/dL before surgery. How many units of RBCs would most likely be required to accomplish this?
A. 2
B. 3
C. 6
D. 8

Answer 1

6

Question 2

Which of the following is not a viable method for removing leukocytes from RBCs?
A. Prestorage filtration
B. Bedside filtration
C. Poststorage filtration
D. Buffy coat removal

Answer 2

Buffy coat removal

Question 3

Four units of packed RBCs were brought to the nurses’ station at 10:20 a.m. Two units were transfused immediately, and 1 unit was transfused at 10:40 a.m. The remaining unit was returned to the blood bank at 11:00 a.m. The units were not refrigerated after leaving the blood bank. What problem(s) is (are) present in this situation?
A. The only problem is with the returned unit; the 30-minute limit has expired and the unit cannot be used
B. The unit should not have been transfused at 10:40 a.m. because the time limit had expired; this unit and the remaining unit should have been returned to the blood bank
C. The returned unit may be held for this patient for 48 hours but cannot be used for another patient
D. No problems; all actions were performed within the allowable time limits

Answer 3

The only problem is with the returned unit; the 30-minute limit has expired and the unit cannot be used

Question 4

A unit of whole blood is collected at 10:00 a.m. and stored at 20°C to 24°C. What is the last hour at which platelet concentrates may be made from this unit?
A. 4:00 p.m.
B. 6:00 p.m.
C. 7:00 p.m.
D. 8:00 p.m.

Answer 4

6:00 p.m.

Question 5

Which of the following is acceptable according to the AABB standards?
A. Rejuvenated RBCs may be made within 3 days of outdate and transfused or frozen within 24 hours of rejuvenation
B. Frozen RBCs must be prepared within 30 minutes of collection and may be used within 10 years
C. Irradiated RBCs must be treated within 8 hours of collection and transfused within 6 hours
D. Leukocyte-reduced RBCs must be prepared within 6 hours of collection and transfused within 6 hours of preparation

Answer 5

Rejuvenated RBCs may be made within 3 days of outdate and transfused or frozen within 24 hours of rejuvenation

Question 6

Which of the following is true regarding apheresis platelets?
A. The minimum platelet count must be 3.0 × 1011, pH must be 6.0 or greater
B. The minimum platelet count must be 3.0 × 1010, pH must be 6.2 or less
C. The minimum platelet count must be 3.0 × 1011, pH must be 6.2 or greater
D. The minimum platelet count must be 5.5 × 1010, pH must be 6.0 or less

Answer 6

The minimum platelet count must be 3.0 × 1011, pH must be 6.2 or greater

Question 7

What is the component of choice for a patient with chronic granulomatous disease (CGD)?
A. Fresh frozen plasma (FFP)
B. Granulocytes
C. Cryoprecipitate
D. RBCs

Question 8

What method can be employed to detect bacteria in random donor platelets?
A. pH
B. Glucose
C. Pan-genera detection (PGD) assay
D. Gram stain

Answer 8

Pan-genera detection (PGD) assay

Question 9

All of the following statements regarding FFP are true, except:
A. FFP must be prepared within 24 hours of collection
B. After thawing, FFP must be transfused within 24 hours
C. Storage temperature for FFP with a 1-year shelf life is –18°C or less
D. When thawed, FFP must be stored between 1°C to 6°C

Answer 9

FFP must be prepared within 24 hours of collection

Question 10

What may be done to RBCs before transfusion to a patient with cold agglutinin disease to reduce the possibility of a transfusion reaction?
A. Irradiate to prevent graft-versus-host-disease (GVHD)
B. Wash with 0.9% saline
C. Warm to 37°C with a blood warmer
D. Transport so that temperature is maintained at 20°C to 24°C

Answer 10

Warm to 37°C with a blood warmer

Question 11

A unit of packed RBCs is split using the open system. One of the half units is used. What may be done with the second half unit?
A. Must be issued within 24 hours
B. Must be issued within 48 hours
C. Must be irradiated
D. Must retain the original expiration date

Answer 11

Must be issued within 24 hours

Question 12

What should be done if a noticeable clot is found in an RBC unit?
A. Issue the unit; the blood will be filtered
B. Issue the unit; note the presence of a clot on the release form
C. Filter the unit in the blood bank before issue
D. Do not issue the unit

Answer 12

Do not issue the unit

Question 13

Cryoprecipitate may be used to treat all of the following, except:
A. von Willebrand disease
B. Hypofibrinogenemia
C. Idiopathic thrombocytopenic purpura (ITP)
D. Factor XIII deficiency

Answer 13

Idiopathic thrombocytopenic purpura (ITP)

Question 14

SITUATION: A transplant patient may receive only type A or AB platelets. Only type O apheresis platelets are available. What devices may be used to deplete the incompatible plasma and replace with sterile saline?
A. Cytospin/irradiator
B. Water bath/centrifuge
C. Centrifuge/sterile connecting device
D. Cell washer/heat sealer

Answer 14

Centrifuge/sterile connecting device

Question 15

What component(s) is (are) indicated for patients who have anti-IgA antibodies?
A. Whole blood
B. Packed RBCs
C. Washed or deglycerolized RBCs
D. Granulocytes

Answer 15

Washed or deglycerolized RBCs

Question 16

What is the expiration date for pooled cryoprecipitate (pooled before freezing)?
A. 12 months from latest date of collection of product in pool
B. 12 months from earliest date of collection of product in pool
C. 4 hours
D. 6 hours

Answer 16

12 months from earliest date of collection of product in pool

Question 17

All of the following are true regarding washed RBCs, except:
A. RBCs are washed with 1 to 2 L of normal saline
B. Volume is 180 mL
C. Shelf life is extended
D. Leukocytes are removed

Answer 17

Shelf life is extended

Question 18

What is a special condition for the storage of platelets?
A. Room temperature, 20°C to 24°C
B. No other components may be stored with platelets
C. Platelets must be stored upright in separate containers
D. Platelets require constant agitation at 20°C to 24°C

Answer 18

Platelets require constant agitation at 20°C to 24°C

Question 19

Transfusion of an irradiated product is indicated in all of the following conditions except:
A. Exchange transfusion
B. Bone marrow transplantation
C. Severe combined immunodeficiency syndrome (SCIDS)
D. Warm autoimmune hemolytic anemia

Answer 19

Warm autoimmune hemolytic anemia

Question 20

What percentage of RBCs must be retained in leukocyte-reduced RBCs?
A. 75%
B. 80%
C. 85%
D. 100%

Answer 20

85%

Question 21

Which of the following is true regarding granulocyte concentrates?
A. The product must contain a maximum of 1.0 × 1010 granulocytes
B. pH must be 6.0
C. The product must be crossmatched
D. The product must be irradiated

Answer 21

The product must be crossmatched

Question 22

What course of action should be taken if an MLS inadvertently irradiates a unit of RBCs twice?
A. Issue the unit
B. Discard the unit
C. Change the expiration date; then issue the unit
D. Note on the irradiation sticker that the unit was irradiated twice, and then issue the unit

Answer 22

Discard the unit

Question 23

What components(s) may be shipped together with FFP?
A. Frozen RBCs and cryoprecipitate
B. Platelets
C. Packed RBCs and granulocytes
D. Double RBC units

Answer 23

Frozen RBCs and cryoprecipitate

Question 24

A blood supplier ships 3 units of pooled cryoprecipitate. Each pool consists of 5 units of cryoprecipitate. If one unit is thawed at 5:00 p.m., when must it be dispensed from the blood bank?
A. Before 9:00 p.m.
B. Before 11:00 p.m.
C. Before 12:00 a.m.
D. Before 5:00 p.m. the next day

Answer 24

Before 9:00 p.m.

Question 25

How does irradiation prevent transfusion-associated graft-versus-host disease (TA-GVHD)?
A. Gamma rays and x-rays destroy the lymphocytes’ ability to divide
B. X-rays cause lysis of the lymphocytes
C. Gamma rays enhance lymphocyte reactivity
D. Ultraviolet radiation induces apoptosis of lymphocytes

Answer 25

Gamma rays and x-rays destroy the lymphocytes’ ability to divide

Question 26

Which component has the longest expiration date?
A. Cryoprecipitate
B. FFP
C. Frozen RBCs
D. Platelet concentrates

Answer 26

Frozen RBCs

Question 27

All of the following are advantages of using single-donor platelets as opposed to random donor platelets, except:
A. Less preparation time
B. Less antigen exposure for patients
C. May be HLA matched
D. No pooling is required

Answer 27

Less preparation time

Question 28

What is the expiration of cryoprecipitate once pooled without the use of a sterile connecting device?
A. 4 hours
B. 6 hours
C. 8 hours
D. 24 hours

Answer 28

4 hours

Question 29

What is the number of WBCs permitted in a unit of leukocyte-reduced RBCs?
A. Less than 5 × 1010
B. Less than 5 × 106
C. Less than 8.3 × 105
D. Less than 8.3 × 106

Answer 29

Less than 5 × 106

Question 30

SITUATION: A patient with cancer recently developed a severe infection. The patient’s hemoglobin level is 8 g/dL as a result of chemotherapy with a drug known to cause bone marrow depression and immunodeficiency. Which blood products are indicated for this patient?
A. Liquid plasma and cryoprecipitate
B. Crossmatched platelets and washed RBCs
C. Factor IX concentrates and FFP
D. Irradiated RBCs, platelets, and granulocytes

Answer 30

Irradiated RBCs, platelets, and granulocytes