8 DONORS

Question 1

(1) Which of the following individuals is acceptable as a blood donor?

A. A 29-year-old man who received the hepatitis B vaccine last week
B. A 21-year-old woman who had her nose pierced last week
C. A 30-year-old man who lived in Zambia for 3 years and returned last month
D. A 54-year-old man who tested positive for hepatitis C last year but has no active symptoms of disease

Answer 1

A. A 29-year-old man who received the hepatitis B vaccine last week

If the donor is symptom free, there is no deferral period for the hepatitis B vaccine. Persons who have had body piercing are given a 12-month deferral. Persons who lived in an area endemic for malaria or who received antimalarial drugs are deferred for 3 years. A positive test for the hepatitis C virus (HCV) is cause for indefinite deferral.

Question 2

(2) SITUATION: A 53-year-old woman donates blood at her place of employment. She weighs 150 lb and has a hemoglobin level of 13 g/dL. She is currently on warfarin and vitamin B12. Is she an acceptable donor?

A. Yes
B. No, she is on warfarin
C. Yes, for RBCs only
D. No, her hemoglobin is too low

Answer 2

C. Yes, for RBCs only

Her age and hemoglobin meet donor criteria. However, because she is currently on warfarin, only RBCs can be prepared from her donation.

Question 3

(3) Which immunization has the longest deferral period?

A. Hepatitis B immune globulin (HBIG)
B. Rubella vaccine
C. Influenza vaccine
D. Yellow fever vaccine

Answer 3

A. Hepatitis B immune globulin (HBIG)

Deferral for HBIG injection is 12 months. Deferral for rubella vaccine is 4 weeks. The deferral period for influenza and yellow fever vaccines is 2 weeks.

Question 4

(4) The following whole blood donors regularly give blood. Which donor may donate on September 10?

A. A 40-year-old woman who last donated on July 23
B. A 28-year-old man who had plateletpheresis on August 24
C. A 52-year-old man who made an autologous donation on September 9
D. A 23-year-old woman who donated blood for her aunt on August 14

Answer 4

B. A 28-year-old man who had plateletpheresis on August 24

A plateletpheresis donor must wait at least 48 hours between donations. The waiting period following an autologous donation is at least 3 days. An 8-week interval must pass between all other types of donations.

Question 5

(5) Which of the following precludes acceptance of a plateletpheresis donor?

A. Platelet count of 75 × 10^9/L in a donor who is a frequent platelet donor
B. Plasma loss of 800 mL from plasmapheresis 1 week ago
C. Plateletpheresis performed 4 days ago
D. Aspirin ingested 7 days ago

Answer 5

A. Platelet count of 75 × 10^9/L in a donor who is a frequent platelet donor

To be eligible for plateletpheresis, the platelet count should be greater than 150 × 10^9/L for a frequent platelet donor. Plasma loss exceeding 1,000 mL would be cause for rejection, but not 800 mL. A donor may donate 24 times a year, but not as frequent as once every 2 days in a 7-day period. A donor cannot ingest aspirin within 36 hours of platelet donation.

Question 6

(6) Which of the following donors could be accepted for whole blood donation?

A. A construction worker who was incarcerated for opiate abuse
B. A triathlete with a pulse of 45
C. A man who is currently taking finasteride (Propecia)
D. A woman in her 14th week of pregnancy

Answer 6

B. A triathlete with a pulse of 45

Athletes may have a pulse below 50 and may still be acceptable as blood donors. Drug addiction is cause for permanent deferral, as is a major illness. The deferral period after treatment for syphilis or gonorrhea is 12 months.

Question 7

(7) Which physical examination result is cause for rejecting a whole blood donor?

A. Weight of 105 lb
B. Pulse of 75
C. Temperature of 37.4°C (99.3°F)
D. Diastolic pressure of 110 mm Hg

Answer 7

D. Diastolic pressure of 110 mm Hg

Diastolic pressure must not be higher than 100 mm Hg. Donors weighing less than 110 lb may donate up to 12% of their blood volume (volume = weight in kg/50 × 450 mL). Oral temperature must not be greater than 37.4°C (99.5°F). BP limits for donation are 180 mm Hg for systolic and 100 mm Hg for diastolic pressure. The limit for hemoglobin is 12.5 g/dL and for hematocrit 38%.

Question 8

(8) Which situation is not a cause for indefinite deferral of a donor?

A. Male donor whose father has been diagnosed with Creutzfeldt-Jakob disease (CJD)
B. Donation of a unit of blood that transmitted hepatitis B virus (HBV) to a recipient
C. Donor tested reactive for HBV by nucleic acid testing (NAT)
D. Accidental needlestick 1 year ago; negative for infectious disease

Answer 8

D. Accidental needlestick 1 year ago; negative for infectious disease

An accidental needlestick would not be a cause for indefinite deferral of a donor. The deferral period is 1 year.

Question 9

(9) A whole blood donor currently on clopidogrel (Plavix) is precluded from donating which product?

A. Platelets
B. RBCs
C. FFP
D. Cryoprecipitate

Answer 9

A. Platelets

Clopidogrel (Plavix) renders platelets nonfunctional, and therefore potential donors on this medication cannot donate platelets.

Question 10

(10) How much anticoagulant would have to be removed from the collection bag given a donor who weighs 90 lb?

A. 12 mL
B. 15 mL
C. 20 mL
D. 23 mL

Answer 10

A. 12 mL

To determine the amount of anticoagulant to remove when the donor is less than 110 lb, divide weight by 110 lb, and multiply by 450 mL; divide that number by 100, and multiply by 14 (this gives the anticoagulant volume needed); then subtract this from 63 mL, which is the standard volume of anticoagulant in a 450 mL bag. The result is the amount of anticoagulant to remove.

Question 11

(11) A woman begins to breathe rapidly while donating blood. Choose the correct course of action.

A. Continue the donation; rapid breathing is not a reason to discontinue a donation
B. Withdraw the needle, raise her feet, and administer ammonia
C. Discontinue the donation, and provide a paper bag for donor to breathe slowly into
D. Tell her to sit upright, and apply a cold compress to her forehead

Answer 11

C. Discontinue the donation, and provide a paper bag for donor to breathe slowly into

This woman is hyperventilating; therefore, the donation should be discontinued. A paper bag should be provided to the donor to breathe into to increase the carbon dioxide in the donor’s air.

Question 12

(12) A donor bag is half filled during donation when the blood flow stops. Select the correct course of action.

A. Closely observe the bag for at least 3 minutes; if blood flow does not resume, withdraw the needle
B. Remove the needle immediately, and discontinue the donation
C. Check and reposition the needle, if necessary; if blood flow does not resume, withdraw the needle
D. Withdraw the needle, and perform a second venipuncture in the other arm

Answer 12

C. Check and reposition the needle, if necessary; if blood flow does not resume, withdraw the needle

If blood flow has stopped, check the needle first. If blood flow does not resume after repositioning, then withdraw the needle and discontinue the donation. Do not perform a second venipuncture on the donor.

Question 13

(13) Who is the best candidate for a predeposit autologous donation?

A. A 45-year-old man who is having elective surgery in 2 weeks; he has alloanti-k
B. A 23-year-old female patient with leukemia and a hemoglobin level of 10 g/dL
C. A 12-year-old boy who has hemophilia
D. A 53-year-old woman who has septicemia

Answer 13

A. A 45-year-old man who is having elective surgery in 2 weeks; he has alloanti-k

The 45-year-old man with alloanti-k is the best candidate for predeposit autologous donation because compatible blood will be hard to find if he needs blood after surgery. The other candidates may not be good choices for donation because the process may prove harmful to them.

Question 14

(14) Can an autologous donor donate blood on Monday if he or she is having surgery on Friday?

A. Yes, he or she can donate up to 72 hours before surgery
B. No, he or she cannot donate within 7 days of surgery
C. Yes, he or she can donate, but only a half a unit
D. No, he or she cannot donate within 5 days of surgery

Answer 14

A. Yes, he or she can donate up to 72 hours before surgery

An autologous donor can donate up to 72 hours before expected surgery.

Question 15

(15) Which of the following is an acceptable time in which a unit of whole blood is collected?

A. 33 minutes
B. 25 minutes
C. 20 minutes
D. 13 minutes

Answer 15

D. 13 minutes

A unit of whole blood should be collected within 15 minutes.

Question 16

(16) Which of the following is true regarding acute normovolemic hemodilution?

A. One or more units of blood are withdrawn from the patient and replaced with FFP
B. Units removed may be stored in the operating room at room temperature for 8 hours
C. Units removed may be stored in the operating room at room temperature for 24 hours
D. Unused units can be added to the general donor blood inventory

Answer 16

B. Units removed may be stored in the operating room at room temperature for 8 hours

In acute normovolemic hemodilution, one or more units of blood are removed from the donor and replaced with crystalloid or colloid. Blood may be stored at room temperature for up to 8 hours or at 1°C to 6°C for up to 24 hours. Bleeding during surgery results in less RBC loss after hemodilution, and the autologous RBCs are infused after bleeding stops. Such units are for autologous transfusion only.

Question 17

(17) All of the following apply to a double RBC unit apheresis collection except:

A. The hematocrit must be at least 38%
B. The weight for a female is at least 150 lb
C. The height for a male is at least 5 ft 1 in
D. The deferral period following collection is 16 weeks

Answer 17

A. The hematocrit must be at least 38%

The minimum hematocrit for a double RBC donation is 40%.

Question 18

(18) An autologous unit of whole blood was collected on a 33-year-old woman in preparation for a knee replacement procedure in 3 weeks. The whole blood unit had her hyphenated last name, first name, and last four digits of her social security number for identification. The laboratory computer system, however, only had her married name and first name, medical record number, and social security number. What should be done with this blood product?

A. Discard the unit
B. Make the unit available for transfusion
C. Confirm the name with the donor, have admissions make the correction in the computer system, and then make the unit available for transfusion
D. Ensure that social security numbers match, confirm the name with the donor and have admissions make the correction in the computer system with the medical director’s approval, and then make the unit available for transfusion

Answer 18

D. Ensure that social security numbers match, confirm the name with the donor and have admissions make the correction in the computer system with the medical director’s approval, and then make the unit available for transfusion

This is a common scenario with women who have recently married, and have not changed their license or other form of identification given to the collection facility. Checking that other demographic information matches is sufficient, if approved by the medical director, because an autologous unit is very difficult to replace in time for surgery.

Question 19

(19) What is the youngest age a person can make allogeneic whole blood donation?

A. 14 years
B. 15 years
C. 16 years
D. 17 years

Answer 19

C. 16 years

In most states, the youngest age a person can donate is 16 years with parental permission

Question 20

(20) Which of the following donors are acceptable for whole blood donation?

A. A man who had sex with another man 2 weeks ago
B. A male construction worker who tested positive for hepatitis B surface antigen (HBsAg)
C. A man who had sex with another man 2 years ago
D. A female who had sex with a male who had sex with another male (MSM) 1 month ago

Answer 20

C. A man who had sex with another man 2 years ago

Men who have sex with men can donate blood if they have not had sex with another man in the past year.