Clinical Laboratory Science
Exam Answer Key
Course Introduction
Clinical Laboratory Science is a multidisciplinary field focused on the analysis of bodily fluids and tissues to aid in the diagnosis, treatment, and prevention of diseases. This course covers essential laboratory techniques, instrumentation, and quality control processes used in areas such as hematology, clinical chemistry, microbiology, immunology, and molecular diagnostics. Students will gain a comprehensive understanding of laboratory safety, specimen collection and processing, and data interpretation, alongside the ethical and regulatory standards governing laboratory practice. Emphasis is placed on developing practical skills and critical thinking necessary for accurate and reliable laboratory results that support healthcare teams in patient management.
Recommended Textbook
Modern Blood Banking and Transfusion Practices 6th Edition by Denise M. Harmening
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27 Chapters
1413 Verified Questions
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Chapter 1: Red Blood Cells and Platelet Preservation:
Historical Perspectives and Current Trends
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44 Verified Questions
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Sample Questions
Q1) The RBC membrane is relatively permeable to all of the following except:
A) chloride.
B) sodium.
C) bicarbonate.
D) water.
Answer: B
Q2) 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.
Answer: A
Q3) 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
Answer: B
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Chapter 2: Basic Genetics
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Sample Questions
Q1) In Mendel's law of separation, the first-filial generation is:
A) recessive.
B) homozygous.
C) heterozygous.
D) autologous.
Answer: C
Q2) All of the following processes occur in replication, except:
A) the two DNA strands separate via helicase.
B) DNA polymerase acts on the 5' to 3' parent strand to produce an anticomplementary duplicate strand.
C) DNA polymerase acts on the 3' to 5' parent strand to produce an anticomplementary duplicate strand.
D) replication of the 3' to 5' parent strand is initiated by the enzyme primase, which anneals to the parent strand.
Answer: C
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4
Chapter 3: Fundamentals of Immunology
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Sample Questions
Q1) Which immunoglobulin exists in a pentameric configuration?
A) IgG
B) IgM
C) IgA
D) IgE
Answer: B
Q2) Which antibodies characteristically demonstrate a decreased avidity for antigen?
A) Rh
B) HTLA
C) Lewis
D) ABO
Answer: B
Q3) Which of the following are produced after exposure to genetically different nonself antigens of the same species?
A) Alloantibodies
B) Autoantibodies
C) Drug-induced antibodies
D) All of the above
Answer: A
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Chapter 4: Concepts in Molecular Biology
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Sample Questions
Q1) Molecular RBC antigen typing is used:
A) to confirm serological testing.
B) when serology is not possible.
C) when serology is not sensitive enough or discrepancies occur.
D) for all of the above.
Q2) Which of the following sequences is recognized by ecoRI?
A) 5'GAATTC3'
B) 5'CTCTTG3'
C) 5'CGCG3'
D) 5'AGCT3'
Q3) In nucleic acid hybridization, nucleic acid hybrids can be formed between______________ .
A) two strands of DNA
B) two strands of RNA
C) one strand of RNA and one strand of DNA
D) all of the above
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6
Chapter 5: The Antiglobulin Test
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Sample Questions
Q1) A patient is discovered to have anti-Fy<sup>a</sup> in their serum. The medical technologist needs to phenotype the patient's cells for the corresponding antigen. What test is appropriate for phenotyping?
A) Absorption
B) Elution
C) DAT
D) IAT
Q2) An advantage of monoclonal anti-C3 over polyclonal anti-C3 is:
A) with monoclonal anti-C3, the antibody potency can be controlled.
B) contamination with anti-IgG is avoided with anti-C3.
C) with monoclonal anti-C3, antibody to immunoglobulin light chains are eliminated.
D) false-positives caused by cold agglutinins are avoided with anti-C3.
Q3) An advantage of polyclonal anti-IgG over monoclonal anti-IgG is:
A) AHG produced in rabbits is more specific than AHG produced in mice.
B) polyclonal anti-IgG will recognize IgG variants.
C) polyclonal anti-IgG also has anticomplement activity.
D) polyclonal anti-IgG recognizes only one IgG epitope.
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Chapter 6: The Abo Blood Group System
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Sample Questions
Q1) How are ABH antigens formed?
A) Production of specific glycosyltransferases add sugars to precursor substances
B) Recombinant gene technology
C) ABO genes code for production of antigens
D) All of the above
Q2) What immunodominant sugar is responsible for B specificity?
A) D-galactose
B) L-fucose
C) N-acetyl-D-galactosamine
D) D-glucose
Q3) What testing is available that will differentiate between a true B and an acquired B?
A) Anti-B lectin
B) Acidification of anti-B reagent
C) Secretor studies
D) All of the above
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8
Chapter 7: The RH Blood Group System
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Sample Questions
Q1) Why do false-negative Rh testing results occur in babies with severe hemolytic disease of the newborn due to anti-D?
A) The cord cells may be contaminated with Wharton's jelly.
B) All D sites are covered by maternal anti-D, which blocks the reagent.
C) Antigens are not expressed yet.
D) None of the above
Q2) The Rh gene is located on which chromosome?
A) 1
B) 7
C) 9
D) 11
Q3) How are the Rh antigens inherited?
A) X-linked recessive
B) Codominant alleles
C) X-linked dominant
D) None of the above
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Chapter 8: Blood Group Terminology and the Other Blood Groups
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Sample Questions
Q1) Why does anti-Lu<sup>a</sup> go undetected in routine testing?
A) Anti-Lu<sup>a</sup> demonstrates low avidity
B) Most reagent cells are Lu(a+)
C) Most reagent cells are Lu(a-)
D) None of the above
Q2) What serologic factor distinguishes anti-Fy3 from anti-Fy<sup>a</sup> or anti-Fy<sup>b</sup>?
A) It is not destroyed by enzymes.
B) It is an IgM antibody.
C) It does not bind complement.
D) It does show dosage.
Q3) How is the En<sup>a</sup> antigen related to the Wr(a-b-) phenotype?
A) En(a-) red blood cells are all Wr(a-b-)
B) En(a+) red blood cells are all Wr(a-b-)
C) All Wr(a-b-) red blood cells are also M-N-
D) En(a-) individuals lack MN-SGP
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Chapter 9: Detection and Identification of Antibodies
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Sample Questions
Q1) Why are screening cells group O?
A) To prevent interference with anti-A and anti-B in patient serum
B) To prevent interference with A and B antigens on patient cells
C) Because group O cells are easier to acquire in random populations
D) Because group O cells contain antigens to clinically significant antibodies
Q2) What test is used to confirm the efficacy of chloroquine treatment?
A) IAT
B) DAT
C) ABO grouping
D) Neutralization test
Q3) When performing the elution procedure, the solution containing the recovered antibody is called:
A) neutralized serum.
B) the buffer.
C) the eluate.
D) absorbed serum.
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11
Chapter 10: Pre-Transfusion Testing
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Sample Questions
Q1) In some institutions, compatibility testing may be eliminated in which type of patient?
A) Cardiac
B) Anemic
C) Massively transfused
D) Pregnant
Q2) Given the following results, what is the probable cause of a positive reaction in the major crossmatch? IS = 0 37?0°C = 0 AHG = 2+ CC = ND Auto-control was negative
A) Alloantibody in patient serum reacting with antigen on donor cells
B) Incorrect ABO grouping of patient or donor
C) Autoantibody in patient serum reacting with antigen on donor cells
D) Rouleaux
Q3) How long after a transfusion must donor and recipient samples be stored at 1°C to 6°C?
A) 7 days
B) 5 days
C) 10 days
D) 14 days
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Chapter 11: Overview of the Routine Blood Bank Laboratory
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Sample Questions
Q1) Which of the following options are suitability requirements for product labeling?
A) Absence of detectable antibodies
B) No discrepancies in ABO and Rh testing
C) Nonreactive viral marker tests
D) All of the above
Q2) Which of the following would lead to non-acceptance of a blood bank specimen?
A) Initials of phlebotomist not on specimen
B) A patient name spelled incorrectly
C) An erroneous Social Security number
D) All of the above
Q3) Which cells are used for a donor's antibody screen?
A) Screening cells (2 vials)
B) Pooled screening cells (2 donors)
C) Screening cells (3 vials)
D) Autologous cells
Q4) Granulocyte concentrates follow the same compatibility protocol as packed red blood cells.
A)True
B)False
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Chapter 12: Other Technologies and Automation
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Sample Questions
Q1) The gel system has all of the following advantages over the traditional tube procedure except:
A) standardization in reading technique.
B) stability of the test reaction.
C) replicability of the test results.
D) different grading system.
Q2) A layer of red blood cells agglutinates at the top of the gel media, and a pellet of unagglutinated red blood cells forms at the bottom. These findings are comparable to which of the following reactions in the test tube?
A) Negative
B) Weak positive
C) Mixed-field
D) Invalid
Q3) Using the gel test system, the technologist used a 3% cell solution. What would be the probable outcome?
A) Normal
B) Weaker results because of the increase in antigen/antibody ratio
C) Stronger results because of the increase in antigen/antibody ratio
D) None of the above
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Chapter 13: Donor Screening and Component Preparation
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Sample Questions
Q1) How many times can a person meeting all the optimal criteria donate an apheresis unit of platelets per year?
A) 56 times
B) 112 times
C) 24 times
D) 48 times
Q2) A patient who recently stopped taking clopidogrel (Plavix) needs to donate platelets. How long must the patient defer donation after completing the medication?
A) 24 hours
B) 48 hours
C) 7 days
D) 14 days
Q3) Normally what percentage of 35-day-old red blood cells should be circulating 24 hours after transfusion?
A) 100%
B) 50%
C) 65%
D) 70%
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15
Chapter 14: Apheresis
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Sample Questions
Q1) What other technique is available for neonates with sepsis when apheresis is unavailable?
A) A buffy coat prepared from plasma less than 12 hours old
B) A buffy coat prepared from red blood cells less than 12 hours old
C) A buffy coat prepared from a whole blood unit less than 12 hours old
D) A buffy coat prepared from platelets less than 12 hours old
Q2) Which of the following conditions would necessitate a plasmapheresis procedure?
A) Sickle-cell anemia
B) Barbiturate poisoning
C) CML
D) Polycythemia vera
Q3) Which of the following incorporates membrane filtration technology with intermittent flow centrifugation (IFC) apheresis?
A) Haemonetics V50
B) COBE Spectra
C) Fenwal Autopheresis-C
D) Haemonetics V30
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16
Chapter 15: Transfusion Therapy
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Sample Questions
Q1) What is the expiration on washed red blood cells?
A) 35 days
B) 24 hours
C) 42 days
D) 6 hours
Q2) Which of the following methods provides the purest factor VIII concentrates?
A) Anion exchange chromatography
B) Monoclonal antibody purification
C) DNA technology
D) Pasteurization
Q3) The pathological cause of a decreased red blood cell mass include(s):
A) compromised bone marrow production.
B) decreased red blood cell survival.
C) bleeding as a result of trauma.
D) all of the above.
Q4) Hemophilia A is clinically apparent when the factor VIII level is less than:
A) 20%
B) 10%
C) 50%
D) 60%
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Chapter 17: Cellular Therapy
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Sample Questions
Q1) Which of the following should be collected immediately from a patient exhibiting signs of a septic reaction to blood products?
A) DAT
B) Complete blood count (CBC)
C) Urine sample
D) Blood cultures
Q2) For a patient who has suffered an acute hemolytic transfusion reaction, the primary treatment goal should be to:
A) prevent alloimmunization.
B) diminish chills and fever and make the patient comfortable.
C) prevent hemoglobinemia.
D) reverse hypotension and minimize renal damage.
Q3) Which of the following may be a factor in a nonimmune transfusion reaction?
A) Post-transfusion purpura
B) Circulatory overload
C) Allergic reaction
D) Immediate hemolytic transfusion reaction
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18
Chapter 18: Transfusion-Transmitted Diseases
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Sample Questions
Q1) Which of the following parasites has not been associated with transmission via blood transfusion?
A) Trypanosoma cruzi
B) Plasmodium sp
C) Leishmania
D) None of the above
Q2) The hepatitis A virus belongs to which family of viruses?
A) Retroviridae
B) Flaviviridae
C) Hepadnaviridae
D) Picornaviridae
Q3) HIV belongs to which family?
A) Flaviviridae
B) Retroviridae
C) Hepadnaviridae
D) Picornaviridae
Q4) A person with acute hepatitis B infection is immune to infection from other hepatitis viruses.
A)True
B)False
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Chapter 19: Hemolytic Disease of the Fetus and Newborn
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Sample Questions
Q1) Why is reverse grouping omitted in neonate ABO grouping?
A) Maternal ABO antibody is identical to newborn ABO antibody
B) Maternal antibodies mask the ABO antibodies of the neonate
C) Newborns do not produce isoagglutinins of their own
D) None of the above
Q2) The antibody titer of maternal antibody is directly proportional to severity of HDFN.
A)True
B)False
Q3) What immunoglobulin is capable of crossing the placenta?
A) IgG
B) IgM
C) IgA
D) All of the above
Q4) Which of the following assays is used to calculate the amount of fetomaternal hemorrhage in a postpartum specimen?
A) Antibody specimen
B) Kleihauer-Betke test
C) Rosette test
D) Solid-phase adherence test
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Chapter 20: Autoimmune Hemolytic Anemias
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Sample Questions
Q1) A 5-year-old boy suffering from the measles complained of back pain, chills, and stomach pain. A visit to the doctor revealed hemoglobinuria, bilirubinemia, and hemoglobinemia. The child's hemoglobin level had fallen to 6 g/dL. A DonathLandsteiner test was performed and showed the following: control sample = no hemolysis; test sample = hemolysis. The results are consistent with what disorder?
A) Warm autoimmune hemolytic anemia
B) Cold hemagglutinin disease
C) Paroxysmal cold hemoglobinuria
D) Secondary cold AIHA
Q2) How can persons with CHD avoid hemolytic episodes?
A) Have a splenectomy
B) Move to a warm climate
C) Corticosteroid therapy
D) None of the above
Q3) Which of the following signifies intravascular hemolysis in AIHA?
A) Increased haptoglobin
B) Bilirubinemia
C) Hemoglobinuria
D) Spherocytosis
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Page 21
Chapter 21: The Hla System
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Sample Questions
Q1) The majority of cross-reactive alloantibodies detect HLA specificities of allelic molecules coded by the same locus.
A)True
B)False
Q2) What kidney transplant strategy is satisfied through matching of the donor and recipient antigens?
A) Use of immunosuppressive agents
B) Reduction of graft "foreignness"
C) Induction of tolerance
D) None of the above
Q3) How many targets are required for HLA antibody screening?
A) 10
B) 20
C) 30
D) 40
Q4) The HLA-A locus antigens A2, A23, A24, and A28 make up the:
A) A4-CREG
B) A3-CREG
C) A2-CREG
D) A8-CREG
Page 22
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Chapter 22: Relationship Testing
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Sample Questions
Q1) In HLA serologic testing, how are cytotoxic effects of antigen-antibody interactions detected?
A) There is visible agglutination, or clumping.
B) The cells remain clear.
C) Trypan blue or eosin stains the cells because of loss of membrane integrity.
D) There is hemolysis.
Q2) What technology is used to demonstrate the presence of allelic variants of red blood cell enzymes and serum proteins?
A) Electrophoresis
B) Polymerase chain reaction
C) Ion-exchange chromatography
D) Fluorescence polarization
Q3) What component of the Hardy-Weinberg equation (p<sup>2 </sup>+ 2pq + q<sup>2</sup>) signifies heterozygotes?
A) p<sup>2</sup>
B) 2pq
C) q<sup>2</sup>
D) None of the above
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Chapter 23: Quality Management
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Sample Questions
Q1) What department evaluates and certifies employee credentials and determines the literacy of the employee?
A) Human Resources
B) Laboratory
C) Administration
D) Education
Q2) Which of the following is used to determine if reagents and equipment are functioning prior to testing?
A) Critical control points
B) Control charts
C) Quality assurance
D) Quality control
Q3) A physician complains that she has not received a test report from the blood bank. The remedial action is to:
A) complete the occurrence report form.
B) prepare a copy of the report for the physician.
C) locate the original report.
D) determine why the report was not delivered.
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Chapter 24: Transfusion Safety and Federal Regulatory Requirements
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Sample Questions
Q1) What is the function of the CBER?
A) To monitor continuing education at designated facilities
B) To issue federal licenses to establishments that are manufacturing biological products
C) To issue certification to medical technologists
D) None of the above
Q2) A drug is considered adulterated if the methods used to manufacture it do not conform with current good manufacturing processes.
A)True
B)False
Q3) Which of the following provides just cause for a product recall by the FDA?
A) The donor blood pressure reading was omitted in donor screening.
B) An A-positive packed red blood cell unit was labeled as an A-negative packed red blood cell unit.
C) An autologous unit was found reactive for anti-HBc.
D) A therapeutic whole blood unit had a hematocrit of greater than 80%.
Q4) Blood grouping reagents are considered medical devices according to the CBER. A)True B)False
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Chapter 24: Utilization Management
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Sample Questions
Q1) Upon review at the end of the quarter, you note that one physician's C/T ratio was high. You discuss this with the medical director, and he has you draft a letter to this physician. This is an example of what kind of review?
A) Retrospective
B) Concurrent
C) Interpreted
D) Prospective
Q2) Blood utilization management programs are designed to do all but which of the following?
A) Increase safety
B) Decrease component availability
C) Reduce expenditure
D) Manage limited blood resources
Q3) The focus of most blood utilization programs is:
A) the underutilization of blood products of a facility.
B) the overutilization of blood products by a facility.
C) to reduce cost.
D) to evaluate the need for ordering more product.
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Chapter 25: Laboratory Information Systems
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Sample Questions
Q1) Data from donor history cards would be stored in what type of file?
A) Static file
B) Antibody file
C) Dynamic file
D) Review file
Q2) What are the two components of computer terminals?
A) central receiving terminal/keyboard
B) monitor/keyboard
C) cathode ray tube/disk
D) central processing unit/keyboard
Q3) What hardware device controls the interpretation and execution of software instructions?
A) Modem
B) Central processing unit
C) Central ray tube
D) File server
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Chapter 26: Medicolegal and Ethical Aspects of Providing
Blood Collection and Transfusion Services
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Sample Questions
Q1) Many transfusion-transmitted acquired immunodeficiency syndrome (TTAIDS) lawsuits have been dismissed because of:
A) inability to prove negligence.
B) lack of precedence.
C) blood shield statutes.
D) statute of limitations.
Q2) The ________ is an example of a voluntary standard, as related to transfusion medicine.
A) Clinical Laboratory Improvement Amendments of 1988
B) Journal of the American Medical Association
C) AABB Standards
D) Code of Federal Regulations
Q3) All of the following injuries from component collection may be grounds for a civil suit except:
A) a hematoma.
B) nerve damage.
C) a sudden fall.
D) severe donor reaction.
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Chapter 27: Tissue Banking: A New Role for the Transfusion Service
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Sample Questions
Q1) If your facility is a member of and accredited by the Eye Bank Associates of America, there is no need to be monitored by the FDA.
Multiple Choice
Identify the choice that best completes the statement or answers the question.
A)True
B)False
Q2) A bone flap is harvested by a physician for a patient at hospital X. The patient has an issue with hospital X and requests to go to hospital Y. The patient is transferred, but the physician wants to continue with the treatment. Which of the following scenarios is possible?
A) Hospital X would need to be registered with the FDA as a tissue vendor in order to transfer the bone flap to hospital Y.
B) The patient is allowed to take the bone flap with him to hospital Y, because it is autologous.
C) The physician is licensed to practice at both hospitals, so he is allowed to transfer the bone flap.
D) There is no tissue with transfer from one hospital to the next, because the material being transferred is bone.
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Page 29