A nurse checked a red cell unit against the patient's chart at the nurses' station, then hung it on the patient in bed 4. The unit had been crossmatched for the patient in bed 5, who has a similar name. Which step, done properly, would most likely have prevented the error?

Checking the wristband against the unit tag at the bedside

Inspecting the unit for hemolysis before issue

Repeating the ABO group on the patient's sample

An antiglobulin crossmatch instead of an immediate spin

Many hospitals confirm a new patient's ABO group on a second, separately collected sample before issuing group-specific red cells. What is the main purpose?

To detect wrong blood in tube errors

To check the reverse grouping reagents

To detect a rising antibody titer

Why is a patient watched most closely during the first 15 minutes of a red cell transfusion, with the unit run slowly?

Severe reactions often start after a small volume

Citrate toxicity is greatest at the start

The unit is still too cold for a faster rate

Bacterial growth in the bag is greatest early

A pretransfusion blood sample tube should be labeled:

At the bedside, straight after the sample is drawn

Before the sample is drawn, to save time

In the laboratory, when the sample arrives

At the nurses' station, after the round

Patient identification and blood administration

5 DOH Abu Dhabi (HAAD) lab licensing practice questions on Patient identification and blood administration, part of Blood Banking. The first 5 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
A nurse checked a red cell unit against the patient's chart at the nurses' station, then hung it on the patient in bed 4. The unit had been crossmatched for the patient in bed 5, who has a similar name. Which step, done properly, would most likely have prevented the error?
1. AChecking the wristband against the unit tag at the bedside
2. BInspecting the unit for hemolysis before issue
3. CRepeating the ABO group on the patient's sample
4. DAn antiglobulin crossmatch instead of an immediate spin
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Answer: A · Checking the wristband against the unit tag at the bedside
Most mistransfusions happen at the bedside, when a correctly prepared unit is given to the wrong patient. The final check must compare the patient's wristband, and when possible the patient's own statement of name and date of birth, with the unit's compatibility tag at the bedside, just before the transfusion starts. A check against a chart away from the patient cannot catch a wrong-patient error. Electronic bedside barcode scanning makes this check more reliable.
- B: Visual inspection checks the unit, not the identity of the patient.
- C: The sample was correct, so retyping it would not have caught the error.
- D: The crossmatch was valid for the right patient; the unit went to the wrong one.
Question 2 · Medium
Many hospitals confirm a new patient's ABO group on a second, separately collected sample before issuing group-specific red cells. What is the main purpose?
1. ATo check the reverse grouping reagents
2. BTo detect weak subgroups of A
3. CTo detect a rising antibody titer
4. DTo detect wrong blood in tube errors
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Answer: D · To detect wrong blood in tube errors
If the first sample was drawn from the wrong patient, its ABO group will be wrong, and retesting the same tube only repeats the error. A second sample drawn at a different time, ideally by a different person, reveals the mismatch. Many laboratories issue group O red cells until the group is confirmed in this way, and AABB requires two ABO determinations, one on a current sample and one from a second sample or a historical record, before an electronic crossmatch. Wrong blood in tube is a leading cause of ABO-incompatible transfusion.
- A: Reagent performance is checked with daily quality control.
- B: Subgroups are resolved with extra reagents and tests, not with a second sample.
- C: Antibody titers are not part of routine ABO confirmation.
Question 3 · Medium
Why is a patient watched most closely during the first 15 minutes of a red cell transfusion, with the unit run slowly?
1. ACitrate toxicity is greatest at the start
2. BSevere reactions often start after a small volume
3. CThe unit is still too cold for a faster rate
4. DBacterial growth in the bag is greatest early
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Answer: B · Severe reactions often start after a small volume
Acute hemolytic reactions from ABO incompatibility, anaphylaxis and septic reactions often begin after only a few milliliters have been given. Starting slowly and staying with the patient for the first 15 minutes means a reaction is noticed early, when stopping the transfusion limits the dose received. Vital signs are recorded before the start, at about 15 minutes and at the end, following local policy. If a reaction is suspected, the transfusion is stopped, the line is kept open with 0.9% saline, and the blood bank is informed.
- A: Citrate toxicity depends on the rate and total volume, as in massive transfusion.
- C: Temperature is not the reason for the slow start; cold blood matters only in rapid, large-volume transfusion.
- D: Bacteria multiply over hours at room temperature, so their number rises later, not early.
Question 4 · Easy
A pretransfusion blood sample tube should be labeled:
1. ABefore the sample is drawn, to save time
2. BAt the bedside, straight after the sample is drawn
3. CIn the laboratory, when the sample arrives
4. DAt the nurses' station, after the round
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Answer: B · At the bedside, straight after the sample is drawn
Labeling the tube at the patient's side, immediately after collection and with the identity checked against the wristband, is the main defense against wrong blood in tube. Prelabeled tubes are easily used for the wrong patient, and labels added away from the patient depend on memory. AABB requires two independent patient identifiers, the collection date, and a way to identify the person who drew the sample. Unlabeled or mislabeled samples are rejected and recollected, not corrected.
- A: Prelabeled tubes are easily used for the wrong patient.
- C: Labels added in the laboratory cannot be checked against the patient.
- D: Labeling away from the patient depends on memory and invites errors.
Question 5 · Easy
Once a red cell unit leaves controlled storage, its transfusion should be completed within:
1. A1 hour
2. B8 hours
3. C24 hours
4. D4 hours
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Answer: D · 4 hours
Red cells warm up at room temperature, and any bacteria in the unit can multiply. AABB and most guidelines therefore require the transfusion to be finished within 4 hours of the unit leaving controlled storage. If a patient cannot take the whole volume in that time, the blood bank can split the unit so that each part is given within 4 hours. Most adult units run over about 1.5 to 2 hours.
- A: One hour is too short for many patients, especially those at risk of fluid overload.
- B: Eight hours exceeds the safe time at room temperature.
- C: 24 hours is the expiry of opened red cells kept at 1 to 6 °C, not an infusion time.

Patient identification and blood administration

A nurse checked a red cell unit against the patient's chart at the nurses' station, then hung it on the patient in bed 4. The unit had been crossmatched for the patient in bed 5, who has a similar name. Which step, done properly, would most likely have prevented the error?

Many hospitals confirm a new patient's ABO group on a second, separately collected sample before issuing group-specific red cells. What is the main purpose?

Why is a patient watched most closely during the first 15 minutes of a red cell transfusion, with the unit run slowly?

A pretransfusion blood sample tube should be labeled:

Once a red cell unit leaves controlled storage, its transfusion should be completed within: