Page | 1
BLOOD BANK ASCP EXAM 2025/2026
UPDATED EXAM WITH VERIFIED
SOLUTIONS.
All of the following criteria for donor RBC to be used for an
exchange transfusion relate to both ABO HDFN and HDFN due to
anti-D - correct answer -Less than or equal to 7 days old (or
fresher)
Reconstituted with AB FFP
CMV negative
Negative for hemoglobin S
Irradiated
A patient has a probable anti-Fya but anti-c and anti-K have not
been excluded. Which of the following cells would be the one
most useful cell to exclude both anti-c and anti-K efficiently in this
patient? - correct answer -Fya-; Fyb+; C-c+; K+k-
The ideal red cell to exclude both antibodies efficiently is one that
is Fy(a-) and homozygous positive for both c and K: Fy(a-b+)C-
c+K+k-
The other red cells exclude only anti-c or anti-K (not both) or are
Fy(a+).
, Page | 2
Which of the following antigens are well developed on fetal cells?
Lewis
ABO
Kell - correct answer -Kell.
Antigens develop at various rates both in utero and after birth.
Kell is an antigen that is well-developed on fetal cells, ABO is
slightly weaker, and Lewis is either poorly developed or not
present at all on fetal cells.
The appropriate dosage of Rh immune globulin (RhIg) to
administer post-delivery to an Rh-negative mother delivering an
Rh-positive child is calculated based on the estimated volume of
fetal bleed.
What is the value of x in the formula given below that is used to
calculate RhIg dosage?
Number of vials of 300 µg RhIg = volume of fetal bleed/x mL
Enter the number in the box below that is represented by x in the
formula; do not spell out the number.(e.g., use "5" and not "five").
- correct answer -30 mL of D-positive whole blood
, Page | 3
If an average-weight adult male patient with a 7 gram/dL
hemoglobin is given two units of packed cells, what would be the
approximate new hemoglobin value (assuming there is no active
bleeding or other predisposing factors that would shorten the
survival of the blood cells)? - correct answer -9 gm/dl
One unit of Red Blood Cells increases the hemoglobin level by
approximately 1g/dL in an adult who is not actively bleeding and
has no other predisposing factors that would shorten the survival
of the transfused blood cells.
What should be done FIRST if a donor unit is found to be
incompatible at the antiglobulin phase with several different
recipients? - correct answer -Perform a direct antiglobulin test
(DAT) on the donor unit
Which Lewis antigen(s) will be exhibited on the red cells of adults
who have the Le, Se, and H genes? - correct answer -Leb
Inheritance of both Le and Se genes produces the Leb antigen on
red blood cells. The Se gene codes for the enzyme, a-2-L-
fucosyltransferase which adds L-fucose to the type 1 precursor H
(type 1). The Le gene codes for another L-fucose which forms the
Leb antigen. Some of the precursor chains are not affected by the
Se gene and, therefore, form the Lea antigen. Hence, it is
, Page | 4
possible to see both Lea and Leb in the plasma and secretory
fluids. However, only Leb adsorbs onto the red cells of adults
(most likely due to competitive binding), causing them to
phenotype Le(a-b+).
Which of the following blood group system antibodies is the direct
antiglobulin test (DAT) most UNRELIABLE in helping to diagnose
hemolytic disease of the fetus and newborn (HDFN)? - correct
answer -ABO
n ABO HDFN, the DAT may be weakly positive or negative,
making it an unreliable test.
The DAT is usually reliable for antibodies in the other listed blood
group systems that cause HDFN.
The concentration of sodium chloride in an isotonic solution is : -
correct answer -0.85 %
Which procedure should be followed when one cross-matched
unit out of five is INCOMPATIBLE at the antiglobulin (AHG)
phase? - correct answer -Perform a direct antiglobulin test (DAT)
on the incompatible unit.
BLOOD BANK ASCP EXAM 2025/2026
UPDATED EXAM WITH VERIFIED
SOLUTIONS.
All of the following criteria for donor RBC to be used for an
exchange transfusion relate to both ABO HDFN and HDFN due to
anti-D - correct answer -Less than or equal to 7 days old (or
fresher)
Reconstituted with AB FFP
CMV negative
Negative for hemoglobin S
Irradiated
A patient has a probable anti-Fya but anti-c and anti-K have not
been excluded. Which of the following cells would be the one
most useful cell to exclude both anti-c and anti-K efficiently in this
patient? - correct answer -Fya-; Fyb+; C-c+; K+k-
The ideal red cell to exclude both antibodies efficiently is one that
is Fy(a-) and homozygous positive for both c and K: Fy(a-b+)C-
c+K+k-
The other red cells exclude only anti-c or anti-K (not both) or are
Fy(a+).
, Page | 2
Which of the following antigens are well developed on fetal cells?
Lewis
ABO
Kell - correct answer -Kell.
Antigens develop at various rates both in utero and after birth.
Kell is an antigen that is well-developed on fetal cells, ABO is
slightly weaker, and Lewis is either poorly developed or not
present at all on fetal cells.
The appropriate dosage of Rh immune globulin (RhIg) to
administer post-delivery to an Rh-negative mother delivering an
Rh-positive child is calculated based on the estimated volume of
fetal bleed.
What is the value of x in the formula given below that is used to
calculate RhIg dosage?
Number of vials of 300 µg RhIg = volume of fetal bleed/x mL
Enter the number in the box below that is represented by x in the
formula; do not spell out the number.(e.g., use "5" and not "five").
- correct answer -30 mL of D-positive whole blood
, Page | 3
If an average-weight adult male patient with a 7 gram/dL
hemoglobin is given two units of packed cells, what would be the
approximate new hemoglobin value (assuming there is no active
bleeding or other predisposing factors that would shorten the
survival of the blood cells)? - correct answer -9 gm/dl
One unit of Red Blood Cells increases the hemoglobin level by
approximately 1g/dL in an adult who is not actively bleeding and
has no other predisposing factors that would shorten the survival
of the transfused blood cells.
What should be done FIRST if a donor unit is found to be
incompatible at the antiglobulin phase with several different
recipients? - correct answer -Perform a direct antiglobulin test
(DAT) on the donor unit
Which Lewis antigen(s) will be exhibited on the red cells of adults
who have the Le, Se, and H genes? - correct answer -Leb
Inheritance of both Le and Se genes produces the Leb antigen on
red blood cells. The Se gene codes for the enzyme, a-2-L-
fucosyltransferase which adds L-fucose to the type 1 precursor H
(type 1). The Le gene codes for another L-fucose which forms the
Leb antigen. Some of the precursor chains are not affected by the
Se gene and, therefore, form the Lea antigen. Hence, it is
, Page | 4
possible to see both Lea and Leb in the plasma and secretory
fluids. However, only Leb adsorbs onto the red cells of adults
(most likely due to competitive binding), causing them to
phenotype Le(a-b+).
Which of the following blood group system antibodies is the direct
antiglobulin test (DAT) most UNRELIABLE in helping to diagnose
hemolytic disease of the fetus and newborn (HDFN)? - correct
answer -ABO
n ABO HDFN, the DAT may be weakly positive or negative,
making it an unreliable test.
The DAT is usually reliable for antibodies in the other listed blood
group systems that cause HDFN.
The concentration of sodium chloride in an isotonic solution is : -
correct answer -0.85 %
Which procedure should be followed when one cross-matched
unit out of five is INCOMPATIBLE at the antiglobulin (AHG)
phase? - correct answer -Perform a direct antiglobulin test (DAT)
on the incompatible unit.
