Deck 26: Patient Blood Management

Question 1

Which patient blood management tool has the least effect on resource conservation?

A) Blood order sets
B) Blood-sparing or salvage techniques
C) Computerized algorithms
D) Preoperative anemia clinics

Answer 1

A

Question 2

Which of the following scenarios serves the purpose of providing needed hemotherapy without transfusing more blood than is necessary?

A) Single-unit transfusion of RBCs, with reassessment prior to ordering additional units
B) Continuation of RBC transfusion until normal levels are reached
C) Transfusing one extra RBC unit after normal level is reached to avoid relapse
D) None of these

Answer 2

A

Question 3

Which of the following is not part of a blood utilization review?

A) Retrospective review
B) Concurrent review
C) Interpreted review
D) Prospective review

Answer 3

C

Question 4

A physician has ordered a 2-unit transfusion on an outpatient. When the outpatient arrives, the patient's hemoglobin is 12. What is the most appropriate action?

A) Cancel the transfusion and send the patient home.
B) Call the physician's office and inform them of their mistake.
C) Inform the pathologist or medical director and allow him to contact the physician.
D) Transfuse. A physicians order should not be questioned.

Question 5

Proper blood utilization audits should review which types of records from transfused patients?

A) Retrospective sample of records
B) Representative sample of records
C) Both
D) Neither

Question 6

Which administrative function is NOT normally that of a transfusion safety officer?

A) Developing transfusion guidelines.
B) Educating laboratory and medical staff
C) Hiring qualified transfusion personnel
D) Writing transfusion policies and procedures

Question 7

Transfusion guidelines typically contain which of the following?

A) Contraindications for transfusion
B) Indications for transfusion
C) Dosage recommendations
D) All of these

Question 8

A patient has a platelet count of 10,000/cumm. This value may be used by transfusion service to:

A) establish the patient's normal range.
B) place scheduled transfusion on hold.
C) proceed with transfusion therapy.
D) None of the above

Question 9

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

Question 10

Targeted and discontinuous are subtypes of what review system?

A) Retrospective
B) Concurrent
C) Interpreted
D) Prospective

Question 11

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

Question 12

Which of the following is NOT a patient blood management tool?

A) Blood order sets
B) Computerized algorithms
C) Maximum surgical blood order schedule
D) Training phlebotomists in donor collection

Question 13

Transfusion guidelines should contain which of the following?

A) Indications for transfusion
B) Incorporation of current best practices
C) Thresholds used in screening and auditing of transfusion records
D) All of these

Question 14

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.

Question 15

What educational functions must a transfusion safety officer be able to perform?

A) Developing educational materials
B) Coordinating education for clinical staff
C) Lecturing to physicians and nurses
D) All of these.

Question 16

An example of direct behavior influence when implementing intervention strategies would be:

A) discussion with a physician about his ordering practice.
B) an e-mail to the nursing staff about their roles in transfusing.
C) a communication tree to all med techs about new protocols of issuing a product.
D) All of the above

Question 17

Which statement is false?

A) There is zero inherent risk of transfusing blood if all protocols are followed.
B) Following quality assurance guidelines for transfusion increases the safety to the patient.
C) You must follow a physician's order no matter what.
D) All of the above statements are true.

Question 18

Which patient blood management tool has no other goals besides safety and quality improvement?

A) Auditing and review of blood utilization
B) Benchmarking continuous monitoring
C) Maximum surgical blood order schedule
D) Preoperative anemia clinics

Question 19

Transfusion guidelines are intended to be

A) a burden on clinicians and their patients in making decisions related to transfusion.
B) prescriptive in nature when dealing with the topic of transfusion therapy.
C) prohibitive in nature when dealing with the topic of transfusion therapy.
D) systematically developed statements relevant to transfusion therapy.

Question 20

Which if the following is NOT a duty of the transfusion safety officer?

A) Administering blood products
B) Auditing transfusion records
C) Reviewing blood utilization
D) Tracking and reporting transfusion metrics

Question 21

Why should a blood utilization review give special attention to each type of blood component?

A) They all have the same risk factors.
B) Their costs are basically the same.
C) Wastage may vary according to component.
D) All of these

Question 22

Presurgical autologous blood donation (PAD) is NOT recommended patients with anemia unless the patient has which of the following?

A) A rare blood type
B) Alloantibodies to high-frequency antigens
C) Multiple antigens that require very rare phenotype-matched products
D) Any of these

Question 23

Which of these is NOT one of the thee pillars of patient-focused blood management?

A) Minimizing the effects of leukemia.
B) Minimization of blood loss and bleeding
C) Optimizing the physiological reserve of anemia
D) Optimization of erythropoiesis

Question 24

The blood utilization review audit should compare which of these?

A) Indications used for actual transfusions against the transfusion guideline
B) Number of units ordered from regional blood banks versus those used and those wasted
C) Number of units transfused by one physician practice group with another physician practice group
D) All of these

Question 25

Which of the following can be a significant contributor to anemia developed as a result of hospitalization?

A) Iron deficiency
B) Iatrogenic blood loss
C) Viscoelastic testing
D) Vitamin deficiency

Question 26

Which of the following is an undesired result of blood utilization review audits?

A) Establishing lower transfusion thresholds
B) Increasing underutilization of blood
C) Reducing blood overutilization
D) None of these

Question 27

Which of the following drugs is NOT a hematinic.

A) B12
B) Erythropoietin
C) Folate
D) Iron