MRO Test Study Guide

If neither the MRO nor the DER are able to contact the Donor, then the MRO must wait ____________ prior to reporting the result.

10 Days

The Collector must send Copy 2 of the CCF to the MRO within _____________.

24 Hours

The Donor has ______ hours to provide a specimen containing 45 mL.

3 Hours

The MRO's office must make at least ____________________ to contact the donor before contacting the DER for assistance.

3 attempts spread over 24 hours

The collector has ___________ from the date of notification to complete Error Correction Training.

30 Days

The collector must read the temperature strip within ______________ of receiving the specimen from the employee.

4 Minutes

The donor must provide a minimum of ____________ of urine.

45ml

Regulatory guidelines for DOT drug and alcohol testing are referred to as

49 CFR Part 40

If instructed by the MRO, the DER must inform the Donor to contact the MRO's office within _____________ of being notified by the DER.

72 Hours

The donor has up to _____________ to request a re-confirmation test of the split specimen.

72 Hours

The temperature of a specimen must be __________ to be considered a valid specimen.

A. 90-100 degrees Fahrenheit or 32-38 degrees Celsius

Which of the following is not a correctable flaw: A. The specimen identification numbers on the specimen bottles do not match the specimen identification numbers on the CCF B. The collector printer their name but failed to sign their name C. Step 5 of the MRO Copy is incomplete D. The collector wrote the incorrect collection date on the CCF E. The collector failed to mark the "Reason for the Test"

A. The specimen identification numbers on the specimen bottles do not match the specimen identification numbers on the CCF

What is the most accurate description of test results that are considered abnormal?

Adulterated, substituted, invalid, dilute, and positive

What drug Classifications are included in the DOT panel?

Amphetamines, Cocaine, Marijuana, Opioids, and PCP

A direct observation may be conducted by

An individual of the same gender as the Donor

The MRO-A may not perform which of the following tasks: A. Review the MRO Copy of the CCF for accuracy B. Cancel a test that has a fatal flaw C. Verify the Donor's identity D. Schedule a time for the MRO and Donor interview

B. Cancel a test that has a fatal flaw

When the MRO assistant calls the donor for the donor interview and the donor refuses to speak to the MRO, what should the MRO assistant do? A. Explain that the MRO wants to speak to the donor about a positive test result, and would like to get additional information from the donor before making his report to the employer. B. Explain that the MRO will report the results of the test to the employer even if the donor chooses not to speak to the MRO. C. Explain that if the donor speaks to the MRO and they give the MRO a valid medical reason why their test is positive, the MRO will not report the test as positive. D. Explain to the donor that if they don't want to speak to the donor right now, they must call back within 72 hours if they change their mind.

B. Explain that the MRO will report the results of the test to the employer even if the donor chooses not to speak to the MRO.

Which of the following is not a true statement regarding the laboratory certifying scientist's signature the lab copy of the CCF? A. The certifying scientist is not required to sign the CCF for negative results. B. If the certifying scientist fails to sign the CCF for a non-negative result, the test is invalid and the MRO must cancel the test. C. Failure of the certifying scientist to sign the CCF for a result of "substituted specimen" may be corrected by the MRO assistant by sending a Memorandum for Record to the lab. D. The certifying scientist must sign the CCF when the laboratory reports the specimen result as "invalid" E. All the above are correct.

B. If the certifying scientist fails to sign the CCF for a non-negative result, the test is invalid and the MRO must cancel the test.

The laboratory result of a specimen is non-negative. However, the collector did not conduct a direct observation as instructed by the DER. What must the MRO office do next? A. Instruct the DER to send the employee for another collection and report both test results B. The MRO office will proceed with verifying the non-negative result. C. The MRO office will cancel the test and instruct the DER to send the employee for an immediate recollection under direct observation D. The MRO office must report the result as "Inconclusive"

B. The MRO office will proceed with verifying the non-negative result.

When the MRO assistant initiates the telephone call to the donor for the MRO interview, which of the following scripts are not acceptable? A. "The doctor needs to speak to you about your test result." B. "Before you speak to the doctor, I need to verify that I am speaking to the correct John Smith." C. "Thank for you verifying your identity. Would you like to speak to the doctor about your test result now? D. "I'd like to leave a message for John Smith to call Dr. Monroe's office between 8:00 am and noon about a test result."

C. "Thank for you verifying your identity. Would you like to speak to the doctor about your test result now?

Which of the following is not a valid reason for test under DOT regulations? A. Pre-employment B. Reasonable suspicion C. Commercial Driver's License (CDL) Examination D. Random E. Post-accident F. Follow-Up G. Return to Duty

C. Commercial Driver's License (CDL) Examination

Which of the following entities is not considered to be a Service Agent? A. Collector B. MRO C. DER D. MRO Assistant E. SAP F. Laboratory G. All the above are Service Agents

C. DER

Which of the following are not valid forms of ID: A. Driver's License or Military ID B. Passport or Company ID C. Facsimile, Photocopy, Student ID D. All of the above

C. Facsimile, Photocopy, Student ID

Each of the five DOT operating agencies has a set of regulations unique to that agency. Which of the following subjects is not found in one of the operating agency regulations? A. List of job duties that are covered by the DOT regulations B. Consequences for a positive drug or alcohol test C. Procedures for performing a urine drug screen collection D. Training requirements for employees and supervisors E. Definition of an accident that requires post-accident testing F. All the above are correct

C. Procedures for performing a urine drug screen collection

Which is not one of the topics covered in 49 CFR Part 40? A. Urine collection personnel B. Medical Review Officer and the Verification Process C. Role of the Medical Review Assistant D. Problems with Drug Tests E. Public Interest Exclusion F. All the above are covered in 49 CFR Part 40

C. Role of the Medical Review Assistant

Which statements are correct regarding laboratory reports of test results? A. The laboratory must use Copy one of the CCF to report negative results. B. The laboratory may use an electronic data file to report negative and non-negative results. C. The Certifying Scientist's name must appear on electronic data file reports. D. The Certifying Scientist scanned signature must appear on electronic data file reports. E. None of the above is correct. F. All the above are correct.

C. The Certifying Scientist's name must appear on electronic data file reports.

The collector used a non-Federal CCF to conduct a DOT collection. Which of the following statements are true? A. This is a fatal flaw that will cause the test to be canceled, and the collector must undergo Error Correction Training. B. The MRO assistant may want to correct this minor error with a Memorandum for Record from the collector if the DER has previously indicated they need accurate information for the annual reporting purposes. C. The MRO assistant must send a Memorandum for Record to the laboratory to request a "DOT Upgrade." D. The MRO assistant must send a Memorandum for Record to the collector to request they copy the donor's information onto a Federal CCF and return the corrected form to the MRO assistant. E. None of the above are correct.

C. The MRO assistant must send a Memorandum for Record to the laboratory to request a "DOT Upgrade."

Which statement is correct about a canceled test? A. The employer must treat a canceled test the same as a negative test. B. The donor must be tested again if the test was a post-accident test. C. The donor must be tested again if the test was a follow-up test. D. If the test was canceled through no fault of the donor, the canceled test will count towards the minimum number of random tests the employer is required to perform.

C. The donor must be tested again if the test was a follow-up test.

Which statement is accurate regarding laboratories performing split specimen tests? A. The laboratory performs a screening test, then a confirmation test if the screening test detects the presence of drugs. B. The laboratory that performed the test of the primary specimen bottle may also perform the test of the split specimen if the lab has approval from HHS and DOT to do so. C. The laboratory that performs the split specimen test runs a confirmation test only for the drug(s) identified on the test of the primary specimen. D. The MRO office selects the laboratory that will perform the split specimen test. E. None of the above answers are correct.

C. The laboratory that performs the split specimen test runs a confirmation test only for the drug(s) identified on the test of the primary specimen.

Which of the following is not a true statement about drug metabolites? A. Some metabolites stay in a person's system longer than the parent drug B. Laboratories sometimes test for the presence of metabolites in addition to testing for the parent drug C. The presence of drug metabolites in a urine specimen suggests the possibility of adulteration. D. Laboratories test for the presence of drug metabolites only for the screening test, not for confirmation tests. E. All the above are correct

C. The presence of drug metabolites in a urine specimen suggests the possibility of adulteration.

Which of the following task may the MRO-A perform? A. Verify positive results B. Verify invalid results C. Verify the Donor's identity D. Cancel a test

C. Verify the Donor's identity

Who completes step 1 of the CCF

Collector or Employee Rep

If the Donor refuses to wash their hands, the Collector should

Consider this a Refusal to Test and document the Refusal in the Remarks section of the CCF

If a donor is unable to provide 45 mL of urine, then the collector must:

Consider this a Shy Bladder. The Collector must document the attempt and instruct the Donor of the Shy Bladder procedures.

If the Donor inadvertently flushes the toilet while they are in the restroom, the Collector should:

Continue with the collection and note "Donor flushed the toilet" in the Remarks section

What copy of the CCF is the MRO Copy?

Copy 2

What is not a true statement regarding dilute specimens and "extreme dilute" specimens? A. An "extreme dilute" specimen requires that the employee must be retested immediately. B. If the specimen is dilute, the employer may retest the donor if company policy permits. C. A retest of an "extreme dilute" specimen must be conducted using direct observation. D. A retest of a dilute specimen may be performed using direct observation if company policy permits. E. All of the above are correct. F. None of the above are correct.

D. A retest of a dilute specimen may be performed using direct observation if company policy permits.

In the event the Collector is not the Observer, the Collector must: A. Instruct the Observer of the direct observation procedures B. Print the Obeserver's name in the "Remarks" section C. Instruct the Observer not to handle the specimen but to maintain visual contact of the specimen until the Donor presents the specimen to the Collector D. All answers are correct

D. All answers are correct

For which reason might the MRO assistant send a Memorandum for Record to the collector for information missing in Step 5 of the CCF? A. Donor's printed name and/or signature is missing B. Donor's date of birth is missing C. Donor's daytime and/or evening phone number is missing D. All of the above are correct

D. All of the above are correct

Which of the following are least likely to be used by the MRO-A as an identifiable marker in order to match the CCFs with the laboratory result? A. Employee's ID Number B. Specimen ID Number C. Collection Site Information D. Employee's Name

D. Employee's Name

Which is a true statement about the Designated Employer Representative (DER)? A. Must receive training and pass a DER certification test B. Must have the authority to terminate employees who violate DOT drug testing rules C. Is responsible for identifying employee behavior that requires a reasonable suspicion test D. Is authorized to receive drug test results from the MRO

D. Is authorized to receive drug test results from the MRO

The MRO assistant receives the MRO copy of the CCF prior to receiving the Lab report, and the collector has failed to sign the CCF. What should the assistant do? A. Immediately send an MFR to the collector to correct the omission. B. Nothing is required to be done as long as the collector's printed name is present and legible. C. Wait until they match the Lab copy of the CCF before sending an MFR to the collector to correct the omission. D. None of the above is correct.

D. None of the above is correct.

Which of the following statements about Fatal Flaws is accurate? A. A Fatal Flaw will cause a test to be canceled unless the MRO judges that the flaw is minor. B. A Fatal Flaw will cause a test to be canceled if it is not corrected within 72 hours of notification. C. All Fatal Flaws are identified by the laboratory and are listed in the laboratory report to the MRO. D. Only the MRO may cancel a test that has a Fatal Flaw.

D. Only the MRO may cancel a test that has a Fatal Flaw.

Which of the following test results require the MRO to interview the donor? A. Adulterated, substituted, rejected for testing B. Adulterated, substituted, dilute C. Substituted, dilute, invalid D. Substituted, adulterated, invalid E. None of the above

D. Substituted, adulterated, invalid

Which of the following statements is accurate regarding notifying a collector about the need for Error Correction Training? A. The MRO Assistant notifies the DER and the collector in writing about the need for error correction training whenever they send a Memorandum for Record requesting that the collector correct a correctable error. B. The MRO assistant notifies the collector of the need for Error Correction training when the laboratory reports the test was canceled due to insufficient specimen for testing, even if the specimen leaked in transit to the lab. C. Best practice is for the MRO assistant to notify the DER, the laboratory, and the Collector of the need for Error Correction Training when a test is canceled due the an error by the collector. D. The DER is responsible for notifying the collector of the need for Error Correction training.

D. The DER is responsible for notifying the collector of the need for Error Correction training.

Which statement about reporting split specimen results is not correct? A. The laboratory reports split specimen results only to the MRO. B. The MRO must report the results to the DER. C. The split specimen result is the final result, regardless of the result of the first test. D. The MRO must report the result of the split specimen test to the donor in writing. E. The MRO uses Step 7 of the CCF to report results.

D. The MRO must report the result of the split specimen test to the donor in writing.

A specimen that contains little or no creatinine is most likely

Dilute or substituted

A Return to Duty and Follow Up collections require:

Direct Observations

When reviewing the MRO copy of the CCF the MRO assistant sees that the Temperature box is not checked. Which of the following statements is not accurate? A. It is likely that the laboratory report to the MRO office will be delayed. B. The laboratory must attempt to correct this error before reporting lab results. C. The laboratory will wait up to five days to receive an MFR from the collector to correct the error and will report the results after that time even if the error is not corrected. D. If the laboratory report shows the error has not been corrected, the assistant may also want to request that the collector send an MFR to the MRO office to correct the error. E. All of the above are correct.

E. All of the above are correct.

Which statements are correct about the difference in verifying negative tests and non-negative steps? A. Negative results require a review to ensure the laboratory report is complete B. Negative results require a review of the MRO Copy of the CCF C. Non-negative results require the MRO to interview the donor D. The review of negative and non-negative results must confirm that the certifying scientist signed the lab report E. All the above are correct

E. All the above are correct

Which statement is true regarding Split Specimen testing? A. The request to test the split specimen may be made by the DER. B. Split specimen testing is only performed for positive test results. C. The request to test the split specimen must be made in writing. D. Split specimen testing may be performed for invalid tests. E. None of the above answers are correct. F. All of the above answers are correct.

E. None of the above answers are correct.

DOT regulations require the employee/donor to sign which of the following documents: A. Waiver of Liability B. Release of Information C. Consent Form D. All of the above are correct E. None of the above are correct

E. None of the above are correct

If a Donor provides ___________ and a temperature is not within range of 90-100 degrees Fahrenheit or 32-38 degrees Celsius, then the Collector must immediately start a second collection utilizing direct observation procedures.

Enough of a specimen to activate the temperature strip

What agencies fall under DOT Regulations:

FAA USCG FMCSA PHMSA FTA FRA

If the result is positive, the MRO-A must interview the donor prior to reporting the test result to the employer.

False

True/False If a temperature does not register on the temperature strip, the collector should insert a thermometer into the specimen in an effort to obtain a temperature.

False

True/False The Collector must use a separate CCF for each collection attempt.

False

True/False The MRO must report the quantitative levels of the positive drug screen result to the DER:

False

True/False The collector must complete Step 5 of MRO Copy on the CCF

False

True/False Confirmation test cut-off levels are always higher than the screening test cut-off levels:

False

True/False MRO is required to review all drug and alcohol test results

False

Ture/False The MRO has personally interviewed a donor regarding a positive or abnormal test result for a previous test. If a subsequent test result is positive or abnormal, another donor interview is optional; the MRO may rely upon the medical information learned in the previous donor interview to verify the test result as long as that information is current and relevant to the current test result.

False

Which of the following are Not MRO responsibilities? A. Review results of blind quality control samples B. Monitor errors made by collectors C. Give official interpretations of DOT regulations to employers D. Act as a "gatekeeper" for drug test results E. All of the above are MRO responsibilities

Give official interpretations of DOT regulations to employers

The role of the MRO was first defined by.

HHS as directed by Reagan's Executive Order 12564

Laboratory guidelines for analyzing dot specimens are developed by who?

Health and Human Services (HHS)

The Reason for Test is marked "Follow-Up". What should the MRO assistant do next?

If the "Observed" box is not checked, check with the collector to see if they used Direct Observation to conduct the test.

If a Donor provides a specimen that appears to have been adulterated or substituted, the Collector must:

Immediately conduct a second collection under direct observation

Omnibus Transportation Employee Testing Act

In 1991, Congress passed the __________________ to specify the DOT agencies covered by the federal testing regulations.

If a donor asks to wait to provide a specimen due to the fact they do not feel they can provide a sufficient amount, then the collector must:

Inform the Donor that DOT regulations require the Collector to begin the collection process without any delay and instruct the Donor to make an attempt

Who may become an MRO?

Licensed physicians such as a Doctor of Medicine or Doctor of Osteopathy

The majority of drug test results are

Negative

In the event that Donor does not contact the MRO's office after being instructed to by the DER, the MRO will report the result as:

Non-Contact Positive

What 2 government agencies are authorized to interpret federal D&A regulations

Office of Drug and Alcohol Policy and Compliance (ODAPC) and the DOT Office of General Counsel (OGC)

Specifies the DOT agencies covered by the Federal testing regulations (1991)

Omnibus Transportation Employee Testing Act

What are the requirements to be an MRO?

Pass a certification exam. Take an MRO course. Be a licensed physician.

If the Donor provides a second specimen under direct observation due to the specimen being out of normal temperature range, adulterated, or substituted, the collector must:

Process both specimens for shipment and send both specimens to the laboratory and notify the DER that a direct observation was conducted

Drug testing requirements for Federal employees were established by who and when

Reagan's Executive Order 12564 in 1986

If the examining physician cannot conclude the donor has a valid medical reason for not being able to provide a sufficient amount of a specimen for the collection, then the MRO will report the result as:

Refusal to Test

If a collector fails to sign their name on the CCF and the Lab is not able to correct the error with an affidavit or Memorandum for Record, the lab will report the test as _____ and the MRO will report the test as _____.

Rejected for testing, canceled

The initial test performed by the laboratory when analyzing a specimen for the presence of drugs is also known as:

Screening Test

What do labs test for when doing a validity test

Specific gravity Creatinine levels pH balance Oxidizing agents

What step is the name/contact info for the MRO located on the CCF

Step 1

What step does the collector print and sign name on the CCF

Step 4

What step does the MRO complete of the CCF when reporting positive results to the DER

Step 6

What does SAP stand for?

Substance Abuse Professional

The Collector may date the specimen seals and instruct the Donor to initial the seals when:

The Collector has affixed the seals on the specimen bottles

Which of the following scenarios should the MRO assistant never attempt to correct with a Memorandum for Record? A. The Temperature Box is not checked in Step 2 of the CCF. B. The Collector's printed name and signature is omitted are Step 4 of the CCF. C. The Donor's printed name and signature is omitted in Step 5 of the CCF, and there is no remark by the collector that the donor refused to complete the form. D. The daytime and evening phone numbers of the donor are omitted in Step 5. E. There is no DOT agency checked for a DOT test.

The Collector's printed name and signature is omitted are Step 4 of the CCF.

What is the next step when the employer is notified that the donor did not produce a sufficient quantity of specimen?

The DER consults with the MRO to select a physician to examine the donor.

Who is ultimately responsible for ensuring a split specimen, or re-confirmation, test occurs if the donor requests the additional testing?

The Employer

Who determines the method that the collector uses to send the MRO copy to the MRO office?

The MRO

When reviewing the MRO copy of the CCF the Reason for Test box is checked as "Other." What should the MRO assistant do?

The MRO assistant should contact the collector and/or the DER to determine to confirm the reason for the test.

Which statement(s) are true about a specimen with creatinine and specific gravity levels outside of normal parameters? A. This will be identified as an adulterated specimen. B. The donor will be required to re-test immediately. C. This will be identified as a dilute specimen. D. The consequences to the donor are the same as for a positive test.

This will be identified as a dilute specimen.

True/False In a DOT collection, a Monitor must be the same gender or a licensed medical professional or technician.

True

True/False The Collector must document each of the Donor's attempts in the "Remarks" section of the CCF.

True

True/False Monitored collections occur when the collector is using a multi-stall restroom for a collection. DOT regulations state that a monitored collection must be conducted if a collector does not or cannot properly secure a multi-stall restroom, such as preventing access to all water sources and removing cleaning supplies and trash cans.

True

What is an adulterated specimen?

When a substance is added to a specimen to mask the presence of drugs or to interfere with the laboratory analysis

true/false the reconfirmation test will test for all substances originally tested for

flase

What is Gas Chromatography/Mass Spectrometry (GC/MC) or Liquid Chromatography/Mass Spectrometry (LC/MS)

methodologies that the lab uses for conducting confirmation test

what step on the coc must be completed by the MRO for. reconfirmation test

step 7

who can order a split specimen to be tested

the doner

True/False The MRO cancle the testing if a reconfirmation can not be completed

true

When the MRO assistant verifies the donor's identity when contacting the donor for the MRO interview, what information should they ask for

verify at least two of the following: specimen ID number, donor identification, and date of birth.