BOC Lab Operations
b (The coefficient of variation % - [standard deviation/mean] x 100.)
166) A cholesterol QC chart has the following data for the normal control: The coefficient of variation for this control is: a. 1.14 % b. 2.19 % c. 4.38 % d. 9.49 %
a (The mode is the most frequently occurring value in a set of data.)
161) The most frequent value in a collection of data is statistically known as: a. mode b. median c. mean d. standard deviation
b (median)
162) The middle value of a data set is statistically known as: a. mean b. median c. mode d. standard deviation
d (The arithmetic mean is the quantity that is most familiar and is ordinarily meant when we refer to the mean or average of a set of data. It is calculated as the sum of values divided by the number of values.)
163) Which of the following is the formula for arithmetic mean? a. square root of the sum of values b. sum of values x number of values c. number of values/sum of values d. sum of values/number of values
b (The mean = sum of values/ number of values.)
164) Given the following values: 100, 120, 150, 140, 130 What is the mean? a. 100 b. 128 c. 130 d. 640
c (Imprecision is the measure of random error commonly expressed as the standard deviation. A more useful measure, the coefficient of variation [CV], is the measure of relative random error usually expressed as a percentage: CV [%] = [standard deviation/ mean] x 100.)
165) Which of the following is the formula for coefficient of variation? a. (standard deviation x 100)/standard error b. (mean x 100)/standard deviation c. (standard deviation x 100)/mean d. (variance x 100)/mean
d (Standard deviation is a measure of the dispersion of data around the mean.)
10) The mean value of a series of hemoglobin controls was found to be 15.2 g/dL, and the standard deviation was calculated at 0.20. Acceptable control range for the laboratory is +/- 2 standard deviations. Which of the following represents the allowable limits for the control? a. 14.5 - 15.5 g/dL b. 15.0 - 15.4 g/dL c. 15.2 - 15.6 g/dL d. 14.8 - 15.6 g.dL
a (Questions that could be discriminatory in nature [eg, nationality, marital status, dependents, religion, affiliations, sexual orientation, or physical or mental disabilities] should be avoided on the employment application or during the interview process, unless the question is relevant or pertinent to the particular job; otherwise, it can be considered illegal.)
113) Which of the following questions can be legally asked on an employment application? a. are you a US citizen b. what is you date of birth c. is your wife/husband employed full time d. do you have any dependents
d (Questions that could be discriminatory in nature [eg, nationality, marital status, dependents, religion, affiliations, sexual orientation, or physical or mental disabilities] should be avoided on the employment application or during the interview process, unless the question is relevant or pertinent to the particular job; otherwise, it can be considered illegal.)
117) Legal pre-employment questions on an application are: a. medical history of an employee b. place of birth c. felonies unrelated to job requirements d. name and address of person to notify in case of emergency
c (Repeating a QC measurement on a new sample of QC material may establish that the alert was caused by a deteriorated QC material rather than a method problem.)
12) Upon completion of a run of cholesterol tests, the technician recognizes that the controls are not within the 2 standard deviations confidence range. What is the appropriate course of action? a. report the results without any other action b. run a new set of controls c. run a new set of controls and repeat specimens d. recalibrate instrument and run controls
d (Manageable and unmanageable cost components for a laboratory manager. While it is under a manager's control to schedule and train employees, "acts of God" [eg, military leave, pregnancy, injury] are not under their control and affect their ability to schedule employees.)
121) Which of the following activities is not under the direction or control of the lab manager? a. number of employees b. direct test costs c. skill mix d. military leave
c (To correct for having used a dilution, multiply the answer obtained times the reciprocal of the dilution made.)
127) An automated CK assay gives a reading that is above the limits of linearity. A dilution of the serum sample is made by adding 1 mL of serum to 9 mL of water. The instrument now reads 350 U/L. The correct report on the undiluted serum should be: a. 2,850 U/L b. 3,150 U/L c. 3,500 U/L d. 3,850 U/L
d (Commonly used units for standard solutions are mg/mL.)
128) The unit of measure for a standard solution is: a. g/L b. % c. mg/% d. mg/mL
a (The value of the unknown is a ratio of the absorbance reading of the unknown to the absorbance reading of the standard.)
129) A glucose determination was read on a spectrophotometer. The absorbance reading of the standard was 0.30. The absorbance reading of the unknown was 0.20. The value of the unknown is: a. 2/3 of the standard b. 3/5 of the standard c. the same as the standard d. 1.5 x the standard
c (Standard deviation is a measure of the dispersion of data around the mean.)
13) The following data was calculated on a series of 30 determinations of serum uric acid control: mean=5.8 mg/dL, 1 standard deviation = 0.15 mg/dL. If the confidence limits are set at =-2 standard deviations, which of the following represents the allowable limits for the control? a. 5.65 - 5.95 mg/dL b. 5.35 - 6.25 mg/dL c. 5.50 - 6.10 mg/dL d. 5.70 - 5.90 mg/dL
b (Volumetric flasks are used to measure exact volumes and are primarily used in preparing solutions of known concentrations.)
130) A technician is asked by the supervisor to prepare a standard solution from the stock standard. What is the glassware of choice for this solution? a. graduated cylinder b. volumetric flask c. acid-washed beaker d. graduated flask
c (The most commonly used equation for preparing suspension solutions is V1 x C1 = V2 x C2. A 4% red cell suspension contains 4 mL of red cells per 100 mL [1 dL] of solution. Therefore, [25] x [4] = [100] x [X]. Solve for x.)
131) How many mL of red blood cells are to be used to make 25 mL of a 4% red cell suspension? a. 0.25 mL b. 0.5 mL c. 1 mL d. 2 mL
c (The most commonly used equation for preparing suspension solutions is V1 x C1 = V2 x C2. In this case, [100] x [5] = [x] x [25]. Solve for x.)
132) The volume of 25% stock sufosalicylic acid needed to prepare 100mL of 5% working solutions is: a. 1.25 mL b. 5 mL c. 20 mL d. 50 mL
c (This is a ratio calculation. 0.9% normal saline contains 0.9 grams NaCl in 100 mL solution. 0.9/100 = x/1,000 Solve for x to determine how much NaCl is needed to prepare 1 L [1,000 mL].)
134) How many grams of sodium chloride are needed to prepare 1 L of 0.9% normal saline? a. 0.9 g b. 1.8 g c. 9.0 g d. 18.0 g
b (Standard deviation is a measure of the dispersion of data around the mean. It is calculated by taking the square root of the summation of the squared differences of the observed x values from their mean divided by n.)
138) Which of the following is the formula for standard deviation? a. square root of the mean b. square root of (sum of squared differenced)/(N-1) c. square root of the variance d. square root of (mean)/(sum of squared differences)
b (The probability of an observation having a value within +/- 2 standard deviations of the mean in a normal distribution is 95.5%. Therefore, 5 control values out of 100 would be out of control due to random error.)
139) The acceptable limit of error in the chemistry laboratory is 2 standard deviations. If you run the normal control 100 times, how many of the values would be out of the control range due to random error? a. 1 b. 5 c. 10 d. 20
d (Precision is the closeness of agreement among replicate measurements, or reproducibility. The coefficient of variation, a more useful measure of reproducibility, is the measure of relative random error expressed as a percentage.)
14) An index of precision is statistically known as the: a. median b. mean c. standard deviation d. coefficient of variation
b (The probability of an observation having a value within +/- 2 standard deviations of the mean in a normal distribution is 95.5%. Therefore, 100 +/- 2 x 1.8 = 95% confidence interval.)
140) A mean value of 100 and a standard deviation of 1.8 mg/dL were obtained from a set of glucose measurements on a control solution. The 95% confidence interval in mg/dL would be: a. 94.6 - 105.4 b. 96.4 - 103.6 c. 97.3 - 102.7 d. 98.2 - 101.8
d (Simple dilutions are ratios of 2 volumes, which involve a single substance diluted with one other substance. In this case, 0.25 mL solution A is added to 19.75 mL solution B [ratio 0.25/19.75], for a total volume of 20 mL. This represents a dilution of 0.25/20. To convert a 0.25/20 dilution to a 1-in-something dilution, set up a ratio" proportion calculation: 0.25 is to 20 as 1 is to x, and solve for x.)
141) When 0.25 mL is diluted to 20 mL, the resulting dilutions is: a. 1:20 b. 1:40 c. 1:60 d. 1:80
a (Definition of a standard.)
142) When the exact concentration of the solute of a solution is known and is used to evaluate the concentration of an unknown solution, the known solution is: a. standard b. normal c. control d. baseline
c (To correct for having used a dilution, multiply the answer obtained times the reciprocal of the dilution made.)
143) A serum glucose sample was too high to read, so a 1:5 dilution using saline was made (dilution A). Dilution A was tested and was again too high to read. A further 1:2 dilution was made using saline (dilution B). To calculate the result, the dilution B value must be multiplied by: a. 5 b. 8 c. 10 d. 20
b (To correct for having used a dilution, multiply the answer obtained times the reciprocal of the dilution made.)
144) In performing a spinal fluid protein determination, the specimen is diluted 1 part spinal fluid to 3 parts saline to obtain a result low enough to measure. To calculate the protein concentration, the result must be: a. multiplied by 3 b. multiplied by 4 c. divided by 3 d. divided by 4
a (This is a ratio calculation. 1:300 dilution equals 1 antigenic unit in 0.5mL. Therefore 2 antigenic units in 0.5mL equals a 1:150 dilution.)
147) If 0.5 mL of a 1:300 dilution contains 1 antigenic unit, 2 antigenic units would be contained in 0.5 mL of a dilution of: a. 1:150 b. 1:450 c. 1:500 d. 1:600
d (Precision is the reproducibility of analytical results, or the degree to which results of multiple analyses of the same specimen agree.)
15) The term used to describe reproducibility is: a. sensitivity b. specificity c. accuracy d. precision
c (The most common equation for preparing dilutions is V1 x C1 = V2 x C2, where V1 is the volume, C1 is the concentration of solution 1, and V2 and C2 are the volume and concentration of the diluted solution.)
151) Which of the following is the formula for calculating the dilution of a solution. a. V1 + C1 = V2 + C2 b. V1 + C2 = V2 + C1 c. V1 x C1 = V2 x C2 d. V1 x V2 = V1 x C2
d (Simple dilutions are ratios of 2 volumes, which involve a single substance diluted with one other substance. In this case, 0.1 mL solution A is added to 9.9 mL solution B [ratio 0.1/9.9], for a total volume of 10 mL. This represents a dilution of 0.1/10. To convert a 0.1/10 dilution to a 1-in-something dilution, set up a ratio proportion calculation: 0.1 is to 10 as 1 is to x, i.e., 0.1/10=1/x, and solve for x.)
152) A colorimetric method calls for the use of 0.1 mL of serum, 5 mL of reagent and 4.9 mL of water. What is the dilution of the serum in the final solution? a. 1:5 b. 1:10 c. 1:50 d. 1:100
c (Simple dilutions are ratios of 2 volumes, which involve a single substance diluted with one other substance. In this case, 1 mL solution A is added to 4 mL solution B [ratio 1/4], for a total volume of 5 mL. This represents a dilution of 1/5.)
153) 4 mL of water are added to 1 mL of serum. This represents which of the following serum dilutions? a. 1:3 b. 1:4 c. 1:5 d. 1:6
a (The most frequently used expression, concentrations of m/v are reported as grams percent [g%] or g/dL, as well as mg/dL and ug/dL. When percent concentration is expressed without a specified form, it is assumed to be weight per unit volume.)
154) Which of the following is the formula for calculating a percent (w/v) solution? a. grams of solute/volume of solvent x 100 b. grams of solute x volume of solvent x 100 c. volume of solvent/grams of solute x 100 d. (grams of solute x volume of solvent)/ 100
b (The concentration of a weight/unit volume solution is expressed as grams/100 mL. Therefore, 20 grams in 0.5 L = 4 grams in 100 mL = 4% solution.)
155) A solution contains 20 g of solute dissolved in 0.5 L of water. What is the percentage of this solution? a. 2% b. 4% c. 6% d. 8%
b (The concentration of a weight/unit volume solution is expressed as grams/100 mL. A 3% [w/v] solution contains 3 grams in 100 mL therefore 1 L contains 30 grams)
156) How many grams of sulfosalicylic acid (MW=254) are required to prepare 1 L of a 3% (w/v) solution? a. 3 b. 30 c. 254 d. 300
b (This is a ratio calculation. 3/100 = 6/x. Solve for x.)
157) How many mL of a 3% solution can be made if 6 grams of solute are available? a. 100mL b. 200mL c. 400mL d. 600mL
a (The mean = sum of values/number of values; standard deviation = square root of the sum of [observed values - mean] squared / number of samples; coefficient of variation = [standard deviation/ mean] x 100. Therefore, [2.64/139] x 100 = 1.9%.)
159) The following 5 sodium control values in unit were obtained: 140, 135, 138, 140, 142 Calculate the coefficient of variation: a. 1.9% b. 2.7% c. 5.6% d. 6.1%
a (Specificity is defined as negativity in the absence of disease.)
16) The ability of a procedure to measure only the component it claims to measure is called: a. specificity b. sensitivity c. precision d. reproducibility
c (The mean [often called the average] is the most widely recognized descriptive statistic. The mean of a set of data can be calculated in several ways, but in each case the result is, in general, an indication of the central point of the data.)
160) The statistical term for the average value is the: a. mode b. median c. mean d. coefficient of variation
c (This is a ratio calculation. 100 [g of NaCl] to 58.5 [gram equivalent weight of NaCl] = 1.709. 23 [gram equivalent weight of Na] x 1.709 = grams of Na in 100g NaCl.)
167) The sodium content (in grams) in 100 grams of NaCl is approximately: (atomic weights: Na=23, Cl=35.5) a. 10 b. 20 c. 40 d. 60
b (Accuracy or trueness is the closeness of agreement with the true value.)
17) The extent to which measurements agree with the true value of the quantity being measured is known as: a. reliability b. accuracy c. reproducibility d. precision
b (By definition, a gram equivalent weight of an element or compound is the mass that will combine with or replace 1 mole of hydrogen.)
171) Which of the following is the formula for calculating the gram equivalent weight of a chemical? a. MW x oxidation number b. MW/oxidation number c. MW + oxidation number d. MW - oxidation number
b (Moles = grams / molecular weight.)
172) 80 grams of NaOH (MW=40) are how many moles? a. 1 b. 2 c. 3 d. 4
c (Electrolyte equivalents can be calculated from the equation: mg/dL x 10 = 10 mg/L. Because mg/mEq weight is the millimolar weight in mg/valence, mg/ L / mg/ mEq = mEq/L.)
173) A serum potassium (MW = 39) is 19.5 mg / 100mL. This value is equal to how many mEq/L? a. 3.9 b. 4.2 c. 5.0 d. 8.9
a (Moles = grams/molecular weight.)
174) Which of the following is the formula for calculating the number of moles of a chemical? a. g/GMW b. g x GMW c. GMW/g d. (g x 100)/GMW
a (Molality is the number of moles of solute per 1 kg of solvent.)
175) A 1 molal solution is equivalent to: a. a solution containing 1 mole of solute per kg of solvent b. 1,000 mL of solution containing 1 mole of solute c. a solution containing 1 g equivalent weight of solute in 1 L of solution d. a 1 L solution containing 2 moles of solute
a (Molarity is a number that expresses the number of moles of substance in 1 L of solution.)
176) Which of the following is the formula for calculating the molarity of a solution? a. number of moles of solute/L of solution b. number of moles of solute x 100 c. 1 GEW of solute x 10 d. 1 GEW of solute/L of solution
b (Specificity is defined as negativity in the absence of disease.)
18) Diagnostic specificity is defined as the percentage of individuals: a. with a given disease who have a positive result by a given test b. without a given disease who have a negative result by a give test. c. with a given disease who have a negative result by a given test d. without a given disease who have a positive result by a given test
d (C1 x V1 = C2 x V2. Therefore [0.25] x [x] = [100] x [0.05]. Solve for x.)
181) How many mL of 0.25 N NaOH are needed to make 100 mL of a 0.05% solution of NaOH? a. 5 mL b. 10 mL c. 15 mL d. 20 mL
b (A method used for screening must have a high degree of sensitivity to detect everyone with the disease.)
184) The reliability of a test to be positive in the presence of the disease it was designed to detect is known as: a. accuracy b. sensitivity c. precision d. specificity
c (Accuracy is the comparison of a result with the true value.)
185) Which of the following parameters of a diagnostic test will vary with the prevalence of a given disease in a population? a. precision b. sensitivity c. accuracy d. specificity
b (The use of manufacturer inserts is not acceptable in place of a procedure manual.)
186) Package inserts may be used: a. instead of a typed procedure b. as a reference in a procedure c. at the bench but not in the procedure manual d. if initialed and dated by the lab director
c (Safety guidelines indicate that before attempting to solve any trouble shooting steps for any equipment it is necessary to turn the power off for the instrument. This step is necessary to prevent any possible electric shock.)
190) The first step to be taken when attempting to repair a piece of electrical equipment is: a. check all the electronic connections b. reset all the printed circuit boards c. turn the instrument off d. replace all the fuses
b (Definition of atomic absorption.)
191) The methodology based on the amount of energy absorbed by a substance as a function of its concentration and using a specific source of the same material as the substance analyzed is: a. flame emission photometry b. atomic absorption spectrophotometry c. emission spectrography d. x-ray fluorescence spectrometry
a (Visual vs ultraviolet wavelength.)
192) Which of the following wavelengths is within the ultraviolet range? a. 340 nm b. 450 nm c. 540 nm d. 690 nm
d (Visual wavelength calibration.)
193) One means of checking a spectrophotometer wavelength calibration is the visible range is by using a: a. quartz filter b. diffraction grating c. quartz prism d. didymium filter
b (Spectrophotometer wavelength.)
194) In spectrophotometry, the device that allows for a narrow band of wavelengths is the: a. hollow cathode lamp b. monchromator c. refractometer d. photodetector
a (Nanometer is the unit for wavelength.)
196) The nanometer is a measurement of: a. wavelength of radiant energy b. specific gravity c. density d. intensity of light
b (Other distractors do not describe double beam-in-space.)
197) In a double-beam photometer, the additional beam is used to: a. compensate for variation in wavelength b. correct for variations in light source intensity c. correct for changes in light path d. compensate for variation in slit-widths
b (The Joint Commission requires 2 patient identifiers when providing care, treatment, or service.)
2) Which action by the phlebotomist will comply with the College of American Pathologists (CAP) Patient Safety Goal "to improve patient and sample identification at the time of specimen collection" and The Joint Commission Patient Safety Goal to "improve the accuracy of patient identification"? a. match the name and room number on the patient's ID bracelet to the name and room number on the preprinted collection label b. match the name and medical record number on the patient's ID bracelet to the name and medical record number on the preprinted collection label c. verify patient information by stating the patient's name when approaching the patient d. label the collection tubes prior to the blood draw at the patient's bedside
d (National Labor Relations Act [NLRA] includes the right to form or join unions, freedom to bargain collectively with the employer and the right to engage in group activity.)
20) Employees are guaranteed the right to engage in self-organization and collection bargaining through representatives of their choice, or to refrain from these activities by which of the following? a. Civil Rights Act b. Freedom of Information Act c. Clinical Laboratory Improvements Act d. National Labor Relations Act
a (Principle of nephelometry.)
201) Nephelometers measure light: a. scattered at a right angle to the light path b. absorbed by suspended particles c. transmitted by now-particulate mixtures d. reflected back to the source form opaque suspensions
d (To obtain the maximum absorbance of the measured chromogen.)
202) A technologist is asked to write a procedure to measure the Evan blue concentration on a spectrophotometer. The technologist is given 4 standard solutions of Evan blue: The first step is to: a. calculate the slope of the calibration curve b. determine the absorbance of the 4 standards c. find the wavelength of the greatest % transmittance for Evan blue d. find the wavelength of the greatest absorbance for Evan blue
c (Wavelength accuracy is an essential performance parameter to be tested for the spectrophotometer. For the narrow- spectral bandwidth instruments, holmium oxide glass may be scanned over the range of 280-650 nm. The material shows very sharp absorbance peaks at the well-defined wavelengths. Prism and diffraction gratings are monochromatic devices. The didymium filter is used with broader bandwidth instruments.)
203) Which of the following is used to verify wavelength settings for narrow bandwidth spectrophometers? a. didymium filters b. prisms c. holmium oxide glass d. diffraction gratings
a (Fluorescence occurs when a molecule absorbs light at one wavelength and emits light of a longer wavelength. The detector in a fluorometer is usually at right angles to the incident light source. A xenon or mercury vapor lamp emits enough UV light to be useful as a light source in a fluorometer.)
204) Which of the following statements about fluorometry is true? a. a compound fluoresces when it absorbs light at one wavelength and emits light at a second wavelength b. the detector in a fluorometer is positioned at 180 degrees from the excitation source c. fluorometry is less sensitive that spectrophotometry d. an incandescent lamp is commonly used in a fluorometer
c (Nephelometric methods are based upon light scatter being proportional to the number of particles in suspension, such as antigen-antibody complexes, which are physically larger than uncomplexed molecules.)
205) The measurement of light scattered by particles in the sample is the principle of: a. spectrophotometry b. fluorometry c. nephelometry d. atomic absorption
b (Light from the lamp or light source of a photometer is reduced to a specific wavelength by the monochromator. In spectrophotometers, a diffraction-grate is used as a monochromator.)
206) In a spectrophotometer, light of a specific wavelength is isolated from the light source by the: a. double beam b. monochromator c. aperture d. slit
c (Mass spectrometers detect mass to charge ratios of ionized molecules.)
207) A mass spectrometer detects which property of ionized molecules? a. column retention time b. charge to mass ratio c. mass to charge ratio d. fluorescence
a (Basis of chromatography.)
208) Chromatography is based on the principle of: a. differential solubility b. gravity c. vapor pressure d. temperature
c (JCAHO sets standards by which healthcare is measured and accredits institutions and laboratories worldwide.)
21) Which of the following organizations was formed to encourage the voluntary attainment of uniformly high standards in institutional medical care? a. Centers for Disease Control b. Health Care Finance Administration c. The Joint Commission d. Federal Drug Administration
a (Samples to be analyzed by gas-liquid chromatography must be volatile upon heating. The vaporized sample then flows, with the inert carrier gas, through the column.)
212) To be analyzed by gas liquid chromatography a compound must: a. be volatile or made volatile b. not be volatile c. be water-soluble d. contain a nitrogen atom
d (Steric-exclusion chromatography is based upon smaller molecules being trapped by the porous column material, but larger molecules are carried along by the mobile phase.)
213) A true statement about column chromatography methods, including high-performance liquid and gas chromatography, is that it: a. all utilizes a flame ionization detector b. requires derivation of nonvolatile compounds c. can be used to separate gases , liquids, or soluble solids d. can be used for adsorption, partition, ion-exchange and steric-exclusion chromatography
c (Electrophoresis involves the migration of a charged molecule or particle in a liquid medium under the influence of an electric field. The 3 roles of the buffer are 1] to carry the applied current; 2] to establish the pH for the electrophoresis procedure and 3] to determine the electrical charge on the solute.)
215) In electrophoretic analysis, buffers: a. stabilize electrolytes b. maintain basic pH c. act as a carrier for ions d. produce an effect on protein configuration
c (Ion-selective electrodes [ISE] are a potentiometric method of analysis. ISEs respond to individual ions present in a sample.)
217) An ion-selective electrode (ISE) measures the: a. activity of one ion only b. concentration of one ion only c. activity of one ion much more than the other ions present d. activity of only H+ ions
a (Ion-selective electrodes portend their selectivity properties through the use of particular membranes, as the selected ions interact with the membranes used in ion-selective electrodes.)
218) The selectivity of an ion-selective electrode is determined by the: a. properties of the membrane used b. solution used to fill the electrode c. magnitude of the potential across the membrane d. internal reference electrode
b (To determine the g factor, use 0.0001 x 30 cm x [3,000]^2. Remember that the radius is half the diameter.)
219) A centrifuge head has a diameter of 60 cm and spins at 3,000 RPMs. What is the maximum achievable G force. G = 0.00001 x radius in cm x RPM squared a. 1.8 G b. 2,700 G c. 27,000 G d. 90,000 G
c (Accreditation is the approval of an institution or program based on a review by one or more independent examiners that specific requirements or predetermined standards are met.)
22) The process by which an agency or organization uses predetermined standards to evaluate and recognize a program of study in an institution is called: a. regulation b. licensure c. accreditation d. credentialing
b (Other distractors do not apply to centrifugal force.)
220) In a centrifugal analyzer, centrifugal force is used for: a. add reagents to the rotor b. transfer liquids from the inner disc to the outer cuvette c. measure changes in optical density in the centrifugal force field d. counteract the tendency of precipitates to settle in the cuvette
c (The devices listed are electronic, but the only device that measures rpm is a tachometer. RPM must be consistent to produce adequate G force.)
221) Which of the following is the best guide to consistent centrifugation? a. potentiometer setting b. armature setting c. tachometer reading d. rheostat readings
b (Point-of-care testing devices use a small volume of sample and are therefore particularly useful in neonates, small babies, and those with increased risk from phlebotomy.)
222) A benefit of microassays, such as point of care methods, include: a. increased analytical reliability b. reduced sample volume c. increased diagnostic specificity d. reduced numbers of repeated tests
a (Dry cobalt-treated CaCl2 is blue.)
223) In the proper use of cobalt treated-anhydrous CaCl2, the desiccant should be: a. changed when it turns pink b. changed when it turns blue c. kept in the dark d. kept in the cold
b (Enzyme-multiplied immunoassay is a homogeneous enzyme immunoassay used to quantitate drugs, hormone, etc. Unlike the heterogeneous assays, the free-labeled reactant does not have to be separated from the bound-labeled reactant.)
224) Enzyme multiplied immunoassay technique differ from all other types of enzyme immunoassays in that: a. lysozyme is the only enzyme used to label the hapten molecule b. no separation of bound and free antigen is required c. inhibition of the enzyme label is accomplished with polyethylene glycol d. antibody absorption to polystyrene tubes precludes competition to labeled and unlabeled antigen
c (Enzymes are one of the several labels used in labeled immunoassays. The catalytic property of the enzyme is used to detect and quantitate the immunological reaction. Alkaline phosphatase and horseradish peroxidase are examples of enzymes used. The product of the enzymatic activity is monitored spectrophotometrically.)
225) Which of the following statements about immunoassays using enzyme labeled antibodies or antigens is correct? a. inactivation of the enzyme is required b. the enzyme label is less stable than an isotopic label c. quantitation of the label can be carried out with a spectrophotometer d. the enzyme label is not an enzyme found naturally in serum
b (Chemiluminescent labels are based on the emission of light produced during a chemical reaction. These labels are very useful because they provide very low levels of detection [2 x 10^-20 mol/L] with little or no background interference.)
226) Which of the following immunoassay labels offer the greatest detection limit? a. fluorescence b. electrochemiluminescence c. radioactivity d. chemiluminescence
d (CLIA was established to ensure quality standards for laboratory testing.)
23) CLIA was established to provide oversight to: a. research labs b. point of care testing by nonlaboratory personnel c. CAP-accredited labs d. any lab performing patient testing
a (HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs, and also addresses the security and privacy of health data.)
31) HIPAA is a federal law that requires: a. confidentiality of patient's health care information between 2 organizations b. reporting of errors in laboratory results c. access to patient records when there is a lawsuit d. unannounced inspections by accreditation agencies
c (Patient education can alleviate anxiety.)
232) Several complaints have been received from parents of children in the pediatric wing about the anxiety that venipuncture causes their children. An informal staff meeting with the phlebotomists reveals that they feel both parents and pediatric nurses are less than supportive and frequently make the task of venipuncture in children worse with their own anxiety. The best course of action would be to: a. have pediatric nurses do venipuncture on children as they are more familiar with the children b. limit physicians to only one draw per day on children c. prepare written pamphlets for parents and in-service education for nursing personnel d. take no action as parents will always overreact where their children are concerned
b (Informative communication shares knowledge about laboratory processes and policies.)
233) A major laboratory policy change that will affect a significant portion of the laboratory personnel is going to take place. In order to minimize the staff's resistance to this change, the supervisor should: a. announce the policy change the day before it will become effective b. discuss the policy change in detail with all personnel concerned, well in advance of implementation c. announce only the positive aspects of the policy change in advance d. discuss only the positive aspects of the policy with those concerned
c (The employee moved into a participating situation.)
234) When employees are going to be responsible for implementing a change in procedure or policy, the manager should: a. make the decision and direct the employees to implement it b. solicit the employee input but do what he/she thinks should be done c. involve the employees in the decision-making process from the very beginning d. involve only those employees in the decision-making process who would benefit from the change
c (Problem solving includes 3 steps: define problem, write down the facts, examine solution [consider options].)
239) The ability to make good decisions often depends on the use of a logical sequence of steps that include: a. defining problem, considering options, implementing decisions b. obtaining facts, considering alternatives, reviewing results c. defining problem, obtaining facts, considering options d. obtaining facts, defining problem, implementing decision
d (A goal targets the purpose of an educational unit. The objective specifies what a learner is expected to know or do.)
240) In planning an instructional unit, the term goal has been defined as a: a. plan for reaching certain objectives b. set of specific tasks c. set of short and long term plans d. major purpose or final desired result
a (Personal communication should be planned: P = plan your communication, L = listen to others, A = avoid assumptions / ensure communication is understood, N = network.)
247) Communication is enhanced by: a. a planned strategy that includes listening skills and ensuring an understanding with questions b. relying on email, memos and voice mail to communicate new info c. formal, hierarchical patterns instead of informal networking patterns d. assumptions if there are questions about the intent of the message
b (A daily "line-up" can be conducted at a time of day that is convenient to the department. Providing a question for discussion is an effective way to foster conversation.)
248) In its guidelines, CAP stresses that communication must be effective and efficient. An effective component to enhance a multifaceted communication plan in the clinical laboratory is: a. posting department goals on communication bulletin boards b. daily meetings with a question to foster conversation and focus the discussion c. written email to communicate all new changes in processes and procedures d. posting errors on communication bulletin boards to prevent repeat errors
b (HIPAA patient confidentiality requirements state that patient data is secure from unauthorized access at all levels of communication of that data.)
251) The use of security systems such as firewalls and data encryption for electronic transmission of patient data from a laboratory information system to a remote location are required for: a. LOINC b. HIPAA c. ICD-9 d. CLIA
a (LIS systems use barcode labels for positive sample identification for many of the processes in the lab. Each LIS vendor will specify which of several barcode label formats are compatible with their system.)
252) CODE 128, ISBT 128, CODE 39 and Interleaved 2 and 5 symbologies are used by laboratory information systems to create which of the following? a. barcode labels b. worklists c. instrument download files d. patient reports
a (Health Level 7 [HL-7] is the organization that specifies requirements for electronic data transmission formatting. It is considered to be the industry standard.)
253) A standard electronic file format recommended for transmitting data from the laboratory information system to an electronic medical record is: a. Health Level 7 b. ISBT 128 c. FTP d. SNOMED
d (Patient results can be automatically released to the patient record as long as they meet selected criteria defined and validated by the users. Auto-verification does not apply to manually entered results and results cannot be released unless QC has been performed and was within limits prior to releasing.)
254) Auto-verification of test results requires all of the following to be established by the lab except: a. patient results entered in the LIS via an instrument interface b. patient results evaluated based on validated rules defined in the LIS c. successful quality control testing obtained prior to releasing patient results d. review of results by a qualified technologist or technician
c (The CAP requires documentation that calculated values that generate a patient report are reviewed every 2 years, or when a system change is made that may affect the calculations. This requirement applies to values calculated by the LIS or middleware.)
255) Validation of calculated test results performed by a laboratory information system must be performed: a. every 6 months b. annually c. biannually d. only upon initial LIS installation
d (The Host Query mode of an instrument is a two-way communication process whereby the instrument reads the specimen barcode and queries the LIS for the orders. The tests to be run are sent to the instrument [i.e. bidirectional communication]. Once results are obtained, they are sent back to the LIS.)
256) The hematology lab is evaluating new instruments for purchase. The supervisor wants to ensure that the instrument they select has directional interface capabilities. The instrument specification necessary to meet this requirement is: a. 9,600 baud rate b. on-board test selection menu c. HL-7 file format d. host query mode
c (Test definitions, as well as all types of stored master files, are contained in the database.)
257) The Chem. Dept. has requested that a new test be defined in the LIS to run on the existing analyzer. The new test set up is completed by the LIS coordinator. A few days later, the accessioning department receives a request for the new test but an error is displayed when they try to place the order. All other tests can be successfully ordered. The most likely cause of the error is the: a. instrument interface for the Chem. analyzer is down b. test was not defined on the Chem. worklist c. database did not properly update with the new test information d. ADT interface with the hospital system is down
a (Validation of the LIS is required by various accrediting agencies in order to prove that the system is performing as expected. This must be done at implementation and over time as changes are made to the LIS.)
258) The process of testing and documenting changes made to a laboratory information system is known as: a. validation b. quality engineering c. customization d. hazard analysis
c (System back-up procedures are mandated by accrediting agencies and include creating an exact copy of sensitive LIS data at regularly defined intervals and storage of the backed-up data at a separate location.)
259) Performance of laboratory information system back-up procedures includes all of the following except: a. creating an exact copy of LIS data b. off-site storage of the data media c. shutting down the LIS and bringing it back up d. completion at regularly defined intervals
a ("GEN 41042: Are refrigerator/freezer temperatures checked and recorded daily?")
27) CAP requires refrigerator temperature to be recorded: a. daily b. weekly c. monthly d. periodically
d ("GEN 41096: Does the paper or electronic report include the following elements? 1. Name and address of testing laboratory[see note below] 2. Patient name and identification number, or unique patient identifier 3. Name of physician of record, or legally authorized person ordering test, as appropriate 4. Date and time of specimen collection, when appropriate 5. Date of release of report [if not on the report, this information should be readily accessible] 6. Time of release of report, if applicable [if not on the report, this information should be readily accessible] 7. Specimen source, when applicable 8. Test result[s] [and units of measurement, when applicable] 9. Reference intervals, as applicable [see note below] 10. Conditions of specimen that may limit adequacy of testing.")
28) A paper or electronic report of lab results must include: a. the name of the person who collected the specimen b. the test price c. a pathologist's signature d. the name and address of the testing laboratory
c ("GEN 41770: Are there appropriate documented procedures for handling and cleaning glassware, including methods for testing for detergent removal?")
29) CAP requires that glassware cleaning practices include periodic testing for: a. chemical residues b. silicates c. detergents d. heavy metals
b (be rejected due to the time delay)
3) A clean-catch urine is submitted to the laboratory for routine urinalysis and culture. The routine urinalysis is done first, and 3 hours later, the specimen is sent to the microbiology department for culture. The specimen should: a. be centrifuged, and the supernatant cultured b. be rejected due to the time delay c. not be cultured if no bacteria are seen d. be processed for culture only if the nitrate is positive
c (The focus must center on a root cause analysis of such errors to prevent them from occurring in the clinical setting.)
3) A swab and requisition are received in the microbiology laboratory with the following information: The laboratory receiving clerk notes a discrepancy between the patient identifiers on the requisition and the specimen label, and questions the emergency department nurse MB. This is the fourth specimen this week that has had a specimen discrepancy. What action is the most appropriate to prevent this type of error in the future? a. correct the error in the laboratory when the nurse communicates the appropriate patient name b. ask nurse MB to correct discrepancy and read the procedure for specimen labeling c. document error and communicate to laboratory supervisor so that the risk manager conducts a root cause analysis d. discard the specimen and call the emergency department for a recollect
c (HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs, and also addresses the security and privacy of health data.)
32) Your friend calls and asks you to access his test results. Which of the following does this violate? a. CAP b. The Joint Commission c. HIPAA d. CLIA
c (MSDS is an OSHA required document that provides information such as physical data [melting point, boiling point, Hash point etc.], toxicity, health effects, first aid, reactivity, storage, disposal, protective equipment, and spill/leak procedures.)
34) A technician is asked to clean out the chemical reagent storeroom and discard any reagents not used in the past 5 years. How should the technician proceed? a. discard chemicals into biohazard containers where they will later be autoclaved b. pour reagents down the drain, followed by flushing of water c. consult MSDS sheets for proper disposal d. pack all chemicals for incineration
d (The correct answer is d, flammability. For distractor a, reactivity is the right yellow quadrant. For distractor b, special reactivity is the lower white quadrant. For distractor c, health is the left blue quadrant.)
35) Using a common labeling system for hazardous material identification such as HMIS or NFPA 704, the top red quadrant represents which hazard? a. reactivity b. special reactivity c. health d. flammability
a (The correct answer is a, high health hazard. The ratings range for both systems is 0-4 with 0 being no hazard and 4 being the most severe hazard. The other distractors are incorrect due to the hazard type or number rating.)
36) If the HMIS or NFPA 704 hazardous material identification system has a number 4 in the left blue quadrant, it represents a: a. high health hazard b. low health hazard c. high reactivity hazard d. low reactivity hazard
b (The correct answer is b, formaldehyde.)
37) Which chemical is a potential carcinogen? a. potassium chloride b. formaldehyde c. mercury d. picric acid
d (The correct answer is d, be secured upright to the wall or other stable source. The other distractors are incorrect practices. Compressed gas tanks should be stored away from flammable materials, have safety covers on when pressure regulators are unattached and transported chained to a hand cart or dolly.)
38) Compressed gas cylinders should: a. be stored with flammable materials b. be transported by rolling or dragging c. have safety covers removed when pressure regulators are unattached d. be secured upright to the wall or other stable source
d (Preanalytical [i.e. pre-examination] variables include all steps in the process prior to the analytic phase of testing, starting with the physician's order. Examples include accuracy of transmission of physicians' orders, specimen transport and preparation, requisition accuracy, quality of phlebotomy services, specimen acceptability rates, etc. This list is neither all-inclusive nor exclusive. The variables chosen should be appropriate to the laboratory's scope of care.)
4) Preanalytical variables in laboratory testing include: a. result accuracy b. report delivery to the ordering physician c. test turnaround time d. specimen acceptability
c (The correct answer is c, 1 in the blue quadrant. The ratings range for both systems is O-4 with 0 being no hazard and 4 being the most severe hazard. The left blue quadrant represents a health hazard and a toxic chemical causes a health hazard. The rating of 1 would be a low or slight health hazard. The other distractors are incorrect due to the hazard type or rating.)
40) The HMIS or NFPA 704 hazardous material identification system rating for a slightly toxic chemical would be: a. 1 in the yellow quadrant b. 4 in the blue quadrant c. 1 in the blue quadrant d. 4 in the yellow quadrant
d (The correct answer is d, corrosive, which causes immediate damage to human tissue, such as a burn. Distractors a and b are health hazards, but generally do not cause immediate tissue damage. For distractor c, ignitable chemicals are both flammable and combustible and only will cause tissue damage if accidental flame or explosion occurs.)
41) A chemical that causes immediate visible destruction or irreversible alterations of human tissue at the contact site is best classified as: a. carcinogenic b. toxic c. ignitable d. corrosive
d (The correct answer is d, does not require labeling. The other distractors are incorrect and are only required on the original containers or secondary containers, which are not used immediately or by a different person.)
43) When hazardous chemicals are transferred from the original appropriately labeled containers to a secondary container for immediate use by the person performing the transfer, it: a. must be labeled with an emergency response phone number b. must be labeled with the identity or contents of the hazardous chemical c. must be labeled with hazard warning related to the effect on involved target organs d. does not require labeling
c (The correct answer is c, evacuate the area. The other distractors are secondary responses after evacuating the area.)
45) A technologist spilled 10 gallons of formaldehyde on the floor. After determining the chemical poses a significant health hazard. the first action step would be to: a. notify emergency assistance b. control the spill with appropriate absorbent material c. evacuate the area d. don appropriate personal protective equipment
a (If multiple controls are out of range and the instrument and reagents are verified, recalibration or calibration verification is required before subsequent control analysis.)
5) The first procedure to be followed if the blood gas instrument is out-of-control for all parameters is: a. recalibrate, then repeat control b. repeat control on the next shift c. replace electrodes, then repeat control d. report patient results after duplicate testing
c (The correct answer is c, designate a laboratory chemical hygiene officer.)
51) One of the elements of a written laboratory chemical hygiene plan is to: a. require employees who handle chemicals to have annual medical evaluations b. prohibit use of carcinogens c. designate a laboratory chemical hygiene officer d. perform chemical monitoring every 6 months of OSHA regulated substances
d (The correct answer is d, hazardous chemicals.)
52) The purpose of the OSHA hazard Communication , General Industry Standard, 29 CFR, Subpart Z, 1910.1200, is to require employees to establish a program ensuring personnel are provide with information regarding the workplace dangers of: a. bloodborne pathogens b. environmental hazards c. general safety hazards d. hazardous chemical
a (Healthcare workers must be knowledgeable of chemical safety signage as they may be using chemicals as preservatives in specimens for transport. The flammable sign is from the Department of Transportation Hazardous Materials Warning Signs.)
53) This symbol indicates which of the following hazards? a. flammable b. electrical c. radiation d. biohazard
b (The correct answer is b, use a mechanical device. Distractors a and c do not afford adequate protection and d leads to recapping injuries vs using a one-handed technique.)
54) When working with sharp equipment and objects use: a. double-glove technique with specimen handling gloves b. mechanical device c. paper towel or gauze as a barrier d. two-handed technique
d (The correct answer is d, ensure proper balance is maintained. For distractor a, a disinfectant should be used. For distractor b, the cover should not be opened until the centrifuge comes to a complete stop. For distractor c, all specimen tubes need to be covered to prevent aerosol formation.)
55) For safe operation of a centrifuge: a. clean with soap/detergent when maintenance is performed or spills occur b. open the centrifuge cove when it is in the process of slowing down c. leave liquid specimen tubes uncovered during centrifugation d. ensure proper balance is maintained
c (The correct answer is c, be filed for all incidents, including near miss incidents. For distractor a, employee's medical history is confidential For distractor b, all incidents require an incident report be filed. For distractor d, incidents reports need to be maintained for a defined period of time.)
57) Incident reports for occupational injury or illness should: a. include information on the employee's past medical history b. be filed only for incidents involving serious injury of illness c. be filed for all incidents including near miss incidents d. not be retained after review by a safety committee or officer
a (The correct answer is a and the other distractors are incorrect and used for other purposes as listed in the answers. The word immediate is the key to this answer.)
58) According to OSHA, what type of sign should be posted in an area where an immediate hazard exists and where special precautions are necessary? a. red, black and white "Danger" sign b. yellow, and black "Caution" sign c. green and white "Safety Instruction" sign d. orange and black "Biohazard " sign
b (The correct answer is b, be grounded or double insulated. For distractor a, repairs should not be conducted while connected to facility wiring. For distractor c, safety checks should be performed initially, annually and whenever repairs are made. For distractor d, multiple outlet adapters are unsafe and should not be used.)
59) All laboratory instruments should: a. have repairs conducted while connected to facility wiring b. be grounded or double insulated c. have safety checks performed initially and then every 6 months d. be connected to multiple outlet adapters
d (The correct answer is d, touch a "contaminated" area phone with ungloved hands if hands are washed afterward. For distractor a, bench tops are to be cleaned after spills and at the end of each shift. For distractor b, personal protective equipment, such as a lab coat, is to be removed prior to leaving a "contaminated" area. For distractor c, cosmetics and lip balm are not to be applied in a "contaminated" area.)
60) If areas of the laboratory are designated as "clean " or "contaminated" it is appropriate for a technologist to: a. clean technical are bench tops after spills and on a weekly basis b. wear a lab coat in the break or lunch room c. apply lip balm in a contaminated area d. touch a contaminated area phone with ungloved hands if hands are washed afterwards
b (The correct answer is b, hallways and corridors should be clear and free of obstruction at all times. For distractor a, fire drills should not be announced or practiced in advanced. For distractor c, laboratories larger than 1,000 square feet and/or contain explosion hazards require 2 exits.)
61) For fire safety and prevention: a. fire drills should be announced and practiced in advance b. hallways and corridors should be clear and free of obstruction at all times c. only one exit is necessary in laboratories that contain an explosive hazard d. hazard evaluations only need to be done prior to initiation of clinical operations
c (The symbol in the figure represents a common labeling system for hazardous material identification, such as HMIS or NFPA 704 and the correct answer is c, chemical hazardous materials. All other distractors are incorrect. Distractors a and b do not use the NFPA hazard label at all, and there is more appropriate signage for radiation. If a chemical is radioactive, there would be a radioactive symbol in the bottom white area.)
62) What type of identification system does this symbol represent? a. transmission-based precautions b. physical environmental hazards c. chemical hazardous materials d. radiation hazards
d (The correct answer is d, approved safety can. For distractor a, flammable safety cabinets should not be vented to room air. For distractor b, flammable and combustible liquids that require refrigeration are only to be stored in an explosion-proof refrigerator. For distractor c, hazardous substances, particularly of that volume, are not to be stored in a fume hood.)
63) Flammable and combustible liquids in containers > 5 gallons should be stored in a(n) a. flammable safety cabinet vented to room air b. nonexplosive proof refrigerator c. fume hood d. approved safety can
b (The correct answer is b, pull the pin. The sequence of actions should be pull the pin, aim the hose, squeeze the lever, and sweep the flow.)
64) After receiving appropriate training, the first step in using a fire extinguisher is to: a. sweep the flow of the hose from side to side b. pull the pin c. squeeze the top handle or lever d. aim the hose at the bottom of the fire
d (The correct answer is d, use only UL or other safety agency-rated electrical equipment. For distractor a, multiple outlet or gang plug adapters are not to be used. For distractor b, there is no requirement to change circuit breakers annually. For distractor c, worn wiring is to be replaced and not taped over.)
65) To help prevent electrical fires in healthcare facilities: a. use multiple outlet or gang plug adapters b. change circuit breakers annually c. tag over worn wiring with certified electrical tape d. use only UL or other safety-agency-rated electrical equipment
b (The correct answer is b, bend at the knees and hips, lift with legs and buttocks. For distractors a and d, you should not bend at the waist. For distractor c, you should not lift with your back. For distractor d, you should not twist.)
66) In addition to keeping the load close to your body and tightening you abdominal muscles when lifting heavy boxes of supplies, it is important to bend at the: a. waist; lift with legs and buttocks b. knees and hips; lift with legs and buttocks c. knees and hips; lift with arms and back d. waist; twist your body when lifting
c (The correct answer is c, remove persons from immediate danger. The other distractors are correct, but are secondary actions. The sequence of actions after removing persons from immediate danger is to pull the fire alarm, contain the fire and evacuate the area, if required.)
68) A fire occurs in the laboratory. the first course of action is to: a. evacuate the area b. pull the fire alarm box c. remove persons from immediate danger d. contain the fire by closing doors
b (The correct answer is b, contain the fire by closing the doors. For distractor a, it is the last action to be taken and only if indicated. For distractor c, a type A extinguisher is for paper, wood and plastics fires, not electrical fires. Also, fire extinguishers only should be used by those who have received appropriate training. For distractor d, it is unnecessary and unacceptable to lock windows and especially doors, which would block access to firefighters.)
69) An electrical equipment fire breaks out in the lab. Personnel have been removed from immediate danger, the alarm has been activated. What is the next action to be taken? a. evacuated the facility b. contain the fire by closing doors c. extinguish fire with type A extinguisher d. lock all windows and doors in the immediate area
d (The correct answer is d, electrical equipment. Distractors a and b would be class B fires, and distractor c would be class A fires.)
70) Class C fires involve: a. grease and oil b. xylene and alcohol c. paper, wood, and plastics d. electrical equipment
c (The correct answer is c, use eyewash station to flush eyes with water for 15 minutes. Distractors a and d are secondary, not the primary actions. Distractor b is incorrect and completely unsafe.)
72) A technologist splashed a corrosive chemical in his/her eyes. to prevent permanent injury, the first action should be to: a. bandage the eyes and seek immediate emergency medical assistance b. flush eyes with a chemical of opposite pH to neutralize the injury c. use the eyewash station to flush eyes with water for 15 mins. d. seek immediate emergency medical assistance
b (The correct answer is b, use emergency safety shower and flush body with water. Distractor a is secondary, not a primary first aid action step. Distractors c and d are incorrect and not appropriate first aid actions.)
73) A technologist spilled concentrated hydrochloric acid on his/her clothing and skin, affecting a large portion of the body. After removing involved clothing the next first aid treatment step would be to: a. seek immediate emergency medical assistance b. use emergency safety shower and flush body with water c. apply burn ointment to affected skin d. pour baking soda on the skin and bandage
d (The correct answer is d, lab coat. The other distractors are examples of engineering controls, not PPE.)
74) An example of personal protective equipment is: a. biological safety cabinet b. emergency safety shower c. eyewash station d. lab coat
c (The correct answer is c, answering the telephone in a designated "clean" area. For distractor a, gloves do not need to be removed. For distractor b, it is essential to keep gloves on during specimen transportation, even through "clean" areas, such as the hallways. Care should be taken not to touch anything in the dean areas. For distractor d, gloves do not need to be changed after these patients unless known contamination has occurred, which is the same for any patient specimen under "standard precautions.")
75) Gloves worn in the lab for specimen processing must be removed and hands washed when: a. answering the telephone in the technical work area b. carrying a specimen outside the technical work area through "clean" area c. answering the telephone in a designated "clean" area d. after handling specimens from known isolation precaution patients
a (The correct answer is a, working with caustic or toxic materials. For the other distractors, it is not required practice to use eye and face protection during these activities.)
76) Safety glasses, face shields or other eye and face protectors must be worn when: a. working with caustic or toxic materials b. present in technical work area c. viewing microbiology culture plates d. processing specimens using a splash barrier
a (The correct answer is a, secure long hair and jewelry. These items should be secured to avoid contamination with biohazards or physical injury. The other distractors are not safe or acceptable work practices. Food should not be stored in supply refrigerators at all, contact lenses should not be worn in laboratories and open weaved shoes are a spill hazard.)
77) To prevent injury, a safe lab work practice is to: a. secure long hair and jewelry b. store well-wrapped food in the supply fridge c. wear contact lenses for eye protection d. wear comfortable, rubber-bottomed ,open weaved shoes
c (Knowledgeable personnel separate waste into designated categories [i.e., chemical, routine, infectious, etc.] at the point of generation to reduce disposal costs and minimize employee exposure to hazardous materials.)
78) Safe handling and disposal of laboratory generated infectious waste require: a. disinfection of all waste b. thorough mixing of infectious and noninfectious waste c. separation of infectious and noninfectious waste d. incineration of all waste
a (A 10% solution of bleach is an effective and economical disinfectant, which inactivates HBV in 10 minutes and HIV in 2 minutes.)
79) Which of the following is the best choice for decontaminating bench tops contaminated by the AIDS virus? a. sodium hypochlorite bleach b. formalin c. a quaternary ammonium compound d. 100% alcohol
b (Repeating a QC measurement on a new sample of QC material may establish that the alert was caused by a deteriorated QC material rather than a method problem.)
8) Shown above is a Levy-Jennings quality control chart, which represents control values for 13 consecutive analyses for a particular serum constituent. If the 14th value is below the —2 SD limit, which of the following should be done? a. control should be repeated to see if it will fall within the established interval b. analysis system should be checked for a deteriorating component c. analysis system should be checked for a change in reagent lot number d. no action is needed
c (The simplest method of disposing of needles is to dispose of the entire collection device into a container reserved for sharps.)
80) The safest method of disposing of hypodermic needles is: a. recap the needle with its protective sheath prior to discarding b. cut the needle with a special device before disposal c. discard the needle in an impermeable container without other handling immediately after use d. drop the needle in the waste basket immediately after use
d (Blood spills must be cleaned up and decontaminated by personnel using the proper PPR.)
81) Precautions for health care workers dealing with patients or patient specimens include: a. mouth pipetting when specimens lack a "Precaution" label b. reinserting needles into their original sheaths after drawing blood from a patient c. wearing a mask and disposable gown to draw blood d. prompt cleaning of blood spills with a disinfectant solution such as sodium hypochlorite
b (Hepatitis B infection is a global public health problem and is one of the most common infectious diseases in the world.)
82) Infection rate is highest for laboratory professionals exposed to blood and body fluids containing: a. hepatitis A b. hepatitis B c. CMV d. HIV
c (The 3 modes of HIV transmission are through intimate sexual contact, contact with blood, and perinatal. Needlestick injury falls under the second mode, and poses, on average, a 0.3% risk of transmission.)
83) Which of the following forms of exposure places a technologist at the highest risk for infection with HIV? a. aerosol inhalation (eg. AIDS patient sneezes) b. ingestion (eg. mouth pipetting) c. needlestick d. splash
d (A 10% solution of bleach is an effective and economical disinfectant, which inactivates HBV in 10 minutes and HIV in 2 minutes.)
84) Which disinfectant inactivates HIV and HBV? a. alcohol b. iodine c. phenol d. sodium hypochlorite
b (Microbiological hazards are contained using a biological safety cabinet with the air exhausting through a HEPA filter.)
85) Filters generally used in biological safety cabinets to protect the laboratory worker from particulates and aerosols generated by microbiology manipulations are: a. fiberglass b. HEPA c. APTA d. charcoal
d (The correct answer is d, perform frequent and appropriate hand hygiene. The other distractors are methods for preventing spread of infection but are not the most effective method.)
86) What is the single most effective method to prevent nosocomial spread of infection? a. wear mask, gown and gloves b. require infectious patients to mask c. wear a N95 respirator mask d. perform frequent and appropriate hand hygiene
c (The correct answer is c, discard directly into an appropriate sharps container, to avoid undo contact with the sharp. Distractor a is a prohibited practice. For distractors b and d, needle recapping or removal is not preferred, but if required, it must be done using mechanical devices or for re-capping only using a one-handed technique.)
87) Contaminated needles and syringes without safety self-sheathing devices should be: a. sheared by a needle cutter or bent b. re-capped using a two-handed technique c. discarded directly into an appropriate sharps container d. removed from the syringe/needle holder
a (The correct answer is a, bloodborne pathogens.)
88) Use of "standard" (universal) precautions minimizes exposure to: a. bloodborne pathogens b. chemical hazards c. radiation hazards d. environmental hazards
d (The correct answer is d, thoroughly wash the wound with soap and water. The other distractors are secondary, not primary actions.)
89) After an accidental needle stick with a contaminated needle, the first action should be to: a. apply antiseptic ointment to the wound b. seek immediate medical assistance c. bandage the wound d. thoroughly wash the wound with soap and water
a (The correct answer is a, parenteral inoculation of blood. The other distractors are not likely transmission modes for bloodborne pathogens.)
90) What is the most likely mode of transmission for bloodborne pathogens in laboratory acquired infections? a. parenteral inoculation of blood b. contact with intact skin c. airborne transmission d. fecal-oral transmission
b (The correct answer is b, hepatitis B.)
91) Which infectious agent is considered to be the primary occupational health hazard regarding transmission of bloodborne pathogens? a. HIV b. HBV c. TB d. MRSA
c (The correct answer is c, biological safety cabinet. Distractor a is used for pharmacy and other "clean room" functions. Distractor b does not provide adequate respiratory protection, and distractor d is used for chemical not biohazard control.)
92) When processing specimens for mycobacterial testing, what specific engineering control must be used? a. horizontal laminar flow hood b. barrier protection only c. biological safety cabinet d. fume hood
c (The correct answer is c, must he provided by the employer free of charge. For distractor a, it is a series of 3, not a single injection. For distractor b, it is recommended, but not a mandatory vaccination. For distractor d, the vaccine is recommended for high-risk employees upon initial employment, not just when an exposure occurs.)
93) Hepatitis B vaccine is: a. administered as a single 1-time injection b. required for all healthcare employees c. must be provided by the employer free of charge d. recommended only when an exposure incident occurs
b (The correct answer is b, absorb the spill with disposable absorbent material. For distractor a, immediately flooding the area with disinfectant may create aerosolization. For distractor c, it is unnecessary to evacuate the area for 30 minutes due to the size and nature of the spill. For distractor d, the area should be first cleaned with a disinfectant, not a detergent.)
94) When cleaning up a small (5 mL) blood spill on the counter-top, the first step after donning appropriate personal protective equipment is to: a. flood the area with an appropriate intermediate to high-level disinfectant b. absorb the spill with disposable absorbent material c. evacuate the area for 30 minutes d. clean the area with an aqueous detergent solution
a (The correct answer is a, sodium hypochlorite, which is a disinfectant. The other distractors are antiseptics, not disinfectants.)
95) The most effective disinfectant recommended for bloodborne pathogens is: a. sodium hypochlorite b. isopropyl alcohol c. chlorhexidine gluconate d. povidone-iodine
c (The correct answer is c, single use and disposable gloves. For distractor a, reusable utility gloves are not ideal or the best choice, but could be used if properly decontaminated after use and inspected for punctures or tears prior to reuse. Latex gloves should be avoided because of potential sensitization to the latex and the development of a latex allergy.)
97) When processing patient blood specimens and handling other potentially infectious material, the best choice of gloves is: a. reusable utility gloves b. latex gloves only c. single use and disposable gloves d. cut-resistant gloves
d (The correct answer is d, change gloves and wash hands with antiseptic soap and water. The other distractors are inappropriate practices.)
98) While processing patient specimens, a technologist splashes a few small drops of a bronchial wash specimen in his/her gloves. The first action should be to: a. wash the gloves with antiseptic/soap and water b. continue to wear the gloves until grossly contaminated or leaving the area c. wash the gloves with an appropriate disinfectant d. change gloves and wash hands with antiseptic/soap and water
a (The correct answer is a, biohazard.)
99) This symbol represents a: a. biohazard b. radiation hazard c. chemical hazard d. environmental hazard