section 1 medical Lab procedures

When performing a microscopic examination of urine, the presence of how many white blood cells/HPF is considered normal?

0 to 5

The life span of a red blood cell is

120 days

How long should you flush your eyes, at an eyewash station, in the event you splash blood or a chemical in them?

15 minutes

What gauge needle is used most often to perform a routine venipuncture using the vacuum tube method?

21 G

There are ______ levels of disinfection.

3

Which of the following is an example of a quantitative test result?

500 mg/dL

Plasma makes up approximately --- of the blood volume

55%

CDC estimates that approximately ____ needlestick and other sharps injuries occur in the United States each year.

600,000 - 800,000

Moderate-complexity testing accounts for what percentage of the total laboratory test performed in the US each year?

75% of the estimated 7 to 10 billion laboratory tests preformed in the US each year.

How much urine does the normal adult excrete each day?

750 to 2000 mL

Urine is composed of how much water? Said another way, what is the % water that urine is made up of?

95%

Most microorganism's grow best at _______ degrees Fahrenheit.

98.6

What type of license or certificate must a POL hold in order to perform waived tests?

A certificate of waiver (CW) from The Centers for Medicare and Medicaid Services.

What is included in a complete urinalysis?

A physical examination of urine, A chemical examination of urine , Microscopic examination of urine sediment

anti-

Against

Which of the following laboratory tests requires fasting?

All of the above (OGTT, Triglycerides, FBG)

Why should the veins of the hands be used as a venipuncture site only as a last resort?

All of the above are correct reasons (They have a tendency to roll, They are more difficult to stick, The procedure is more uncomfortable for the patient, The hand veins are more susceptible to collapsing)

Which of the following techniques can be used to prevent a vein from rolling?

Applying firm pressure below and to the side of the vein

ante-

Before

How does the medical assistant determine the blade length to use to perform a skin puncture?

Blade length is based on the size of the patient's fingers and the amount of blood specimen required.

What may occur if the needle is removed from the arm before removing the tourniquet?

Bleeding may occur around the puncture site.

hemat/o

Blood

oste/o

Bone

myel/o

Bone marrow

lysis

Breakdown

chondr/o

Cartilage

What is the primary function of glucose in the body?

Chief source of energy for the body

Which of the following is an example of personal protective equipment?

Clean, disposable gloves

List the various parts of the vacuum tube system.

Collection needle, a plastic holder, and a evacuated tube.

Name two things the physical examination of urine includes

Color and clarity

stasis

Control, stop

Which of the following is a quality control method?

Discarding outdated reagent, Proper storage of test systems, Calibration, Allowing refrigerated controls to come to room temperature before use

What is the one word for an agent that kills disease-producing microorganisms and that usually is applied to inanimate objects?

Disinfectant

What should be done if a control does not perform as expected?

Do not perform patient testing until the problem is resolved.

Which of the following is a violation of the OSHA standard?

Eating in the office laboratory

What does EMR stand for:

Electronic Medical Record

In ONE sentence, describe the purpose of the Hazard Communication Standard.

Ensure that employees are informed of the hazards associated with chemicals in their workplace and the precautions to take to protect themselves when working with hazardous chemicals.

nocturia

Excessive (voluntary) urination during the night

What should be done if the patient collects a specimen at home and does not store the specimen properly?

Explain to the patient why the specimen will not be appropriate for testing and give the patient detailed instructions both verbally and written so that they can collect a new appropriate sample.

What is the abbreviation for Fasting blood glucose

FBG

What is the most critical limitation of CLIA-Waived Automated Analyzers?

Failure of the equipment.

anuria

Failure of the kidneys to produce urine

A mature erythrocyte has a biconcave shape and contains a nucleus.

False

Wet alcohol should be wiped off the puncture site with a gauze pad.

False

When the body is in homeostasis, an imbalance exists in the body.

False

What is atherosclerosis?

Fatty deposits that build up on the walls of the arteries; the arteries may become occluded, which eventually could lead to a heart attack or stroke.

How are laboratory reports delivered to the medical office?

Faxed, Mailed, Hand-delivered by a laboratory courier, Electronically

How is serum obtained?

From clotted blood that has been centrifuged

Which of the following urine tests may be positive when a patient has undiagnosed diabetes mellitus?

Glucose

The biggest threat to health care workers from occupational exposure are?

HBV, HCV, HIV

Which one of the below is bad cholesterol and which is good cholesterol?

HDL good cholesterol LDL bad cholesterol

What is the name of the hormone present only in the urine and blood of a pregnant woman?

Human chorionic gonadotropin

urgency

Immediate need to urinate

nocturnal enuresis

Inability to control urination at night (bedwetting)

retention

Inability to empty the bladder; the urine is being produced normally by the kidneys but is not being voided

urinary incontinence

Inability to retain urine in the bladder

-otomy

Incision

What is the purpose of warming before performing a dermal puncture?

Increases the blood flow to the area ans promotes bleeding from the puncture site.

-itis

Inflammation of

What does insulin enable glucose to do?

Insulin enables glucose to enter the body's cells and be converted to energy. Insulin is also required for proper storage of glycogen

Which of the following is included in a product insert of a testing kit?

Intended use, Principles of the procedure, Storage and stability, Interpretation and reading results

What is the name for a control that is built into the test system?

Internal control

What occurs if a urine specimen is allowed to stand for more than 1 hour at room temperature?

It becomes cloudy.

What effect does concentrated urine have on red blood cells?

It causes them to shrink and become crenated.

Why is a first-voided morning specimen preferred for performing a microscopic examination of urine?

It contains more dissolved substances.

Explain why a first-voided morning specimen is often preferred for urinalysis.

It contains the greatest concentration of dissolved substances.

What is the composition of capillary blood?

It is a mixture of venous, arterial, and capillary blood as well as interstitial and cellular fluids.

Which of the following is not a symptom of acute HIV infection?

Jaundice

The purpose of performing a BUN is to test the function of which organ?

KIDNEY

When collecting a venous blood specimen to be transported to an outside laboratory for testing, which of the following should be consulted for information on collecting and handling requirements?

Laboratory directory

Which of the following sites can be used to make a skin puncture on an adult?

Lateral part of the third fingertip

List two major categories that lab tests fall into.

Microbiology, chemistry, hematology, paristology, blood banking, immunology, cytology, histology

Frequency

Need to urinate often

Name two ways a hematoma can form when performing a venipuncture?

Needle inserted too far and goes through vein, Bevel opening is partially in vein and partially out of vein, Needle is withdrawn before removing tourniquet, Applying insufficient pressure after needle removal

What term is used to describe a microorganism that does not produce disease?

Nonpathogen

micturition

Normal act of voiding urine

The first critical step in blood collections is

Patient identification

What may occur if a finger puncture is made that is deeper than 3.1 mm?

Penetration of the bone

If a patient has fainted from a venipuncture in the past, what should you do before performing the procedure?

Perform the procedure with the patient in a reclining position

-ous

Pertaining to

What is the term for when an adult excretes more than 2000mL of urine a day?

Polyuria

pyuria

Presence of pus in the urine

glycisuria

Presence of sugar in the urine

Put the following in the correct order of draw for the vacuum tube method of venipuncture: Gray Green Red Lavender

Red, Green, Lavender, Gray

Which of the following is not a function of the urinary system?

Regulation of the temperature of the body

_______________flora normally resides and grows in the epidermis and deep layers of the skin known as the dermis. _______________flora lives and grows on the superficial skin layers, or epidermis.

Resident, Transient

What type of specimen is required for most blood chemistry tests?

Serum

What is the most common means of transmission for hepatitis C?

Sharing needles for illegal injection drug use

Which of the following test results indicates a concentrated urine specimen?

Specific gravity: 1.025

What information is provided by a Hemoglobin A1C test?

The average amount of glucose in the blood over a 3-month period.

Why is the first drop of blood wiped away after performing a dermal puncture?

The first drop is diluted with alcohol and tissue fluid.

What may occur if an angle of less than 15 degrees is used to perform the venipuncture?

The needle may enter the skin above the vein and not puncture it.

What type of patient preparation is required for a fasting blood glucose test?

The patient should not have anything to eat or drink except water for 12 hours preceding the test.

What may occur if an outdated evacuated tube is used to collect the blood specimen?

The tube may no longer have a vacuum

What does it mean if a urine specimen is light yellow?

The urine specimen does not contain many dissolved substances.

The preferred site for a skin puncture for an adult is the fingertip of the _______or ________finger.

Third , Fourth

You need to collect a venous blood specimen from a patient to run an FBG. Which of the following would be an inappropriate statement to make to the patient during this procedure?

This procedure will not hurt

What is the first thing you should do if a cut on your bare hand accidentally comes in contact with a patient's blood?

Thoroughly wash the area with soap and water.

What is the purpose of performing a routine test?

To assist in the early detection of disease

What is the purpose of a laboratory report?

To relay the results of laboratory tests to the physician

Which of the following represents an error in technique when testing a urine specimen with a reagent strip?

Touching the reagent areas with the fingers

A function of the plasma is to transport antibodies, enzymes, and hormones.

True

Leukocytes do their work in the tissues.

True

Leukocytosis is an abnormal increase in the number of leukocytes

True

-oma

Tumor or swelling

Which of the following tests requires a clean-catch midstream specimen?

Urine culture

Which of the following used items is not an example of regulated medical waste?

Urine testing strip

Which of the following represents an error in technique when obtaining a capillary blood specimen?

Using the first drop of blood for the test

phleb/o

Vein

CLIA regulations establish the three categories of laboratory testing on the basis of the complexity of the testing methods. Name one category.

Waived, Moderate-complexity and High-complexity

Which of the following is another name for the butterfly method of venipuncture?

Winged infusion method

How do you mix a specimen that has an additive?

With clot activator - rotate tube gently 5 times, With anticoagulant - rotate tube gently 8 to 10 times, Provides adequate mixing without causing hemolysis

A urine culture is used in the diagnosis of

a urinary tract infection.

The pH of most urine specimens is

acidic

A pH reading of 8 means that the urine specimen is

alkaline

Infectious waste includes:

all of the above (Blood and blood products, Contaminated sharps, Microbiological waste)

Which of the following are characteristics of the brachial artery (located in the antecubital space)?

all of the above (Pulsates when palpated, Has a more elastic and thicker wall than a vein, If punctured, blood is bright red in color, If punctured, patient feels more than usual amount of pain)

Medical ____and _________control are crucial in preventing the spread of disease.

asepsis , infection

Which of the following is the proper method for identifying a patient before performing a venipuncture?

ask the patient to state his or her full name and DOB

he kidneys are ---- organs.

bean-shaped

List six structures that may be found in microscopic examination of urine

casts, crystals, epithelial cells, rbc, wbc, bacteria

AIDS cannot be transmitted through

casual contact

A ---- is a solution that is used to monitor a test system to ensure the reliability and accuracy of test results

control

Before making the puncture, the medical assistant asks the patient to rinse his hand in warm water.

correct

The first drop of blood is wiped away.

correct

The puncture is made perpendicular to the lines of the fingerprint.

correct

The site is allowed to dry thoroughly after it is cleansed with an antiseptic wipe.

correct

The specimen is collected from the lateral part of the tip of the ring finger.

correct

For a pathogen to survive and produce disease, a continuous ______________ must be followed; this is known as the infection process _______________.

cycle

A 24-hour urine specimen may be collected to

determine the cause of kidney stone formation.

A urinalysis may be performed to

diagnose a pathological condition, screen a patient for the presence of disease, evaluate the effectiveness of therapy

When performing a capillary puncture, the finger should not be squeezed to avoid

diluting the blood sample with tissue fluid.

Difficult or painful urination

dysuria

The purpose of quality control is to

ensure accurate and valid test results.

he laboratory requisition is a valuable resource for the proper collection and handling of specimens.

false

All of the following are included in a lipid profile except

glucose

Presence of blood in the urine

hematuria

Bilirubin is an orange-colored pigment that is produced through the breakdown of

hemoglobin

Which capillary test has a higher reference range than that for venous?

hemoglobin

During the venipuncture procedure, a sudden swelling occurs in the area around the puncture site. You should

immediately remove the tourniquet and then the needle.

The purpose of the Clinical Laboratory Improvement Amendment (CLIA) is to

improve the quality of laboratory testing in the United States.

How should urine reagent strips be stored?

in a cool area; in a dark container; in a dry area; with the cap tightly closed (all of the above)

The depth of the puncture is 4 mm.

incorrect

The puncture is made with the patient in a standing position.

incorrect

The puncture site is squeezed to obtain the blood specimen.

incorrect

Alcohol is frequently used as a disinfectant in the medical office. The disinfecting action of alcohol is______________ by the presence of water.

increased

After a urine culture has been inoculated, it must be

incubated for 18 to 24 hours.

All of the following are reasons for indicating the clinical diagnosis on the laboratory request form except to

inform laboratory personnel as to the source of the specimen

The agent used to destroy microorganisms on an article depends on the

intended use of the article.

If the internal control of a urine pregnancy test does not perform as expected, the test results are interpreted as

invalid

All of the following are included on a laboratory request form except the

laboratory test results

All of the following are correct techniques for applying a tourniquet except

leaving the tourniquet on for at least 3 minutes before drawing the specimen

Hepatitis C is an infection of the ________________.

liver

Which of the following antecubital veins is considered the best vein to use for a venipuncture?

median cubital vein

All of the following are an example of a CLIA-waived test except

microscopic analysis of urine sediment.

Name the TWO most likely means of contracting hepatitis B in the health care setting.

needlesticks and blood splashes. or cuts with contaminated sharps

An increase in ---- occurs during an acute infection

neutrophils

An evacuated tube with a red stopper contains

nothing

What is the function of the urinary system?

o regulate the fluid and electrolyte balance of the body and to remove waste products

What is the maximum age of a child when performing a heel puncture?

one year, or when the child starts walking.

When running controls on a blood chemistry analyzer, what should be done if the controls do not perform as expected?

patient testing should not be conducted until the problem has been identified and resolved

Name two chemical tests for urine.

ph, specific gravity, protein, blood, nitrite, leukocyte, glucose, ketones, bilirubin, urobilinogen

Urinalysis consists of

physical, chemical, and microscopic examinations

The preferred site for a skin puncture for an infant is the [area] surface of the heel.

plantar

another name for a thrombocyte is a

platelet

If a POL is performing moderate-complexity tests, CLIA requires

proficiency testing three times per year, calibration procedures at least every 6 months, two levels of controls daily, a system to identify patient specimens throughout the testing process.

The purpose of patient preparation for a laboratory test is to

provide a specimen that yields accurate test results.

The chemical analysis of urine involves the use of

qualitative and quantitative tests

A ---- range is a certain established and acceptable parameter within which the laboratory test results of a healthy individual are expected to fall.

reference

If the hands are not visibly soiled, the CDC recommends that an alcohol-based hand rub, rather than hand washing, be used to sanitize hands. Why does the CDC recommend this?

repeated hand washing tends to dry out the hands, leading to irritation, chapping and dermatitis.

Methods for performing venipuncture include all of the following except the _____ method.

retractable lancet

On palpation, a scarred vein feels

stiff and hard.

The function of the urinary bladder is to

store and expel urine.

Casts are formed in

the lumen of the nephron tubules.

A disinfectant must be applied for a certain length of _______ to kill microorganism's.

time

Why is the order of draw important?

to prevent: Contamination of nonadditive tubes with additive tubes Cross-contamination between different types of additive tubes Leads to inaccurate test results

The function of hemoglobin is to

transport oxygen to the cells

The external opening of the urethra is known as the

urinary meatus.

List two tests that CANNOT be collected via capillary method?

urine is not a blood test. Acceptable answer is ESR and other tests requiring large amounts of blood/plasma/serum

The period of time that a disinfecting solution is effective after it has been activated is known as its

use life.

If you think a vein selected for venipuncture may collapse, you should

use the butterfly method to perform the venipuncture.

Describe how whole blood is obtained. Focus on what is needed in the tube to achieve this.

using a tube containing an anticoagulant.

Which of the following represents an error in technique when selecting a vein for venipuncture?

using the thumb to palpate the vein

The presence of bile pigments in a urine specimen causes the specimen to be

yellow-brown.