blagh

3) John works in a molecular diagnostics laboratory and receives a blood sample that has the name of a close friend printed on the bar-coded label. The genetic test that is ordered on the friend's sample would provide diagnostic information about a disorder that has a poor prognosis, and the test is usually performed by John. He asks a fellow employee to analyze the sample for him and not divulge the results. This ethical issue concerns: a. confidentiality of patient genetic and medical information. b. a conflict of interest. c. resource allocation. d.​ diagnostic accuracy.

A

17) You are performing a precision study on a new chemistry analyzer in your hospital lab by analyzing a single sample many times. The study involves performing the analysis on different shifts using different calibrators and analysis by different laboratorians. This aspect of precision is referred to as: a. repeatability. b. reproducibility c. validity. d.​reliability.

B

19) The ability of an analytical method to assess small variations of the concentration of an analyte, and that is often expressed as the slope of the calibration curve, is referred to as: a. analytical specificity. b. analytical sensitivity. c. limit of detection. d.​ analytical range.

B

36) ROC curves are most useful in assessing the performance of quantitative laboratory analyses because: a. multiple tests for the same analyte can be evaluated at one time. b. they can display performance of tests over the entire range of decision values. c. they allow specific reference intervals to be determined for each analysis. d.​they can evaluate combination testing in a single plot.

B

59) Even if somewhat impractical, which one of the following preanalytical factors should be standardized when establishing a reference interval for an analyte? a. Location (building, city, etc.) in which the venipuncture is performed b. The method of specimen collection c. Reagents used in analyte analysis d. The specific method used for analysis

B

69) Visually inspecting the distribution of reference values can provide a safeguard against misinterpretation of statistical methods, and it may provide valuable information about the data. Which of the following observations might represent erroneous values? a. Skewed distributions b. Outlier values c. Partition criteria d. Bimodal distributions

B

You have received your proficiency test results from the accrediting agency and note that your creatinine result was unacceptable at greater than 2 SDI from the group mean.The value that was entered on your survey report form was 15 mg/dL.The group method mean was 1.3 mg/dL with a method standard deviation of 0.3 mg/dL.You realize that your laboratory made an error in entering the result.If you had entered 1.5 mg/dL as the result on your survey report,would the recalculated SDI now be in agreement with the rest of the laboratories in the testing program?

Yes

85) A skin puncture of an individual's finger is ordered for hematocrit analysis and is to be collected into a capillary tube. It is cold in the phlebotomy area, and the phlebotomist notices that the individual appears cold and pale. What should the phlebotomist do to stimulate blood circulation to the finger so an acceptable fingerstick specimen will be obtained? a. Slap the individual's hand to warm it up. b. Tie a tourniquet around the individual's finger. c. Warm the finger for 3 minutes using a warming device. d. Massage the finger and hand.

C

90) Upon examination of the week's analytical run of plasma glucose tests, you notice that four consecutive normal control values are +1 s (standard deviation) from the mean. In your QC report, you note that a Westgard multirule has been broken and realize that this rejection rule is sensitive to a specific type of error. An example of this type of error would be: a. poor pipetting technique. b. incubator temperature change. c. improper calibrator preparation. d. unstable photometer.

C

2) A patient visits her physician stating that her prescribed painkiller is not working to reduce the pain following her recent surgery. A friend of the patient claims that the same painkiller "worked wonders" to reduce her pain after the same surgery. The physician states that the difference in the effect of the drug might be caused by ____, which is studied in pharmacogenetics. a. epidemiology b. an inherited disease c. a conflict of interest d.​ a genetic variation in drug-metabolizing enzymes

D

27) In a chemistry methods analysis, linearity refers to the: a. closeness of agreement between independent results of measurements obtained under stipulated conditions. b. closeness of agreement between the average value obtained from a large series of results of measurements and a true value. c. analyte concentration range over which measurements are within the declared tolerances for imprecision and bias of the method. d.​ relationship between measured and expected values over the range of analytical measurements.

D

What is the role of quality planning in the five-Q framework of quality?

To ensure that the laboratory's performance satisfies quality requirements

The first step in the development of an in-service training program using an instructional system for employee competency in the laboratory is:

a needs assessment or gap analysis

Two types of error may be encountered during chemical analysis of a substance.The type of error that occurs as a result of contaminated calibrating solutions would be _____ error.

systematic

You have received your proficiency test results from the accrediting agency and note that your creatinine result was unacceptable at greater than 2 SDI from the group mean.The value that was entered on your survey report form was 15 mg/dL.The group method mean was 1.3 mg/dL,with a method standard deviation of 0.3 mg/dL.You realize that your laboratory made an error in entering the result.If you had entered 1.5.0 mg/dL as the result on your survey report,what would the correct SDI be?

0.67 SDI

41) To calculate the sensitivity of a laboratory test to correctly classify true positives, one must first know the number of: a. true positives and false negatives. b. true negatives and false positives. c. true positives and false positives. d. false positives and false negatives.

A

44) Systematic reviews are used to assess and answer very specific clinical questions in an unbiased way. The most important of the steps in conducting a systematic review is the: a. formulation of the clinical question that will form the basis of the review. b. choosing of the reviewer who will perform the work. c. primary literature search and review. d. data extraction from the literature.

A

60) To determine the confidence intervals of percentiles of ranked data (data arranged by magnitude of value), it is most appropriately assessed using: a. nonparametric testing. b. univariate analysis. c. parametric testing. d. multivariate analysis.

A

63) Which one of the following is an example of an exclusion criterion when establishing a healthy population-based reference interval? a. Use of oral contraceptives b. Sex c. Age d. Ethnicity

A

67) The proportion of a population (or of those being tested) with the disease being studied is referred to as the: a. prevalence. b. clinical sensitivity. c. clinical specificity. d. predictive value.

A

73) The best use of a saliva specimen would be for which one of the following analyses? a. Measurement of blood group substances to determine secretor status and genotype b. Determination of whether the specimen is an effusion or an exudate c. Early gestational age diagnosis of inherited genetic disorders d. Characterization of the type of arthritis present in an individual

A

74) Hemolysis will cause potassium _____ when analyzed. a. and lactate dehydrogenase (LD) values to appear increased b. value to appear increased and LD value to appear decreased c. value to appear decreased and LD value to appear increased d. and LD values to appear decreased

A

79) Which one of the following anticoagulants is considered unacceptable for a blood sample that will be used for DNA amplification in the polymerase chain reaction? a. Heparin b. EDTA c. Iodoacetate d. Acid citrate dextrose

A

81) An individual has several laboratory tests ordered and is having blood collected. After applying the tourniquet, the phlebotomist has to answer the phone and write down a message, leaving the tourniquet in place for approximately 3 minutes. How will this affect this individual's serum composition of bilirubin? a. It will be increased. b. It will be decreased c. It will not be affected.

A

86) An example of a preanalytical error would be: a. mislabeling a tube of blood with an incorrect name. b. using expired reagents in an analysis. c. sending the test results to the incorrect physician. d. failing to run controls with unknown samples.

A

88) If alerted to a control problem when using Westgard multirules, an analyst should first: a. assess the analytical method, equipment, reagents, and specimens. b. rerun controls several times until the values finally are acceptable. c. call the laboratory manager. d. call the manufacturer's repair hotline.

A

91) Preparation of a CLSI-defined procedure document of an analytical protocol is a means of controlling which one of the following types of variables? a. Analytical b. Preanalytical c. Postanalytical d. Reproducibility

A

1) An individual working in a clinical chemistry laboratory is married to a sales representative who works for a company that sells chemistry laboratory supplies. When the laboratory manager requests a list of needed supplies, cost of supplies, and vendors, this individual only recommends the spouse's company as the vendor. This is considered to be a(n): a. accounting issue. b. possible conflict of interest. c. maintenance of confidentiality issue. d.​ problem with resource allocation.

B

10) A statistic is a: a. constant that describes some particular characteristic of a population. b. value calculated from the observations in a sample to describe a particular characteristic of that sample. c. complete set of all observations that might occur as a result of performing a particular procedure according to specified conditions. d.​ graphic device for displaying a large set of data.

B

22) The Student t distribution: a. compares a sample mean to a population mean using the population. b. compares the means of two samples using sample statistics. c. assesses the means of samples prior to and following some intervention. d.​ assesses the significance of difference between more than two variables.

B

30) True negatives ÷ (false positives + true negatives) is the formula for determining: a. sensitivity. b. specificity. c. the odds ratio. d.​ the likelihood ratio.

B

38) Non-diseased individuals that are classified as diseased by having a positive result on a specific laboratory test are considered: a. true positives. b. false positives. c. true negatives. d. false negatives.

B

43) The probability of occurrence of a specific test value given that the disease is present divided by the probability of the same test value if the disease was absent is the: a. odds ratio. b. likelihood ratio. c. prevalence. d. predictive value.

B

5) Clinical epidemiology, which is the study of the patterns, causes, and effects of health and disease in certain populations, has provided the clinical laboratory with methods that evaluate the effects and outcomes of laboratory testing. This allows for a more effective: a. process of determining the cost of the testing methods. b. selection and interpretation of laboratory tests. c. determination of the boundaries between the components of the clinical lab. d.​ conduct assessment.

B

6) Analysis of which one of the following by molecular diagnostic methods provides a measure of processes that are ongoing at the time of blood sampling? a. Genetic variation in an individual's response to a drug b. Circulating plasma nucleic acids c. Malignant lymphomas d.​ Histocompatibility

B

61) True negatives ÷ (false positives + true negatives) x 100 is the formula for determining: a. clinical sensitivity. b. clinical specificity. c. analytical sensitivity. d. analytical specificity.

B

64) An important assumption that is made when using parametric methods to estimate percentiles and their confidence intervals in determining reference limits is that: a. the type of distribution that the reference values exhibit is a t-distribution. b. the true distribution that the reference values exhibit is Gaussian. c. the distribution parameters cannot be estimated. d. there is no set distribution pattern of reference values.

B

71) When a coagulated blood sample is separated by centrifugation, the liquid component is separated from the cells. This "serum" is the: a. liquid component with all clotting factors present in it. b. liquid component with no clotting factors in it. c. unclotted cellular component. d. clot.

B

16) A research project examining cholesterol values using a new Cholestcheck assay produces the following cholesterol values from a random sample of 14, 25-year-old women: Mean = 137 mg/dL 2 standard deviations = 6 mg/dL N = 14 The coefficient of variation percent for this assay is: a. 1.14%. b. 2.19%. c. 4.38%. d.​ 9.49%.

B If 2sd=6 then 1sd=3 CV=sd/mean x 100 CV=3/137 x100 CV=0.02189 x 100 CV=2.19%

100) In regard to a Gaussian distribution, ±2 s from the mean encompasses _____ of values. a. 99.7% b. 98.0% c. 95.5% d. 68.2%

C

12) Which one of the following is the correct formula for calculating the percent coefficient of variation of a set of measurements? a. CV = standard deviation × 100% b. CV = standard deviation ÷ 100% c. CV = (standard deviation ÷ mean) × 100% d. CV = (mean + standard deviation) ÷ 100%

C

14) How is the formula for population standard deviation (σ) stated? a. The positive square root of the mean ÷ sum of squared differences between mean and individual values b. Square root of the mean ÷ (N - 1) c. The positive square root of the [(sum of squared differences between mean and individual values) ÷ N] d.​ The sum of squared differences ÷ the positive square root of the mean

C

21) The statistical analysis used to compare values obtained by a new method with those obtained by an established method is: a. a Student t test. b. standard deviation. c. regression analysis. d.​ limit of detection.

C

25) Comparisons of measurement values between clinical laboratories require a hierarchical approach that obliges routine clinical chemistry measurements to be referred back to a reference measurement procedure. This concept is known as: a. uncertainty. b. error. c. traceability. d.​ reliability.

C

28) In the calibration hierarchy, a reference measurement procedure, which is a fully understood procedure of highest analytical quality, is at the top. This procedure is associated with which one of the following types of error? a. Calibration error b. Specificity error c. Pure random error d.​ Systematic error

C

35) A receiver operating characteristic (ROC) curve is a plot of: a. systematic error against random error. b. tumor marker decision levels versus upper limit of reference intervals. c. true positives versus false positives. d.​ specificity of one method against the specificity of another method.

C

4) Molecular diagnostic testing methods and results can be: a. qualitative only. b. quantitative only. c.​ either qualitative or quantitative.

C

40) A method that can be used to calculate the probability of a disease after new information is added to previously obtained information involves: a. likelihood analysis. b. sensitivity analysis. c. Bayes theorem. d. combination testing.

C

112) To make 20 mL of a 0.1 g/L solution from a 10 mg/mL stock solution, you should add _____ mL of the stock solution to _____ mL of solvent. a. 2; 18 b. 10; 10 c. 1; 19 d. 0.2; 19.8

D If you had 10mL you'd put .1 into 9.9mL 0.1g/L=10mg/L If you're making 20mL you need to double it so .2 into 19.8

18) Following a precision study in which repeatability and reproducibility of 20 samples are assessed, which one of the following formulae would be used to determine the total standard deviation (σ2T)? a. σ2within-run/2 + σ2between-run b. (x2i − x1i) c. Σ(x1 − μ)2/N d. σ2within-run + σ2between-run

D The degree of precision is usually expressed on the basis of statistical measures of imprecision, such as the standard deviation. The total standard deviation (σ2T) may be split into within-run and between-run components using the principle of analysis of variance components (variance is the squared standard deviation): σ^2T = σ^2within-run + σ^2between-run

13) The type of method comparison that compares the average results between two analyses with the differences between varying concentration values of the two analyses is referred to as a(n): a. Deming analysis. b. linear regression plot. c. ordinary least-squares plot. d.​ Bland-Altman difference plot.

D

23) A list of intervals followed by a list of frequencies is referred to as a: a. frequency histogram. b. range. c. cumulative frequency distribution. d.​ frequency distribution.

D

37) A laboratory analysis that produces quantitative results with an infinite number of sensitivity and specificity pairs is referred to as a _____ test. a. predictive b. qualitative c. dichotomous d.​ continuous

D

42) To calculate the predictive value of a positive test, which of the following should be known? a. Sensitivity only b. Specificity and prevalence only c. Sensitivity and specificity only d. Sensitivity, specificity, and prevalence

D

65) A physician asks your laboratory to begin performing thyroid-stimulating hormone (TSH) analyses on all specimens that have a free thyroxine (FT4) analysis ordered, a practice that your laboratory currently does not perform. Your laboratory typically performs TSH only on those FT4 specimens that are outside the population-based reference interval. The physician suggests using subject-based reference intervals, claiming that population-based intervals are clinically insensitive. What is the basis of this claim? a. Subject-based reference values more closely resemble the group of reference individuals that were used to establish population-based reference intervals. b. Standardized laboratory methods produce more accurate results when examining individual subject values. c. Subject-based reference values are more easily tracked and applied in settings in which large numbers of specimens are analyzed. d. Changes i

D

7) A healthy individual with no clinical signs or symptoms of disease visits his physician for a routine physical examination. Blood samples are collected and sent to the laboratory. The tests requested on the sample are for general laboratory analyses, including a complete blood count, a panel of general chemistry tests (including glucose, protein, cholesterol, and others), and an analysis of urine. This type of testing in laboratory medicine is directed at: a. confirming a clinical suspicion of disease. b. selecting a treatment for disease. c. ruling in a diagnosis. d.​ screening for disease in the absence of clinical signs or symptoms.

D

70) The results of a certain type of quantity obtained from a single individual or group of individuals corresponding to a stated description is the definition of: a. reference intervals. b. reference limits. c. clinical decision limits. d. reference values.

D

72) An example of an uncontrollable preanalytical variable would be: a. improper specimen collection. b. preanalytical errors. c. prolonged bed rest. d. an individual's age.

D

78) As an anticoagulant, heparin acts to: a. chelate calcium. b. inhibit platelet aggregation. c. antagonize vitamin K. d. activate antithrombin.

D

84) When collecting a timed urine specimen for laboratory analysis: a. all of the urine must be collected at once into one large container instead of using smaller separate containers that are emptied into the large container. b. the container used for collection must be maintained at room temperature throughout the entire collection period. c. it is acceptable and best practice to collect the urine into one container containing two different mixed preservatives if more than one test is ordered. d. the individual's bladder must be emptied first at the beginning of the time of collection, and this urine is discarded.

D

87) The best additive in a collection tube for enhancing the vitality and recovery of white blood cells for isolation of genomic DNA is: a. sodium citrate. b. heparin. c. oxalate. d. acid citrate dextrose.

D

9) A male laboratorian works in the clinical chemistry laboratory of a large hospital. He is approached by his friend, who is a representative of a drug company, and asked to analyze some patient samples for drug levels of a specific drug that the representative's company sells and that these patients use. The representative wants to publish a report on the rate of drug absorption and distribution of this drug and tells his laboratorian friend that he will personally reimburse him for his time. What ethical issues come into play here? a. Resource allocation and conflict of interest b. Maintenance of confidentiality and publishing issues c. Maintenance of confidentiality, conflict of interest, and publishing issues. d.​ Resource allocation, maintenance of confidentiality, conflict of interest, and publishing issues.

D

92) Which one of the following would be considered a postanalytical variable in regard to laboratory services? a. Test ordering b. Specimen acquisition c. Test procedures d. Result reporting

D

32) What is the positive predictive value of a test in which 220 tested individuals with positive test results actually have the disease and 45 tested individuals with positive test results do not have the disease? a. 16.9% b. 66% c. 83% d.​ 120%

The predictive value for a positive test examines the number of true positives (TP) and false positives (FP). The formula for calculating the predictive value is TP/(TP + FP). In this case, 220/(220 + 45) × 100% = 83%. C

According to CLIA regulations,a score of _____ must be attained on three consecutive external proficiency test challenges for a laboratory to be accredited and continue patient testing.

80%

11) A population mean (µ) is calculated by which one of the following formulae? a. Σxi/N b. (b − 1)/SE(b) c. (x2i − x1i) d. Σ(x1 − μ)2/N

A

15) Two types of error may be encountered during analysis of a substance. The type of error that occurs with a constant or predictable difference or trend, either positive or negative, and thus is related to bias, is a(n) _____ error. a. systematic b. random c. analytical d.​ All of the above are correct.

A

20) Method selection involves consideration of several different criteria. Assessment of a candidate method's precision, accuracy, and analytical specificity are components of which one of the following categories? a. Analytical performance criteria b. Medical criteria c. Instrument parameters d.​ Descriptive measures criteria

A

24) The type of regression analysis that is considered to reliably estimate the relationship between modified target values and that takes into account errors in both methods 1 and 2 is _____ regression analysis. a. Deming b. ordinary least-squares c. nonparametric d.​ random error

A

26) To systematically assess errors associated with laboratory results, a parameter associated with the result of a measurement that characterizes the dispersion of the values reasonably attributed to the substance being measured is considered. This parameter is expressed by a formula that includes preanalytical, analytical, and traceability components and is referred to as: a. uncertainty. b. error. c. traceability. d.​ reliability.

A

29) In a qualitative point-of-care test, clinical sensitivity is considered as the: a. probability of classifying a result as positive. b. probability of classifying a result as negative. c. ability of an analytical method to assess small variations of the concentration of an analyte. d.​ ability of an assay procedure to determine specifically the concentration of the target analyte in the presence of potentially interfering substances.

A

31) The proportion of a population that has the particular disease being studied is referred to as the: a. prevalence. b. predictive value. c. positive value. d.​ clinical sensitivity.

A

33) In regard to the number of true-positive and negative, and false-positive and negative, results in laboratory testing, the prevalence times the sensitivity is equal to the number of: a. true positives. b. false positives. c. true negatives. d.​ false negatives.

A

39) Combination testing involves the use of multiple laboratory tests in an attempt to decrease costs or assist in diagnosing a specific disease. One of the problems with this type of testing is that: a. false positive results increase. b. true negative results increase. c. the prevalence of the disease increases. d. the predictive value of a negative test increases.

A

114) What is the relative centrifugal force (RCF) for a centrifuge spinning at 1200 rpm with a rotor head radius of 8 inches? A. 32.7 g B. 3200 g C. 130 g D. 1300 g

A Inch to cm = 2.54 x inch 2.54 x 8= 20.32cm g=1.118 x r x (n/1000)^2 g=1.118 x 20.32 x. (1200/1000)^2 g=22.7x (1.2)^2 g =22.7 x 1.44 g=32.7

You arrive at the clinical chemistry laboratory one morning and discover that personnel from the third shift left you the QC sheet from the thyroid-stimulating hormone (TSH)run.The technician has circled the level I TSH control values,and you realize that all six of the level I control values are +3 s from the mean.No results have been released.Now it's your decision regarding what to do next.First,which Westgard rule(s)has (have)been violated?

All of the above rules have been broken.

77) An amniotic fluid specimen for bilirubin analysis is received in the laboratory in a clear plastic collection tube. How will this affect the results of the bilirubin analysis? a. There will be no effect on the bilirubin analysis results, because this specimen is properly collected. b. Because the tube is not darkened, light will cause the bilirubin to be photo-degraded and the results will be falsely decreased. c. Because there is no additive in the tube, the amniotic fluid cells will hemolyze, leading to a false increase in bilirubin. d. Because the tube is made of plastic, the amniotic fluid will clot, and no analysis can be performed on a clotted sample.

B

80) An individual has several laboratory tests ordered and is having blood collected. After applying the tourniquet, the phlebotomist has to answer the phone and write down a message, leaving the tourniquet in place for approximately 3 minutes. How will this affect this individual's serum composition of total protein and potassium? a. Both will be increased. b. Total protein will be increased and potassium will be decreased. c. Total protein will be decreased and potassium will be increased. d. Both will be decreased.

B

83) A blood collection tube containing a specific amount of additive is only half filled with blood instead of being completely filled. Will this collection affect laboratory test results? a. There will be no effect on the results because the additive is "calibrated" for any amount of blood in the tube. b. There will be a significant effect on the test results because the additive must be mixed with a full tube of blood to achieve its appropriate effect.

B

89) Upon examination of the week's analytical run of plasma glucose tests, you notice that four consecutive normal control values are +1 s (standard deviation) from the mean. In your QC report, you note that Westgard multirule _____ has been broken and realize that this rejection rule is sensitive to _____ error. a. 14s; random b. 41s; systematic c. R4s; systematic d. 4Rs; random

B

93) The Westgard multirules for quality control were designed to interpret control data and to aid in troubleshooting. The rule stated as 22s is interpreted as meaning: a. one control value has exceeded ±2 s from the mean. b. two consecutive control values have exceeded the mean ±2 s. c. two consecutive control values have exceeded the mean ±1 s. d. four consecutive controls have exceeded the mean ±2 s.

B

96) Six Sigma processes: a. use simulated patient specimens made from a common pool to determine the "quality" of a laboratory's performance using standard deviation calculations. b. are quality performance goals that require a specific number of standard deviations of process variation to fit within the tolerance limits for the process. c. are focused on creating more value by eliminating activities that are considered waste. d. are international standards for quality management produced by the International Organization for Standardization.

B

97) Upon examination of the control chart of the week's analytical run of serum creatinine, you notice that 10 consecutive level II control values lie on the same side of the mean. In your QC report, you note that Westgard multirule _____ has been broken and realize that this rejection rule is sensitive to _____ error. a. 10 0; random b. 10 0; systematic c. X10; random d. X10; systematic

B

98) Upon examining a Levey-Jennings control chart for analyte X, you notice that on day 6 the one control was −2.5 s from the mean and the duplicate control was +3.3 s from the mean. Which of the following Westgard control rules was/were broken? a. 41s and 22s b. R4s and 13s c. R4s and 22s d. 22s only

B

99) Which one of the following statements concerning the use of internal control materials is incorrect? a. Use of control materials can aid in the identification of assay malfunctions that lead to unreliable data. b. Serum controls are prepared from human serum pools and are analyzed in analytical runs that are separate from patient samples. c. QC data are collected over a period of time and statistically analyzed using measures of central tendency. d. Controls that exceed specific limits are examined with the Westgard rules to determine what kind of error is present and what actions are to be taken.

B

68) To reduce workload in your chemistry laboratory, you are setting up a small laboratory on the opposite side of your large city from the main laboratory. When preparing the new laboratory's chemistry analyzer, you decide to use the reference values that have been generated by the main laboratory's chemistry analyzer, which is a larger model (but similar in all other respects) than yours. Can this be justified? a. No, because each analyzer will produce completely different results from the other laboratory. b. No, because the populations that will be tested are completely different. c. Yes, if certain conditions have been fulfilled, such as population matching, data comparison, analytical performance agreement, and specimen standardization. d. Yes, because you cannot afford to perform reference value determinations

C

75) The type of urine specimen that is best for detection of abnormal amounts of certain analytes such as chorionic gonadotropin for pregnancy testing is a: a. random and untimed specimen. b. 24-hour collection. c. clean, early morning, fasting specimen. d. catheter specimen.

C

76) Arthrocentesis is a technique used to collect: a. pleural fluid. b. blood. c. synovial fluid. d. amniotic fluid.

C

8) The discipline involved in the selection, provision, and interpretation of diagnostic testing that uses primarily samples from patients is: a. clinical chemistry. b. hematology. c. laboratory medicine. d. molecular diagnostics.

C

82) Which one of the following analytes shows no difference in composition between a serum and a plasma specimen? a. Lactate dehydrogenase b. Potassium c. Cholesterol d. Total protein

C

94) Lean Production: a. involves use of simulated patient specimens made from a common pool to determine the "quality" of a laboratory's performance using standard deviation calculations. b. is a quality performance goal that requires a specific number of standard deviations of process variation to fit within the tolerance limits for the process. c. is a quality process that focuses on creating more value by eliminating activities that are considered wasteful. d. is a set of international standards for quality management produced by the International Organization for Standardization

C

95) Which one of the following would be considered a cost of nonconformance? a. Performing preventive maintenance on analyzers b. Employee training c. Repeating an analytical run because the QC is out of range d. Sending an employee to a fire safety class

C

113) Which one of the following statements concerning type I water is not correct? A. Type I water is acceptable for analytical purposes. B. Testing that requires minimal interferences (such as iron or enzyme analysis) requires the use of type I water. C. Type I water is obtained from distillation only and contains a few impurities. D. Type I water results in part from ion exchange purification and reverse osmosis.

C More than one way to get type 1 water

66) What is the statistical range of the following distribution of data? 21 25 18 20 19 21 23 26 a. 18 to 26 b. 21.6 c. 8 d. -8

C Statistical range is taken by adding number of data points.

You arrive at the clinical chemistry laboratory one morning and discover that personnel from the third shift left you the QC sheet from the thyroid-stimulating hormone (TSH)run.The technician has circled the level I TSH control values,and you realize that all six of the level I control values are +3 s from the mean.No results have been released.Now it's your decision regarding what to do next.What is your decision regarding the release of results in the problem stated in the preceding question?

Hold all results, reject the run, and troubleshoot

34) Calculate the sensitivity for the following data: in a group of 80 patients diagnosed with sickle cell disease, 72 tested positively for it. The sensitivity of this test is: a. 111%. b. 100%. c. 90%. d.​75%.

Sensitivity is the presence of a particular disease in those individuals who have a positive test result for that disease expressed as a percentage. In this case, 72/(72+8) × 100% = 90%. C

You arrive at the clinical chemistry laboratory one morning and discover that personnel from the third shift left you the QC sheet from the thyroid-stimulating hormone (TSH)run.The technician has circled the level I TSH control values,and you realize that all six of the level I control values are +3 s from the mean.No results have been released.Now it's your decision regarding what to do next.What kind of error is most likely occurring?

Systematic error due to calibration issues

62) Calculate the clinical sensitivity for the following data: in a group of 80 patients diagnosed with sickle cell disease, 72 had positive test results. The clinical sensitivity of this test is: a. 111%. b. 100%. c. 90%. d. 75%.

TP/(TP+TN)=Clinical Sensitivity 72/(72+8) 72/80 90% C

Random error would be caused by:

pipetting errors

According to the five-Q framework,the "QP" refers to quality:

planning