Lab CE lab operations
What is indicated by the number 3 in the BLUE section of the NFPA diamond?
A potentially dangerous health hazard that can be associated with the chemical with continued exposure
Heparin interacts with _____________, which subsequently inhibits thrombin.
Antithrombin III
What is the intent of the Health Insurance Portability & Accountability Act (HIPAA) of 1996?
Establish security and privacy standards
Critical values not reported or not reported in a timely manner is an example of a laboratory error made during which phase of laboratory testing?
Postanalytic
The majority of all laboratory errors occur during which phase of laboratory testing?
Preanalytic
A slow, progressive drift of values away from the mean is called a:
Trend
Which of the following describes the Westgard multirule 22s?
Two consecutive data points fall outside +2SD or fall outside -2SD.
If a sodium citrate sample drawn for coagulation is noted to be filled an inch below the fill line (black line), then the specimen is considered:
Unacceptable for coagulation studies
Which one of the following statements about fingersticks is correct?
Use the middle or fourth finger.
Which of the following procedures is most effective in preventing the spread of infectious diseases in the hospital environment?
Washing hands in between each patient contact and wearing gloves.
classic automated blood cell counters are based on which of the following technologies?
impedance principle
You are working to validate a new method for detecting C-reactive protein (CRP) in serum. To assess precision, you run a medium-level control 30 times and determine the mean to be 4.0 mg/dL with a standard deviation of 0.04 mg/dL. What could be said about the precision of this run, assuming a CV less than 3% is acceptable?
It is acceptable, with a coefficient of variation of 1%.
What best describes the proper lifting procedure when lifting a heavy item that will help to prevent back injuries?
Keep the item close to the body, bend the knees, and lift with the legs.
Blood samples for complete blood counts are collected on morning rounds and stored in a rack in the phlebotomist's basket. When the phlebotomist delivers the samples to your workstation, the cells and plasma in the samples have separated. As a result, one of the samples has lipemic plasma. Which of the following parameters may be affected by the lipemia?
MCHC
Which type of healthcare occupational exposure has the greatest risk of HIV transmission?
Percutaneous injury
Below are the creatinine levels in mg/dL for 21 healthy hospital employees: .87.98.931.04.86.901.051.08.84.971.12.95.961.021.01.93.91.98.99.941.04 What is the median of these data?
.97 mg/dL
Creatinine levels in mg/dL for 21 healthy hospital employees .87.98.931.04.86.901.051.08.84.971.12.95.961.021.01.93.91.98.99.941.04 What is the mean of the data?
.97 mg/dL
How would one prepare 3 mL of a 5% albumin working solution from a stock 30% albumin solution?
0.5 mL stock 30% albumin + 2.5 mL diluent
Holding pressure on the puncture site after withdrawing the needle may prevent:
Hematoma formation
A mother and young child arrive at the outpatient laboratory with a physician's order for a lead test on the child. The phlebotomist decides to perform a dermal puncture (fingerstick). What procedure is important to implement when a test for lead is collected by finger puncture that would NOT be necessary prior to an antecubital venipuncture?
Thoroughly washing patient's hands with soap and water.
Which of the following activities may lead to a HIPAA violation lawsuit?
Throwing laboratory test requests into the regular trash.
All of the following affect the relative centrifugal force of a centrifuge, EXCEPT?
Time
What is a lyophilized control?
A control that is dehydrated to powder
Which of the following is considered an engineering control?
Biosafety cabinet
The process of the motion of a liquid when a voltage is applied between the ends of an insulating tube that contains that liquid is known as:
Electroosmosis
EDTA and Sodium citrate combine with _________ to inhibit coagulation in blood samples.
Calcium
Which nitrogen base would bind with a guanine nucleotide in forming double-stranded DNA?
Cytosine
Identify the Light intensity control and Stage controls.
H, F
Nephelometry and turbidimetry measure different properties of:
Light transmission and scatter by particles in suspension
Which of the following is the main function of the ASCP Board of Certification?
Maintain a registry of certified personnel
The numeric value that occurs most frequently in a sample distribution is called the:
Mode
Molecular diagnostics utilizes blotting techniques to separate nucleic acids; northern blotting separates:
RNA
When two consecutive controls are greater than ± 2 SD units from the mean, what should you do first?
Recalibrate, then repeat controls followed by patient specimen results if QC is acceptable.
What is the definition of a waived laboratory test or procedure?
Tests that are cleared by the FDA for home use
which of the following definitions describes ribonucleic acid (RNA)?
a single-stranded polymer that incorporates uracil instead of thymine
General Hospital is considering the addition of a new chemistry panel containing 12 tests. The laboratory is asked to calculate the total cost of quality control per new chemistry test panel. Quality control must be performed 3 times per day (every 8 hours). The labor cost per quality control test for this panel is $2.63. A month's worth of quality control reagent costs $354.00. What is the total quality control cost per new chemistry test panel if 76,000 of these new panels are performed each year?
$0.09 In this case, if quality control is run 3 times per day, a total of 1095 quality control runs are performed each year. The direct labor cost of $2.63 multiplied by 1095 quality control runs equals $2879.85 per year in quality control direct labor. The hospital pays $354.00 per month on quality control consumables, which equals $4248.00 per year. The total quality control costs in a year are equal to $2879.85 + $4248.00 = $7127.85. If 76,000 new chemistry tests panels are performed each year, the total quality control cost per new chemistry test panel will be $0.09.
To convert degrees Celsius to degrees Fahrenheit, which formula would you use?
(9/5 x degrees Celsius) + 32
Convert 800 microliters to milliliters.
0.80 mL
the concentration of sodium chloride in an isotonic solution is
0.85%
What are the Westgard rules?
1-2SD rule: 1 observation > 2SD but < 3SD; WARNING 1-3SD rule: 1 Observation > 3SD; REJECTED 2-2SD rule: 2 Consecutive obs >2SD; REJECTED 3SD rule: 2 of 3 Obs > 2SD; within run, REJECTED 3 -1SD rule: 3 Obs > 1SDin same direction in same run. REJECT 1-2sd,1-3sd rules: Random errors 2-2SD rule: Systematic error
The images below represent the results of normal and abnormal levels of control that are tested daily for a particular analyte. On which day should the run be rejected if Westgard rules are used to evaluate quality control?
13
A technologist pipetted 200 microliters of serum in a test tube and added 5 milliliters of saline to the tube. What is the dilution ratio of serum to the total volume in the tube?
1:26
Unless the new Individualized Quality Control Plan (IQCP) is used, CLIA'88 requires how many levels of controls and at what time intervals for most methods in the Clinical Laboratory?
2 controls, daily
The time needed for the retention of laboratory records (and as applicable: slides, blocks, and tissue) is typically ___ year(s) and ___ year(s) for immunohematology records.
2 years, 5 years
how many grams of NaOH is required to prepare 500 ml of a 5% (w/v) NaOH solution
25 grams concentration = 5% (w/v) NaOH = 5 g NaOH/100 mL desired volume = 500 mL concentration times volume = (5 g NaOH / 100 mL) x 500 mL = 25 g NaOH
A technologist put five (5) tubes in a test tube rack and put 3 mL of diluent in each tube. The tech then put 0.3 mL serum in the first tube and mixed it. Next, the tech then transferred 1 mL of the mixture from the first tube to the second tube. This process was carried on through tube number five (5). What is the dilution factor in tube number five?
2816
What is the standard deviation of the following data set, rounded to the nearest whole number? 15, 16, 18, 16, 14, 10, 20, 12, 14
3
A 4.0 mg/dL creatinine standard is needed. To prepare 100 mL of the working standard, how much stock standard of 1 mg/mL creatinine is needed?
4 mL
When should a pipette be wiped off?
After lowering the meniscus to the calibration mark
Which protein is represented by the band labeled by the number 4 on the SPE scan?
Albumin
What is the total magnification produced when using a 10X ocular lens and a 40X objective lens on a Bright Field light microscope?
400x
For a certain method, a control has a mean result of 12 with a standard deviation (SD) of 2. What is the acceptable 95% range for this control?
8 - 16
What is the Coefficient of Variation for a set of numbers when: ± 1 SD = 6.8, mean = 80, and the range for ± 1 SD = 73.2 - 86.8
8.5%
The statistics for a specific laboratory test method are illustrated to the right. What is the sensitivity of this test?
94%
Which statement refers to the coefficient of variation?
A measure of imprecision that is expressed as a percentage.
The preparation of a Levey-Jennings quality control chart for any constituent of serum requires:
A minimum of 20-30 analyses of control serum over a period of 20-30 days.
Which of the following best defines "specificity":
A test's ability to correctly exclude individuals who do not have the given disease or disorder.
A standard is used to check the __________ of a method or instrument.
Accuracy
An assayed glucose control produces the following results in 10 runs: 99, 99, 99, 98, 98, 98, 98, 97, 97, 97. The established range for this control is 90-92. Where does the problem lie with this control?
Accuracy
"Universal precautions" is an approach to infection control that is designed to reduce the risk of transmission of microorganisms in hospitals and other health care settings. Which of these statements BEST describes the intent of standard precautions?
All blood, tissue, body fluids, secretions (except sweat), and excretions should be considered potentially infectious, and health care workers should use appropriate personal protective equipment and safe work practices when in direct contact with patients or any specimen types.
All of the following statements are true regarding the significance of performing direct microscopic examinations of specimens for culture, EXCEPT:
Allows the microbiologist to discard the sample and cancel testing if no organisms are observed.
which of the following correctly matches the name of the PCR stage to its definition
Annealing - binding of single stranded primers
What mathematically establishes the direct relationship between the concentration of a substance and its absorbance?
Beer's law
Which of the following is a TRUE statement concerning the Category A agents of bioterrorism?
Category A agents cause high mortality and the potential for major public health impact.
Which of the four classes of fires is described as resulting from flammable liquids/gases?
Class B
Which of the following describes the quality standards that all laboratories must meet to ensure testing accuracy, reliability, and timeliness no matter where a patient sample is tested?
Clinical Laboratory Improvement Amendments
The three base nucleotide sequence that provides the information necessary to identify an amino acid is termed a(n):
Codon
What are the steps of Root Cause Analysis?
Collect the information, identify reasons, chart the factors, and generate recommendations
What is defined as the ability of the test to detect a given disease or condition?
Diagnostic sensitivity
If a pipette is labeled (TC) "to contain" you would do the following:
Drain contents then rinse out with diluting fluid
An osmometer can use any of the following principles EXCEPT:
Electrostatic charge
Which of the following statements about the HBV vaccine is INCORRECT?
Employers may require a fee to administer the vaccine.
Which of the following is the MOST commonly used anticoagulant in the routine hematology laboratory?
Ethylenediaminetetraacetic acid (EDTA)
Which agency enforces the regulations of the Public Health Service (PHS) Act?
FDA
Isopropyl alcohol is considered (a):
Flammable
The pairing or annealing of two strands of DNA is termed:
Hybridization
All of the following would are considered molecular testing techniques used in the clinical laboratory to identify unique nucleic acid sequences, EXCEPT?
Immunoassays
All of the following is true about real-time RT-PCR, EXCEPT?
It does not require the use of reverse transcriptase
What information can you find on the label affixed to the primary container of a hazardous chemical?
Manufacturer's name and contact information
The regulations that are listed in the Code of Federal Regulations (CFR) should be considered:
Minimum standards that a facility can exceed
Which of the following analytical techniques measures scattered light?
Nephelometry
Which of these United States' federal agencies has the responsibility of enforcing the Bloodborne Pathogens Standard?
Occupational Safety and Health Administration (OSHA)
Which statement is associated with random error?
Occurs solely by chance
A tool used to show chain of command by defining responsibility and authority is a/an:
Organizational chart
A phlebotomist arrives in the blood draw area where a mother and her 3-year-old toddler have been seated. Prior to performing the capillary blood collection on the child, the phlebotomist asks the mother, "Is this Amanda? " The mother says yes. The phlebotomist then proceeds to cleanse the child's middle finger with alcohol and allows the site to air dry before performing the finger puncture. The phlebotomist punctures the side of the fleshy pad of the finger, wipes away the first drop, fills a lavender top microcollection container, caps it, inverts it several times, and lays it on the table. She makes sure that the child's finger has stopped bleeding and then tells the mother that they can go. She then labels the specimen. Using the scenario above, answer the following question. Which of the following steps in the venipuncture process did the phlebotomist perform correctly?
Puncture site preparation
Which of the following procedures would you employ to monitor the precision of an assay?
Run samples in duplicate
Which of the following terms is used to describe a sudden change in the quality control data mean that persists throughout subsequent days of testing?
Shift
According to _________ , all workplaces, including the laboratory, must have a fire prevention plan.
The Occupational Safety and Health Administration (OSHA)
An MCV is reported by the instrument as 82 fL. The MCV is flagged with a delta check alert as the previous MCV reported on this patient 12 hours earlier was 97 fL. What is a possible cause for this discrepancy?
The specimens are not from the same patient
The definition of competency can best be described as:
The standardized requirements for those who work in the clinical laboratory to accurately perform their job.
Based on the data illustrated on the right, which of the following statements is true? For the experimental and tried-and-true procedures, which test would produce fewer false-negatives?
The tried-and-true method will give 7 false positives out of every 100 samples.
In what section of the safety data sheet (SDS) manual would you find information on which chemical might affect your health:
Toxicological information section
All of the following sites would be considered primary sites for obtaining an arterial blood gas sample, EXCEPT?
carotid artery
which of the following statistical methods would be employed to determine how closely two different methods compare?
coefficient of variation
which combination of test/quality control organisms is correct
indole: e. coli and p. mirabilis
what order of draw should be used to collect the following tubes if plastic evacuated tubes with a regular blood collection needle (not a winged blood collection device) Lavender top Light blue top serum
light blue first, then serum, finally lavender tube
The Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulations apply to which type of patient health information?
paper, electronic, and oral forms
Which of the following is a violation of billing requirements for laboratory services?
performing testing on a verbal order from the nursing assistant
A direct antigen test for detecting the presence of an infection has the statistics in the table below: Test Sensitivity Specificity 5% Prevalence Positive Predictive Value 5% Prevalence Negative Predictive Value 30% Prevalence Positive Predictive Value 30% Prevalence Positive Predictive Value Direct Antigen 90%96%54%90%91%89% Therefore, you can conclude that:
the higher the prevalence, the greater the chance a positive test results is correct
Does the Levey-Jennings chart to the right show acceptable quality control results?
yes