ALL CLINICAL CHEM LAB QUIZES
The Federal law that regulates laboratory operations and personnel is:
Clinical Laboratory Improvement Act of 1988
The proportion of a population (or of those being tested) with the disease being studied is referred to as the:
Prevalence
Which of the following describes meta-analysis?
is a statistical technique that compares results from various studies.
Calculate the dilution factor when 20 ul of serum is added to 200 ul of saline, what is the dilution.
0.1
The "I" in a laboratory evidence based medicine question represents:
1 and 2
How many grams of NaOH are present in 250mL of a 0.15 M NaOH solution?molecular weight NaOH: 40.0 g/mol
1.5
What is the percent concentration of a solution that contains 90.0 g of NaOH in 750.0 mL of buffer?
12
What is the Clinical Laboratory Standards Institute (CLSI) recommendation for the most appropriate RCF and time for centrifugation of blood samples to obtain sufficient separation of cellular and liquid components?
1200 g for 10 min
How many ml of solution A are required to prepare 500 mL of a 1/4 dilution of solution A in water?
125
A patient sample was diluted 1/5 with serum diluent and then tested for sodium. tTe sodium concentration of the diluted sample was determined to be 28 mmol/L. What is the concentration of sodium n the original patient.
140
Calculate the molarity of a solution of NaCl when 58.5g of NaCl are dissolved in 0.50L of solution?Molecular Weight NACL = 58.5g/mol
2
What single rule would cause the rejection of a run of QC?
2, 3, 4
What is the molarity of a solution that contains 32 g of NaOH in 300. mL of buffer? MW of NaOH is 40..
2.7
A stock glucose standard has a concentration of 1000 mg/dl. A 1/50 dilution of the standard is done. What is the concentration of the resulting dilution?
20
How many grams of HCl are required to make a 6.00N solution of HCl in 1.00 L of buffer? gram molecular weight of HCl = 35.0 g
210
How many grams of NAOH are required to prepare 0.350 L of 6.50% (w/v) NaOH
23
How many grams of NaOh are needed to make 350.0 mL of an 8.00% solution of NaOH in buffer.
28
What is the normality of a solution containing 80.0 g of H2SO4 in 450 mL buffer? gram molecular weight of H2SO4 = 98 g
3.6
How many mL of 95.0% ethanol would you need to prepare 500.0 mL of 70.0% ethanol?
368
Upon examination of the morning's run of free thyroxine tests, you notice that four consecutive normal control values are +1 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.
41s; systematic
What is the next interval at which competency assessment should be performed following the completion of initial training/competency assessment in a moderately complex POCT situation?
6 months after initial training/competency assessment
How much of a 1/3 dilution of solution B could you make if you had only 20 mL of concentrated solution B?
60
How many grams of NaCl are required to prepare 250.0 mL of 6.00 mol/L NaCl? (NaCl, MW = 58.5)
87.8
As explained in the module lesson the category of validation that is most related to predictive value and reciever operator characteristic is:
Analytic validation
Method verification tests for method correlation are testing measure:
Accuracy
The range of analyte values that a test method can directly measure without any dilution is identified as the:
All of the above Linearity Analytical measurement range Analytical range
Patient misidentification results in:
All of the above Wrong blood in the tube Treatment errors Increased cost of healthcare
As explained in the module lesson the category of validation that is most related to providing accurate and reliable laboratory information is:
Analytic validation
The significant effect of the anticoagulant sodium flouride is:
Antiglycolytic
Which of the following could significantly alter an FDA cleared test such that a method validation would be required?
Changing specimen types
A type of error that is consistent or constant results in:
Bias
The National Fire Protection Association (NFPA) rating system code (hazard diamond) on a bottle of a powdered, highly mutagenic (causes genetic mutation) substance, such as ethidium bromide would be marked
Blue 3.
When assessing the competency of POCT personnel that perform coagulation testing, which assessment tool is appropriate to use when documenting the direct observation of patient test performance?
Checklist
As explained in the module lesson the category of validation that is most related to evidence based laboratory medicine practices is:
Clinical utility
Classify the level and domain of this learning objective: Calculate the formula for the preparation of solutions
Cognitive
Which of these measures is not required for method verification?
Determine calibration and QC procedures
Ask, Acquire, Appraise, Analyze, Apply, Audit/assess are:
EBLM A6 Steps
Which image represents an analysis that is precise but not accurate
Exp 3
You have seen another laboratorian mouth-pipetting some buffers and patient serum samples to make dilutions. What OSHA safety issue is she specifically ignoring?
Exposure control plan
A chemistry profile, complete blood count, and fasting blood glucose studies are requested on a patient. What is the correct order of draw for the appropriate blood collection tubes with the stopper colors listed?
Green, lavender, gray
The target audience for this year's learning unit is:
Health care professionals who interact with medical laboratory scientists
Per module 6 lesson materials, the overall purpose of learning or training in broad, general terms is best classified as a:
Learning goal
A serum sample from an individual who has eaten a fatty meal 2 hours before having his blood drawn will appear
Lipemic
A technical bulletin that contains information about a hazardous chemical, such as chemical composition, chemical and physical hazard, and precautions for safe handling and use is known as the:
MSDS
POCT is being considered at XYZ hospital. Clinical and laboratory administrations have met and discussed the advantages and disadvantages to POCT. Which of the following points could be classified as possible disadvantages?
Maintaining an inventory of reagents that are stored properly and used prior to their expiration dates.
The purpose of a graduated cylinder is to:
Measure specific volumes
Which is the correct term for the procedure to confirm method quality for an FDA approved test?
Method Verification
Which of the following is true regarding the Clinical Laboratory Improvement Act of 1988?
NOT It is a "deemed" organization for laboratory accreditation
Upon examination of the morning's run of creatinines, you notice that 10 consecutive normal control values lie on the same side of the mean. In your QC report, you note that Westgard rule _____ has been broken and realize that this rejection rule is sensitive to _____ error.
NOT X10; systematic
Self-testing or testing performed by personnel such as the intensive care unit (ICU) nursing staff fits into this point of care testing category.
Operational
Results related to the quality or quantity of life of patients; examples include mortality, functional status, quality of life, and well-being are:
Outcomes
Patient identification and specimen collection,patient satisfaction with phlebotomy and blood culture contamination are managed in which phase of labortory testing?
Pre-analytical
The statistical closeness of agreement between repeated test procedures of the same sample under stipulated conditions is:
Precision
The purpose of a volumetric flask is to:
Prepare solutions
Accurately performing laboratory procedures falls into this domain of learning:
Psychomotor
Upon examining a Levey-Jennings control chart for analyte X, you noticed that on Day 6 the one control was -2.5s from the mean and the duplicate control was +3.3s from the mean. Which of the following Westgard control rules was/were broken?
R 4s and 13s
Categorize the learning level of these learning objective verbs: Define, Memorize, List, Recall, Repeat
Recall : the ability to remember information
If a POCT supervisor observes that an employee is not correctly performing a POCT procedure, the first action that the supervisor should take is:
Remove the employee from performing the test procedure
Categorize the learning level of these learning objective verbs: Answer, assist, discuss, report, select
Responding (willing to participate): active pursuit of an interest, willingness to respond, motivation
Which one of the following statements concerning controls is incorrect?
Serum controls are prepared from human serum pools and are analyzed in analytical runs that are separate from patient samples.
A 2-2s error is suggestive of what type of error?
Systematic
Testing performed with small, portable devices that produce results in a faster turnaround time than when sent to the laboratory.
Technological
What is it about purple top tubes that makes them less useful for chemistry?
The EDTA salt causes many interferences with clinical chemistry analytes
Even if somewhat impractical, which one of the following preanalytical factors should be standardized when establishing a reference interval for an analyte?
The method of specimen collection
In regard to clinical evaluation of method, a high clinical sensitivity means few false negatives.
True
The minimum frequency of quality control testing for non-waived tests is specified as:
Two levels of control for each 24 hours of testing
Which one of the following statements concerning type I water is not correct?
Type I water is obtained from distillation only and contains a few impurities.
Which of the following is not an accepted use of delta checks?
Within run quality control
Verification of reference range allows the lab to reliably report the following:
a basis of comparison for patient test values
An example of a noncontrollable preanalytical variable would be
age
Hemolysis will cause potassium _____ when analyzed.
and lactate dehydrogenase (LD) values to appear increased
A type of error that is proportional results in: (choose the answer that makes the most sense)
bias related to concentration
An etched ring near the mouth (bulb) end of Serologic pipette signifies that the pipette is of the _____ type
blow-out
As an anticoagulant, EDTA acts to:
chelate calcium.
True negatives ÷ (false positives + true negatives) × 100 is the formula for determining:
clinical specificity
" following review of module learning materials, the learner will successfully prepare an outline of a continuing education session": the words following review are this component of a learning objective.
condition
Universal Precautions
consist of guidelines that in part necessitate the wearing of barrier protection when handling potentially infectious material.
When reference values are established, the criteria used to determine which individuals should be included in the group of reference individuals are referred to as:
exclusion criteria
A type of error that is random results in:
imprecision
The CV% statistic is best used to evaluate the following measure between two analytic methods:
imprecision
When a blood sample is separated by centrifugation, the liquid component is separated from the cells. The "serum" is the
liquid component with no clotting factors in it.
Per the module lesson, the concentration of analyte, at which some medical action is indicated is known as:
medical decision level
The anticoagulant effect of sodium heparin is to:
neutralize thrombin
The Westgard rules for quality control were designed to decrease subjectivity in data analysis and to aid in troubleshooting. The multirule stated as 12s indicates:
one control value has exceeded ±2 SD from the mean.
When is it acceptable to report patient results?
option 1 and 2
When reference limits are determined, the statistical method that assumes that the true distribution of reference values is a Gaussian distribution is the:
parametric methoc
The one technical aspect of a clinical laboratory that has received considerable attention in the need for ergonomic design to decrease musculoskeletal stress would be
pipetting
An example of random error would be:
pipetting inconsistency
Using an incorrect colored-stopper tube to obtain a blood sample is referred to as a(n) _____ variable.
preanalytical
The number of true positive results divided by the sum of true positive results plus false positive results is referred to as:
predictive value of a positive result
The process in which simulated patient specimens made from a common pool are analyzed by laboratories to determine the "quality" of the laboratories' performance is referred to as:
proficiency testing.
The protocol and materials used by an analyst to determine whether a method is working accurately are referred to a
quality control procedures
The protocol and materials used by an analyst to determine whether a method is working accurately are referred to as
quality control procedures
The protocol and materials used by an analyst to determine whether a method is working accurately are referred to as:
quality control procedures.
Two types of error may be encountered during chemical analysis of a substance. The type of error that occurs with no trend or means of predicting is called _____ error.
random
Two types of process error may be encountered during chemical analysis of a substance. The type of error that occurs with no trend or means of predicting is called _____ error.
random
An experimental study in which study participants are randomly allocated to an intervention (treatment) group or an alternative treatment (control) group is a(n)
randomized control trial
In the NFPA hazard diamond, the yellow diamond represents
reactivity level.
The anticoagulant effect of sodium citrate is to:
remove calcium
Which of the following is an example of a preanalytical, post collection source of variation?
sample exposure to light
" following review of module learning materials, the learner will successfully prepare an outline of a continuing education session": "successfully" is this component of a learning objective.
standard
A methodical and comprehensive review of all published and unpublished information about a specific topic to answer a precisely defined clinical question is a:
systematic review
Regarding centrifugation, what is the formula for calculating relative centrifugal force (RCF)?
times greater than gravity.
In order for POCT to contribute to the patient-centered healthcare approach desired, the laboratory staff must be instrumental in providing expertise and support to the staff members performing testing in locations outside of the central or main laboratory
true
POCT methods can be any level of CLIA complexity
true
Package inserts may be used as procedures for POCT
true
QC testing is used to verify the accuracy of test results by evaluation of samples with known values prior to performing patient testing.
true
The Westgard rules for quality control were designed to decrease subjectivity in data analysis and to aid in troubleshooting. The rule stated as 22s is interpreted as meaning.
two consecutive control values have exceeded the mean ±2s
Type I water, suitable for use in quantitative chemistry procedures, is typically prepared by:
ultrapure filtration. double distillation. deionization. more than one of the above processes.
Quality control material which must be tested by the laboratory in order to determine the mean and confidence interval (does not come with pre-determined ranges) is known as:
unassayed