Deck 5: Performance Improvement in the Microbiology Laboratory

Question 1

Commercial media must have quality control testing performed by the manufacturer. Because of high failure rates, all of the following media must be retested by the hospital laboratory, except

A) Campylobacter media.
B) selective media for pathogenic Neisseria.
C) trypticase soy agar with 5% sheep blood.
D) chocolate.

Answer 1

C

Question 2

All of the following activities are included in a laboratory quality control program, except

A) air quality.
B) temperatures.
C) media.
D) antimicrobial susceptibility testing.

Answer 2

A

Question 3

All the following are components of TJC recommendations for establishing performance monitors, except

A) plan.
B) design.
C) do.
D) assess.

Answer 3

C

Question 4

How can personnel competency be determined?

A) Asking an employee to explain how to do a test
B) Proficiency testing
C) Asking another employee to comment on someone's competency
D) Assuming competency from one's credentials

Question 5

Preventive maintenance on an instrument includes all the following, except

A) disinfecting the surface of the instrument.
B) oiling and cleaning the instrument.
C) replacing filters.
D) recalibrating instruments.

Question 6

The following are provisions of CLIA 88, except:

A) Verify employee competency upon employment.
B) Determine an employee's competency.
C) Reverify the employee's competency monthly.
D) Reverify the employee's competency annually.

Question 7

Quality control stock cultures are available from all of the following, except

A) American Type Culture Collection (ATCC).
B) commercial sources.
C) proficiency testing isolates.
D) Centers for Disease Control and Prevention (CDC).

Question 8

Media that do not need to be retested by the hospital laboratory must still undergo observation for all of the following, except

A) moisture.
B) sterility.
C) breakage.
D) organism colony characteristics.

Question 9

All of the following activities will directly affect the quality of a laboratory test, except

A) preanalytic.
B) analytic.
C) accreditation.
D) postanalytic.

Question 10

Quality control is designed to

A) ensure the medical reliability of laboratory data.
B) check media
C) check reagents
D) monitor incubator and refrigerator temperatures

Question 11

Actual laboratory testing is called a(n)

A) preanalytic activity.
B) analytic activity.
C) postanalytic activity.
D) research activity.

Question 12

The morning technician arrives at the microbiology laboratory and goes around checking daily temperatures. This person will check temperatures daily on all of the following equipment, except

A) centrifuges.
B) incubators.
C) heating blocks.
D) refrigerators.

Question 13

Thermometers used in the laboratory must be calibrated before they are put into use. This is accomplished by

A) sending to the National Institute of Standards and Technology (NIST) to determine its accuracy.
B) checking against an NIST thermometer.
C) measuring the grades to make sure they are the standard size and accurate.
D) using a colored dye.

Question 14

When a medium needs to be quality controlled because it was prepared in house or because it is complex, all the following rules must be followed, except:

A) Only media not specified in Clinical and Laboratory Standards Institute (CLSI) guidelines should be tested.
B) The medium should be tested for sterility and pH.
C) The organism selected for quality control testing should represent most fastidious organisms for which the medium is designed.
D) Testing techniques should be different for primary plating media than for biochemical or subculturing media.

Question 15

Which of the following is an example of a mission statement for an institution?

A) "The AFMS Flagship-Comprehensive Healthcare…On Time…On Target"
B) "Working Together for a Healthy America"
C) "Your Total eLearning Solution"
D) "Will Answer Questions Correctly 95% of the Time"

Question 16

In January 2004, The Joint Commission (TJC) implemented performance measurements for organizational systems that are critical to patient safety, quality of care, treatment, and services. This new initiative is called

A) performance improvement.
B) quality control.
C) quality assurance.
D) shared visions new pathway.

Question 17

Reagents that should undergo quality control in the microbiology laboratory include all the following, except

A) Optochin.
B) immersion oil.
C) $\beta$ -lactamase.
D) nitrate.

Question 18

In any susceptibility system, variables that can affect the results include the following: 1. Antibiotic potency
2) Inoculum concentration
3) Bactericidal level
4) pH
5) Anion content

A) 1, 2, and 3 are correct
B) 1, 3, 4, and 5 are correct
C) 1, 2, 3, 4, and 5 are correct
D) 1, 2, and 4 are correct

Question 19

Susceptibility testing of control organisms is usually conducted daily until precision can be demonstrated with _____ or _____ _____ days of susceptibility testing using CLSI guidelines.

A) 20; 30; consecutive
B) 15; 20; consecutive
C) 30; 40; nonconsecutive
D) 5; 10; consistent

Question 20

Popular media choices for maintaining stock cultures include

A) Tryptic soy agar deeps.
B) cornmeal.
C) Sabouraud dextrose.
D) Cystine tryptic agar with glucose.

Question 21

A test is performed on a group of 10 patients. Six patients have a disease, and four are free of the disease. If six patients (all known to have the disease) of this group test positive for the disease, we say that the clinical sensitivity of this test is

A) 60%.
B) 40%.
C) 50%.
D) 100%.

Question 22

Multiple unlabeled specimen have been sent to the laboratory from multiple in-patient locations. The laboratory manager decides corrective action needs to occur. What should be constructed to evaluate and correct the problem?

A) Find fault with the nurse causing the problem.
B) Provide training for the nurse responsible for the problem.
C) Empower a facilitator.
D) Make a cross-functional team.

Question 23

Screening is

A) used for only particular test analytes.
B) not practical in a hospital laboratory.
C) used for testing large populations of patients.
D) when a high incidence of a disease is found in a population.

Question 24

Confirmation is used after

A) careful consideration by the doctor to do the test.
B) a test that has a low predictive value.
C) a test that has a low specificity.
D) obtaining a positive screening result.

Question 25

A technician is performing a chemistry test on a control sample. The technician gets the following values for the control: 4.3, 4.3, 4.3, 4.2, 4.4, 4.3, 4.2, and 4.4. The actual value is 4.3. These results are said to be

A) systematically inaccurate.
B) sensitive.
C) accurate.
D) bias.

Question 26

When choosing a test to perform in your laboratory, an in-house verification is always performed. Verification of a test

A) serves to establish that the performance parameters of the test are satisfactory.
B) lets technicians actually perform the test.
C) lets physicians perform the test.
D) allows laboratory management to view positive results.

Question 27

Customers of a laboratory include all the following, except

A) patients.
B) insurers.
C) doctors.
D) accrediting organizations.

Question 28

A test can have both a positive and a negative predictive value (NPV). All the following elements are needed to compute the positive and NPV of a test, except

A) sensitivity of a test.
B) specificity of a test.
C) type of disease being tested.
D) prevalence of the disease being tested.

Question 29

When is a broken process fixed?

A) When the problem is prevented from happening again.
B) When everyone is happy with the process.
C) When the process becomes seamless.
D) When the hospital administrator determines that the cross-functional team is no longer needed.

Question 30

A group of 10 patients are to be tested: six are known to have a disease and four are disease free. If the four disease-free patients tested negative for this disease, what would the clinical specificity of this test be?

A) 100%
B) 60%
C) 40%
D) 50%

Question 31

The efficiency of a test indicates

A) the percentage of patients who test positive for the disease.
B) the percentage of patients who are correctly identified as having or not having the disease.
C) the percentage of patients who test negative for the disease.
D) the number of patients tested for a disease.

Question 32

Usually, negative test results are more reliable in predicting

A) the absence of disease.
B) the presence of disease.
C) the sensitivity of a test.
D) the specificity of a test.

Question 33

What is benchmarking?

A) Identifying a problem to be fixed
B) Seeking an industry's or profession's best practices to imitate and improve
C) Explaining why a problem occurred
D) Asking the CEO's opinion and going with his or her idea

Question 34

Assume that a certain test for group A Streptococcus has reported sensitivity and specificity of 90% and 98%, respectively, and the estimated prevalence for group A Streptococcus infection in acute pharyngitis is 5%. What is the PPV of this test?

A) 99.5%
B) 30%
C) 90%
D) 70.3%

Question 35

Test validation is the ongoing process of providing information that a test is performing correctly. The components of validation include all the following, except

A) quality control.
B) specimen requirements.
C) proficiency testing.
D) instrument calibration.

Question 36

When performing tests in the microbiology laboratory, the detection limit of a test refers to the _____ of that test.

A) analytic specificity
B) analytic sensitivity
C) clinical sensitivity
D) clinical specificity

Question 37

Incidence is

A) the frequency of a disease at a designated single point in time in the population being tested.
B) the number of new cases of disease over a period of time.
C) proportion of negative test results in a population known to be free of disease.
D) positive results in patients with the disease.

Question 38

All of the following provide guidelines to ensure the continual correct performance of tests, except

A) accrediting agencies.
B) regulatory agencies.
C) CDC.
D) manufacturers.