Deck 12: Waived Testing and Collection of Non-Blood Specimens

Question 1

Swabs used in the collection of specimens from the back of the throat should be: (check all that apply)
i. calcium alginate
ii. cotton
iii. Darcon
iv. sterile

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Answer 1

i, iii, and iv

Question 2

When collecting a throat swab rub the following areas: (check all that apply)
i. back of throat
ii. both tonsils
iii. sides of mouth
iv. uvula

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Answer 2

i and ii

Question 3

When collecting a throat swab avoid the following areas: (check all that apply)
i. mouth
ii. teeth
iii. tonsils
iv. uvula

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Answer 3

i, ii, and iv

Question 4

The mouth and teeth should be avoided when collecting throat cultures because

A) touching these areas causes a gag reflex
B) these areas contain normal bacteria
C) these areas do not contain bacteria
D) these areas contain too much saliva

Question 5

The throat swab must be placed in a transport media because it

A) preserves the bacteria
B) acts as a growth media
C) kills microorganisms
D) keeps microorganisms dry

Question 6

To minimize the gag reflex when collecting throat cultures you should: (check all that apply)
i. avoid the back of the throat
ii. avoid the uvula when swabbing the throat
iii. have the patient breathe through his or her mouth
iv. have the patient breath through his or her nose

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 7

Normally two swabs are obtained when collecting throat swabs because

A) you might drop one
B) they are used for different tests
C) the strep screen is performed twice
D) the first one is discarded

Question 8

A sputum specimen is collected when

A) saliva is spit out of the mouth into a sterile cup
B) the mouth is rinsed with water and spit into a sterile cup
C) coughing onto a microbiology culture media plate
D) mucous that is coughed up from deep within the lungs is spit into a sterile cup

Question 9

A stool specimen are used to test for (check all that apply)

A) digestive problems
B) pathogenic bacteria
C) ova and parasites
D) gastrointestinal bleeding
E) All of the above

Question 10

The container in which stool specimens are collected should be (check all that apply)
i. clean and dry
ii. sealable and leak proof
iii. transparent
iv. wide and easy to use

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 11

Test results on stool specimens can be affected by (check all that apply)
i. the presence of urine in the specimen
ii. following a prescribed diet prior to collection
iii. having an enema before collecting the specimen
iv. collecting the specimen before taking barium sulfate

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 12

Proper handling of semen specimens includes (check all that apply)

A) delivered within 30 minutes of collection
B) kept refrigerated and transported on ice
C) should be collected in a condom
D) are best collected after 7 days of continence

Question 13

Proper temperature for transporting semen specimens includes

A) placing specimen in a cup of ice 15oC
B) maintaining the specimen at room temperature 20oC
C) keeping specimen close to body temperature 37oC
D) using a heating block to warm the specimen to 45oC

Question 14

The best container for collection of semen specimens is (check all that apply)

A) condom
B) test tube
C) wide-mouth jar
D) Ziploc bag

Question 15

Using condoms for collection of semen specimens (check all that apply)
i. is convenient and easy
ii. may kill or immobilize sperm
iii. ensures the whole specimen is collected
iv. will cause false results due to lubricant contamination

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 16

The best urine specimen to use for general health assessment is the

A) 24-hour collection
B) clean catch specimen
C) first morning void
D) random void

Question 17

The best urine specimen to use for measurement of total amount of substances is the

A) 24-hour collection
B) clean catch specimen
C) first morning void
D) random void

Question 18

The best urine specimen to use for culturing bacteria is the

A) 24-hour collection
B) clean catch specimen
C) first morning void
D) random void

Question 19

The most convenient urine specimen to collect is the

A) 24-hour collection
B) clean catch specimen
C) first morning void
D) random void

Question 20

A catheter is used to obtain specimens

A) for specimens that require absolutely sterile conditions
B) on patients who cannot void urine normally
C) as a routine procedure
D) required for 24-hour collection

Question 21

During collection of a clean catch urine, which portion is collected into the sterile container?

A) beginning of the stream
B) middle of the stream
C) end of the stream
D) all of the urine

Question 22

If urine cannot be delivered to the laboratory within one hour for routine testing it should be (check all that apply)
i. refrigerated but not frozen
ii. kept at room temperature
iii. transferred to a grey stoppered urine tube
iv. transferred to a yellow-red stoppered urine tube

A) i and ii
B) ii and iv
C) i and iv
D) ii and iii

Question 23

Urine for culture and susceptibility testing should be (check all that apply)
i. refrigerated but not frozen
ii. collected in a sterile urine specimen container
iii. transferred to a grey stoppered urine tube
iv. transferred to a yellow-red stoppered urine tube

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 24

The grey stoppered urine collection tube contains (check all that apply)
i. sodium borate
ii. sodium fluoride
iii. sodium formate
iv. sodium propiopnate

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 25

The yellow-red stoppered urine collection tube contains (check all that apply)
i. boric acid
ii. chlorhexidine
iii. ethyl paraben
iv. sodium propiopnate

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 26

When adding preservatives to 24-hour urine collection containers you should(check all that apply)
i. wear goggles, gloves and a chemical apron
ii. add preservatives in a fume hood
iii. label the container with appropriate caution label
iv. add water to acid if required to dilute the acid

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 27

When instructing patients how to collect urine at home for a 24-hour collection the phlebotomists should inform the patient to (check all that apply)
i. add the urine to the container slowly
ii. mix the urine container after each addition of urine
iii. keep the container on ice or in the refrigerator
iv. shake the container vigorously every hour

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 28

When instructing patients on how to collect a 24-hour urine specimen, which of the following should be collected?
i. first morning void on the first day
ii. all urine after the first void the first day
iii. first morning void on the second day
iv. last void on the second day

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 29

Levels of laboratory testing complexity were established by

A) CAP
B) CLIA
C) CLSI
D) COLA

Question 30

How many levels of laboratory test complexity are currently recognized?

A) two
B) three
C) four
D) five

Question 31

Which of the following is NOT a level of laboratory testing?

A) Waived
B) Provider Performed Microscopy
C) Low Complexity
D) High Complexity

Question 32

Provider Performed Microscopy is a level that is included within which other level of laboratory testing?

A) Waived
B) Low Complexity
C) Moderate Complexity
D) High Complexity

Question 33

Laboratory test kits designed for home use fall within which classification of laboratory tests?

A) Waived
B) Patient Performed Microscopy
C) Moderate Complexity
D) Low Complexity

Question 34

Laboratory tests that can be learned on the job by persons with little training fall within which classification of laboratory tests?

A) Waived
B) Personnel Performed Microscopy
C) Moderate Complexity
D) Low Complexity

Question 35

Tests that are classified as "Waived"include (check all that apply)

A) urine screening (dipstick method)
B) blood glucose (single analyte instrument)
C) urine pregnancy (visual color comparison)
D) sedimentation rate (non-automated)
E) All of the above

Question 36

Tests that are classified as "Waived"include all of these EXCEPT

A) dipstick urine screening
B) monitoring of blood glucose
C) microhematocrit
D) multi-step staining procedures

Question 37

Specialized training and experience are required of personnel performing tests that are classified as

A) Waived
B) Low Complexity
C) Moderate Complexity
D) High Complexity

Question 38

The testing classification that is abbreviated PPMP indicates that these tests can be performed by

A) Patients
B) Personnel in the laboratory
C) PhD level scientists
D) Physicians

Question 39

Tests classified as PPMP include

A) KOH preps
B) pinworm exam
C) urine sediment
D) nasal smears
E) All of these

Question 40

Laboratories that have a Certificate of Waiver (check all that apply)

A) can perform every level of testing
B) can modify test procedures as needed
C) must allow random inspections by CMS
D) do not need to follow OSHA guidelines

Question 41

The pre-examination phase of laboratory testing includes (check all that apply)
i. confirmation of laboratory test requests
ii. proper identification of the patient
iii. running required control samples
iv. reporting results to the physician

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 42

The examination phase of laboratory testing includes (check all that apply)
i. following test timing requirements
ii. interpreting results accurately
iii. running required control samples
iv. reporting results to the physician

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 43

The post-examination phase of laboratory testing includes (check all that apply)

A) confirmation of laboratory test requests
B) performing recommended follow-up
C) running required control samples
D) reporting results to the physician

Question 44

Waived testing includes (check all that apply)
i. erythrocyte sedimentation rate
ii. complete blood count
iii. microhematocrit determination
iv. white blood cell differential

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 45

An erythrocyte sedimentation rate is

A) the distance RBCs settle in a calibrated tube after one hour
B) the speed at which RBCs move through an automated analyzer
C) how far red blood cells settle in the EDTA tube
D) the percent of red blood cells in a centrifuged capillary tube

Question 46

A microhematocrit is

A) the percent of red blood cells in a centrifuged capillary tube
B) the amount of hemoglobin in the average red blood cell
C) the number of red blood cells seen using a microscope
D) none of these

Question 47

What phenomenon is responsible for the rate at which RBCs settle?

A) rouleaux
B) hemoconcentration
C) sticky platelets
D) surface tension

Question 48

Erythrocyte sedimentation rates may be performed on blood up to

A) 2 hours old at room temperature
B) 4 hours old at room temperature
C) 12 hours old refrigerated
D) 24 hours old refrigerated
E) Either 4 hours old at room temperature or 12 hours old refrigerated

Question 49

The erythrocyte sedimentation rate is performed by

A) spinning blood in a capillary tube and measuring the % of erythrocytes
B) using a reagent strip to test for blood and hemoglobin
C) allowing blood to settle in a calibrated tube and measuring the distance
D) applying blood to a guaiac card and reacting it with hydrogen peroxide

Question 50

Factors that affect the results of an erythrocyte sedimentation rate include (check all that apply)

A) testing time
B) temperature
C) tilting the tube
D) vibrations
E) All of the above

Question 51

The guaiac card occult blood test is commonly performed on what specimen?

A) sputum
B) stool
C) throat swab
D) urine

Question 52

Fecal occult blood can be present in patients with (check all that apply)

A) colorectal cancer
B) gastric ulcers
C) hemorrhoids
D) inflammatory bowel
E) All of the above

Question 53

The fecal occult blood test is performed by

A) spinning the specimen in a capillary tube and measuring the % of erythrocytes
B) using a reagent strip to test for blood and hemoglobin
C) allowing blood to settle in a calibrated tube and measuring the distance
D) applying specimen to a guaiac card and reacting it with hydrogen peroxide

Question 54

False positive results may occur in the fecal occult blood test if patients have ingested (check all that apply)
i. alcohol
ii. bananas
iii. milk
iv. horseradish

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 55

A specimen is tested for occult blood and was found to be positive. A brief history on the patient revealed that he had recently had a meal that included steak with horseradish dressing. What is the most appropriate course of action?

A) consult with the physician
B) add a comment onto the results stating the diet history
C) kindly inform the patient of the proper dietary restrictions and have him recollect the specimen
D) cancel the test

Question 56

Patients collecting stool specimens for fecal occult blood should be told to avoid ingesting (check all that apply)
i. alcohol
ii. aspirin
iii. diet drinks
iv. vitamin C

A) i and ii
B) ii and iv
C) i and iii

Question 57

A microhematocrit test is performed by

A) spinning blood in a capillary tube and measuring the percent of erythrocytes
B) using a reagent strip to test for blood and hemoglobin
C) allowing blood to settle in a calibrated tube and measuring the distance
D) applying specimen to a guaiac card and reacting it with hydrogen peroxide

Question 58

A microhematocrit is (check all that apply)
i. the packed volume of red blood cells
ii. microscopic analysis of the size of red blood cells
iii. the percent of red blood cells in a volume of blood
iv. microscopic analysis of the shapes of red blood cells

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 59

A microhematocrit test is used to screen for

A) anemia
B) diabetes
C) occult blood
D) strep infection

Question 60

A microhematocrit may be performed on blood (check all that apply)
i. directly from a dermal puncture
ii. collected in a microcollection container
iii. collected in an evacuated EDTA tube
iv. oosing from the venipuncture site

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 61

The Strep screening test is commonly performed on what specimen?

A) sputum
B) stool
C) throat swab
D) urine

Question 62

A strep screen test is performed by

A) applying specimen to a guaiac card and reacting it with hydrogen peroxide
B) testing patient's blood for antibodies to strep
C) looking for the streptococcus bacteria on a blood smear
D) looking for a color change on an immunoassay device

Question 63

Strep screen devices are approved for waived testing because (check all that apply)
i. premeasured reagents are used
ii. controls are built into the devices
iii. interpretation is simple
iv. there are many intricate steps involved

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 64

Testing for human chorionic gonadotropin assesses the status of

A) pregnancy in women
B) male fertility
C) streptococcus infection
D) none of these

Question 65

Pregnancy is confirmed by testing for hormones produced by the

A) mammory glands
B) ovaries
C) placenta
D) uterus

Question 66

Pregnancy test kits are approved for waived testing because (check all that apply)

A) often no reagents are required
B) controls are built into the devices
C) interpretation is simple
D) the specimen is easy to collect
E) All of the above

Question 67

Urine chemistry screening is part of which other laboratory test?

A) complete blood cell count
B) comprehensive chemistry panel
C) blood tests for renal profile
D) urinalysis

Question 68

Urine reagent strip can be used to screen for (check all that apply)
i. yeast infections
ii. glucose
iii. urinary crystals
iv. protein

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 69

Urine reagent strip can be used to screen for (check all that apply)

A) blood
B) glucose
C) ketones
D) protein
E) All of the above

Question 70

Chemicals that react with a particular substance in urine to produce a color change are called:

A) analytes
B) dipsticks
C) reagents
D) reactants

Question 71

Points of concern when using reagent strips for urine chemical testing include (check all that apply)
i. the time urine is in contact with reagent pads
ii. removal of excess urine off the reagent pads
iii. correctly comparing color changes of reagent pads
iv. time of day the specimen was collected

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 72

Upon removing a reagent strip from its container, you notice that the urobilinogen pad is discolored. What could this indicate? (check all that apply)
i. the strip may be out-of-date
ii. the strip was used and put back
iii. the container may have been left open
iv. this is the normal color for urobilinogen pads

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 73

What is POCT?

A) physician ordered chemistry test
B) patient operated cholesterol test
C) point of care testing
D) personnel occupational care training

Question 74

Point of care testing is designed to (check all that apply)

A) reduce healthcare costs
B) enhance patient care
C) reduce testing turnaround time
D) be performed at the patient's side
E) All of the above

Question 75

Point of care tests (check all that apply)

A) cost a lot to perform
B) keep the patient hospitalized longer
C) take a long time to perform
D) can be performed at the patient's side

Question 76

Point of care testing devices (check all that apply)
i. are typically portable
ii. are internally calibrated
iii. are easy to use
iv. require highly skilled personnel

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 77

A glucose test is used to screen for

A) anemia
B) diabetes
C) occult blood
D) strep infection

Question 78

The blood glucose test is performed by

A) applying blood to a strip inserted into a specially designed electronic meter
B) using a urine reagent strip to test for glucose
C) allowing blood to settle in a calibrated tube and measuring the distance
D) applying blood to a guaiac card and reacting it with hydrogen peroxide

Question 79

The blood glucose test can be performed to (check all that apply)

A) screen patients prior to glucose tolerance testing
B) monitor and manage diabetic patients
C) allow for continuous monitoring by patients
D) help patients regulate their diets
E) All of the above

Question 80

Factors that affect patient glucose levels include all EXCEPT

A) maintaining a diet
B) physical activity
C) emotional stress
D) missing a log entry