Question 1

One of the later steps in Six Sigma is to improve the process under study. Improvements are based on:

Accepted Answer

A)   the way that most laboratories perform the functions studied.
B)   the most expensive methods currently available.
C)   the data collected in the study.
D)   the least expensive methods currently available. C

Question 2

Turnaround time (TAT) for a test generally means:

Accepted Answer

A)   the amount of time between the ordering of a test and the reporting of the result.
B)   the amount of time between collecting a patient's samples and their arrival in the lab.
C)   the amount of time needed to identify the patient and collect all samples.
D)   the amount of time between the ordering of a test and collection of the sample. A

Question 3

A Delta check helps to detect potential errors in patient results by:

Accepted Answer

A)   comparing quality control results against acceptable ranges.
B)   comparing patient results for selected tests that are outside of established parameters.
C)   comparing randomly selected test results against reference ranges.
D)   comparing patient results for all tests that are outside of established parameters. B

Question 4

Quality system essentials (QSEs) form the basis of a laboratory's quality management system (QMS) and contain the management information needed for a laboratory to perform quality work. Which of the following items might be studied as part of an examination of a laboratory's purchasing and inventory?

Accepted Answer

A)   Total budget for purchase of reagents
B)   A check to verify that all a laboratory's instrument are owned by the laboratory
C)   Availability of adequate reagents, supplies, and service arrangements
D)   Number of years each instrument has been in use

Question 5

Preexamination variables occur:

Accepted Answer

A)   during the testing of samples.
B)   during the reporting of test results.
C)   at variable and unpredictable times.
D)   before testing has taken place.

Question 6

Quality assessment (QA) differs from quality control (QC) because:

Accepted Answer

A)   QA refers to the overall process of guaranteeing quality patient care.
B)   QC refers to controls of waived tests only.
C)   QA refers only to controls for lab surveys.
D)   QC refers to the overall process of guaranteeing quality patient care.

Question 7

A failure to properly fill a light blue top tube for coagulation tests may introduce what type of variable to the test system?

Accepted Answer

A)   Examination
B)   Preexamination
C)   Postexamination
D)   No variable will result

Question 8

Phlebotomy personnel must review the procedure manual (and document this review):

Accepted Answer

A)   only when procedures are revised, added, or deleted.
B)   once every 6 months.
C)   once each year.
D)   only when required to do so by a supervisor.

Question 9

A phlebotomist collects a patient sample for potassium using a syringe because the patient's veins were too small and fragile to allow collection with evacuated tubes. It was a difficult draw, involving much needle probing and pulling on the syringe handle. Which of the following test results is most likely to be influenced by this collection method?

Accepted Answer

A)   Glucose
B)   Sodium
C)   Blood urea nitrogen (BUN) 
D)   Potassium

Question 10

Quality system essentials (QSEs) form the basis of a laboratory's quality management system (QMS) and contain the management information needed for a laboratory to perform quality work. Which of the following items might be studied as part of an examination of a laboratory's facilities and safety?

Accepted Answer

A)   Required safety precautions practiced and availability of equipment
B)   A minimum amount of square feet available in every department
C)   The number of windows available in the laboratory
D)   Adequate space available for an employee lounge

Question 11

The following are valid reasons for performing Delta checks except:

Accepted Answer

A)   verify that phlebotomists are following the proper order of draw.
B)   verify that samples were properly inverted when required.
C)   verify that sharps wastes were properly disposed of.
D)   verify that patients have been properly identified.

Question 12

An effective means of documenting improper patient identification is:

Accepted Answer

A)   an incident report.
B)   a quality control chart.
C)   an acceptable Delta check.
D)   verbal counseling.

Question 13

Six Sigma methodology:

Accepted Answer

A)   is a means of eliminating errors when properly applied to a process.
B)   is a statistical modification of the original plan-do-check-act (PDC
A)   process.
C)   has the primary goal of reducing spending on safety devices and practices.
D)   is only used in the manufacturing and construction industries.

Question 14

An effective means of increasing the accuracy of patient identification is to:

Accepted Answer

A)   label all patient tubes ahead of time before beginning collections.
B)   use signs on the walls or on the ends of beds showing patient names to identify them.
C)   use the patient chart to identify the patient.
D)   utilize wrist bands with bar codes to identify the patient.

Question 15

Accidental punctures with contaminated sharps can reduce productivity and lower morale among the phlebotomy staff and may delay collection and testing of other specimens. Strategies for reducing these incidents include:

Accepted Answer

A)   provision of ample sharps containers.
B)   immediate reports to the supervisor and documentation with incident reports.
C)   regular and ongoing training in the use of safety features and phlebotomy practices.
D)   all the above

Question 16

One effective means of detecting improper patient identification is the:

Accepted Answer

A)   label check.
B)   duplicate testing of all patient samples on random days.
C)   Delta check.
D)   examination of sharps containers for wasted tubes.

Question 17

Documentation of the time between the delivery of a requisition to the laboratory and the arrival of the associated specimen in the laboratory can be accomplished by the use of:

Accepted Answer

A)   time entries in the computer system.
B)   handwritten notes kept by the phlebotomist.
C)   telephone records.
D)   pneumatic tube system time entries.

Question 18

A phlebotomist is performing point-of-care (POC) glucose measurements on patients in the outpatient clinic using a glucose meter according to established procedures. He or she notices that one patient's glucose value is very high at 327 mg/dL. Lab policy requires that POC glucoses greater than 200 mg/DL be verified by a glucose performed in the central laboratory on an instrument. However, the phlebotomist forgets this requirement in his or her haste to phone the result to the patient's physician as soon as possible. This action has introduced which type of variable into the test system?

Accepted Answer

A)   Examination
B)   Postexamination
C)   Preexamination
D)   Examination and postexamination

Question 19

In a laboratory test, variables:

Accepted Answer

A)   can occur in all phases of testing.
B)   have been eliminated using modern instruments.
C)   occur during the analytical phase only.
D)   are so unpredictable they cannot be studied.

Question 20

Quality system essentials (QSEs) form the basis of a laboratory's quality management system (QMS) and contain the management information needed for a laboratory to perform quality work. Which of the following items might be studied as part of an examination of a laboratory's personnel?

Accepted Answer

A)   Continuing education records
B)   Pension and 401K plans available
C)   Number of years of service
D)   Highest year of education completed

Exam 13: Quality Assessment and Management in Phlebotomy