MLT 110 Exam 4

Blood collection and Lab Quality

One measurement exceeds 2 standard deviations either above or below the mean of the reference range.

1(2S)

One measurement exceeds 3 standard deviations either above or below the mean of the reference range.

1(3S)

2 consecutive measurements exceed 2 standard deviations of the reference range, and on the same side of the mean.

2(2S)

Two measurements in the same run have a 4 standard deviation difference (such as one exceeding 2 standard deviations above the mean, and another exceeding 2 standard deviations below the mean.

R4s

4 consecutive measurements exceed 1 standard deviation on the same side of the mean.

4(1S)

10 consecutive measurements are on the same side of the mean.

10x

A “blind” sample is an assayed sample that is sent as an unknown to laboratories participating in ____________________.

proficiency testing

The three steps of quality assessment of patient specimen processing?

Pre-analytical, Analytical and Post-analytical

All of the following are included in a quality systems program EXCEPT:

quality assessment components

evaluation of personnel qualifications

proficiency testing

cost accounting

cost accounting (FALSE)

The name of the quality control chart used to record daily quality control values is the ____________________.

Levey-Jennings chart

An abrupt change in one direction from the established mean is called a(n) ____________________.

shift

Gradual increase or decrease in numerical values on the levey-Jennings’s chart.

Trend

An example of an analytical factor that can affect the actual test procedure is an interfering substance in the patient’s specimen.

True or False?

True

The reproducibility of results or the closeness of obtained values to each other is…?

Precision

The ____________________ is the sum of a set of values divided by the number of values.

Mean

Which of the following is true of a standard?

solution made from human serum having a known concentration of the same constituents measured in patient samples

chemical solution of a known concentration that can be used as a reference or calibration substance

reagent that has a long history of use in the laboratory

assayed biological specimen

chemical solution of a known concentration that can be used as a reference or calibration substance

What occurrence is within the image?

Shift

Accuracy expresses how close a determined value is to the ________.

actual value

A patient’s hands can be placed in warm water for a few minutes to enhance circulation.

True or False?

True

A sterile, sharp-pointed blade used to perform a capillary puncture is a(n) ____________________.

lancet

What occurrence is within the image?

Trend

All of the following are true of capillary puncture EXCEPT:

In the newborn the lateral portion of the heel pad is used.

The thumb is usually the site in most adults.

Capillary blood can be obtained from the great toe in infants.

Blood can be collected in capillary tubes.

The thumb is usually the site in most adults. (FALSE)

Capillary blood can be collected in:

a. special microcontainers or vials

b. directly into blood glucose strips

c. capillary tubes

d. All are true.

d. All are true

Capillary puncture is also known as ____________________.

fingerstick

Small red spots on the skin caused by a tourniquet that is too tight…

petechiae

A lavender stoppered vacuum tube contains:

Heparin

No anticoagulant

Sodium Citrate

EDTA

EDTA

The green topped stopper vacuum tube contains:

Heparin

Clot activator

EDTA

Potassium Oxalate

Heparin

A red stoppered vacuum tube contains:

Heparin

No anticoagulants

Sodium Citrate

EDTA

No anticoagulants

A light blue stoppered vacuum tube contains:

Heparin

No anticoagulant

Sodium Citrate

EDTA

Sodium Citrate

A tiger (top) stripe stoppered vacuum tube contains:

Clot activator

Gel Separator

Sodium Citrate

EDTA

Clot activator & Gel separator

The grey top stopper vacuum tube contains: Guess.

a. EDTA

b. Potassium Oxalate

c. Herparin

d. Sodium fluoride

A & D (Potassium Oxalate and Sodium fluoride)

A gold top stopper vacuum tube contains:

Gel Separator

Clot Activator

EDTA

Heparin

Gel Separator & Clot Activator

All of the following are part of proper venipuncture technique EXCEPT:

The patient should hold the arm up and out, away from body.

The puncture site should be cleansed with alcohol and allowed to dry.

The tourniquet should be released before the needle is removed from the vein.

The patient is identified by asking the name and checking the armband.

The patient should hold the arm up and out, away from body. (FALSE)

A band used to constrict blood flow is called a(n) ____________________.

tourniquet

An increase in the concentration of cellular elements in the blood is called ____________________.

hemoconcentration

After blood is collected, the needle should be removed from the vein before the tourniquet is released.

True or False?

False

Whats the color of the vacuum specimen tube for hematology and Hemoglobin A1C tests?

Lavender

The light blue vacuum stopper tube that contains sodium citrate is for what testing?

Coagulation studies

List all the colored top vacuum tubes for specimen collection, that are for chemistry lab tests?

Red, tiger top, gold and green.

Blood alcohol and glucose tests have vacuum specimen tubes with what color top?

Grey

What part of quality assessment are these factors: Sample preparation, Instrument maintenance and calibration, Standards and controls, Test procedure, Operator technique, Interfering substances/conditions, Statistical analysis of control results

Analytic factors

What part of quality assessment are these factors: Patient & specimen ID, Specimen collection, Selection of test method, Qualified testing personnel, Up-to-date procedure manual.

Pre-analytical

What part of quality assessment are these factors: Reporting results, Charting results, Calculations, Transcription and Clerical errors

Post analytical

Samples send to the lab—- The Lab analyze and sends to result to PT agency, Results compared to those from other laboratories and the participating laboratories receive a report evaluating their performance. This is…

Proficiency testing

Is proficiency testing required for all laboratories? Yes or No?

Yes

The lower the gauze number of the needle; the larger the diameter of the needle: True or False?

True

Mean ± 1SD equals

68% CI

In venipuncture, the first drop of blood is wiped away. True or False?

False

Sites are prepared for venipuncture by:

wiping in a circular motion with sterile cotton

cleansing with 70% alcohol and allowing the site to dry

cleansing with iodine

palpating the vein after the site is cleansed

cleansing with 70% alcohol and allowing the site to dry

All of the following anticoagulants exhibit their anticoagulants action by binding to calcium except:

EDTA

Sodium Citrate

ACD

Heparin

Heparin

Which type of sample and color of tube used for most commonly ordered clin chem lab tests?

Plasma - Light Blue Tube 

Serum – Gold top-Yellow/ SST

Whole blood - Lavender tube

Capillary Blood- Microtainer

Serum – Gold top-Yellow/ SST

Which statement is true regarding Equivalent or Internal Controls?

All statements are true

Common in POC instruments

Do not require operator’s action at every use

Internal monitoring systems

All statements are true

Which nonanalytical factors are included in quality assessment?
Both qualified personnel and established laboratory policies 

Established laboratory policies

Quality control charts

Qualified personnel

Both qualified personnel and established laboratory policies 

Which analytes exhibits diurnal variation?

Cortisol

Filled vacuum blood collection tubes should be:

labeled after delivery to the lab

mixed by inversion every 3 minutes

placed on ice until delivery to the lab

handled according to tube type, test ordered, and instructions in the procedure manual

handled according to tube type, test ordered, and instructions in the procedure manual

All of the following statements are true of venipuncture EXCEPT:

The cephalic vein of the forearm can be used.

The needle should enter the lumen of the vein.

The median cubital vein can be used.

Blood can be collected above an IV in an arm.

Blood can be collected above an IV in an arm.

The anticoagulant used for most hematology studies is EDTA. True or False?

True