FINAL

1. The order of blood flow through the nephron is:D) Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta

2. Increased production of aldosterone causes:C) Increased plasma sodium levels

3. The primary chemical affected by the renin-angiotensin-aldosteronesystem is:D) Sodium

4. For active transport to occur, a chemical:A) Must combine with a carrier protein to create electrochemical energy

5.The enzyme renin is produced by the kidney: *(Bonus)*B) In response to low plasma sodium levels

6. Production of antidiuretic hormone is controlled by the:C) State of body hydration

7. The most routinely used laboratory method for measuring the glomerularfiltration rate is:C) Creatinine clearance

8. The most common error in measuring the glomerular filtration rate usingthe creatinine clearance is:B) Inaccurate timing of urine collection

9. Calculate the creatinine clearance for a patient of average size fromthe following data: Urine volume: 720 mL for 12hrs/ Urine creatinine:120 mg/dL/ Serum creatinine: 1.5 mg/dLB) 80 mL/min

10. A 12-hour urine specimen with a volume of 360 mL is collected for acreatinine clearance. What is the volume (V) used to calculate theclearance?A) 0.5 mL/min

11. Given the following information, calculate the Osmolar clearance: Urinevolume: 720 mL in 24 hrs.Urine osmolarity: 700 mOsmPlasma osmolarity:300 mOsmB) 1.2 mL/min

12. All the following are parts of the routine urinalysis EXCEPT:D) Cytodiagnostic examination

13. Urine from a patient with diabetes insipidus has: *(Bonus)*D) Increased volume and decreased specific gravity

14. Person taking diuretics can be expected to produce:B) Polyuria

15. A urine specimen may be rejected by the laboratory for all of thefollowing reasons EXCEPT:D) The container uses a screw-top lid

16. The primary cause of the changes that take place in unpreserved urine is:A) Bacteria growth

17. A urine specimen containing a large amount of precipitated amorphousmaterial may have been preserved using:A) Refrigeration

18. Before analysis, a refrigerated urine specimen must be:D) Returned to room temperature

19. All the following specimens are acceptable for a urine culture, EXCEPT:B) Timed specimen

20. Quantitation of a substance that varies with daily activities should beperformed on a:C) 24-hour specimen

21. Documentation of appropriate handling of specimens for drug analysis isprovided by the:D) Chain of custody form

22. Where should labels on urine specimen container be placed:A) Container

23. What is the maximum length of time a urine specimen should remainunpreserved at room temperature before testing?B) 2 hours

24. Increased turbidity in urine that remains at room temperature is usuallycaused by:C) Bacterial growth

25. The primary pigment responsible for normal urine color is:B) Urochrome

26. A dark yellow urine producing yellow foam may contain:D) Bilirubin

27. Which of the following colors and causes match:C) Black---melanin

28.Specimens that contain intact red blood cells can be visuallydistinguished from those that contain hemoglobin because:C) Red blood cells produce a cloudy specimen

29. Urine from a patient diagnosed with hepatitis will appear:*(Bonus)*B) Amber

30. The presence of a white precipitate in freshly voided urine can becaused by:C) Amorphous phosphates in alkaline urine

31. The addition of dilute acetic acid to a cloudy urine specimen willdissolve:D) Amorphous phosphate

32. The specific gravity of urine is directly proportional to its:B) Dissolved solids

33. A urine specific gravity measured by refractometer is 1.028, and theurine temperature is 29C. The specific gravity should be reported as:C) 1.028

34. A urine specimen is diluted 1:10, and the specific gravity reads 1.006.The actual specific gravity is:C) 1.060

35. Bacterial decomposition of urea produces urine that has an odor resembling:C) Ammonia

36. A pale urine is primary indication of impaired renal function:B) False

37. Urine specific gravity can be measured by both physical and chemical methodsA) True

38. The density of urine specimen can affect the frequency of a sound wave.A) True

39. Quality control on reagent strips must be performed whenever a/anC) New bottle of strips is opened

40. Failure to blot the edge of the reagent strip may result in errors ininterpretation caused by:B) Runover

41. Reagent strip chemical tests may be inaccurate if the specimen is:B) Tested immediately after refrigeration

42. When performing reagent strip quality control, the:A) Positive reading should match the reference value by plus or minusone color block

43. The principle of the reagent strip test for pH is:A) A double indicator reaction

44. A urine specimen with a pH of 9.0 indicates that the patient should be:D) Asked to collect a new specimen

45. Urinary pH provides valuable information for the:A) Identification of urinary crystals

46. Which of the following is a cause of prerenal proteinuria?B) Multiple myeloma

47. When using the reagent strip protein method, false-positive results mayoccur in the presence of *(Bonus)*D) Highly alkaline urine

48. The principle of the reagent strip test for protein is the:D) Protein error of indicators

49. The SSA test should be performed on:D) Urine that has been centrifuged

50. Pediatric urine specimens are additionally tested for the presence of:D) Galactose using Clinitest

51. A urine specimen is analyzed for glucose by a glucose oxidase reagentstrip and a copper reduction test. If both results are positive, whichof the following interpretations is correct?B) Glucose only is present

52. While performing a Clinitest, you observe that the color changes rapidlyform blue to orange and then back to blue. You should: *(Bonus)*C) Repeat the test using fewer drops of urine to check for "pass through"

53. Ammonium sulfate is added to red urine. The urine had a positivereaction for blood, but there were no RBCs in the sediment. Aftercentrifugation, the sedimented ammonium sulfate is red. The abnormalcolor is caused by:B) Hemoglobin

54. Which of the following can produce a negative nitrite test in thepresence of significant bacteriuria?A) Production of nitrogen from the presence of many bacteria

55. What do the following results suggest? Color: Yellow/ Protein: Trace/Blood: Negative/ Clarity: Hazy/ Glucose: Negative/ Urobilinogen: 0.1EU/SG: 1.019/ Ketones: Negative/ Nitrite: Positive/ pH: 8.0/ Bilirubin:Negative/ Leukocytes esterase: PositiveC) Urinary tract infection

1. As supervisor of the UA laboratory, you have just adopted a newprocedure. You should:D) Place a complete, referenced procedure in the procedure manual

2. Urinalysis procedure manuals are reviewed:C) Annually by a designated person

3. Following rejection of a specimen, a technologist must:D) Both A and C A) Document the problem C) Document corrective actions taken

4. Reagents must be labeled with all of the following except:C) Instructions for use

5. When you receive a specimen and a requisition form that do not match,you should:A) Notify the personnel who collected the specimen

6.Instruments used in the urinalysis laboratory are kept in good workingcondition by: *(Bonus)*B) Performing routine preventive maintenance

7. The ability to obtain the published (expected) result on a controlsample is reffered to as:B) Accuracy

8. Obtaining the same result after testing the same specimen three times iscalled test:C) Precision

9. Proficiency testing should be performed:B) By personnel performing the tests routinely

10. The least regulated level of CLIA '88 testing categories is:A) Waived

11. All of the following are accrediting agencies recognized as meetingCLIA'88 standards except:B) NCCLS

12. Waived tests performed in a hospital urinalysis laboratory must meet theCLIA'88 standards for:C) Moderate-complexity testing

13. Customers of the laboratory include all of the following except:B) Accreditation agencies

14. Diseases affecting the glomerulus are primarily caused by:C) Immunological disorders

15. The buildup of crescentic formations on the glomerular capillaries ischaracteristic of:B) Rapidly progressive glomerulonephritis

16. Goodpasture syndrome and Wegener's granulomatosis are associated withthe presence of which of the following in the urine sediment? *(Bonus)*B) Red blood cell casts

17. The presence of heavy proteinuria is most characteristic of:D) Nephrotic syndrome

18. A decrease in systemic blood flow affects the renal tubules by producing:B) Ischemia

19. Glucosuria and generalized amino aciduria are characteristics of:A) Fanconi syndrome

20. Infection of the bladder is termed:C) Cystitis

21. Increased urinary eosinophils diagnostic for:B) Acute interstitial nephritis

22. Causes of acute renal failure include all of the following except:B) Goodpasture syndrome

23. Most renal calculi are composed of:D) Calcium

24. The microscopic hematuria associated with renal lithiasis is caused by:C) Tissue irritation

25. All the following may be helpful in preventing the formation of renalcalculi except:B) Increased exercise

26. A patient with a history of intermittent hematuria following strenuousexercise has an elevated serum immunoglobulin A level. What is the mostprobable disorder?B) IgA nephropathy

27. Following ingestion of mushrooms found growing in his garden, a mandevelops symptoms of oliguria, lethargy, and edema. Many RTE cells areobserved in his urinalysis. What is the most probable disorder?B) Acute tubular necrosis

28. Phenylketonuria is caused by:

C) Lack of the enzyme phenylalanine hydroxylase

29. The Guthrie is a:A) Bacterial inhibition test

30. All of the following disorders are caused by defects in thephenylalanine-tyrosine pathway except:B) Hartnup's disease

31. A disease that causes large amounts of branched-chain amino acids to beexcreted in the urine is:C) Maple syrup urine disease

32. Urine with an odor of "sweaty feet" and a positive ketone test indicates:C) Organic acidemia

33. Which of the following reacts with p-nitroaniline to produce anemerald-green color:D) Methylmalonic acid

34. The finding of a "blue diaper" is indicative of a defect in themetabolism of:C) Tryptophan

35. The finding of increased amounts of the serotonin degradation product5-HIAA in the urine indicates:D) Argentaffin cell tumors

36. All of the following porphyrin compounds will exhibit fluorescence underultraviolet light except:D) Porphobilinogen

37. The most common cause of acquired porphyria isB) Lead poisoning

38. Symptoms of inherited porphyrias include all of the following except:* A) Fanconi's syndrome

39. The presence of porphobilinogen in the urine can be suspected when:A) Acidic urine turns a port wine color after standing

40. All of the following porphyrin compounds can be found in urine except:C) Protoporphyrin

41. Hurler's and Sanfilippo's syndromes present with mental retardation andincreased urinary:D) Mucopolysaccharides

42. The presence of "orange sand" in an infant's diaper is indicative of:D) Lesch-Nyhan disease

43. The screening test result for PKU is:*(Bonus)*A) Ferric Chloride

44. The screening test result for Homocystinuria is:C) Silver nitroprusside

45. The odor of Phenylketonuria:C) Mousy

46. The number of fields that should be examined when quantitating urinarysediment constituent is:C) 10

47. All the following are reported as the quantity per *high*-power fieldEXCEPT:A) Casts

48. The purpose of including glucose as a significant chemical parameter bya laboratory that performs macroscopic screening is to check for thepresence of:D) Candida albicans

49. Glitter cell is term used to describe a specific type of:C) Neutrophil

50. The location of epithelial cells in the urinary tract in ascending order is:A) Squamous, transitional, renal tubular

51. Which of the following structures could be found in both a vaginal wetprep and a urine sediment?D) Both A and C A) Yeast cells C) Clue cell

52. Waxy casts are most easily differentiated from hyaline casts by their:D) Refractivity

53. Identification of crystals is based on shape and:A) Urine pH and crystal solubility

54. The description for Triple phosphate crystal:B) Coffin lid

55./Schistosoma haematobium/ would most likely be found in the urine froma: *(Bonus)*A) Foreign-service employee

1. The functions of the cerebrospinal fluid include all of the followingEXCEPT: *(Bonus)*B) Transmission of neurologic impulses

2.A xanthochromic CSF specimen will appear:C) Yellow and clear

3. The third tube of CSF collected from a lumbar puncture should be used for:D) Hematology tests

4. When using the cytocentrifuge, a daily control slide of saline andalbumin is prepared to check:C) For bacterial contamination

5. Three tubes of CSF are submitted to the laboratory. They are numbered1,2,and 3, and they show blood in all tubes but decreasing in amount asone inspects tubes 1 through 3. This observation should be interpreted as:B) A traumatic or bloody tap and, in all likelihood, no pathogenicsignificance should be attached to the presence of the blood.

6. A slightly hazy CSF specimen is diluted 1:10 with acetic acid. A totalof 50 cells are counted in five squares on both sides of the Neubauercounting chamber. The count is reported as: *(Bonus)*D) 500 WBCs/uL

7. The presence of xanthochromia and an increased D-dimer test in the CSFin indicative of:C) A cerebral hemorrhage

8. Examination of a CSF shows 1000 WBCs, of which 75% are lymphocytes and25% are monocytes. This finding is consistent with:C) Viral meningitis

9.Damage to the blood-brain barrier by /Mycobacterium tuberculosis/ maycause the CSF to:C) Contain a pellicle or clot

10.The CSF/serum albumin index is performed to determine: *(Bonus)*C) The integrity of the blood-brain barrier

11. CSF electrophoresis to confirm the diagnosis of multiple sclerosis wouldbe expected to show:A) Increased IgG with oligoclonal bands not seen on serum electrophoresis

12. To determine if fluid draining from the ear of a patient with severehead injury is CSF, the fluid should be:B) Electrophoresed for the presence of transferrin isoforms

13. Measurement of CSF lactate levels is a valuable aid for all of thefollowing EXCEPT:D) Distinguishing between viral and fungal meningitis

14. India ink preparations are useful in the diagnosis of:A) Fungal meningitis

15. Using 1:10 dilution, 64 wbcs are counted in five large squares on bothside of the hemocytometer. Calculate the WBC count.C) 640 cells/uL

16. A patient previously diagnosed with acquired immunodeficiency arrives inthe emergency room with symptoms of meningitis. A lumbar puncture isperformed.In addition to Gram's stain, what additional testing should beperformed?*(Bonus)*D) Both A and B A) India Ink preparation B) Electrophoresis

17. What diagnostically significant observation might be made on one of thetest from the previous question?C) Starburst microbial pattern

18. What type of meningitis would most probably be suspected in this patient?A) Fungal

19. Using the lab results to determine the type of infection they represent:WBC count: 1000 per L/ Lymphocytes: 10%/ Neutrophils: 90%/ Protein: 150mg/dL/ Glucose: 15 mg/dL/ Blood Glucose: 90 mg/dL/ Lactate: 40 mg/dLA) Bacterial

20. The CSF glucose in a patient with a blood glucose of 90 mg/dL is60mg/dL. These results are representative of:C) Normal CSF

21. All of the following statement on synovial fluid are true EXCEPT that it:B) Is found only in the knee

22. Which of the following descriptions of synovial fluid does not match?D) Sepsis: Uniform blood

23. Crystals found in synovial fluid during attacks of gout are:A) Monosodium urate

24. Synovial fluid is produced by: *(Bonus)*B) Ultrafiltration of plasma

25. The primary cells seen in normal synovial fluid include all of thefollowing EXCEPT:B) Neutrophils

26. A cloudy, yellow-green synovial fluid with 100,000 WBCs, a predominanceof neutrophils, and a decreased glucose is classified as:C) Septic

27. A clear, pale yellow synovial fluid with with good viscosity and a WBCcount of 1000 is classified as:A) Noninflammatory

28. To determine is an unknown fluid is synovial fluid, the fluid can betested:C) By adding acetic acid and observing clot formation

29. The milky-appearing synovial fluid is associated with the presence of:D) Monosodium urate crystals

30. The recommended diluting fluid for synovial fluid cell count is:D) Saline

31. Neutrophils that contain precipitated rheumatoid factor in theircytoplasm are called:C) Ragocytes

32. Vacuolated macrophages containing ingested neutrophils seen in synovialfluid are called:A) Reiter's cells

33. Before performing a cell count on a highly viscous synovial fluid, itmay be necessary to incubate the fluid with:D) Hyaluronidase

34. Examination of synovial fluid under direct polarized revealsintracellular needle-shaped crystals that appear white against the blackbackground. When a red compensator is added and the crystals are alignedwith the slow vibration, they appear yellow against the red background.These crystals are: *(Bonus)*B) Monosodium urate showing negative birefringence

35. All of the following diseases are frequently associated with joindisorders EXCEPT:B) Tuberculosis

36. A synovial fluid with a normal WBC count from a patient with a normalserum uric acid contains extracellular birefringent crystals underpolarized light. A possible reason for this finding is that the:D) Specimen was collected in powdered EDTA

37. Fat droplets seen in synovial fluid are associated with:

D) Both A and B A) Crush injuries B) Chronic inflammation

38. Synovial fluid crystals seen in patients undegoing renal dialysis mostcommonly are:C) Calcium oxalate

39. A turbid synovial fluid with yellow-green color is indicates:*(Bonus)*B) Infection

40. Crystals frequently seen with chronic inflammation are:B) Cholesterol

41. Peritoneal lavage is performed to:C) Detect intra-abdominal bleeding

42. The pathological accumulation of fluid in a body cavity is termed a/an:*(Bonus)*D) Effusion

43. Peritoneal fluid is collected by a procedure called:C) Paracentesis

44. All of the following are unique characteristics of malignant cells EXCEPT:C) Cellular clumping

45. Differentiation between a hemothorax and a hemorrhagic effusion on abloody pleural fluid is done by:B) Performing a hematocrit value, because a hemothorax will give a valueclose to that of blood

46. A pleural fluid pH of less than 6.0 is indicative of:D) Esophageal rupture

47. Request for amylase and alkaline phosphatase determinations on asciticfluid are received in suspected cases of:B) Gastrointestinal perforations

48. Which of the following tests is valuable in the diagnosis of esophagealrupture?A) Pleural pH

49. A milky pleural fluid that *stains strongly positive with Sudan III*indicates:A) Thoracic duct leadkage

50. A milky, green-tinged pleural fluid: *(Bonus)*D) Stains weakly with Sudan III

51. Differentiaion between an ascitic fluid transudate or exudate is most

accurately made using the:B) Serum-ascites albumin gradient

52. The test performed on peritoneal lavage fluid is the:A) RBC count

53. An ascitic fluid absolute neutrophil count of 1000/uL is most indicative of:C) Bacterial peritonitis

54. A screening test performed on a cloudy, green ascitic fluid would be a/an:D) Ictotest

55.A peritoneal fluid with a positive CEA and a negative CA 125 indicates: *(Bonus)*A) Gastrointestinal malignancy

56. An ascitic fluid exudate with a positive CA125 and a negative CEAD) Ovarian malignancy

57. Peritoneal fluid with an elevated creatinine levelC) Ruptured bladder

58. Pleural fluid with a hematocrit of 30% (blood hematocrit:34%)A) Hemothorax

59. Increased serous fluid can be caused by all of the following EXCEPT:C) Increased plasma sodium

60. The findin gof a mesothelioma cell in pericardial fluid is indicative of:D) Metastatic malignancy

1. Absence of a normal sperm acrosome:B) Affects ovum penetration

2. Yellow color in a semen specimen may be caused by all of the following EXCEPT:B) Preservation at room temperature

3. Normal semen should liquefy:B) Within 1 hour

4. Semen viscosity is most closely related to:*(Bonus)*D) Specimen liquefaction

5. Before analysis, semen specimens should be:C) Allowed to liquefy

6. Prior to reporting a postvasectomy specimen as negative for the presenceof sperm, the specimen must be:D) Centrifuged

7. Evaluation of sperm motility includes:D) Both A and B A) Determining slow and fast movement B) Differentiation between forward and lateral movement

8. When performing sperm morphology analysis, the minimum number of spermthat should be evaluated is:C) 200

9. When using routine morphology criteria, the normal value is greater than:B) 30% normal forms

10. Using a 1:20 dilution and the 5 RBC counting squares of the Neubauercounting chamber, and average of 54 sperm is counted. The spermconcentration is:B) 54,000,000/mL

11. The motility component of a sperm analysis includes all of the followingEXCEPT evaluation of the:D) Motility of normal and abnormal sperm

12. The sugar on interest in cases of infertility is:C) Fructose

13. The immunobead test detects *(Bonus)*A) Male antisperm antibodies

14. Sperm function tests include all of the following EXCEPT the:C) Meiosis and mitosis assay

15. Spermatogenesis takes place in the:B) Seminiferous tubules

16. Using a 1:20 dilution of a specimen with a volume of 3 mL, an average of86 sperms are counted in the 5 RBC squares of the Neubauerhemocytometer. Calculate the concentration and sperm count:B) 86 million/mL and 258 million/specimen

17. Using a 1:20 dilution of a specimen with a volume of 4 mL, 30 sperm arecounted in 2 large squares (WBC) of the Neubauer hemocytometer.Calculate the sperm concentration and sperm count:B) 3 million/mL and 12 million/specimen

18. A dark green amniotic fluid is associated with:A) Meconium

19. A primary function of amniotic fluid is to:B) Provide protection for the fetus

20. The volume of amniotic fluid increases after the first trimester as a result of:C) Production of fetal urine

21. Amniotic fluid for fetal lung maturity testing should be preserved:A) In the refrigerator

22. To differentiate between maternal and fetal blood in blood-streakedamniotic fluid, the fluid is tested for:*(Bonus)*B) Fetal hemoglobin

23. An increased level of alpha fetoprotein in amniotic fluid should be further tested for:C) Acetylcholinesterase

24. Alpha fetoprotein is produced by the fetal:D) Liver

25. An amniocentesis is performed on a woman whose last two pregnancies haveresulted in still births due to hemolytic disease of the newborn. Ascreening test performed at the hospital is positive for bilirubin, andthe specimen is sent to a reference laboratory for a bilirubin scan.Doctors are concerned when the report comes back negative, and questionif the:C) Specimen was exposed to light

26. The purpose of plotting amniotic fluid bilirubin on a Liley graph is to:D) Determine further treatment

27. The A450 of an amniotic fluid is plotted in zone 3 of a Liley graph. Thephysician should:

C) Request testing for fetal lung maturity

28. The foam, or shake test is a screening test for amniotic fluid:B) Surfactants

29. Microviscosity of amniotic fluid is measured by:D) Fluorescence polariztion

30. The test for amniotic fluid lamellar bodies uses:D) An automated cell counter

31.The Amniostat agglutination test is performed on amniotic fluid frompregnant women to detect the presence of:*(Bonus)*B) Phosphatidyl glycerol

32. The most frequent concern of premature delivery is underdevelopment of the:D) Lungs

33. Lamellar bodies contain:C) Phospholipids

34. When performing an L/S ratio by thin-layer chromatography, a maturefetal lung will show:C) Lecithin twice as concentrated as sphingomyelin

35. The method of choice for testing amniotic fluid contaminated withhemoglobin for fetal lung maturity is:B) Amniostat

36. The normal brown color of the feces is produced by:B) urobilin

37. Stools from persons with steatorrhea contain excess amounts of:D) fat

38. A black, tarry stool is indicative of:A) Upper GI bleeding

39. A pale, frothy stool is indicative of:C) Excess fat

40. The recommended specimen for quantitative fecal testing is a:C) 72-hour specimen

41. The unpleasant odor associated with fecal analysis is caused primarily by:C) bacterial metabolism

42. Large orange-red droplets seen on direct microscopic examination of

stools mixed with Sudan III represent:C) neutral fats

43. Wet preparations for the detection of fecal neutrophils are stainedwith: *(Bonus)*D) methylene blue

44. Increased neutrophils in a stool may indicate:D) /Salmonella/ infection

45. To prevent false-positive fecal occult blood tests, patients shouldavoid eating all of the following for 3 days before testing /*except*/:B) chicken

46. What is the recommended procedure for collecting a 24-hr urine sample?D) Void the first morning specimen, start the timing, and collect allother specimens including the next morning's specimen

47. Which fluid is aspirated from the peritoneal cavity?A) Ascites

48. What additional information is typically required when labeling anonblood specimen?D) Specimen type and source

49. Which of the following tests requires a 24-hour urine specimen?A) Creatinine clearance

50. A first morning specimen is preferred for hCG testing because it isC) typically more concentrated.

51. Drugs of abuse can be detected inD) all of the above A) hair B) saliva C) urine

52. This type of urine collection involves the aspiration of urine directlythrough the wall of the bladder using a sterile needle and syringe.D) Suprapubic

53. Fluid found around the heart is called pericardial.A) True

54. DNA analysis can be done using a buccal swab on the inside of the cheek.A) True

55. Part of a phlebotomist's job may be to instruct a patient on how tocollect a clean catch midstream urine specimen.A) True

1. Which needle gauge has the largest lumen?A) 18

2. The tests performed in the following department are typically collectedin a tube with a light blue stopperB) Coagulation

3. A tube with a green stopper normally containsC) Heparin

4. What is the most important factor in choosing which gauge needle to usefor venipuncture?C) Size and condition of the vein

5. Which additive is usually present in a tube with a lavender stopper?B) EDTA

6. The slanted tip of the needle that enters the vein is called the:A) bevel

7. According to CLSI standards, which tube is filled last when using a syringe:A) EDTA

8. A type of needle used to collect blood from small or difficult veins isknown as a butterfly.A) True

9.EDTA is the most common source of carryover problems *(Bonus)*A) True

10. In a routine ETS venipuncture, the lavender tube should be drawn beforethe red tube.B) False

11. In a routine ETS venipuncture, the red tube should be drawn before thegreen tube.A) True

12. There is a request to draw a specimen from an inpatient by the name ofJohn Doe. Which of the following is an acceptable way to confirm thepatient's identity? *(Bonus)*C) Match the ID band and requisition with his verbal statement if ID.

13. The following tests have all been ordered at the same time on differentin inpatients. There is only one phlebotomist on duty. Which test shouldthe phlebotomist collect first?C) STAT electrolytes in the ER

14. Communicating in this way before obtaining a blood specimen from a childis poor technique.C) Telling the child it won't hurt

15. What may happen if you mix a specimen too vigorously?C) Hemolysis

16. Never leave a tourniquet on for more thanB) 1 minute

17. What is the most critical error a phlebotomist can make?D) Misidentifying a patient specimen

18. What would be the system of choice to identify laboratory specimens froman unconscious, unidentified woman in the emergency room?D) Use a three-part identification band and labels.

19. The priority designation for a test request is based on all of thefollowing EXCEPT:A) age and gender

20. An unconscious patient is not wearing an ID band. There is an ID bandtaped to the patient's IV pole with the information that matches therequisition. What should the phlebotomist do?D) Only draw the specimen after an ID band has been applied.

21. What is the purpose of waiting 30 seconds for the alcohol to dry beforeneedle insertion?D) All of the options are correct. A) To let evaporation help destroy microbes. B) To avoid a stinging sensation C) To prevent hemolysis of the specimen.

22. The process of collecting blood from a vein is known as Venipuncture *(Bonus)*A) True

23. The procedure of identifying a patient using the written requisition,arm band, and verbal confirmation is known as three-way-ID.A) True

24. It is important to mix anticoagulant tubes immediately so that they willclot properly.B) False

25. You must draw a protime specimen from a patient with IVs in both arms.Which of the following is the best thing to do? Draw the specimenB) below an IV

26. You have no choice but to draw a specimen from a site with a hematoma.Where should you obtain the specimen?

A) Distal to the hematoma

27. Which of the following vascular access devices is placed in a peripheralvein for the purpose of blood collection and administration of medication?B) Heparin lock

28. A phlebotomist has attempted twice to draw a partial thromboplastin(PTT) specimen from a patient with difficult veins. Both times thephlebotomist has been able to draw only a partial tube. What should thephlebotomist do?B) Have another phlebotomist attempt to draw the specimen

29. Which instance may lead you to suspect that you have accidentallypunctured an artery?C) The blood pulses into the tube

30. If blood is drawn to quickly from a small vein, the vein will have atendency toB) collapse

31. When a test requires a fasting specimen, but the serum is _______, it isa clue that the patient is not fasting.D) lipemic

32. Tests influenced by diurnal variation are often ordered as ______ tests,and it is important to collect them as close as possible to the timeD) timed

33. When the additive from a tube "backwashes" into the patient, it is known as "reflux".A) True

34. The medical term for fainting is syncope.A) True

35. A condition in which blood components that cannot easily leave the bloodstream become concentrated in the smaller plasma volume is known as"hemoconcentration".A) True

36. A person who lives on Pike's Peak is more likely to have a higher RBCcount than a person who lives in Florida.A) True

37. If the blood is filling the tube very slowly and a hematoma is beginningto form, the needle may not be deep enough.A) True

38. If a patient is complaining of sharp radiating pain from the needle

insertion site, the phlebotomist should hurry and finish the draw.B) False

39. A blood smear made from an EDTA specimen should be madeB) within 1 hour of collection.

40. Why are capillary blood gases less desirable than arterial blood gases (ABGs)?D) All of the above A) Skin puncture blood contains tissue fluid B) Skin puncture blood is only partly arterial C) The blood is exposed to air during collection

41. Why are EDTA specimens obtained before other specimens when collected by skin puncture?A) To minimize effects of platelet clumping

42. Why should a laboratory report form indicate the fact a specimen hasbeen collected by capillary puncture?A) Because test results can vary depending on the method of collection

43. Which of the following is the safest area for infant heel puncture?C) The lateral plantar surface

44. The purpose of wiping away the first drop of blood during skin puncture is toB) eliminate tissue fluid contamination

45. Which microcollection container would be used to collect a specimen for a CBC?C) Purple top

46. What is a PKU?B) A hereditary inability to metabolize phenylalanine

47. It is necessary to control depth of lancet insertion during capillarypuncture to avoidC) injuring the heel bone

48. What is the purpose of warming the site before skin puncture?B) It increases blood flow up to seven times

49. A good blood smear should exhibit a feather edge.*(Bonus)*A) True

50. Capillary bilirubin specimens should be protected from light.A) True

51. A microhematocrit tube is primarily used for manual potassiumdeterminations.B) False

52. A phlebotomist should puncture a finger perpendicular to the fingerprint whorls.A) True

53. If a baby has a huge, fleshy big toe, it is acceptable to collect abilirubin specimen from it.B) False

54. Of the following tests, which is most likely to result in fatalconsequences if the patient is misidentified?D) Type and crossmatch

55. Which test requires strict skin antisepsis procedures before specimen collection?A) Blood Culture

56. What type of additive is recommended for collecting an ethanol test specimen?D) Sodium fluoride

57. When performing a GTT, the timing should beginA) as soon as the patient finishes the drink.

58. Which test is used to monitor heparin therapy?A) ACT

59. At what intervals is the blood blotted during a bleeding time test?C) 30 seconds

60. To prevent introducing a contaminating substance into a trace-elementcollection tube, it is suggested that the phlebotomistB) draw it by itself using a syringe or evacuated tube system

61. When collecting a blood culture specimen directly from a butterfly intoblood culture bottles, which should be filled first?A) Aerobic

62. Which of the following tests may require special "chain of custody"documentation when collected?C) Drug screen

63. Identify the condition in which a unit of blood is withdrawn from apatient as treatment.C) Hemochromatosis

64. Which of the following tubes can be used to collect blood for a type andcrossmatch?B) Pink top EDTA tube

65. An autologous blood transfusion is a transfusion of bloodB) donated by the patient for the patient.

66. The most critical aspect blood of blood culture collection is

B) skin antisepsis.

67. The hormone detected in positive urine pregnancy test isC) HCG

68. TDM is used by physicians toA) Determine a beneficial drug dosage for a patient

69. A condition in which a patients has a high blood glucose level is knowas hypoglycemiaB) False

70. A patient who is suspected of having lead poisoning should have his orher lead test specimen drawn in a light blue tube. *(Bonus)*B) False

71. The process of entering a password and gaining access to a computer is calledC) Logging on

72. A specimen would most likely be accepted for testing despite this problem.C) No phlebotomist initials

73. Which of the following is used by the laboratory to identify a specimenthroughout the testing process?A) Accession number

74. A pneumatic tube is aA) pressurized air transportation system.

75. An example of a preanalytical error happening during specimen processing isB) inadequate centrifugation.

76. Which of the following would NOT be considered a preanalytical error?C) Misreporting patient results

77. this is a source of preanalytical error that occurs before specimen collection.A) Dehydrated patient

78. Which of the following specimens needs to be chilled?A) Ammonia

79. Which of the following specimens are least likely to require special handling?B) Cholesterol and uric acid

80. Which specimen can be centrifuged immediately upon arrival in specimenprocessing?B) Calcium in a green top tube.

81. The handling of a specimen before it is actually tested is part of the postanalytical phase.B) False

82. A specimen arrives with less volume than is needed for the test. It willbe noted why the specimen was rejected by using the abbreviation QNS.A) True

83. "ASAP" or "Med Emerg" specimens must be attended to before routinespecimens.A) True

84. What is the recommended procedure for collecting a 24-hr urine sample?D) Void the first morning specimen, start the timing, and collect allother specimens including the next morning's specimen

85. Which fluid is obtained by lumbar puncture?A) Cerebrospinal

86. What additional information is typically required when labeling a nonblood specimen?D) Specimen type and source

87. Which test is used to diagnose cystic fibrosis?D) Sweat chloride

88. Which of the following tests requires a 24-hour urine specimen?A) Creatinine clearance

89. A urine C & S is typically ordered to detectD) presence of UTI

90. An NP culture swab is collected to detect the presence of organisms that causeD) whooping cough

91. A first morning specimen is preferred for hCG testing because it isC) typically more concentrated.

92. Drugs of abuse can be detected inD) all of the above A) hair B) saliva C) urine

93. Which type of specimen must be protected from light?A) Amniotic fluid

94. Sputum samples are typically collected to diagnoseD) tuberculosis.

95. A urine specimen collected directly from the bladder through a tube inthe urethra is called:A) Catheterized

96. The fluid found around a fetus is known as amniotic fluid.A) True

97. Inserting a needle between the 2nd and 3rd lumbar vertebrae to collectfluid from the spinal cavity is called suprapubic aspiration.B) False

98. DNA analysis can be done using a buccal swab on the inside of the cheek.A) True

99. Cellular components in urine are well preserved and require no additional preservation.B) False

100. Part of a phlebotomist's job may be to instruct a patient on how tocollect a clean catch midstream urine specimen.A) True

101. Which artery is typically the easiest to access during low cardiac output?B) Femoral

102. The artery of choice for ABG collection:C) Radial

103. Which of the following is the most common arterial puncture complicationeven when proper technique is used?A) Arteriospasm

104. Which of the following abbreviations represent a test that is typicallypart of ABG evaluation?C) PaO2

105. The primary reason for performing arterial puncture is to:B) evaluate blood gases.