2 SAFETY: PATIENT AND CLINICAL LABORATORY PRACTICS

Question 1

When reviewing the goals of national patient safety goals, the laboratory application of related goals is to:
a. Improve accuracy of patient identification
b. Identify analytical errors before releasing results
c. Decrease the laboratory turn-around time
d. All the above

Answer 1

a. Improve accuracy of patient identification

Question 2

A medical euphemism is associated with which of the following?
a. A desire to avoid painful, complex quality improvement issues
b. A desire to avoid extra paperwork that improvement strategies create
c. Not being used to describe medical errors
d. Both a and b

Answer 2

d. Both a and b

Question 3

In developing a plan to manage information technology (IT) downtime, the initial planning step is to:
a. Have a clear activation and communications plan.
b. Establish the estimated downtime.
c. Set up a command center.
d. Critique the processes and events during an IT outage

Answer 3

a. Have a clear activation and communications plan.

Question 4

CDC is an abbreviation for the:
a. College of DC Clinicians
b. Centers for Disease Control and Treatment
c. Centers for Disease Control and Prevention
d. Communicable Disease Center

Answer 4

c. Centers for Disease Control and Prevention

Question 5

Which of the following is primarily responsible for safeguards and regulations to ensure a safe and healthful workplace?
a. Health Care Finance Administration
b. Occupational Safety and Health Administration
c. Clinical Laboratory Improvement Act of 1988
d. Centers for Disease Control and Prevention

Answer 5

b. Occupational Safety and Health Administration

Question 6

Safety in the clinical laboratory includes:
a. Educating and training all health workers in Standard
Precautions
b. Providing disposable gloves
c. Monitoring compliance with protective biosafety
policies
d. All the above

Answer 6

d. All the above

Question 7

The CDC Bloodborne Pathogen Standard and the OSHA Occupational Exposure Standard mandate:
a. Education and training of all health care workers in Standard Precautions
b. Proper handling of chemicals
c. Calibration of equipment
d. Fire extinguisher maintenance

Answer 7

a. Education and training of all health care workers in Standard Precautions

Question 8

Where appropriate, the OSHA standards provide:
a. Provisions for warning labels
b. Exposure control procedures
c. Implementation of training and education programs
d. All the above

Answer 8

d. All the above

Question 9

To comply with various federal safety regulations, each
laboratory must have which of the following?
a. A chemical hygiene plan
b. A safety manual
c. Biohazard labels in place
d. All the above

Answer 9

d. All the above

Question 10

The term Standard Precautions refers to:
a. Treating all specimens as if they are infectious
b. Assuming that every direct contact with a body fluid is infectious
c. Treating only blood or blood-tinged specimens as infectious
d. Both a and b

Answer 10

d. Both a and b

Question 11

Microorganisms included in the top 10 laboratory-acquired infections are:
a. Hepatitis B virus
b. Hepatitis C virus
c. Human immunodeficiency virus
d. Both a and b

Answer 11

d. Both a and b

Question 12

The most common source of human immunodeficiency
virus (HIV) in the occupational setting is:
a. Saliva
b. Urine
c. Blood
d. Cerebrospinal fluid

Answer 12

c. Blood

Question 13

Chose the correct terms to fill in the
blanks from the choices below. Transmission to medical personnel of
(1) _________________ is more probable than (2)
_________________ in unvaccinated individuals.

(1)
a. Human immunodeficiency virus (HIV)
b. Hepatitis B virus (HBV)
c. Hepatitis C virus (HCV)
d. Malaria

(2)
a. Human immunodeficiency virus (HIV)
b. Hepatitis B virus (HBV)
c. Hepatitis C virus (HCV)
d. Malaria

Answer 13

(1)
b. Hepatitis B virus (HBV)

(2)
a. Human immunodeficiency virus (HIV)

Question 14

Gloves for use in the clinical laboratory are:
a. Sterile
b. Nitrile or latex
c. Used more than once, if no visible signs of blood contamination
d. All the above

Answer 14

b. Nitrile or latex

Question 15

Decontaminate hands after:
a. Contact with patient’s skin
b. Contact with blood or body fluids
c. Removing gloves
d. All the above

Answer 15

d. All the above

Question 16

All work surfaces should be sanitized at the end of the shift with a solution of:
a. 5% bleach
b. 5% phenol
c. 10% bleach

Answer 16

c. 10% bleach

Question 17

Clinical laboratory personnel need to have demonstrable immunity to:
a. Rubella
b. Polio
c. Hepatitis B
d. Both a and c

Answer 17

d. Both a and c

Question 18

Sue and her manager Jane are finishing their shift doing outpatient phlebotomy and specimen processing. Sue has just finished putting a paper clip on a requisition with a
couple of blood drops on it. As she pushes the requisition into a pneumatic tube holder with the specimen of patient’s blood, the paper clip sticks her finger through her gloved hand. What action does Jane need to initiate first?

a. Take Sue to emergency department for initiation of the hepatitis B vaccine series.
b. Immediately have Sue’s vaccination status and vaccine response status determined.
c. Determine the hepatitis B surface antigen status of
the source patient.
d. File an incident report with the Occupational Health
Office and assure Sue that everything will be okay.

Answer 18

b. Immediately have Sue’s vaccination status and vaccine response status determined.

Question 19

Joe is a new employee assigned to inventory chemicals stored in clinical chemistry. While conducting his inventory, Joe notices that many of the labels have a red square with the letter B in the middle of the square. Conscious of safety practices, Joe checks the expiration date of the fire extinguisher in the immediate area of the chemicals and
sees it is in date and labeled as a Class B extinguisher. Is
this the appropriate class of fire extinguisher for dealing
with Joe’s chemical inventory?

a. Yes; he needs an extinguisher for ordinary combustibles.
b. Yes; he needs an extinguisher for flammable liquids and gases.
c. No; he needs an extinguisher for powdered-metal
(combustible) material.
d. No; he needs an extinguisher for a fire that cannot be extinguished.

Answer 19

b. Yes; he needs an extinguisher for flammable liquids and gases.

Question 20

The origin of a class A fire is:
a. Paper
b. Electrical
c. Gasoline
d. Hazardous chemicals

Answer 20

a. Paper

Question 21

The OSHA Hazard Communication Standard, the “right-to-know” rule, is designed for what purpose?
a. To avoid lawsuits
b. To protect laboratory staff
c. To protect patients
d. To establish safety standards

Answer 21

b. To protect laboratory staff

Question 22

A triangle with an outline of a person inside the triangle
in the hazards identification system indicates which type
of hazard?
a. Flammability
b. Reactivity-stability hazard
c. Special hazard information
d. Health hazard

Answer 22

d. Health hazard

Question 23

The simplest, most important step in proper handling of
any hazardous substance is:
a. Wearing disposable gloves
b. Wearing safety glasses
c. Properly labeling containers
d. Using a biosafety hood

Answer 23

c. Properly labeling containers

Question 24

The term biohazard denotes:
a. Infectious materials that present a risk to the health of humans in the laboratory
b. Infectious materials that present a potential risk to the health of humans in the laboratory
c. Agents that present a chemical risk or potential risk to
the health of humans in the laboratory
d. Both a and b

Answer 24

d. Both a and b

Question 25

Infectious sharps waste must be discarded into containers with all the following features except:
a. Made of sturdy cardboard for landfill disposal
b. Has a standard symbol
c. Orange, orange and black, or red
d. Marked “Biohazard”

Answer 25

a. Made of sturdy cardboard for landfill disposal

Question 26

Terminal waste of infectious material can be processed by
autoclaving or by:
a. Incineration
b. Soaking in bleach
c. Ethylene dioxide gas
d. Normal garbage disposal

Answer 26

a. Incineration

Question 27

A safety audit should consist of all the following considerations except:
a. Laboratory coats
b. Fire extinguishers
c. Incubators
d. Eyewash stations and safety showers

Answer 27

c. Incubators

Question 28

Immediate first aid for acid burns on the skin is:
a. Ice
b. Running water
c. Petroleum jelly
d. Butter

Answer 28

d. Butter

Question 29

Bess, a 21-year-old medical laboratory science student in her last year of training, is completing her morning phlebotomy rounds. Her final patient is a 16-year-old girl diagnosed with type 1 diabetes mellitus. The order is for a fasting blood sugar and a CBC, so Bess collects samples via venipuncture. After performing the venipuncture, Bess cleans up the equipment and trash from the patient’s bed. In doing so, she pokes a gloved finger with the used needle because she failed to engage the safety cover correctly. Even though she is distraught, Bess keeps herself composed and exits the patient’s room. Bess immediately goes and washes her hands with soap and warm water and then heads back to the laboratory.

What is the first thing Bess should do?
a. Go to break; coffee is in order after this ordeal.
b. Inform her supervisor.
c. Go home sick; she cannot effectively work the rest of the day.
d. She was wearing gloves, so it is not a major concern.

Answer 29

b. Inform her supervisor.

Question 30

Bess, a 21-year-old medical laboratory science student in her last year of training, is completing her morning phlebotomy rounds. Her final patient is a 16-year-old girl diagnosed with type 1 diabetes mellitus. The order is for a fasting blood sugar and a CBC, so Bess collects samples via venipuncture. After performing the venipuncture, Bess cleans up the equipment and trash from the patient’s bed. In doing so, she pokes a gloved finger with the used needle because she failed to engage the safety cover correctly. Even though she is distraught, Bess keeps herself composed and exits the patient’s room. Bess immediately goes and washes her hands with soap and warm water and then heads back to the laboratory.

Bess meant to, but has not yet been vaccinated against hepatitis B virus (HBV). The source patient has consented to postexposure testing. What should be done to help protect Bess?
a. HBV testing is performed every other day, so wait and see if patient is positive or negative first.
b. Bess should receive HBIG immediately.
c. Bess should be vaccinated for HBV.
d. Nothing should be done until the patient results are available.

Answer 30

b. Bess should receive HBIG immediately.

Question 31

Bess, a 21-year-old medical laboratory science student in her last year of training, is completing her morning phlebotomy rounds. Her final patient is a 16-year-old girl diagnosed with type 1 diabetes mellitus. The order is for a fasting blood sugar and a CBC, so Bess collects samples via venipuncture. After performing the venipuncture, Bess cleans up the equipment and trash from the patient’s bed. In doing so, she pokes a gloved finger with the used needle because she failed to engage the safety cover correctly. Even though she is distraught, Bess keeps herself composed and exits the patient’s room. Bess immediately goes and washes her hands with soap and warm water and then heads back to the laboratory.

What are the next steps for Bess in her postexposure care plan?
a. Nothing; the patient was negative for HIV and HBV.
b. Bess should be given an antiretroviral agent.
c. A confirmatory HIV test should be performed on the source patient and on Bess.
d. Bess should be screened for HIV at 3 months and 6 months after exposure.

Answer 31

d. Bess should be screened for HIV at 3 months and 6 months after exposure.