Other Diagnostic Tests Flashcards
Which of the following is a CLIA waived laboratory test?
A. urine culture and sensitivity
B. complete blood count
C. pap smear
D. fecal occult blood testing
fecal occult blood testing
Rationale:
If CLIA waives a laboratory test, it must be relatively simple to perform and have a low risk for error (according to CDC guidelines). However, the test may still have the potential for serious health risk if performed incorrectly. Inaccurate results can have consequences: a patient’s medication dose could be adjusted based on erroneous test results. A fecal occult blood test is easy to perform and interpret. The other test options listed in this scenario require higher level training and expertise. Waived tests are still important and should be performed with care.
. Which of the following patient tests is considered a “high-complexity” lab test?
A. glucose
B. spun microhematocrit
C. pap smear manual slide reading
D. dipstick urinalysis
Pap smear manual slide reading
Rationale:
Tests within a clinical laboratory are allocated to either the moderate complexity or high complexity category based on provisions in CLIA (Clinical Laboratory Improvement Amendments), the governing body that regulates laboratory testing. Certain testing can only be performed by highly trained professionals and therefore will not be within the scope of practice of a Medical Assistant. A pap smear is a high complexity test that is only performed by specifically trained professionals.
Which of the following volumes is the approximate total bladder capacity for a healthy adult patient?
A. 500 mL
B. 2000 mL
C. 100 mL
D. 1500 mL
500 mL
Rationale:
The exact capacity of the adult human bladder is often debated. In general, many sources agree on a capacity range of 500 mL to 1000 mL.
Which one of the following tests is CLIA waived?
A. GTT
B. PT/PTT
C. HgbA1C
D. HCT
HCT
Rationale:
HCT is a hematocrit, also referred to as packed cell volume. This is a measure of the percentage volume of red blood cells in a sample of whole blood. It is considered a waived test by CLIA standards. CLIA refers to the Clinical Laboratory Improvement Amendment, which specifies personnel requirements for performing laboratory testing based upon the complexity of the method. Moderate and high complexity testing are outside the scope of practice for non-laboratory professionals (performed only by certified Medical Laboratory Scientists or Medical Technicians). CLIA-waived testing, such as Point of Care Testing, are low complexity tests (including Hemoglobin and Hematocrit) that may be performed by other personnel with proper training. The other tests listed in this scenario are performed by methods in a higher complexity category by CLIA standards.
Accurate and reliable laboratory results depend upon adherence to quality standards. Which of the following applies to every United States Clinical Laboratory that tests human specimens?
A. Clinical and Laboratory Standards Institute (CLSI)
B. Clinical Laboratory Improvement Amendments (CLIA)
C. College of American Pathologists (CAP)
D. Joint Commission on the Accreditation of Health Care Organizations (JCAHO)
Clinical Laboratory Improvement Amendments (CLIA)
Rationale:
The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing (except research) performed on humans in the U.S. through the Clinical Laboratory Improvement Amendments (CLIA). CLSI: The Clinical and Laboratory Standards Institute (CLSI) brings together the global laboratory community to foster excellence in laboratory medicine by developing clinical laboratory testing standards based on input from and consensus among industry, government, and health care professionals. CAP: The College of American Pathologists is an organization of board-certified pathologists serving patients, pathologists, and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine worldwide. JC: The Joint Commission accredits and certifies health care organizations and programs in the United States.
Which cellular component of blood plays a role in hemostasis?
A. Neutrophil
B. Eosinophil
C. Lymphocyte
D. Thrombocyte
Thrombocyte
Rationale:
Thrombocytes, also called platelets, are small blood components that work with the coagulation factors to stop bleeding (i.e., hemostasis). They are fragments of cytoplasm that help the clotting process by sticking to the lining of blood vessels. They are made in the bone marrow and eventually enter the bloodstream. The other response options are all types of white blood cells, which function in the body’s responses to infection, allergic reactions, and immune response. They are not required for hemostasis.
Which of the following tasks is a medical assistant responsible for when given a requisition for guaiac testing?
A. Collect venous specimens for testing as required.
B. Perform skin tests as required.
C. Collect and perform point-of care testing.
D. Perform QC checks on POCT instruments.
Collect and perform point-of care testing.
Rationale:
Guaiac testing is for hidden fecal blood, also known as occult blood. A patient stool sample would be brought to the laboratory and the medical assistant would perform point-of-care testing (POCT ) on a very small fecal sample using a manual slide test with built in controls. Venous specimens (blood samples) are not necessary for a fecal (stool) test. Skin tests are not required in this instance, since the specimen is a stool specimen.
Diabetic patients require an index of their average glucose level. Which of the following laboratory tests is required?
A. glucose tolerance test
B. glycosylated hemoglobin
C. hemoglobin & hematocrit
D. fasting glucose
glycosylated hemoglobin
Rationale:
The hemoglobin A1c test (HbA1c) is a laboratory test for glycolysated hemoglobin. When diabetes is not controlled, the extra blood sugar combines with hemoglobin and provides an average amount of the “glycolysated hemoglobin” over time instead of relying upon measuring glucose levels on any single day. This provides an overview of compliance and medication effectiveness, and is used along with Point of Care Test monitoring to help monitor treatment.
Which of the following laboratory tests would be ordered for a patient with diabetes insipidus?
A. ETOH
B. GH
C. RH
D. ADH
ADH
Rationale:
Diabetes insipidus occurs when the body cannot regulate how it handles fluids. The rate of fluid excretion is greatly influenced by the anti-diuretic hormone (ADH). Diabetes insipidus is not related to diabetes mellitus, although both can result in increased urinary output. The remainder of the tests are not related to a condition of diabetes. Their uses are as follows: ETOH = Ethanol (ethyl alcohol)ingestion - GH = Growth Hormone - RH = Rh Factor (on red blood cells)- ADH = Anti-diuretic Hormone
Which task should a medical assistant complete prior to using a POCT instrument?
A. Read the operation manual.
B. Perform QA and QC on the instrument.
C. Ensure that QA and QC were performed within the last month.
D. Perform QC and test the instrument on a blood sample.
Perform QA and QC on the instrument.
Rationale:
Each time a POCT instrument is used, both Quality Assurance and Quality Control procedures must be completed. This ensures the instrument and reagents are performing properly so test results can be validated. Without QA/QC, patient test results cannot be guaranteed. Although reading the operation manual is fine, it is not a substitute for training and need not be performed prior to each use. There would be no rationale for selecting “within the last month” as a time frame for completion of QA or QC, and certainly QC without QA is insufficient.
The agency that regulates physician office labs is
A. OSHA.
B. CDC.
C. HIPAA.
D. CLIA.
CLIA.
Rationale:
CLIA (Clinical Laboratory Improvement Amendments) is an agency in charge of regulating physician office labs as well as ensuring the laboratory is performing quality testing. OSHA (Occupational Safety and Health Administration) is responsible for making sure the workplace is safe for workers. CDC (Centers for Disease Control) follows and investigates health issues affecting the public. HIPAA (Health Insurance Portability and Accountability Act) is a set of regulations put in place to ensure confidentiality of health insurance; also making it easier for a person to keep their health insurance if they change or lose jobs.
Which of the following are examples of CLIA waived tests that may be performed by a medical assistant who has received appropriate training? (Select the three (3) correct answers.)
A. spun hematocrit
B. urine hcg
C. rapid strep
D. blood culture and sensitivity
E. pap smear
spun hematocrit, urine hcg, rapid strep
Rationale:
A spun hematocrit, urine hcg, and rapid strep test are considered low complexity tests which hold the least risk for erroneous results when performed incorrectly. Blood culture and sensitivity testing and pap smears are considered high complexity and outside a medical assistant’s scope of practice; these tests should be performed by qualified laboratory personnel. CLIA refers to the Clinical Laboratory Improvement Amendment, which specifies personnel requirements for performing laboratory testing based upon their complexity. Moderate and high complexity testing are outside the scope of practice for a phlebotomist. Phlebotomists may perform CLIA-waived testing, such as Point of Care Testing, with proper training.
A patient’s urine specimen is noted to be dark yellow with sediment, and has a strong, ammonia-like odor. Which of the following is most likely to be present when processing the specimen?
A. bacteria
B. ketones
C. erythrocytes
D. pH 7.0
bacteria
Rationale:
Bacteria is most likely present in this patient’s urine, which is causing the dark yellow color, sediment, and odor. Common causes of this are inadequate fluid intake, bacterial overgrowth, and/or infection. The sole presence of ketones in the urine (ketonuria) would not cause a dark yellow color or an ammonia-like odor because ketones cause a sweet smell. When erythrocytes (red blood cells) are present in the urine (hematuria), the urine would be a reddish color. A pH of 7.0 would indicate that the urine is neutral, thus it wouldn’t have an ammonia-like odor (ammonia is a weak base). Ketonuria, hematuria, and neutral urine in and of themselves would not produce the urinalysis results in this scenario.
ECG machines with LCD displays allow which of the following information to be added before the test? (Select the two (2) correct answers).
A. patient name
B. room artifacts
C. lead placement
D. blood pressure
E. type of electrodes used
patient name, blood pressure
Rationale:
The LCD display on an ECG machine generally allows the patient name and blood pressure to be added before the test begins. Lead placement and electrode types would be determined beforehand. Room artifacts could cause erratic results, but wouldn’t generally be on the LCD display.
The medical assistant is responsible for performing which of the following QC measures? (Select the three (3) correct answers.)
A. checking the expiration dates of venipuncture supplies
B. perform calibration on the Chemistry analyzer
C. monitoring temperatures of specimen refrigerators
D. equipment checks on the laboratory Hematology analyzer
E. routine cleaning of surfaces where specimens are processed
checking the expiration dates of venipuncture supplies, monitoring temperatures of specimen refrigerators, routine cleaning of surfaces where specimens are processed
Rationale:
Medical assistants would perform QC measures on equipment and work surfaces they use regularly in collecting, processing, and storing samples. They are not responsible for performing calibrations or equipment checks on Chemistry or Hematology analyzers in the laboratory. Medical laboratory scientists would typically perform those functions.
