Quality Assurance - (Module) Flashcards
The ability of an item of equipment to produce similar results when a known value is repeatedly introduced is
A. calibration.
B. accuracy.
C. precision.
D. linearity.
B. accuracy
All of the terms are important on the exam. Listen to the audio explanation
Calibration - introducing a known substance and matching the equipment to the known amount “making it match”
Accuracy - The ability of an item to produce simliar results when a known value is repeatedly introduced. “a good average.” The average of the results are all near the target
Precision - getting the exact result every time, regardless of if they are near the target. The results are identical to each other
Linearity - Multiple measurements along a range. Requires at least 3 measurements at different points.
The ability of an instrument to accurately measure the same values under a variety of conditions is
A.reproducibility.
B.repeatability.
C.linearity.
D.precision.
A. reproducibility
The difference between reproducibility and repeatability is
reproducibility will achieve the same results under a variety of conditions. eg, different times or dates, different machines, etc.
repeatability will be the ability to repeat results immediately. No changes in method, date, etc.
The CLIA-88 regulations fall under the authority of which of the following agencies?
A. Occupational Safety and Health Administration
B. National Institute for Occupational Safety and Health
C. Health and Human Services
D. The Joint Commission
C. Health and Human Services
*page F-7
CLIA-88: Clinical Laboratory Improvement Amendments of 1998
OSHA makes the rules that address workplace hazards.
NIOSH enforce the OSHA rules
HHS oversees administration of CLIA-88 and the rules for operating PFT and blood gas labs.
TJC develops standards of quality for healthcare organizations
Patient performance standards for the purpose of quality control include all of the following EXCEPT
A. the type of test signals for checking accuracy and precision.
B. instruction and coaching of the patient.
C. insuring that the data collected meets acceptable standards.
D. the technologist’s ability to operate the equipment correctly.
A. the type of test signals for checking accuracy and precision
Equipment performancs standards:
type of equipment
type of maintenance
type of test signals for checking accuracy and precision
Patient performance standards:
technologists ability to operate the equipment correctly
instruction and coaching of the patient
patient effort and cooperation
insuring that the data collected meets acceptable standards
The question asked for patient performance standards, and choice A was an equipment performance standard.
*page F-8
Which of the following is/are true regarding the ATS-ERS Standards for measuring slow vital capacity during spirometry?
- Flow range of 0 – 14 L/sec
- Time of 15 seconds
- 3 L calibration syringe as test signal
A. 3 only
B. 1 and 3 only
C. 1 and 2 only
D. 1, 2, and 3
B. 1 and 3 only
SVC time is 30 seconds, not 15. 2 is false
Flow range is up to 14 L/sec for both SVC and FVC. 1 is true
3 L calibration syringe as a test signal is true for both SVC and FVC. You will use a 3 L syringe to test your equipment for accuracy. 3 is true
Remember test time is the only difference for SVC and FVC. SVC is 30 seconds, FVC is 15 seconds.
*page F-9
The Westguard Rules apply to
A. calibration of the flow transducer during body plethysmography.
B. determining workload for a patient utilizing an arm ergometer.
C. calculation of respiratory exchange ratio from calorimetry.
D. determination of whether ABG data for the purpose of quality control is in or out of control.
D. determination of whether ABG data for the purpose of quality control is in or out of control.
*page F-10
Associate Westguard Rules with Levey Jennings and ABG data in and out of control.
During evaluation of quality control data from a blood gas analyzer, the pulmonary function technologist notes that the values for PO2 are a mean of 80 torr with a standard deviation of 2 torr. What is the acceptable range of values for the PO2 electrode?
A. 72 – 88 torr
B. 74 – 86 torr
C. 76 – 84 torr
D. 78 – 82 torr
C. 76 - 84 torr
*page F-10
2 standard deviations is acceptable for ABGs.
The question says a standard deviation is 2 torr.
2 deviations times 2 torr is 4 torr.
If your mean is 80, your acceptable range is +/- 4, so 76 - 84.
The following quality control data is reported for the PCO2 electrode of a blood gas analyzer with a mean value of 42 torr and a standard deviation of 2 torr:
Run Measured Value (torr) 1 43 2 41 3 42 4 47 5 47
The pulmonary function technologist should
A. perform an additional quality control run.
B. proceed with analysis of patient blood samples.
C. flush the surface of the electrode with water.
D. replace the electrode.
*page F-10
2 standard deviations is acceptable for ABGs. The question says a standard deviation is 2 torr.
You can deviate 4 points from the mean of 42, so your acceptable range is 38-46.
Run 4 and 5 are at 47, outside of acceptable range, and there are 2 ERRORS.
- page F-11: 2 errors indicate the electrode is “out of control” and needs to be recalibrated or replaced.
note: if only 1 run was out of range, that would be a “random error” and you could proceed with your analysis.
Quality control of the body plethysmograph is accomplished with the use of a/an
A. 3 L super syringe.
B. isothermal lung model.
C. sinusoidal pump.
D. mercury barometer.
B. isothermal lung model.
*page F-13
The isothermal lung model is specifically designed to quality control a body box.
isothermal = same temperature
lung model = simulated lung
Which of the following quality control methods involves sending unknown control specimens to different laboratories which utilize the same make and model of analyzer?
A. Proficiency testing
B. Multiple machine analysis
C. Gas exchange validation
D. Gas tonometry
A. Proficiency testing
*page F-13
“Proficiency testing - unknown control specimens are sent out to different laboratories using the same make and model of analyzers.”
mutiple machine analysis is done on different machines in the same lab
gas exchange validation and gas tonometry are the same thing. The tonometer equilibrates your blood sample with a specific set PaO2, so that you can verify the result produced by your ABG machine is the same.
While evaluating a recently performed spirogram, the pulmonary function technologist notes that exhalation lasted 5 seconds and the extrapolated volume was 6% of the FVC. The technologist should
A. report the results as obtained.
B. contact the referring physician.
C. ask the patient to perform another forced vital capacity maneuver.
D. administer a bronchodilator and repeat the maneuver.
C. ask the patient to perform another forced vital capacity maneuver.
Your FVC should last 6 seconds, and the extrapolated volume should be less than 5% of FVC.
*page F-14
Which of the following trials should the pulmonary function technologist use to record the results of spirometry?
See image: Quality Assurance - Question 12
A. Trial #1
B. Trial #2
C. Trial #3
D. Trial #4
C. Trial #3
The “best test” is the test that has the highest combined FVC + FEV1
Trial 1 = 9.4
Trial 2 = 10.7
Trial 3 = 10.8
Trial 4 = 10.0
Which trial would you report the FVC? Trial 2
Which trial would you report the FEV1? Trial 3
How many acceptable FVC maneuvers should be obtained before the pulmonary function technologist can report accurate results?
A. One
B. Two
C. Three
D. Four
C. Three
*page F-14
You need 3 good efforts within 150 ml of each other.
A good effort is free of artifact, lasts 6 seconds, and has an extrapolated volume less than 5% of the FVC.
The pulmonary function technologist notes that a patient has a reported FEV1 of 4 L and a reported MVV of 220 L/min. The technologist should
A. question the patient’s effort on the FVC maneuver.
B. have the patient repeat the MVV maneuver.
C. repeat the FEV1 following inhalation of methacholine.
D. report the results to the referring physician.
A. question the patient’s effort on the FVC maneuver.
*page F-17
“if the MVV exceed the FEV1 x 35 by a large amount, question the effort on the FVC.”
Note: It works in reverse as well. If the FEV1 x 35 is much lower than the MVV, question the effort on the MVV.
A patient with normal spirometry and diffusing capacity takes six (6) minutes to reach the end-of-test during a nitrogen washout maneuver. This is most likely the result of a
A. faulty Geissler tube ionizer.
B. depleted CO2
absorber canister.
C. poor effort by the patient.
D. leak in the system.
D. leak in the system
*page F-18
A normal person should take about 3 minutes to complete the test.
A leak will cause more nitrogen to enter the system.
Choices B and C are not relevant to the issue, and choice A is not the best answer because the analyzer was able to reach the end of test, therefore it was working properly.
