Specimen collection, Processing, and other Preanalytical variables

Question 1

1. Identify the incorrect specimen collection scenario below.
   a. Ask a parent to name a pediatric patient.
   b. Ask an adult patient to state his or her name and
   another identifier.
   c. Show the patient or parent the labeled tube after collection is complete.
   d. Check the room and bed number of the patient to be
   collected and proceed with collection.
   e. Contact a translation service for a patient unable to
   speak the local language.

Answer 1

d. Check the room and bed number of the patient to be
collected and proceed with collection.

Question 2

2. Identify the correct tube (additive)/biochemical action
   below:
   a. Lavender (EDTA)/anticoagulated specimen that will
   limit effects on cell morphology
   b. Light blue (ACD)/chelation of calcium to allow effective coagulation testing
   c. Red (no additive, no gel)/serum sample that can be
   sampled directly by many analyzers
   d. Light green/no gel/sodium–heparin tube prevents any
   further cellular activity that might affect analytes such
   as glucose
   e. Dark green/lithium heparin/requires prompt removal
   of the plasma from the cell pellet

Answer 2

a. Lavender (EDTA)/anticoagulated specimen that will
limit effects on cell morphology

Question 3

3. Patients should not pump their fists after the tourniquet is
   applied because
   a. it may or may not cause venous stasis not under the
   control of the collector.
   b. it will affect the chemical interaction between the tube
   additive and the patient’s blood.
   c. metabolic activity of the blood and muscles will affect
   analytes such as potassium and calcium through effects
   on pH.
   d. it will affect the distribution of analytes between plasma
   and serum.
   e. it will make it more difficult to find the patient’s vein.

Answer 3

c. metabolic activity of the blood and muscles will affect
analytes such as potassium and calcium through effects
on pH.

Question 4

4. For urine collections, which of the following is true?
   a. Samples should be kept at room temperature for a
   timed collection.
   b. Special identification of the patient may be required for
   forensic purposes.
   c. Identification of added preservative does not need to be
   communicated to the patient because all are safe.
   d. For a 24-hour collection, the patient may collect
   into a rinsed milk jug and then pour the sample into
   the provided container at the end of the collection
   period.
   e. No special handling is required because of collection
   preservative if the sample is sent to another laboratory.

Answer 4

b. Special identification of the patient may be required for
forensic purposes.

Question 5

5. Additional testing requested by the clinician treating the
   patient (add-on testing) should always be carried out,
   when
   a. the sample was not stored correctly per local validated
   storage policies.
   b. the patient is not identified correctly.
   c. the request is for a labile compound that may have been
   affected by storage
   d. the sample needs to be retrieved from a waste container.
   e. the request is for a test that has been validated on the
   sample submitted.

Answer 5

e. the request is for a test that has been validated on the
sample submitted.