CAMLPR Specimen Collection Competency Practice Test

These questions are part of the practice quiz. Start practicing

• In a patient evaluated for Cushing's disease, cortisol was high on several days but Day 4 cortisol was lower. What is the most likely reason for the Day 4 result?
• How long can a urine specimen stay at room temperature before it must be refrigerated before testing?
• Capillary blood collection is appropriate in which scenario, and what is a critical step to avoid dilution?
• A punch biopsy of a skin lesion is taken from a patient and the pathologist orders direct immunofluorescence testing. Which of the following mediums should be used for transport?
• Which statement about bedside labeling is true?
• For a 24-hour urine collection, which procedure is correct?
• To minimize contamination during urine collection, which practice is recommended?
• What is the protocol if a requisition is incomplete or mislabelled?
• When four specimens arrive at the same time—a STAT arterial blood gas, a synovial fluid sample for a suspected gout, a gray top tube for a fasting glucose test, and a green top tube for a routine liver panel—what is the correct processing priority?
• For newborns, what is the recommended site and depth for a capillary heelstick to minimize tissue damage?
• What is the correct sequence for doffing PPE after specimen collection?
• If a patient provides their own specimen, what steps ensure authenticity and accuracy?
• Which items comprise the key packaging requirements when shipping specimens to external laboratories?
• Which practice is essential for specimens collected with anticoagulants?
• Which of the following best describes proper labeling practices for specimen collection?
• What is the correct cold-chain procedure during transport?
• What needle gauge is commonly used for adult venipuncture and why?
• Why is an early morning sputum specimen preferred for certain tests?
• In which scenario is a butterfly needle particularly recommended, and what disruption risk increases if used improperly?
• Why are blood culture bottles collected before other tubes, and how many sets are typically needed?
• For fasting lipids testing, what is the standard fasting period and what should the patient avoid?
• Which step ensures specimen integrity for urine drug testing?
• An emergency blood request is made for an patient with known A positive history, but the current specimen is poorly labeled. Which specimen would be most appropriate for an anaerobic culture request?
• Which statement best describes privacy considerations during specimen collection?
• During venipuncture, what indicates successful venous entry?
• What must be verified before specimen collection to ensure correct patient identification?
• Which practice helps accommodate latex allergy during specimen collection?
• Which color-top tube is used for coagulation testing such as PT and APTT?
• Which of the following is not typically part of a standard liver function panel?
• What is the rationale for the standard order of draw?
• What are the key steps for preserving RNA-containing specimens during transport?
• Which statement is not applicable to platelet storage and handling?
• A creatinine clearance was ordered and a midstream urine was collected and brought to the lab. What is the appropriate response?
• Where should labeling be performed to prevent specimen misidentification in a multi-sample collection?
• Which test would be used to assess iron stores?
• What is the purpose of a double-check step for specimen labeling and what does it involve?
• A gold top tube shows extreme hyperkalemia, hypocalcemia, hypomagnesemia, and very low ALP in a patient with no distress. What is a possible cause?
• Which approach helps improve venous access in elderly patients with fragile veins?
• Which venipuncture technique minimizes tissue trauma and helps prevent vein collapse?
• How do urine collection methods differ for urinalysis versus urine culture?
• What steps should you take if you sustain a needle-stick injury during collection?
• A chemistry panel shows glucose 24.8 mmol/L (↑), total protein 33 g/L (↓), Na 128 mmol/L (↓), K 2.1 mmol/L (↓). What is this indicative of?
• Which color top tube is used for a fasting glucose test?
• Which PPE is required when performing venipuncture on a patient with suspected bloodborne infection?
• What information must be recorded when reporting a critical result?
• What is the best practice when drawing blood cultures from infants or neonates?
• A CBC on a 45-year-old female shows low RBC, low Hgb, low Hct, high MCV, and high MCHC; what is the most likely cause and how should the specimen be resolved?
• For creatinine clearance, what collection is required?
• Lipemic or icteric samples can interfere with spectrophotometric assays; what should you do?
• How should you handle a requisition note that lists incorrect patient information?
• What is the general order of draw for non-blood culture specimens in venipuncture?
• After venipuncture, what immediate actions should you perform regarding the tourniquet and needle?
• In a CBC with a delta check that flags a potential artifact, which action is appropriate to resolve?
• If testing is delayed, how should a swab for suspected Neisseria meningitidis be stored?
• Is there a requirement for dating and signing the specimen label?
• Which of the following is not applicable to Cryoprecipitate?
• Which action sequence best minimizes contamination and ensures proper processing of blood culture specimens?
• What is a key pre-analytical quality indicator for specimen collection, and how is it used to drive improvement?
• During capillary collection, why is the first drop wiped away?
• What strategies can reduce vasovagal reactions in anxious patients or those with a history of fainting during venipuncture?
• During a phlebotomy, the patient expresses discomfort and requests that the procedure stop with one tube left to collect. What should the technologist do?
• A synovial fluid sample is collected for a suspected gout patient. Which specimen type is this?
• Distinguish between hemolyzed and lipemic samples and their effects on results.
• Which statement is not applicable for Cryoprecipitate?
• Which trio makes up the thyroid panel described in the test ordering?
• What information must be on a specimen label to meet quality control standards?
• Which statement about platelets storage is not correct?
• A urine sample shows pH 9.0, turbidity, many bacteria, ammonium biurate present, and amorphous phosphates present. Which explanation best accounts for these results?
• A CBC shows Hgb 140 g/L, Hct 0.340 L/L (↓), MCV 72 fL (↓), MCHC 411 (↑). With no history of abnormalities, what is the most likely cause?
• Which urine collection is typically used when a specimen needs to be more concentrated?
• What consent considerations should be confirmed prior to specimen collection?
• An arterial blood gas sample is drawn from a patient on room air at 12:00 and received in the lab at 12:10. The MLT notices there is an air bubble present, expels it and runs the sample. How will this compare to the patient's true physiological state?
• Which specimen type is most appropriate for diagnosing anaerobic infection in deep tissue?
• A fresh, un-fixed surgical tissue biopsy arrives in the histopathology laboratory and is immediately placed into a container of 10% Neutral Buffered Formalin (NBF) by the laboratory staff. Ten minutes later, the operating room surgeon calls the lab and requests an immediate frozen section on that tissue to determine intraoperative margins. What is the best action the MLT could take?
• What is the purpose of a plain red-top tube and when is it used?
• Which tests commonly require EDTA as anticoagulant?
• What constitutes insufficient volume rejection and how should you respond?
• What practice helps minimize hemolysis during venipuncture?
• If a CSF sample from suspected meningitis, a clean catch urine for UTI, a stool sample for suspected C. difficile, and a positive blood culture bottle from ICU arrive together, what is the correct processing order?
• Which additive and tube type is commonly used for a complete blood count (CBC)?
• How do you determine specimen stability, and what action should be taken if a sample is at risk of degradation?
• Which labeling element is included to indicate hazard during transport of certain specimens?
• Which is an example of a time-critical specimen and how should it be handled to preserve its integrity?
• Which collection practice reduces the risk of specimen mix-ups when multiple samples are collected in one encounter?
• Outline essential PPE and infection control practices for specimen collection.
• When the following specimens arrive simultaneously: a type and screen for knee arthroplasty, a crossmatch for a postpartum patient with severe hemorrhage, a crossmatch for an anemic patient with Hb 60 g/L, and a Direct Antiglobulin Test for suspected hemolytic transfusion reaction, what is the correct priority order?
• Name a common pre-analytical interference caused by medications and how to mitigate?
• List three common reasons a specimen may be rejected before analysis.
• A chemistry specimen collected at 1100h sits unspun until 1300h. Which analyte is most likely to be falsely decreased?
• Why is the time of collection critical for certain tests, and give two examples of such tests?
• Which vein is typically preferred for routine venipuncture and why?
• Which statement best describes the order of draw for venipuncture in different institutions?
• Which situation would cause an unused Packed Red Blood Cell (PRBC) unit to be returned into the inventory?
• Explain chain of custody in specimen collection and provide a scenario where it's required.
• A 62-year-old male requires compatibility testing but two samples are on file: the original pre-transfusion sample from 3 months ago and a plasma sample collected 7 days ago. What is the most appropriate action?
• A 3.2% sodium citrate (blue top) tube collected for PT and APTT is filled to 80% of the stated line. What will happen to the test results?
• Name two commonly known temperature-sensitive tests and how you should handle them.
• Which of the following is not applicable for thawed Fresh Frozen Plasma (FFP)?
• Which tube color is drawn second in the standard order of draw?
• What patient education should occur prior to specimen collection?
• Describe proper capillary (fingerstick) collection technique and common pitfalls for adult patients.
• Which action best describes handling latex allergies during specimen collection?
• What is the primary fixative used for transmission electron microscopy (TEM) tissue preparation?
• Which analytes must be rejected when a non-fasting specimen is collected due to fasting requirements?
• What is the protocol when a contaminated specimen is suspected or observed?
• Which statement is not applicable to Fresh Frozen Plasma (FFP)?
• What is the recommended protocol for blood cultures regarding bottle order, site, and antibiotic therapy?
• Which of the following is not a part of the chain of custody protocol for legal specimens?
• What steps should you take to verify patient before specimen collection?
• An MLT receives a pap smear cervical specimen in the lab to be fixed immediately. What is the correct fixation protocol?
• Which statement correctly describes capillary samples for CBC testing?
• If a specimen labeling is inconsistent with the requisition, what is the proper action?
• Why is prompt labeling of specimens important for test routing and patient safety?
• Which of the following is not applicable to Fresh Frozen Plasma (FFP)?
• Which action is part of the standard post-venipuncture procedure?
• What adjustments are commonly used in pediatric venipuncture to reduce distress?
• How should bilirubin-sensitive specimens be protected during collection and transport?
• What analyte is least beneficial when determining if a patient has had an Acute Myocardial Infarction (AMI)?
• What does a serum separator tube contain and why is it used?
• Which statement about platelets storage is NOT applicable?
• Which CBC artifact is most consistent with EDTA contamination?
• How should you decide whether a specimen should be processed immediately or batched for later processing?
• For a clean-catch midstream urine collection, which procedure is correct?
• What is the standard order of draw for evacuated tubes and the rationale?
• What is the primary purpose of labeling the specimen immediately after collection?
• In pediatric venipuncture, which approach improves success and safety?
• What are common reasons a specimen may be rejected by the lab?
• Which elements are essential to include in specimen collection documentation in the laboratory information system?
• Formalin-fixed tissue is not suitable for which intraoperative evaluation?
• What special considerations apply to blood alcohol or toxicology specimen collection?
• A shipment of Packed Red Blood Cells arrives with a broken tamper-proof seal. What is the best course of action?
• Which action should you take to ensure patient safety when a requisition lists incorrect information before collection?
• Which additive is commonly used for CBC testing?
• What are key aseptic techniques for sterile specimen collection?
• In an emergency transfusion, a patient is labeled as A positive but the specimen labeling is poor and the historic ABO type is A positive. What should be given?
• If a specimen leaks during transport, which action is appropriate?
• When four specimens arrive: a large colon specimen for tumor staging, a breast specimen for frozen processing, a small skin punch biopsy in 10% neutral buffered formalin, and a gallbladder specimen in a dry container labeled 'Routine', in what order should they be processed?
• What is the purpose of the blue top 3.2% sodium citrate tube used in recollection?
• What handling practices preserve urine analytes?
• Which statement is not applicable to Cryoprecipitate?
• How many blood culture sets are typically collected and from how many sites?
• What temperature conditions are typically required for transported urine specimens and why?
• What precautions are needed when collecting specimens from immunocompromised patients?
• Which test is used to investigate a suspected hemolytic transfusion reaction?
• Describe the proper sputum collection technique to ensure sample appropriateness.
• What distinguishes arterial blood gas collection from venipuncture in technique and handling?
• What differentiates arterial blood gas collection from venous collection, and what are the critical handling steps?
• Which substances are commonly reported to interfere with laboratory assays and should be documented?
• If a specimen appears moderately hemolyzed, which group of analytes can still be run?
• Which color top tube is used for a routine liver panel?
• What could cause a chemistry panel to show high glucose with other electrolyte abnormalities if a sample was drawn from an arm with an active IV infusion?
• In which situation would an RhIG work-up be ordered?
• What is used to ensure traceability of specimens in lab processing?
• In capillary collection for infants, which site is appropriate?
• The chemistry results show Ca2+ 3.05 mmol/L, TP 92 g/L, and ALB 58 g/L in a hydrated patient with no history of hyperparathyroidism. What is the most likely cause?
• Which antiseptic is commonly used for blood culture collection?
• If you suspect a collection error has occurred, what is the immediate action?
• Which urine collection is used for quantitative measures like creatinine clearance and protein?
• When should refrigeration be used for specimen transport, and why is timing important?
• In the ED, a 19-year-old male with suspected diabetic ketoacidosis has an HbA1c ordered to assess current glucose. What is the most appropriate action for the MLT?
• What is the maximum tourniquet time during venipuncture, and what are the consequences of exceeding it?
• Which action helps ensure correct patient identity during specimen labeling?
• Which of the following would prompt returning a PRBC unit to inventory due to storage conditions?
• What is the first action to take when reporting a critical or abnormal result?
• Which signs indicate hemolysis and why do they affect test results?
• Which statement about HbA1c in acute settings is true?
• Why is it important to obtain a newly collected specimen within 3 days of planned transfusion?
• Which additive does a light blue top tube contain, and what is its primary use in testing?
• What are the consequences of incorrect labeling on test results and patient care?
• Why must light blue-top tubes be completely filled when collecting coagulation studies?
• Which handling practice is essential to preserve arterial blood gas sample integrity?
• What is the purpose of hand hygiene before and after specimen collection, and what technique is recommended?
• What is the correct order of draw based on tube color?
• What is the purpose and source of a peripheral smear?
• Which adaptation is recommended for elderly patients with fragile venous access?
• What are the steps and instructions for a 24-hour urine collection?
• Which practice maintains patient confidentiality during specimen collection?
• What is the purpose of gently inverting blood collection tubes after collection?
• How many times should most routine blood collection tubes be inverted after collection to ensure proper mixing of additive?
• A 24-hour urine collection is primarily used to obtain quantitative measurements of which parameters?
• List strategies to minimize patient discomfort during phlebotomy.
• Which urine collection is typically used for routine urinalysis and culture?
• What constitutes the correct approach when a specimen shows insufficient volume for testing?
• Which statement is not applicable for Fresh Frozen Plasma (FFP) that has been thawed?
• A stool sample from a patient suspected of Clostridium difficile infection appears firm and formed. What should you do?
• A tissue fixative is unavailable and the specimen could be out for 30 minutes. What is the recommended temporary handling for the tissue?
• Which of the following statements explains why a light blue top tube must be completely filled when collecting blood for coagulation studies?
• How should you assess for contamination in urine testing and what action is taken if contamination is suspected?
• Which actions are essential when documenting a 24-hour urine collection?
• What information must be included on a specimen label to ensure proper processing and tracking?
• Which statement accurately describes the difference between plasma and serum?
• Which statement best describes the importance of labeling for specimen collection?
• Why is it important to document medications and supplements that may affect test results before collection?
• In a 24-hour urine collection, what is the correct initial step?
• Which collection approach minimizes contamination for urine culture?
• A sputum sample from a patient with suspected Streptococcus pneumoniae shows WBCs >25 per LPF, epithelial cells 10-25 per LPF, and mucus. How should you proceed?
• A requisition for crossmatch and immediate issue of two units of PRBCs for an adult inpatient is received. The patient’s Hgb is 120 g/L with no active hemorrhage documented. What is the most appropriate response?
• Which component is included in a standard lipid panel?
• What is the role of absorbent material in the shipping packaging for specimens?
• What are essential transportation requirements for laboratory specimens?
• A requisition is received for urine assays and the sample has been acidified with HCl to pH 1.5-5.0 before testing. Which analyte would now have to be rejected?
• A serum sample has TSH, FT4, and osmolality ordered, but the requisition shows a patient name mismatch (Jane Rodgers vs Jane Robinson). The TSH and FT4 results have been verified. What should the technologist do?
• Which of the following would NOT cause a falsely negative blood culture result?
• Which tube color is commonly used for CBC testing?
• Which statement best describes handling of RNA-containing specimens when transport is delayed?
• What are the essential components of proper specimen labeling?
• Which component serves to prevent leakage if the primary container leaks during shipping?
• What is the proper method for disposing of used sharps?
• Which tube is used for coagulation studies?
• What steps should you take to ensure fasting status is correct for tests requiring fasting?
• For ammonia and lactate testing, why is ice slurry used and how fast must samples be processed?
• A needle core biopsy of a kidney is obtained from a patient. The pathologist requests transmission electron microscopy to evaluate the specimen. Which of the following is the correct order for specimen preservation?
• What is chain of custody and in which scenarios is it critical?
• A MLT collects an EDTA (purple-top) tube from an inpatient for an ABO grouping and antibody screen. The tube was never labeled at bedside. The MLT prints the barcode label and applies it at the bench. A colleague notes the infraction. What should the colleague do?
• What is the required approach to obtaining consent for pediatric venipuncture?
• How does barcoding enhance traceability of specimens in pre-analytical handling?
• If the requisition does not match the patient labels, what is the correct action?
• The urine test results show WBC: TRACE, PRO: NEG, BLD: 1+, NIT: POS, GLU: NEG, pH: 9.0, SG: 1.020, Color: Dark Yellow, Clarity: Turbid, Bacteria: Many, Ammonium Biurate: Present, Amorphous Phosphates: Present. Which explanation best accounts for these results?
• Which overarching practices ensure high-quality preanalytical specimen collection?
• Which action is inconsistent with proper specimen handling for legally controlled tests?
• When a bone marrow aspirate, a CSF sample, a CBC pre-operative, and an ESR for a child in the ED are received together, what is the correct order to process?
• Which practice minimizes the risk of mislabeling when collecting samples for ABO grouping?
• Which PRBC scenario would prompt returning the unit to inventory?
• Which option is not applicable to Fresh Frozen Plasma (FFP) thawed?
• Which statement about lipid panel ordering is true?
• What is the maximum recommended tourniquet time during venipuncture?
• What is the correct order of site determination for phlebotomy when checking veins in each arm (median cubital, cephalic, basilic, dorsal hand)?
• When is a recollection typically triggered?
• A CBC is processed on an analyzer and flags WBC 3.0 x 10^12/L, RBC 3.1 x 10^12/L, PLT 18 x 10^9/L, Hgb 95 g/L, Hct 0.290. The patient sample collected two days ago shows a fibrin clot on manual inspection. What is the next step?
• Which analyte should NOT be transported on ice?
• What action should you take if a urine sample has been exposed to improper temperature during transport?
• If a specimen appears to be moderately lipemic, which analytes can still be run?
• What is indicated by a hemolyzed specimen, and what is the recommended action?
• Which statement describes EDTA use and tests that require it as an anticoagulant?
• What is the purpose of participating in QA and continuous improvement in the preanalytical phase?
• Which of the following is a correct practice for handling arterial blood gas samples?
• What is a common error during blood culture collection that can lead to false negatives?
• If patient identifiers do not match the requisition, what should you do?