Question 1

Moving averages can be used to monitor the instrument's performance in determining parameters of which cell line?

Accepted Answer

A) Leukocyte 
B) Erythrocyte 
C) Platelets 
D) Reticulocytes 
A) Leukocyte 
B) Erythrocyte 
C) Platelets 
D) Reticulocytes B

Question 2

What is the importance of documentation in a quality assessment program?

Accepted Answer

Implementation of a quality assessment program is required by CLIA 88.A laboratory's quality assessment program should be designed to monitor all aspects related to testing patient's samples.

Question 3

Patient samples are run on hematology analyzers to assess the instrument's:

Accepted Answer

A) Accuracy. 
B) Precision. 
C) Specificity. 
D) Sensitivity. 
A) Accuracy. 
B) Precision. 
C) Specificity. 
D) Sensitivity. B

Question 4

When using moving averages to monitor an automated hematology instrument, 	the clinical laboratory professional notes that a moving average falls out of 	range, but the recently performed quality control was acceptable, what would this 	indicate?

Accepted Answer

A)  The instrument should be recalibrated. 
B)  The range is incorrect for the moving average. 
C)  The patient samples for last 20 results were from a single location. 
D)  The clinical laboratory professional should open and run new control 	materials. 
A)  The instrument should be recalibrated. 
B)  The range is incorrect for the moving average. 
C)  The patient samples for last 20 results were from a single location. 
D)  The clinical laboratory professional should open and run new control 	materials.

Question 5

Given the following fibrinogen control limits: Level I $ \quad x=246 \mathrm{mg} / \mathrm{dL} \quad \mathrm{s}=6.0 \mathrm{mg} / \mathrm{dL} $
Level II $ \quad \mathrm{x}=75 \mathrm{mg} / \mathrm{dL} \quad \mathrm{s}=2.5 \mathrm{mg} / \mathrm{dL} $
If the multirule control procedure for the fibrinogen assay is 13s, 22s, and R4s, how would you interpret the fibrinogen control results for the current run?
$\begin{array}{lccc}
  \text { Current Run:} & \text { Level I } &232 \mathrm{mg} / \mathrm{dL} \
 & \text { Level II }& 82 \mathrm{mg} / \mathrm{dL}
\end{array}$

Accepted Answer

A)  Acceptable 
B)  Unacceptable, 1?s violation 
C)  Unacceptable, 2?s violation 
D)  Unacceptable, R?s violation 
A)  Acceptable 
B)  Unacceptable, 1?s violation 
C)  Unacceptable, 2?s violation 
D)  Unacceptable, R?s violation

Question 6

What are the components of a method evaluation? Explain the purpose of each.

Accepted Answer

The components of a method evaluation in

Question 7

Which of the following is an acceptable means for competency testing?

Accepted Answer

A) Direct observation checklists 
B) Random assignment of proficiency samples 
C) Blinded pre-analyzed samples 
D) All of the above 
A) Direct observation checklists 
B) Random assignment of proficiency samples 
C) Blinded pre-analyzed samples 
D) All of the above

Question 8

Regarding the evaluation of proficiency testing results, which of the following sets 	the tolerance limit for a given hematology procedure (e.g., hemoglobin)?

Accepted Answer

A)  The Joint Commission 
B)  CLIA '88 
C)  College of American Pathologists 
D)  COLA 
A)  The Joint Commission 
B)  CLIA '88 
C)  College of American Pathologists 
D)  COLA

Question 9

Implementation of a quality assessment program in laboratories is mandated by:

Accepted Answer

A) OSHA. 
B) JCAHO. 
C) CLIA 88. 
D) CAP. 
A) OSHA. 
B) JCAHO. 
C) CLIA 88. 
D) CAP.

Question 10

What is the first step in the selection of a new instrument?

Accepted Answer

A) Conduct a needs assessment survey. 
B) Determine the cost per test. 
C) Perform an in-house evaluation of the instrument. 
D) Evaluate the quality control program offered. 
A) Conduct a needs assessment survey. 
B) Determine the cost per test. 
C) Perform an in-house evaluation of the instrument. 
D) Evaluate the quality control program offered.

Question 11

A patient's automated reticulocyte count was 203 x 10⁹/L.Which of the following could account for this result?

Accepted Answer

A)  Heinz bodies 
B)  Platelet satellitism 
C)  Leukocytosis 
D)  Fibrin strands 
A)  Heinz bodies 
B)  Platelet satellitism 
C)  Leukocytosis 
D)  Fibrin strands

Question 12

What is the goal of the Westgard multirule protocol for evaluating control 	results?

Accepted Answer

A)  Reject all runs in which 1₂s control rule is violated. 
B)  Eliminate random error detection. 
C)  Minimize false rejection of a control run. 
D)  Increase analytical sensitivity of a control run. 
A)  Reject all runs in which 1₂s control rule is violated. 
B)  Eliminate random error detection. 
C)  Minimize false rejection of a control run. 
D)  Increase analytical sensitivity of a control run.

Question 13

Which of the following statistical measurements can be used to analyze a new instrument's precision?

Accepted Answer

A) F-test 
B) Linear regression 
C) Calculated SD 
D) T-test 
A) F-test 
B) Linear regression 
C) Calculated SD 
D) T-test

Question 14

Which of the following represents an appropriate step to meet universal 	precautions?

Accepted Answer

A)  Check the sample source before using protective equipment 
B)  Require HIV immunization for all healthcare workers 
C)  Use mechanical pipeting devices to deliver all sample aliquots 
D)  Dispose of capped needles in biohazard trash bags 
A)  Check the sample source before using protective equipment 
B)  Require HIV immunization for all healthcare workers 
C)  Use mechanical pipeting devices to deliver all sample aliquots 
D)  Dispose of capped needles in biohazard trash bags

Question 15

The purpose of a control material is to:

Accepted Answer

A)  Ensure the reliability of a given test procedure. 
B)  Determine if a patient result is normal, increased or decreased. 
C)  Establish the calibration factor for calculation of results. 
D)  Verify the reportable range for a given test procedure. 
A)  Ensure the reliability of a given test procedure. 
B)  Determine if a patient result is normal, increased or decreased. 
C)  Establish the calibration factor for calculation of results. 
D)  Verify the reportable range for a given test procedure.

Question 16

Identify the critical information that must be on a material safety data sheet.

Accepted Answer

Critical information that must be on an

Question 17

The treatment of everything in the laboratory as infectious is defined as:

Accepted Answer

A) Proficiency testing. 
B) Quality control. 
C) Reference interval. 
D) Universal precautions. 
A) Proficiency testing. 
B) Quality control. 
C) Reference interval. 
D) Universal precautions.

Question 18

A clinical laboratory professional performed a procedure to verify the hemoglobin reportable range on the Cell-Dyn 4000.The highest level of linearity check material was 22.0 g/dL.This material was run several times with 21.7 g/dL, representing the mean.How should this finding be interpreted?

Accepted Answer

A) The result is within the tolerance limits, and the reportable range is verified. 
B) The result exceeds the tolerance limits, and the procedure should be repeated with new check material. 
C) The result exceeds the tolerance limits, and additional check material should be run in the upper limits of the reportable range. 
D) The result exceeds the tolerance limits, and the verification of reportable range should be repeated after the instrument is recalibrated. 
A) The result is within the tolerance limits, and the reportable range is verified. 
B) The result exceeds the tolerance limits, and the procedure should be repeated with new check material. 
C) The result exceeds the tolerance limits, and additional check material should be run in the upper limits of the reportable range. 
D) The result exceeds the tolerance limits, and the verification of reportable range should be repeated after the instrument is recalibrated.

Question 19

Which performance study in the method evaluation process determines the 	reportable range for the test method?

Accepted Answer

A)  Precision study 
B)  Linearity study 
C)  Calibration study 
D)  Method comparison study 
A)  Precision study 
B)  Linearity study 
C)  Calibration study 
D)  Method comparison study

Question 20

A sample collected for a prothrombin time is delivered to the laboratory 4 hours 	after collection.Which source of error does this represent?

Accepted Answer

A)  Pre-examination 
B)  Examination 
C)  Post-examination Correct 
A)  Pre-examination 
B)  Examination 
C)  Post-examination Correct

Exam 40: Quality Assessment in the Hematology Laboratory

Moving averages can be used to monitor the instrument's performance in determining parameters of which cell line?

What is the importance of documentation in a quality assessment program?

Patient samples are run on hematology analyzers to assess the instrument's:

When using moving averages to monitor an automated hematology instrument, the clinical laboratory professional notes that a moving average falls out of range, but the recently performed quality control was acceptable, what would this indicate?

What are the components of a method evaluation? Explain the purpose of each.

Which of the following is an acceptable means for competency testing?

Regarding the evaluation of proficiency testing results, which of the following sets the tolerance limit for a given hematology procedure (e.g., hemoglobin)?

Implementation of a quality assessment program in laboratories is mandated by:

What is the first step in the selection of a new instrument?

A patient's automated reticulocyte count was 203 x 10⁹/L.Which of the following could account for this result?

What is the goal of the Westgard multirule protocol for evaluating control results?

Which of the following statistical measurements can be used to analyze a new instrument's precision?

Which of the following represents an appropriate step to meet universal precautions?

The purpose of a control material is to:

Identify the critical information that must be on a material safety data sheet.

The treatment of everything in the laboratory as infectious is defined as:

A clinical laboratory professional performed a procedure to verify the hemoglobin reportable range on the Cell-Dyn 4000.The highest level of linearity check material was 22.0 g/dL.This material was run several times with 21.7 g/dL, representing the mean.How should this finding be interpreted?

Which performance study in the method evaluation process determines the reportable range for the test method?

A sample collected for a prothrombin time is delivered to the laboratory 4 hours after collection.Which source of error does this represent?

Introduction

Cellular Homeostasis

Hematopoiesis

Structure and Function of Hematopoietic Organs

The Erythrocyte

Hemoglobin

The Leukocyte

Introduction to Anemia

Anemias of Disordered Iron Metabolism and Heme Synthesis

Hemoglobinopaties: Qualitative Defects

Thalassemia

Megaloblastic and Nonmegaloblastic Macrocytic Anemias

Introduction to Hemolytic Anemia

Hemolytic Anemia: Membrane Defects

Hemolytic Anemia: Enzyme Deficiencies

Hemolytic Anemia: Immune Anemias

Hemolytic Anemia: Nonimmune Defects

Nonmalignant Granulocyte and Monocyte Disorders

Nonmalignant Lymphocyte Disorders

Introduction to Hematopoietic Neoplasms

Myeloproliferative Disorders

Myelodysplastic Syndromes

Acute Myeloid Leukemias

Acute Lymphoblastic Leukemias

Lymphoid Malignancies: Chronic Lymphoid Leukemias, Lymphomas, and Plasma Cell Neoplasms

Hematopoietic Stem Cell Transplantation

Morphologic Analysis of Body Fluids in the Hematology Laboratory

Primary Hemostasis

Secondary Hemostasis and Fibrinolysis

Disorders of Primary Hemostasis

Disorders of Secondary Hemostasis

Thrombophilia

Hematology Procedures and Hemostasis

Bone Marrow Examination

Automation in Hematology and Hemostasis

Flow Cytometry

Chromosome Analysis of Hematopoietic and Lymphoid Disorders

Molecular Analysis of Hematologic Diseases

Laboratory Testing in Coagulation

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