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AMT CMLA Practice Questions

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AMT CMLA Practice Questions

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500
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About these practice questions

These practice questions will help you prepare for the AMT CMLA exam.

This practice test contains 500 practice questions covering the four sections of the AMT CMLA exam:

  1. Laboratory Safety and Quality
  2. Pre-examination (Preanalytical) Considerations
  3. Examination (Analytical) Considerations
  4. Patient Test Management, Communications, and Foundations

All questions have been carefully designed to reflect the questions on the real exam, to help you prepare and get a passing grade.

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Section 1: Laboratory Safety and Quality

1) Which term refers to a technique that prevents infection?
  1. Aseptic
    The aseptic technique is a set of procedures designed to prevent infection. "Aseptic" means free from infection or contamination by microorganisms.
  2. Decontaminated
  3. Nonpathogenic
  4. Sanitary
2) Which test is used to monitor warfarin therapy?
  1. Erythrocyte sedimentation rate
  2. Hemoglobin
  3. International normalized ratio
    Warfarin is a medication used to prevent blood clots. Patients taking warfarin require laboratory testing to monitor the effectiveness of the medication. These tests measure how long it takes blood to clot. One such test is the prothrombin time (PT). When used to monitor warfarin therapy, prothrombin time results are reported as the international normalized ratio (INR).
  4. Partial thromboplastin time
3) External quality assessment schemes are also known as:
  1. compliance
  2. proficiency testing
    External quality assessment schemes (EQAS) are programs that assess the performance of laboratories by comparing their results to those of other laboratories. Proficiency testing is often used as a synonym for EQAS.
  3. quality assurance
  4. quality management systems
4) What are the four steps of the Shewhart Cycle?
  1. Analyze, create, inspect, and create again
  2. Initiate, plan, execute, and close
  3. Plan, do, check, and act
    The Shewhart cycle (also known as the PDCA cycle) is a method for improving processes and products. The four steps are Plan (identify the problem), Do (test potential solutions), Check (study the results), and Act (implement the best solution).
  4. Specify, produce, inspect, and change
5) Which problem-solving methodology consists of the phases Define, Measure, Analyze, Improve, and Control?
  1. Lean
  2. Pareto charts
  3. Shewhart cycle
  4. Six Sigma
    Define, measure, analyze, improve, and control (DMAIC) is a five-stage method used by Six Sigma to improve processes and products.
6) Which of these is an example of quality assurance rather than quality control?
  1. Calibrating an analyzer
  2. Repeating an out-of-range control
  3. Reviewing incident reports
    Quality control (QC) focuses on monitoring test performance (e.g., running controls), whereas quality assurance (QA) is a broader term and focuses on preventing errors before they occur (e.g., setting standards, staff training, audits). Reviewing incident reports is an example of quality assurance because it helps identify the root cause of errors to prevent them from happening again.
  4. Running daily controls
7) Which of these situations would cause random errors?
  1. Reading liquid volumes from different angles
    Random errors come from unpredictable changes and cause measurements to differ each time. A lab assistant who reads the volume in flasks at a different angle every time is an example of a random error. The other options cause systematic errors, not random errors. Systematic errors affect measurements by the same amount every time.
  2. Using a balance that was not zeroed before use
  3. Using a scale that always reads 10 g too low
  4. Using a thermometer that always reads 2°C too high
8) Random error mainly affects:
  1. accuracy
    Systematic error, not random error, mainly affects accuracy.
  2. external validity
  3. internal validity
  4. precision
    Random errors shift each measurement from its true value by a random amount and in a random direction. These errors reduce precision (how close the measurements are to each other).
9) A coworker suggests skipping thermometer calibration because “the thermometer is always accurate.” What is the best response?
  1. Agree to save time
  2. Calibrate only if temperatures look wrong
  3. Explain that calibration is essential for valid results
    Calibration is a fundamental component of Quality Assurance (QA). Even if a thermometer has been accurate for a long time, calibration checks are needed to ensure it is still working correctly.
  4. Stop using the thermometer entirely
10) Precise values:
  1. are caused by random errors
  2. are close to the true value
    Accurate values are close to the true value, not precise values.
  3. are the same as the true value
  4. fall within a narrow range
    Precision describes how close repeated measurements are to each other, while accuracy refers to how close those values are to the true value.
11) Which term means the extent to which measurements agree with the true value?
  1. Accuracy
    Accuracy is how close a measurement is to the real value.
  2. Precision
    Precision is how close repeated measurements are to each other.
  3. Reliability
  4. Reproducibility
12) What is the purpose of instrument calibration?
  1. To ensure the accuracy of the instrument
    Instrument calibration means comparing an instrument's readings to a known standard and then adjusting the instrument to correct errors. This ensures the instrument's accuracy.
  2. To ensure the instrument is properly cleaned
  3. To prolong the battery life of instruments
  4. To repair broken instruments
13) Which is an example of external quality control?
  1. Daily glucose control testing
  2. Instrument calibration
  3. Levey-Jennings charts
  4. Proficiency testing
    Proficiency testing is an external quality assessment where a provider sends identical blind samples to multiple laboratories. Each lab tests the samples and submits the results to the provider. The provider then compares the results and sends each lab a performance report, so labs can identify problems and improve.
14) The quality control chart of an instrument shows ten consecutive data points on one side of the mean. What should you do?
  1. Accept the run
  2. Reject the run and follow the method's troubleshooting procedures
    Ten consecutive data points on one side of the mean violates the 10ₓ Westgard rule. This indicates a shift in the results, suggesting systematic error. You should reject the run and follow the method’s troubleshooting procedures.
  3. Repeat the control sera on the next run
  4. Report the results with a disclaimer that they may be erroneous
15) Which of these is NOT a quality system essential (QSE)?
  1. Customer Focus
  2. Nonconforming Event Management
  3. Process Management
  4. Profit maximization
    The 12 quality system essentials are:
    1. Assessments
    2. Continual Improvement
    3. Customer Focus
    4. Documents and Records Management
    5. Equipment Management
    6. Facilities and Safety Management
    7. Information Management
    8. Nonconforming Event Management
    9. Organization and Leadership
    10. Personnel Management
    11. Process Management
    12. Supplier and Inventory Management
16) Which of these results is most likely to require notification to public health authorities?
  1. Acute allergic reaction
  2. Positive HIV test
    Public health authorities require the reporting of certain diseases. These are often referred to as notifiable diseases. HIV is typically a notifiable infectious disease that must be reported to public health authorities.
  3. Positive mononucleosis test
  4. Positive pregnancy test
17) Which test confirms a positive immunoassay drug test?
  1. Enzyme-linked immunosorbent assay
  2. Gas chromatography-mass spectrometry
    Immunoassays are used for presumptive drug tests and give an initial positive or negative result. However, the result may be a false positive because immunoassays can react with other compounds similar to drugs. A definitive finding requires gas chromatography (GC) or liquid chromatography (LC) to separate substances, followed by mass spectrometry (MS) to identify each substance by its unique mass.
  3. Ion-selective electrode
  4. Thin-layer chromatography
18) What is the least effective type of hazard control in the ISO 45001 Hierarchy of Controls?
  1. Administrative controls
  2. Engineering controls
  3. Personal protective equipment
    The hierarchy of controls is a list of methods for reducing workplace hazards. It ranks these methods from most to least effective:
    1. Elimination (most effective)
    2. Substitution
    3. Engineering controls
    4. Administrative controls
    5. Personal protective equipment (least effective)
    Personal protective equipment (PPE) is the least effective way to protect workers. It is better to eliminate, substitute, or control hazards instead.
  4. Substitution
19) If an employee is hospitalised due to a work-related accident, how soon must the employer notify OSHA?
  1. Immediately
  2. Within 12 hours
  3. Within 24 hours
    Employers must report any amputation, loss of an eye, or inpatient hospitalization of a worker to OSHA within 24 hours. Work-related fatalities are more serious and must be reported within 8 hours.
  4. Within 8 hours
20) In OSHA, a(n) __________ person is defined as "one who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous, or dangerous to employees, and who has the authorization to take prompt corrective measures to eliminate them."
  1. authorized
  2. capable
  3. competent
    In the context of Occupational Safety and Health Administration (OSHA) regulations, a "competent person" is someone capable of identifying existing and predictable hazards in the surroundings or working conditions that are unsanitary, hazardous, or dangerous to employees. This person must have the authority to take corrective actions to eliminate these hazards and ensure a safe working environment.
  4. qualified

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About the AMT CMLA exam

What is the AMT CMLA exam?

The AMT CMLA (Certified Medical Laboratory Assistant) certification exam is set by the American Medical Technologists (AMT). Passing the exam proves to employers that you can work in a laboratory as a medical laboratory assistant.

The exam contains 200 questions. All questions are multiple-choice.

How do I apply to take the exam?

The easiest way to apply to take the exam is online. Go to the AMT website (americanmedtech.org), and under Certification, click Apply/Check Status. Scroll down and click the Apply Today button to begin the application process. The exam fee is $135.

What if I need to cancel or reschedule the exam?

You can cancel or reschedule your exam by contacting Pearson Vue at least 24 hours before your exam starts. There is no charge for canceling or rescheduling, however, the exam fee is non-refundable.

What to bring to the exam

You must bring two valid forms of ID with you, one of which must have your photo.

Acceptable photo IDs are:

  • Driver’s License
  • Passport
  • Military Identification
  • State Identification Card

Calculators aren't allowed in the exam.

What's the exam like?

On the exam day, you'll need to go to your testing center. Make sure to arrive 30 minutes before the exam starts because you'll need time to check in and show your ID.

You'll be taken to a computer where you'll do the exam. The consists of 200 multiple-choice questions and there are no breaks.

What score do I need to pass?

There is no set number of questions you must answer to pass. Instead, each question is worth a certain number of points depending on its difficulty. Easy questions are worth fewer points and hard questions are worth more points.

How do I get my results?

You'll get your result immediately after finishing the exam. The computer will tell you if you passed or failed.

The testing center will also give you a paper copy of your results before you leave.

What if I fail the exam?

If you fail the exam, you can take it again after 45 days. To retake the exam, contact AMT at 847/823-5169 or complete the Examination Retake Form and email it to AMT. You'll also need to pay a retesting fee.

Exam content

The AMT CMLA exam is divided into four Work Areas:

  1. Laboratory Safety and Quality
  2. Pre-examination (Preanalytical) Considerations
  3. Examination (Analytical) Considerations
  4. Patient Test Management, Communications, and Foundations

Work Area 1: Laboratory Safety and Quality

The first Work Area, Laboratory Safety and Quality, is worth 22.5% of the exam and consists of 45 questions.

Safety

On the topic of laboratory safety, you will need to know about:

  • Basic safety
    • General safety principles used in clinical and laboratory settings
    • Common workplace hazards (especially biological and chemical hazards)
    • Safety terminology: Standard Precautions, Universal Precautions, aseptic technique, pathogen, infection, exposure, airborne transmission, transmission-based precautions, chemical hygiene plan, hazard, pictogram, Safety Data Sheet (SDS)
  • Chain of infection
    • How infections spread (the chain of infection)
    • Ways to break the chain to prevent transmission
  • Infection control and safety practices
    • Basic infection control practices (e.g., hand hygiene and PPE)
    • How to handle specimens, sharps, and contaminated materials safely
    • Cleaning and disinfection practices to reduce risk of spread
  • Isolation and aseptic practices
    • Accepted isolation techniques
    • Aseptic techniques to prevent contamination and disease spread
    • Methods of disease prevention in routine lab work
  • Required OSHA standards
    • OSHA Bloodborne Pathogens Standard
    • Needle Safety and Prevention Act
    • Federal, state, and locally mandated safety regulations
  • Hazard Communication and chemical safety
    • OSHA Hazard Communication Standard
    • Safety Data Sheets (SDS)
    • Chemical labeling and hazard warnings
  • GHS
    • How chemicals are classified and labeled under GHS (Globally Harmonized System)
    • Standardized pictograms and hazard communication elements
  • Public health reporting
    • Know that some diseases and conditions are nationally or state notifiable
    • Proper reporting requirements for examples such as HIV, HCV, and lead exposure

Quality assessment (QA) and quality control (QC)

For quality assessment (QA) and quality control (QC), you will need to know about:

  • Basic concepts of QA and QC
    • The purpose of QC and QA in the laboratory
    • How QC and QA help ensure accurate and reliable test results
    • QC/QA terminology: precision, accuracy, reliability, linearity, mean value, standard deviation, coefficient of variation, shift, trend
  • QC vs QA
    • The difference between quality control (QC) and quality assessment (QA)
    • Understand that QC focuses on day-to-day test performance
    • Understand that QA focuses on overall laboratory processes and outcomes
  • Internal and external quality control
    • The difference between internal QC and external QC
    • What each type of QC is designed to monitor
    • How internal and external QC support test accuracy and reliability
  • Quality control procedures
    • QC/QA procedures within the laboratory assistant’s scope of practice
    • Daily quality control checks
    • Interpreting QC results
  • Proficiency testing
    • Regulations related to proficiency testing
    • The role of proficiency testing in monitoring laboratory performance
    • Proficiency testing requirements within the laboratory assistant’s scope of practice
  • Environmental monitoring
    • Maintaining temperature and humidity logs
    • Documenting out-of-range temperatures or humidity levels
    • Taking appropriate corrective action when values are outside acceptable limits
  • Instrument maintenance and calibration
    • Routine instrument maintenance within scope of practice
    • Instrument calibration
    • Recognizing when instruments should not be used due to QC or calibration failure

Modified use of waived tests

You will need to:

  • Understand that off-label or modified use of a waived test increases test complexity
  • Recognize that modified use defaults the test to high complexity

Following manufacturer’s instructions

You will need to:

  • Follow package inserts and manufacturer instructions exactly
  • Avoid using tests on populations not indicated by intended use
  • Read test results within the required time frame
  • Store reagents and supplies according to instructions
  • Use the correct specimen type for each test

Confirmatory and supplemental testing

You will need to:

  • Follow manufacturer guidance on when confirmatory testing is required
  • Confirm urine drug screen results using GC/MS or LC/MS
  • Confirm rapid strep screens using culture or approved molecular testing
  • Confirm culture results using DFA or approved confirmatory molecular tests

Work Area 2: Pre-examination (Preanalytical) Considerations

The second Work Area, Pre-examination (Preanalytical) Considerations, is worth 18.0% of the exam and consists of 36 questions.

Phlebotomy

On the topic of phlebotomy, you will need to know about:

  • Terminology related to phlebotomy and blood specimens
    • Tourniquet, lancet, safety lancet, safety needle, evacuated tube, and adapter, syringe, butterfly (winged infusion set), hematoma and petechiae, pulse, syncope and seizure, vein (venous), artery (arterial), and capillary, serum, plasma, and whole blood, anticoagulant and preservative, transfer device
  • Blood components and specimen types
    • Know the differences between serum, plasma, and whole blood
    • Understand the difference between clotted and anticoagulated blood
    • Recognize appropriate specimen types for different tests
  • Patient identification and preparation
    • Properly identify patients using approved identification methods
    • Prepare patients appropriately for various laboratory tests
    • Recognize factors that may affect test results (fasting, posture, stress)
  • Specimen containers and anticoagulants
    • Select the correct container for each test
    • Understand container labeling requirements
    • Use appropriate anticoagulants for each analysis
    • Understand the effects of improper anticoagulant use
  • Venipuncture procedures
    • Select an appropriate venipuncture site
    • Understand basic physiological aspects of blood collection
    • Perform venipuncture using correct technique
    • Collect specimens safely and efficiently
  • Specimen collection considerations
    • Follow the correct order of draw
    • Understand the effects of a short draw
    • Prevent hemolysis and recognize the impact of hemolyzed specimens
    • Know time limits for plasma contact with cells
  • Post-collection care and specimen handling
    • Provide proper post-care of venipuncture sites
    • Handle blood specimens to maintain specimen integrity
    • Prevent contamination, clotting, or degradation of specimens
  • Specimen labeling, transport, and processing
    • Follow standard operating procedures for labeling specimens
    • Transport specimens according to time and temperature requirements
    • Process specimens properly, including transport to reference laboratories
  • Specimens used as legal evidence
    • Describe criteria for specimens used as legal evidence
    • Follow chain-of-custody procedures when required

Other collection methods

As well as phlebotomy, you will need to know about these other collection methods:

  • Capillary punctures
    • Perform capillary punctures correctly
    • Perform capillary punctures on infants using appropriate techniques
    • Select appropriate puncture sites for capillary collection
  • Urine specimen collection and handling
    • Instruct patients in proper urine collection methods
    • Mid-stream, random, clean-catch, and timed collections
    • Urine collections for drug screening
    • Recognize suitability of urine specimens based on test requirements
    • Know types and uses of urine preservatives
  • Other specimen types
    • Instruct patients in collection of semen, feces, and sputum specimens
    • Handle body fluids appropriately for chemical analysis

Other

  • Additional preanalytical processes
    • Prepare and stain slides for further analysis
    • Prepare, store, and dispose of specimens according to SOPs
    • Process specimens for shipping
  • Preanalytical errors and patient complications
    • Identify and report preexamination errors during collection, labeling, transport, and processing
    • Recognize patient complications such as syncope, nausea, and seizures
    • Respond appropriately to patient problems during or after specimen collection

Work Area 3: Examination (Analytical) Considerations

The third Work Area, Examination (Analytical) Considerations, is worth 41.5% of the exam and consists of 83 questions. It will test your knowledge of:

Chemistry

  • Understand the purpose of clinical chemistry testing
  • Know common categories of chemistry tests
  • Chemistry terminology: hepatic (liver) function tests, kidney (renal) function tests, carbohydrate (glucose) metabolism tests, general chemistry tests, electrolytes, endocrinology, serum, plasma, supernatant, decant
  • Use chemistry analyzers within the laboratory assistant’s scope of practice
  • Understand basic principles of analyzer operation
  • Perform routine cleaning and maintenance of chemistry analyzers
  • Perform waived and point-of-care chemistry tests
  • Perform approved toxicology tests as required
  • Know which toxicology tests fall within scope of practice

Hematology

  • Hematology terminology: hematology, blood, cells, hemoglobin, hematocrit, erythrocytes, leukocytes, thrombocytes (platelets), neutrophils, lymphocytes, monocytes, eosinophils, basophils, reticulocytes, anemia, complete blood count (CBC), erythrocyte sedimentation rate (ESR), plasma, serum, mononucleosis
  • Understand transport, protection, and regulation functions of blood
  • Recognize functional differences between RBCs, WBCs, and platelets
  • Follow established quality control procedures
  • Maintain and calibrate hematology instruments
  • Know coagulation terminology (PT, PTT, INR)
  • Understand the role of heparin and warfarin
  • Perform PT testing and know what medication it monitors
  • Perform PTT testing and know what medication it monitors
  • Understand the linear range for INR
  • Perform waived hematology tests

Immunology, serology, and immunohematology

  • Immunology terminology: antigen, antibody, agglutination, hemolysis, serum, plasma, Strep A test, HIV test, RSV test, influenza A/B tests, RPR test, heterophile agglutination (mono test), fibrinogen, rheumatoid arthritis tests (latex agglutination), qualitative and quantitative pregnancy tests
  • Understand antigen–antibody reactions
  • Know that blood groups, Rh types, and other antigens exist
  • Perform immunologic, serologic, and immunohematologic point-of-care and waived tests

Microbiology

  • Microbiology terminology: bacteria, viruses, yeast, fungi, aerobic organisms, anaerobic organisms, pathogenic organisms, culture, colony, normal flora, sensitivity, resistance, MIC, gram-positive cocci, gram-negative rods, agar, incubator, inoculate, loop, alpha hemolysis, beta hemolysis, gamma hemolysis, contaminant, AFB smear, KOH, Gram stain, wet prep, culture and sensitivity (C&S)
  • Recognize correct specimens for microbiological tests
  • Follow special safety and aseptic procedures
  • Prepare, store, transport, and dispose of specimens correctly
  • Recognize specimen rejection criteria
  • Assemble reagents, standards, and controls
  • Prepare and stain slides for analysis

Urinalysis

  • Urinalysis terminology: random urine collection, midstream urine collection, clean-catchurine collection, timed urine collection, casts, crystals, sediment, artifacts, specific gravity, hematuria, pyuria, proteinuria, glycosuria, ketones, polyuria, microscopic analysis, macroscopic analysis, refractometer, bacteria, yeast, trichomonas, spermatozoa
  • Prepare, transport, and dispose of urine specimens properly
  • Prepare slides for microscopic examination
  • Perform waived urinalysis testing within scope of practice
  • Know microscope terminology
  • Perform microscopic urinalysis procedures
  • Perform general microscope cleaning

Basic anatomy and physiology

  • Basic human anatomy and physiology

Work Area 4: Patient Test Management, Communications, and Foundations

The fourth Work Area, Patient Test Management, Communications, and Foundations, is worth 18.0% of the exam and consists of 36 questions.

You will need to know about the following topics:

Law

  • Liability
    • Understand basic legal responsibilities of laboratory personnel
    • Recognize situations that may result in liability
  • Consent, waivers, and test authorization
    • Understand the purpose and use of consent forms
    • Know the use of Advance Beneficiary Notices (ABN) for Medicare
    • Understand regulations governing who may order laboratory tests
  • Patient rights
    • Know the patient’s right to refuse treatment
    • Comply with the American Hospital Association’s Patient’s Bill of Rights
    • Follow workplace policies related to patient rights
  • Medicolegal concepts
    • Define common medicolegal terms
    • Follow policies and procedures designed to prevent legal problems
    • Recognize documentation requirements for legal protection
  • Provider-performed microscopy (PPM)
    • Know that regulations restrict PPM to providers only
    • Understand that laboratory assistants may not perform PPM
  • HIPAA and confidentiality
    • Observe HIPAA requirements for patient confidentiality
    • Protect patient health information
    • Follow appropriate procedures for release of medical records

Professional appearance and ethical conduct

  • Maintain appropriate personal appearance
  • Demonstrate professional behavior and mannerisms
  • Apply ethical standards when performing job duties
  • Use professionalism and ethical judgment when engaging on social media

Clerical skills

  • Laboratory reports and documentation
    • Chart and file laboratory reports correctly
    • Know what constitutes a complete and final laboratory report
    • Document and report abnormal results appropriately
  • Health information technology
    • Enter patient data accurately
    • Retrieve and verify collection data and special notations
    • Use electronic systems correctly and securely
  • Inventory and supply management
    • Maintain appropriate inventory levels
    • Order and restock laboratory supplies
    • Manage supplies according to expiration dates
    • Understand the difference between expiration date and open-date expiration
  • Billing and coding
    • Apply billing and coding procedures within scope of practice
  • Critical values
    • Recognize critical laboratory values
    • Notify appropriate personnel of critical results
    • Document critical value reporting properly
  • Time management and technology use
    • Understand the importance of time management
    • Use technology (cell phones, Internet) appropriately in the workplace

Communication

  • Patient communication
    • Inform patients of special test requirements
    • Communicate clearly with patients and families
  • Interpersonal communication skills
    • Use professional verbal and non-verbal communication
    • Interact appropriately with staff, patients, and families
  • Telephone etiquette
    • Use proper technique when answering laboratory calls
    • Provide information accurately and professionally