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CSMLS MLT Certification Exam: Practice Test 2

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About the CSMLS MLT exam

The CSMLS MLT Certification Exam is an examination for laboratory technicians in Canada. The exam is set by the CSMLS (Canadian Society for Medical Laboratory Science).

About these practice questions

These practice questions will help prepare you for the CSMLS MLT exam.

This page contains 300 practice questions divided into the eight sections of the exam: 1. Safe Work Practices, 2. Data and Specimen Collection and Handling, 3. Analytical Processes, 4. Interpretation and Reporting of Results, 5. Quality Management, 6. Critical Thinking, 7. Communication and Interaction, and 8. Professional Practice.

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

Check out all the practice tests in this series: Practice Test 1, and Practice Test 2.

Sections

  1. Safe Work Practices
  2. Data and Specimen Collection and Handling
  3. Analytical Processes
  4. Interpretation and Reporting of Results
  5. Quality Management
  6. Critical Thinking
  7. Communication and Interaction
  8. Professional Practice

Section 1: Safe Work Practices

1.1) What is the name of a document that identifies hazards and the ways to minimize their impact?
  1. Accident and incident recording form
  2. First aid assessment form
  3. Inspection report
  4. Risk management policy
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1.2) Which of these actions helps prevent repetitive strain injuries at computer workstations?
  1. Adjusting the chair height so your feet are flat on the floor
  2. Keeping the computer monitor above eye level
  3. Keeping the keyboard angled towards you
  4. Leaning forward for long periods of time
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1.3) In which of these situations should a lab technician remove their gloves?
  1. Before carrying specimens through a designated clean area
  2. Before loading the autoclave
  3. Before using a restroom
  4. For cleaning a chemical spill
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1.4) Which of these actions should be taken when installing a CO₂ incubator?
  1. Place the incubator in direct sunlight
  2. Place the incubator next to a ventilator
  3. Place the incubator on the floor
  4. When stacking incubators, only stack similar brands
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1.5) The systematic process of evaluating potential hazards is called a:
  1. Myers Briggs Type audit
  2. health needs evaluation
  3. risk assessment
  4. workplace danger evaluation
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1.6) Used needles should be discarded in:
  1. a biohazard sharps container
  2. a glass disposal bucket
  3. a glass recycling bin
  4. the regular garbage
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1.7) A lab assistant accidentally drinks a beaker of Zenker's fluid. He says he feels a burning sensation in his mouth and throat. The lab manager phones 911. While waiting for the ambulance to arrive, which of these other first-aid measures should be taken?
  1. Give the lab assistant water to drink
  2. Place the lab assistant in the recovery position
  3. Take the lab assistant outside for fresh air
  4. Tell the lab assistant to rinse his eyes with water for several minutes
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1.8) You find an old bottle of picric acid in the laboratory. The picric acid is dry. There are crystals in the bottle. How should you dispose of it?
  1. Call a bomb disposal service
  2. Dilute it with water and pour it into a hazardous waste container
  3. Pour it down the drain
  4. Send it for incineration
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1.9) What is the correct order of removal of PPE?
  1. Gloves, gown, goggles, mask
  2. Gown, goggles, gloves, mask
  3. Gown, mask, gloves, goggles
  4. Mask, gown, gloves, goggles
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1.10) Nitrile gloves:
  1. are a good substitute for latex gloves
  2. are cheaper than latex gloves
  3. are less resistant to punctures than latex gloves
  4. are unsuitable for routine laboratory work
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1.11) How do you care for someone with a possible neck injury?
  1. Ask the person to try to move their head
  2. Keep the person's head still and do not try to move it
  3. Move the person into a comfortable position
  4. Move the person's head so that it rests above their heart
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1.12) Which of these infectious agents is spread through the air?
  1. HIV
  2. Norovirus
  3. Salmonella
  4. Varicella virus
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1.13) Universal precautions apply to which type of hazard?
  1. Bloodborne pathogens
  2. Dangerous chemicals
  3. Environmental hazards
  4. Radiation
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1.14) Which of these items of information is found on a safety data sheet?
  1. Expiry date
  2. Health hazards
  3. Price
  4. Production date
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1.15) What does the following sign mean?
  1. Biohazard
  2. Do not eat
  3. General warning
  4. Toxic material
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1.16) On the NFPA hazard diamond below, what do the letters SA mean?
  1. Can shock and/or cause acid damage
  2. Safety assessed
  3. Simple asphyxiant
  4. Substance abuse
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1.17) How should ethers be stored?
  1. In airtight bottles
  2. In the light
  3. In the refrigerator
  4. Underwater
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1.18) Where should bulk quantities of acetone be kept?
  1. Biological safety cabinet
  2. Flammable storage cabinet
  3. Freezer
  4. Refrigerator
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1.19) Which of these chemicals would be the best choice to neutralize a weak acid spill in the laboratory?
  1. Acetic acid
  2. Boric acid
  3. Sodium bicarbonate
  4. Sodium hydroxide
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1.20) Which concentration of bleach is used to decontaminate benchtops?
  1. 10%
  2. 20%
  3. 30%
  4. 50%
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1.21) Which of these dilutions is the most effective disinfectant?
  1. 1% ethyl alcohol
  2. 10% ethyl alcohol
  3. 40% ethyl alcohol
  4. 70% ethyl alcohol
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1.22) Which disinfectant inactivates prions?
  1. Alcohol
  2. Formaldehyde
  3. Formalin
  4. Sodium hydroxide
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1.23) Class 1 hazardous materials are:
  1. explosive
  2. infectious
  3. poisonous
  4. radioactive
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1.24) Class 8 hazardous materials are:
  1. corrosive
  2. explosive
  3. poisonous
  4. radioactive
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1.25) Which class of dangerous goods are compressed gases, gases in their liquefied form, and refrigerated gases?
  1. 1
  2. 2
  3. 3
  4. 4
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1.26) Infectious substances that pose the highest risk of infection during transportation and are capable of causing permanent disability, life-threatening disease, or fatal disease are known as ______________ substances.
  1. Category A
  2. Category B
  3. Category C
  4. Type 1B
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1.27) Which agency is responsible for the regulation of human pathogens and toxins under the authority of the Human Pathogens and Toxins Act?
  1. Canadian Food Inspection Agency
  2. Health Canada
  3. Public Health Agency of Canada
  4. World Health Organization·
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Section 2: Data and Specimen Collection and Handling

2.1) Which of these specimens has the lowest priority?
  1. Postop
  2. Preop
  3. Routine
  4. Timed
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2.2) If a patient refuses to have blood drawn, you should:
  1. ask the patient for a urine sample instead
  2. notify the patient's nurse or physician
  3. restrain the patient and draw the blood
  4. try to convince the patient to be cooperative
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2.3) You have to draw blood from an elderly patient. You think his name is John Smith but you are not sure. Which of these is the best question to confirm the patient's name?
  1. "Are you John Smith?"
  2. "Can you confirm that you are John Smith please?"
  3. "I'm a phlebotomist and I'm here to draw your blood. First, though, I have to confirm your name. Can you confirm that your name is John Smith?"
  4. "What is your name?"
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2.4) When drawing blood from an obese patient, which location should be the first place you look for a vein?
  1. The antecubital fossa
  2. The back of the knee
  3. The feet
  4. The neck
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2.5) There are several short lengths of IV-type tubing protruding from a patient's chest. This is most likely a:
  1. CVC
  2. PICC
  3. arterial line
  4. implanted port
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2.6) After applying a tourniquet, small red spots appear on the patient's arm. These spots are a sign that:
  1. the patient has diabetes
  2. the patient is taking an anticoagulant
  3. the site may bleed excessively
  4. the tourniquet is too tight
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2.7) What might happen if an angle of 8 degrees is used when performing venipuncture?
  1. A deep hematoma may form
  2. The needle may enter above the vein
  3. The needle may go completely through the vein
  4. The needle may go through the posterior wall of the vein
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2.8) Which of these statements about venipuncture is true?
  1. After collecting the blood, remove the needle first, then the tourniquet
  2. Do not leave the tourniquet on for more than 1 minute
  3. Enter the vein at a 50-degree angle
  4. The bevel of the needle should be pointing down when the needle enters the vein
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2.9) What should you do if a patient faints during a venipuncture?
  1. Continue the procedure until all blood is collected
  2. Leave the needle in the vein and call the physician
  3. Remove the needle and attend to the patient
  4. Yell loudly at the patient to keep him conscious
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2.10) A phlebotomist is collecting blood from the vein of a 14-month-old baby when the blood stops flowing. Which of these actions should the phlebotomist take to try to continue the draw?
  1. Give the baby something sweet to eat
  2. Release the tourniquet
  3. Try a new tube
  4. Try to collect blood from the baby's heel instead
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2.11) When drawing blood, when should the phlebotomist remove the tourniquet?
  1. After removing the needle from the arm
  2. As soon as a suitable vein has been found
  3. Ten minutes after applying the tourniquet
  4. While the last tube to be drawn is filling
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2.12) Westergren tubes are used for which test?
  1. Erythrocyte sedimentation rate
  2. Hematocrit
  3. Microhematocrit
  4. Reticulocyte count
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2.13) Which tube would be drawn for an antinuclear antibody test (ANA)?
  1. Green
  2. Grey
  3. Red
  4. SST
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2.14) What are cross-match tubes used for?
  1. Blood compatibility testing
  2. Coagulation studies
  3. Glucose tests
  4. Trace element studies
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2.15) Which anticoagulant is used for blood gas tests?
  1. EDTA
  2. Heparin
  3. Potassium oxalate
  4. Trisodium citrate
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2.16) A phlebotomist needs to collect blood samples from a patient for a blood glucose test and a hemoglobin test. What colour tubes should the phlebotomist use?
  1. Grey and green
  2. Grey and lavender
  3. Grey and red
  4. Red and green
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2.17) What are lavender top tubes used for?
  1. Blood cultures
  2. Erythrocyte sedimentation rates
  3. Glucose determinations
  4. Hematology tests
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2.18) Lavender-top collection tubes are used for:
  1. glucose determinations
  2. hematology tests
  3. immunology tests
  4. molecular diagnostic tests
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2.19) A phlebotomist needs to draw blood into a grey-top tube, a gold-top tube and a lavender-top tube. What is the correct order to fill the tubes?
  1. Gold, grey, lavender
  2. Gold, lavender, grey
  3. Grey, gold, lavender
  4. Grey, lavender, gold
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2.20) Which of these is needed to collect blood by syringe?
  1. Multisample needle
  2. Transfer device
  3. Tube holder
  4. Winged infusion set
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2.21) Immediately after blood collection, how many times must tubes be inverted to ensure proper mixing of blood and additives?
  1. 1 or 2
  2. 8 to 10
  3. 10 to 15
  4. 15 to 20
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2.22) Which area on a newborn is suitable for skin puncture?
  1. Any calloused areas of the foot
  2. The lateral, flat portion of the heel
  3. The posterior curvature of the heel
  4. The second or third finger on either hand
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2.23) Why is it important to control the depth of the lancet insertion during heel puncture?
  1. To avoid puncturing a vein
  2. To prevent bacterial contamination
  3. To prevent bone injury
  4. To prevent excessive bleeding
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2.24) Which part of an infant's foot is the safest area to perform a capillary puncture?
  1. a
  2. b
  3. c
  4. d
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2.25) Which sample does the glycosylated hemoglobin test require?
  1. Plasma
  2. Serum
  3. Urine
  4. Whole blood
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2.26) There are two reasons why phlebotomists should wipe away the first drop of blood when performing a capillary puncture. The first reason is to remove traces of alcohol. What is the second reason?
  1. The first drop of blood contains excess tissue fluid
  2. The first drop of blood is high in clotting factors
  3. To increase blood flow to the area
  4. To remove pathogens
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2.27) Which of these tests is collected first during a single capillary puncture?
  1. Complete blood count
  2. Electrolytes
  3. Glucose
  4. Phosphorus
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2.28) Which of these statements about the blood gas test is true?
  1. The specimen is collected in a plain red top tube
  2. The specimen is frozen immediately after collecting
  3. The specimen is tested within 24 hours
  4. The test requires an arterial sample
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2.29) PKU tests are performed routinely on:
  1. HIV patients
  2. cancer patients
  3. new employees
  4. newborn infants
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2.30) A patient needs to collect urine in a container for urinalysis. However, the patient is nervous and says he is having trouble producing the urine specimen. What should you do?
  1. Cancel the test
  2. Offer the patient a drink of water and ask him to try again
  3. Take a blood sample instead and make a note on the requisition form
  4. Tell the patient he is not trying hard enough
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2.31) An inpatient is eating breakfast when you arrive to collect a specimen for a fasting blood glucose test. Which of these would be the best action to take?
  1. Ask the patient to vomit into a sink or emesis basin before taking the sample
  2. Ask the patient's nurse if the specimen should still be collected
  3. Draw the specimen quickly before the patient finishes eating
  4. Give the patient a dose of insulin to counteract the food they have eaten
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2.32) Blood specimens for which of these tests require cooling during transport?
  1. Blood culture
  2. Cold agglutinin
  3. Cryoglobulin
  4. Homocysteine
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2.33) Blood specimens for sodium testing must be transported at which temperature?
  1. –20°C
  2. 1–6°C
  3. 20–24°C
  4. 37–40°C
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2.34) Which of these urine constituents increases in a urine specimen left at room temperature?
  1. Bilirubin
  2. Leukocytes
  3. Nitrites
  4. Urobilinogen
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2.35) Which of these chemicals can be used to preserve 24-hour urines for endocrine testing?
  1. Boric acid
  2. Potassium chloride
  3. Sodium bicarbonate
  4. Sodium hypochlorite
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2.36) Which of these biochemistry tests should be kept away from the light?
  1. Bilirubin
  2. Calcium
  3. Glucose
  4. Urea
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2.37) Blood samples for cold agglutinin testing should be kept at what temperature before testing?
  1. –6°C
  2. 6°C
  3. 20°C
  4. 37°C
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2.38) Urine samples that cannot be tested within an hour of collection should be:
  1. discarded
  2. frozen
  3. left at room temperature
  4. refrigerated
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2.39) A urine specimen arrives at the laboratory five hours after it was collected. To be acceptable for culture testing, the specimen must have been:
  1. kept at room temperature
  2. kept frozen
  3. kept refrigerated
  4. mixed with a preservative additive
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2.40) Serum specimens for vitamin K should be:
  1. kept at 37–40°C
  2. kept away from light
  3. mixed with an antiglycolytic agent
  4. mixed with glass beads
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2.41) The results of which of these tests may be falsely increased if the stopper is removed from the specimen?
  1. Cortisol
  2. Glucose
  3. Potassium
  4. pH
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2.42) Specimens containing the smallpox virus must be transported as:
  1. Category A
  2. Category B
  3. contagious specimen
  4. infectious specimen
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2.43) Before you perform urinalysis on a refrigerated urine specimen, you should bring the urine to room temperature and _______ it.
  1. boil
  2. centrifuge
  3. filter
  4. stir
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Section 3: Analytical Processes

3.1) What special action does a phlebotomist need to take before drawing a blue top tube with a butterfly needle?
  1. Draw a discard tube
  2. Get a bucket of ice ready
  3. Label the tube
  4. Make sure the patient is lying down
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3.2) How many grams of NaOH are in 100 mL of a 15% NaOH solution?
  1. 15 g
  2. 30 g
  3. 45 g
  4. 60 g
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3.3) What is the osmolarity of 400 ml of a 15 % MgCl₂ solution? (Assume magnesium has a molecular weight of 24.3 and chlorine has a molecular weight of 35.5.)
  1. 4.73 OsM
  2. 5.91 OsM
  3. 6.39 OsM
  4. 7.82 OsM
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3.4) What is the osmolarity of a 1 mol/L NaCl solution?
  1. 1 osmol/L
  2. 2 osmol/L
  3. 3 osmol/L
  4. 4 osmol/L
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3.5) A lab technician requires 400 mL of a 3% solution but has only a 5% solution available. How would the lab technician prepare the 3% solution?
  1. Mix 240 mL of the 5% solution with 160 mL of diluent
  2. Mix 300 mL of the 5% solution with 100 mL of diluent
  3. Mix 360 mL of the 5% solution with 40 mL of diluent
  4. Mix 380 mL of the 5% solution with 20 mL of diluent
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3.6) How many millilitres of an 80% acetic acid solution is needed to make 2 litres of a 10% acetic acid solution?
  1. 20
  2. 50
  3. 100
  4. 250
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3.7) A lab technician has 20 L of a 2 g/L solution. To this solution, the technician adds 30 L of water. What is the final concentration of the new solution?
  1. 0.2 g/L
  2. 0.8 g/L
  3. 1.2 g/L
  4. 1.25 g/L
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3.8) Stray light can be measured in spectrophotometers with:
  1. a cut-off filter
  2. a mercury-vapour lamp
  3. a potassium dichromate solution
  4. holmium oxide glass
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3.9) What is the total magnification of a microscope if the eyepiece lens is 10x and the objective lens is 20x?
  1. 30x
  2. 200x
  3. 375x
  4. 525x
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3.10) Which microscope magnification is used to distinguish between different bacteria and see their internal structure?
  1. 10x
  2. 100x
  3. 400x
  4. 1000x
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3.11) Which of these actions will prevent the formation of acid formaldehyde hematin in formaldehyde solutions?
  1. Adding drops of cytochrome b5 reductase
  2. Keeping the solutions refrigerated
  3. Using buffered formalin
  4. Washing excess fixative overnight with water
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3.12) Which fixative do Pap stains use?
  1. 10% buffered formalin
  2. 95% ethanol
  3. Helly's fixative
  4. Methanol
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3.13) Which of these decalcifying agents decalcifies tissues via chelation?
  1. EDTA
  2. Formic acid
  3. Nitric acid
  4. Picric acid
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3.14) Which of these could cause stain precipitation?
  1. Excessive buffer
  2. Excessive humidity in the air
  3. Insufficient staining time
  4. Use of aged staining solutions
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3.15) New methylene blue reagent is used to stain:
  1. Heinz bodies
  2. eosinophils
  3. platelets
  4. reticulocytes
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3.16) Which type of bacteria does the Ziehl-Neelsen stain identify?
  1. Acid-fast
  2. Facultative anaerobic
  3. Gram-negative
  4. Spore-forming
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3.17) What is the counterstain in Gram's technique?
  1. Acetone-alcohol
  2. Crystal violet
  3. Iodine
  4. Safranin
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3.18) What is the correct order of reagents used for Gram staining?
  1. Crystal violet, iodine, acetone-alcohol, safranin
  2. Crystal violet, safranin, acetone-alcohol, iodine
  3. Iodine, crystal violet, acetone-alcohol, safranin
  4. Safranin, iodine, crystal violet, acetone-alcohol
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3.19) What cell structure turns blue in H&E staining?
  1. Cytoplasm
  2. Golgi apparatus
  3. Nuclei
  4. Reticulum
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3.20) The most common mordant for H&E staining is:
  1. Alcian blue
  2. alum
  3. eosin
  4. sodium metabisulphite
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3.21) Which two stains are routinely used in Pap stains?
  1. Hematoxylin and eosin
  2. Methenamine silver and mucicarmine
  3. Periodic acid-Schiff-diastase and azur
  4. Perl's Prussian blue and mucicarmine
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3.22) The Pap stain stains which structure blue, purple or black?
  1. Cytoplasm
  2. Golgi apparatus
  3. Mitochondria
  4. Nuclei
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3.23) Which stain can differentiate collagen fibres from other fibres?
  1. Hematoxylin and eosin stain
  2. Masson's trichrome stain
  3. Reticular stain
  4. Sudan stain
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3.24) Mucicarmine is used primarily to stain:
  1. elastic fibres
  2. epithelial mucin
  3. fat
  4. nervous tissue
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3.25) Which element does Perls Prussian blue detect?
  1. Iron
  2. Lead
  3. Mercury
  4. Potassium
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3.26) At which of these pH levels is Alcian blue solution used?
  1. 2.5
  2. 4.5
  3. 6.5
  4. 8.5
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3.27) What colour are red blood cells after Giemsa staining?
  1. Dark blue
  2. Pale blue
  3. Pale pink
  4. Violet
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3.28) What is the purpose of susceptibility testing?
  1. To determine if a patient has an allergy to a drug
  2. To determine the effectiveness of drug therapy
  3. To identify which antibiotic will kill a pathogen
  4. To identify which organism is in a specimen
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3.29) Which of these tests is used to differentiate between staphylococci and streptococci?
  1. Catalase test
  2. Coagulase test
  3. Oxidase test
  4. Urase test
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3.30) Which of these tests differentiates Staphylococcus aureus from other Staphylococcus species?
  1. Catalase
  2. Coagulase
  3. Oxidase
  4. Urase
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3.31) In vivo testing is useful for diagnosing:
  1. HIV
  2. Hepatitis A
  3. Rubella virus
  4. tuberculosis
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3.32) Which test detects antibodies to the Epstein-Barr virus?
  1. C-reactive protein test
  2. Influenza test
  3. Monospot test
  4. Rapid Group A Streptococcus test
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3.33) What colour does the indicator strip inside a GasPak chamber turn when oxygen is present?
  1. Black
  2. Blue
  3. Colourless
  4. Red
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3.34) Which of the following incubation conditions is used to grow Streptococcus pneumoniae?
  1. At 35–37°C, over 3 days in chocolate agar or MacConkey agar, with 20% H₂
  2. At 35–37°C, overnight in media containing blood and sugar, with 5−10% CO₂
  3. At 42°C, over 2 days in media containing electrolytes and peptone water, and under microaerophilic conditions
  4. At 42°C, over 3 days in Luria Bertani agar, and under anaerobic conditions
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3.35) Staphylococcus aureus grows best in which type of environment?
  1. Aerobic
  2. Anaerobic
  3. Highly alkaline
  4. Microaerobic
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3.36) Which of these types of agar is used to isolate and differentiate species of Salmonella and Shigella?
  1. Hektoen enteric
  2. Chocolate
  3. CLED
  4. Thayer Martin
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3.37) What variant of the blood agar plate contains red blood cells that have been lysed by slowly heating them to 80°C?
  1. Chocolate
  2. MacConkey
  3. Phenylethyl Alcohol
  4. Thayer Martin
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3.38) Löwenstein-Jensen media is used to isolate which type of bacteria?
  1. Escherichia
  2. Haemophilus
  3. Listeria
  4. Mycobacteria
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3.39) What organisms grow on MacConkey agar?
  1. Acid-fast
  2. Gram-negative
  3. Gram-positive
  4. Non-acid fast
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3.40) Which of the following bacteria can be grown on Colistin-nalidixic acid agar?
  1. Haemophilus influenzae
  2. Neisseria gonorrhea
  3. Salmonella
  4. Streptococcus pneumoniae
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3.41) What does modified Thayer-Martin agar contain that Thayer-Martin agar does not?
  1. Peptone water
  2. Potassium dihydrogen phosphate
  3. Trimethoprim lactate
  4. Vancomycin
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3.42) What is reducing media used for in microbiology?
  1. Cultivating organisms that only grow in blood
  2. Growing anaerobic bacteria
  3. Isolating fungi and yeasts
  4. Testing pathogens for antibiotic susceptibility
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3.43) In Gram staining, what will happen if the decolourizer is not left on long enough?
  1. All organisms will appear colourless
  2. All organisms will appear gram-negative
  3. All organisms will appear gram-positive
  4. No cells will appear on the slide
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3.44) What is the term for a rod-shaped microorganism that appears red after Gram staining?
  1. Gram-negative bacillus
  2. Gram-negative cocci
  3. Gram-positive bacillus
  4. Gram-positive cocci
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3.45) Which acid-fast staining method is known as the hot method?
  1. Auramine-Rhodamine
  2. Fluorochrome
  3. Kinyoun
  4. Ziehl-Neelsen
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3.46) When performing a quadrant streak plate, what action must be taken after streaking each quadrant?
  1. Allow the colonies to rest for 15–20 seconds
  2. Flame the inoculating loop
  3. Invert the plate
  4. Take another loopful of inoculum from the original sample
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3.47) Which of these organisms is a strict anaerobe?
  1. Clostridium perfringens
  2. Escherichia coli
  3. Klebsiella pneumoniae
  4. Nocardia brasiliensis
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3.48) Based on the following test results, what is the most likely organism? Microscope: Cocci growing in clusters Gram stain: Gram-positive Catalase: Positive
  1. Bacillus
  2. Clostridia
  3. Staphylococcus
  4. Streptococcus
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3.49) A man cuts his hand while doing yard work. The wound becomes infected. A Gram stain reveals the wound contains gram-positive cocci and gram-negative bacilli. Which media can be used to selectively isolate each organism?
  1. Columbia-CNA and Chocolate
  2. KV-laked agar and Thayer-Martin
  3. PEA and MacConkey
  4. Sheep blood and Chocolate
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3.50) Which of these is needed to prepare defibrinated blood?
  1. Filter paper
  2. Glass beads
  3. UV light
  4. Vacuum pump
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3.51) Why is ammonium oxalate added to blood samples before platelet counts?
  1. To force the blood to clot
  2. To lyse the red blood cells
  3. To prevent hemodilution
  4. To stain the platelets blue
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3.52) The hematocrit test is also known as the:
  1. erythrocyte sedimentation rate
  2. hemoglobin test
  3. packed-cell volume test
  4. red blood cell count
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3.53) In the prothrombin time test, the patient's plasma is mixed with:
  1. calcium and activator
  2. calcium and thromboplastin
  3. glass beads
  4. platelet lipids
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3.54) Which microscope objective is used first when examining a stained blood film?
  1. 10x
  2. 40x
  3. 50x
  4. 70x
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3.55) When blood is transfused, what is the most important consideration?
  1. Do the donor's red cells contain an antibody against the patient's red cells?
  2. Do the patient's red cells contain an antibody against the donor's red cells?
  3. Does the donor's serum contain an antibody against the patient's red cells?
  4. Does the patient's serum contain an antibody against the donor's red cells?
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3.56) A 28-year-old patient needs a blood transfusion of red blood cells. However, the patient has an inherited immune system disorder that makes him vulnerable to transfusion-associated graft-versus-host disease (TA-GvHD). The red blood cells for this patient should be:
  1. centrifuged
  2. frozen and deglycerolized
  3. irradiated
  4. saline washed
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3.57) Which of these blood products needs to be irradiated before being transfused into a patient?
  1. Cryoprecipitate
  2. Fresh frozen plasma
  3. Frozen washed red cells
  4. Granulocytes
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3.58) A patient requires an immediate transfusion but his blood type is unknown. The doctors should transfuse the patient with red blood cells from which donor?
  1. AB+
  2. AB−
  3. O+
  4. O−
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3.59) Which blood type is most commonly used for intrauterine transfusions?
  1. AB+
  2. AB−
  3. O+
  4. O−
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3.60) If a patient with severe chronic anemia receives a transfusion of whole blood, which acute transfusion complication is most likely to occur?
  1. Acute intravascular hemolysis
  2. Anaphylactic reaction
  3. Fluid overload
  4. Septic shock
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3.61) TRALI is a transfusion complication where excess fluid builds up in which part of the body?
  1. Brain
  2. Heart
  3. Kidneys
  4. Lungs
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3.62) Transfusion of red blood cells with low 2,3-DPG levels causes which pathophysiological effect?
  1. Decreased carbon dioxide levels
  2. Increased cardiac output
  3. Increased mixed venous oxygen tension
  4. Lower blood viscosity
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3.63) Why is donated blood kept refrigerated?
  1. To prevent blood components from breaking down
  2. To prevent coagulation
  3. To prevent the blood from producing alloantibodies
  4. To slow bacterial growth
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3.64) When donated blood is bright yellow to brown, it is probably due to:
  1. bacterial contamination
  2. high levels of bilirubin
  3. high levels of fat
  4. red blood cells
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3.65) Anti-G would react with red blood cells with which of these phenotypes?
  1. A+ B− C+ D− E−
  2. A− B+ C− D− E+
  3. A− B+ C− D− E−
  4. A− B− C− D− E−
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3.66) A 40-year-old woman needs two units of red blood cells. The antibody screen is positive. The results of the antibody panel are as follows: Which antibody most likely caused the positive result?
  1. Anti-C
  2. Anti-D
  3. Anti-E
  4. Anti-K
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3.67) You suspect a patient has the Bombay blood group. To test your suspicion, you would mix the patient's red blood cells with a reagent containing which antigen?
  1. Anti-D
  2. Anti-E
  3. Anti-H
  4. Anti-K
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3.68) Whole blood is stored between:
  1. −12°C and −18°C
  2. −6°C and 3°C
  3. 2°C and 6°C
  4. 8°C and 16°C
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3.69) Which cryoprotective agent is most commonly used for red blood cells in blood banking?
  1. Glycerol
  2. Mannitol
  3. Sorbitol
  4. Thiol
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3.70) What is the 30-minute rule in blood banking?
  1. After a transfusion, the donor should sit in a quiet room for 30 minutes before going home
  2. Red blood cell units left out of a refrigerator for more than 30 minutes cannot be returned to the refrigerator
  3. The tourniquet should not be left on the patient's arm for more than 30 minutes
  4. Transfusions of red blood cell units should take no longer than 30 minutes
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3.71) What is the 4-hour rule in blood banking?
  1. Blood donors should not be kept waiting in the waiting room for more than 4 hours
  2. Blood donors should refrain from exercise four hours after donating blood
  3. Red blood cell units left out of refrigeration for more than 4 hours cannot be returned to the refrigerator
  4. Transfusions of red blood cell units should be completed within 4 hours of their removal from refrigeration
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3.72) Which of these is a sign of hemolysis in a unit of red blood cells?
  1. Blood clots
  2. Bright cherry red colour
  3. Excessive and unusual air bubbles
  4. Increased opacity
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3.73) For how long can donated platelets be stored at room temperature?
  1. 1 hour
  2. 4 hours
  3. 24 hours
  4. 5 days
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3.74) When performing an antiglobulin test, why must the lab technician wash the red blood cells before adding the AHG reagent?
  1. To ensure the antibodies bind to the antigens
  2. To neutralize excess AHG reagent
  3. To remove hemolyzed cells
  4. To remove unbound serum globulins
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3.75) Which blood type is used to make Coombs control cells?
  1. AB+
  2. AB−
  3. O+
  4. O−
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3.76) In antibody screens, what is the best pH for the incubation phase?
  1. 6.8–7.2
  2. 7.2–7.5
  3. 7.5–7.8
  4. 7.8–8.2
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3.77) Six hours after a blood transfusion, a patient presents with pain at the infusion site, back, chest, and flank. The patient's urine is dark brown. Tests reveal the patient has hemoglobinemia, hemoglobinuria, and hypotension. What is the likely cause?
  1. Acute hemolytic reaction
  2. TRALI
  3. Transfusion-associated graft-versus-host disease
  4. Transfusion-associated sepsis
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3.78) A patient's temperature rises by 2°C while receiving a blood transfusion. There are no abnormal results in the transfusion reaction investigation. Which transfusion reaction is the patient experiencing?
  1. Allergic
  2. Anaphylactic
  3. Febrile non-hemolytic
  4. Hemolytic
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3.79) Which blood type has no Rh antigens?
  1. Rh-null
  2. R₀R₀
  3. r'r'
  4. rr
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3.80) A patient with an Rh genotype of DCe/DCe is transfused with red blood cells with an Rh genotype of Dce/Dce. Which alloantibody will the patient's body likely produce in response to the donor's blood?
  1. Anti-C
  2. Anti-D
  3. Anti-E
  4. Anti-c
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3.81) A B− patient requires a blood transfusion but no B− blood is available. From which of these donors could the patient safely receive blood?
  1. A+
  2. AB+
  3. B+
  4. O−
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3.82) A patient's ABO testing results are as follows:
Red cell grouping Serum grouping
anti-A anti-B anti-A₁ A₁ cells B cells
4+ 0 0 2+ 4+
What is the patient's ABO subtype?
  1. A₁
  2. A₂
  3. A₁B
  4. A₂B
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3.83) A patient's ABO testing results are as follows:
Red cell grouping Serum grouping
anti-A anti-B A cells B cells
4+ 1+ 0 4+
What is the likely cause of these results?
  1. Acquired B
  2. Chimerism
  3. Hypogammaglobulinemia
  4. Immunosuppression
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3.84) A blood sample is tested with anti-A antibodies and anti-B antibodies. No clots form. What is the blood type?
  1. A
  2. AB
  3. B
  4. O
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3.85) A patient's red blood cells plus anti-A antisera result in agglutination. However, his red blood cells plus anti-B antisera result in no agglutination. Therefore, the patient has what type of antigens and is what blood type?
  1. Type A antigens and type A blood
  2. Type A antigens and type B blood
  3. Type B antigens and type A blood
  4. Type B antigens and type B blood
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3.86) A blood donor is tested with Rh antisera. The results are as follows:
anti-D anti-C anti-E anti-c anti-e
+ + 0 + +
What is the donor's most probable Rh genotype?
  1. CDe/CDe
  2. CDe/cDE
  3. CDe/cde
  4. cDe/Cde
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3.87) A fasting patient has cloudy white serum. What condition does the patient have?
  1. Hemolysis
  2. Hyperbilirubinemia
  3. Hyperthyroidism
  4. Hypertriglyceridemia
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3.88) Which of these analytes can be analyzed by headspace gas chromatography?
  1. Folate
  2. Hemoglobin
  3. Methanol
  4. Oestrogen
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3.89) Which test monitors the treatment of colorectal cancer?
  1. Blood urea nitrogen test
  2. Carcinoembryonic antigen test
  3. Circulating tumor cells test
  4. Lactate dehydrogenase test
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3.90) In the glucose oxidase reaction, glucose oxidase reacts with glucose, water, and oxygen to form:
  1. gluconic acid and hydrogen peroxide
  2. gluconic acid nitric acid
  3. glycogen and carbonic acid
  4. glycogen and sodium hydroxide
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3.91) Estrogen and progesterone receptor testing are used to assess the prognosis and guide the treatment of:
  1. breast cancer
  2. endometriosis
  3. hepatoma
  4. ovarian cancer
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3.92) Which marker is commonly used to monitor the treatment of ovarian cancer?
  1. CA-125
  2. CA-15-3
  3. CA-19-9
  4. CEA
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Section 4: Interpretation and Reporting of Results

4.1) What is the term for a sodium level of 130 mmol/L?
  1. Hyperkalemia
  2. Hypernatremia
  3. Hypokalemia
  4. Hyponatremia
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4.2) Von Willebrand factor stabilizes which coagulation factor in the bloodstream?
  1. Factor IIa
  2. Factor VIII
  3. Factor X
  4. Factor XI
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4.3) Which of the following initiates the coagulation cascade via the extrinsic pathway?
  1. Factor XII
  2. Prothrombinase
  3. Thrombin
  4. Tissue factor
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4.4) What coagulation factor is deficient in Hemophilia B?
  1. Factor IX
  2. Factor VIII
  3. Factor XII
  4. Factor XIII
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4.5) Blood tests reveal high levels of immature white blood cells, many of which are myeloblasts. Red blood cell levels are low and platelet levels are low. Which type of leukemia best fits these results?
  1. Acute lymphocytic leukemia
  2. Acute myeloid leukemia
  3. Chronic lymphocytic leukemia
  4. Chronic myeloid leukemia
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4.6) A patient is positive for the Philadelphia chromosome and negative for acute lymphoblastic leukemia. What is the most likely diagnosis?
  1. Chronic lymphoblastic leukemia
  2. Chronic myeloid leukemia
  3. Pernicious anemia
  4. Thalassemia
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4.7) Blood tests reveal high levels of lymphoblasts and low levels of red blood cells and platelets. Which type of leukemia best fits these results?
  1. Acute lymphocytic leukemia
  2. Acute myeloid leukemia
  3. Chronic lymphocytic leukemia
  4. Chronic myeloid leukemia
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4.8) Which leukemia correlates best with the following results?
Test Result
WBC 23 x 10⁹/L
RBC 3.2 x 10¹²/L
Platelets 35 x 10⁹
Blasts in bone marrow: 41%
  1. Acute lymphoblastic
  2. Acute monoblastic
  3. Chronic myelogenous
  4. Chronic myelomonocytic
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4.9) Auer rods are characteristically found in which leukemia?
  1. Acute lymphocytic
  2. Acute myeloid
  3. Chronic lymphocytic
  4. Chronic myeloid
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4.10) A 36-year-old man complains of tiredness and headaches. Blood tests reveal low vitamin B12 levels, low erythrocyte levels, and the presence of antibodies to intrinsic factor. The patient's MCHC is normal but the MCV is high. Which disease does the patient most likely have?
  1. Aplastic anemia
  2. Pernicious anemia
  3. Polycythemia
  4. Sickle-cell anemia
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4.11) Which of these conditions causes high iron levels and a decreased total iron binding capacity (TIBC)?
  1. Anemia of chronic disease
  2. Hemochromatosis
  3. Iron deficiency anemia
  4. Sickle cell anemia
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4.12) Which type of anemia best correlates with the following test results?
Test Result
Hemoglobin 5.7 g/dL
Hematocrit 25%
Ferritin 736 ng/mL
Iron 314 mcg/dL
Transferrin 813 mg/dL
Transferrin saturation 75%
  1. Anemia of chronic diseases
  2. Hemolytic anemia
  3. Iron-deficiency anemia
  4. Sideroblastic anemia
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4.13) Which abnormal form of hemoglobin has iron in the Fe³⁺ state instead of the Fe²⁺ state?
  1. Carboxyhemoglobin
  2. Methemoglobin
  3. Myohemoglobin
  4. Oxyhemaglobin
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4.14) Which abnormal hemoglobin causes rigid red blood cells with short lifespans?
  1. HgC
  2. HgE
  3. HgF
  4. HgG
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4.15) An organism from a lung biopsy grows as a mould at room temperature and as yeast at 37°C. What is the most appropriate way to interpret these results?
  1. Dimorphic fungus present
  2. The specimen is contaminated, ask for a repeat collection
  3. Two pathogens are present
  4. Two pathogens are present but only the mould is significant
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4.16) A lab technician observes mucoid colonies growing on a blood agar plate. This finding tells you that the organism:
  1. has a capsule
  2. has a permeable plasma membrane
  3. produces acetic acid
  4. produces beta-galactosidase
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4.17) A negative result on the nitrate reduction test is demonstrated when the broth ________________ when nitrate I and nitrate II are added and ________________ when zinc is added.
  1. remains colourless, remains colourless
  2. remains colourless, turns blue
  3. remains colourless, turns red
  4. turns red, turns blue
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4.18) Given the results below, what is the minimum inhibitory concentration of the organism?
Volume of microbial-rich broth (mL) 200 200 200 200 200 200 200
Amount of antimicrobial agent (mg) 0 1 2 3 4 5 6
Result turbid turbid turbid turbid clear clear clear
  1. 3.33 mg/L
  2. 5 mg/L
  3. 20 mg/L
  4. 80 mg/L
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4.19) A lab technician performs Gram staining of a urine specimen. Under a microscope, the lab technician sees gram-negative cocci in chains. What mistake did the lab technician make?
  1. Forgot the iodine treatment step
  2. Forgot to bring the urine specimen to room temperature
  3. Performed the safranin counterstain too quickly
  4. Used too much crystal violet
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4.20) What is the Gram stain appearance of E. coli?
  1. Gram-negative coccus
  2. Gram-negative rod
  3. Gram-positive rod
  4. Gram-positive rod
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4.21) A three-day-old neonate exhibits lethargy, fever, and vomiting. A lumbar puncture reveals bacterial meningitis. A Gram stain of the neonate's spinal fluid shows short gram-positive rods. This organism is most likely:
  1. Group B Streptococcus
  2. Listeria monocytogenes
  3. Neisseria meningitidis
  4. Streptococcus pneumoniae
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4.22) A 29-year-old man is admitted to the hospital with a fever. He recently finished a course of chemotherapy for acute leukemia. The doctor performs two blood cultures, a sputum culture, a urine culture, and a chest x-ray. All tests are negative except for one blood culture, which grows a gram-negative bacillus. This bacillus is:
  1. an indication that the patient has meningitis
  2. most likely a contaminant
  3. most likely an organism the patient acquired from the hands of a healthcare provider the last time he was in the hospital
  4. the most likely cause of the fever
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4.23) A 6-year-old child presents with nausea and diarrhea. The physician orders an O&P stool examination. The following organism is found in the child's stool: Which organism is in the image?
  1. Cryptosporidium meleagridis
  2. E. coli
  3. Giardia duodenalis
  4. Shigella dysenteriae
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4.24) Which bacteria correlates with the results below?
Agar Result
Blood agar Beta-hemolytic colonies
MacConkey agar Colourless colonies
Cetrimide agar Green colonies
  1. Escherichia coli
  2. Pseudomonas aeruginosa
  3. Staphylococcus aureus
  4. Streptococcus pyogenes
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4.25) A Neisseria species is isolated from a patient sample. A carbohydrate utilization test is performed. The results are as follows:
Test Result
Glucose +
Maltose
Fructose
Sucrose
Lactose
Based on these results, which Neisseria species is in the sample?
  1. N. gonorrhea
  2. N. lactamica
  3. N. meningitidis
  4. N. sicca
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4.26) Which parasite is 2 mm long, slender, and cylindrical?
  1. Ascaris lumbricoides
  2. Enterobius vermicularis
  3. Giardia lamblia
  4. Strongyloides stercoralis
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4.27) A 50-year-old inpatient develops a catheter-associated urinary tract infection while in hospital. The urine culture grows >100,000 oxidase-positive gram-negative bacilli. What is the most likely organism?
  1. E. coli
  2. Enterococcus
  3. Klebsiella
  4. Pseudomonas aeruginosa
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4.28) Calculate the corrected reticulocyte count from the following information.
Hct 8%
Normal Hct 40%
Reticulocyte count 5%
  1. 1%
  2. 3%
  3. 5%
  4. 7%
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4.29) Platelet satellitism can occur in blood samples containing which additive?
  1. EDTA
  2. Heparin
  3. Sodium fluoride
  4. Sodium oxalate
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4.30) Leukocyte alkaline phosphatase (LAP) staining was performed on a blood specimen. The specimen was scored as follows:
Score Neutrophils
0 10
+1 40
+2 30
+3 10
+4 10
Which condition most likely explains the result?
  1. Chronic myeloid leukemia
  2. Leukemoid reaction
  3. Leukocytosis
  4. Leukopenia
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4.31) A patient has a potassium result of 7.2 mEq/L. Before reporting the result, the lab technician should:
  1. check the age of the patient
  2. check the serum for bacterial contamination
  3. check the serum for hemolysis
  4. test the serum for ketones
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4.32) Refer to the serum protein electrophoresis patterns below. Which disease does the abnormal pattern indicate?
  1. Hepatic cirrhosis
  2. Hypogammaglobulinemia
  3. Monoclonal gammopathy
  4. Nephrotic syndrome
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4.33) A woman has the following blood test results:
Test Result
Red cell count 7.8 × 10¹²/L
White cell count 7.5 × 10⁹/L
Platelets 242 × 10⁹/L
What term applies to these results?
  1. Hypererythrocytosis
  2. Leukocytosis
  3. Leukopenia
  4. Polycythemia
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4.34) A microscopic analysis of a patient's blood sample reveals neutrophils with six-lobed nuclei. Which illness does this indicate?
  1. Acute myelogenous leukemia
  2. Erythrocytosis
  3. Hemochromatosis
  4. Megaloblastic anemia
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4.35) Which of the following clinical signs is characteristic of Bernard-Soulier syndrome?
  1. Abnormal aggregation with ADP
  2. Increased platelet count
  3. Large platelets
  4. Shortened bleeding time
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4.36) A patient has a prothrombin time (PT) of 12 seconds and an activated partial thromboplastin time (aPTT) of 25 seconds. Which condition does this indicate?
  1. Antiphospholipid antibody syndrome
  2. Factor V Leiden
  3. Liver disease
  4. Normal health
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4.37) A patient has an abnormal aPTT but a normal PT. A deficiency in which of the following factors could be the cause?
  1. Factor I
  2. Factor II
  3. Factor V
  4. Factor VIII
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4.38) Along with the patient's prothrombin time and the average prothrombin time of the reference range population, what other information is needed to calculate a patient's international normalized ratio?
  1. The half-life of the patient's anticoagulant medication
  2. The international sensitivity index of the thromboplastin reagent
  3. The patient's age
  4. The total thrombus volume from the thromboelastograph waveform
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4.39) Which factor deficiency correlates with the following results?
Test Result
PT 22 seconds
APTT 79 seconds
Fibrinogen 0.5 g/L
  1. Factor I
  2. Factor IV
  3. Factor III
  4. Factor VI
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4.40) Which test evaluates the extrinsic pathway of coagulation?
  1. Closure time
  2. Partial thromboplastin time
  3. Prothrombin time
  4. Thrombin time
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4.41) Acute blood loss is associated with which of the following red blood cell morphologies?
  1. Macrocytic hyperchromic
  2. Macrocytic normochromic
  3. Microcytic hypochromic
  4. Normocytic normochromic
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4.42) Given the following results, which red blood cell morphology does the patient most likely have?
Test Result
MCV 61 fL
MCH 12.8 pg
MCHC 29.1 g/dL
  1. Macrocytic normochromic
  2. Microcytic hypochromic
  3. Normocytic hypochromic
  4. Normocytic normochromic
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4.43) Which of the following patients has microcytic red blood cells?
HCT RBC (x10¹²/L)
Patient 1 42% 3.9
Patient 2 43% 5.5
Patient 3 50% 4.5
Patient 4 40% 3.1
  1. Patient 1
  2. Patient 2
  3. Patient 3
  4. Patient 4
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4.44) A woman has the following blood test results:
Test Result
HCT 37%
RBC 5.4 × 10¹²/L
WBC 5.5 × 10⁹/L
PLT 320 × 10⁹/L
Which term describes the red blood cells?
  1. Hypochromic
  2. Macrocytic
  3. Microcytic
  4. Normocytic
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4.45) Which type of abnormal red blood cells is in the blood smear below?
  1. Acanthocytes
  2. Dacrocytes
  3. Echinocytes
  4. Schistocytes
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4.46) In the blood smear below, which type of red blood cell is the arrow pointing to?
  1. Burr
  2. Sickle
  3. Spur
  4. Target
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4.47) A patient has a decreased Factor VIII assay, a normal Factor IX assay, and a prolonged APTT. Which condition does the patient have?
  1. Acute lymphocytic leukemia
  2. Acute myeloid leukemia
  3. Hemophilia A
  4. Hemophilia B
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4.48) A patient has the following test results:
Test Result
RBC 2.8 × 10¹²/L
WBC 13.1 × 10⁹/L
Janus kinase 2 (JAK2) mutation Positive
Which condition best fits these results?
  1. Acute lymphocytic leukemia
  2. Chronic lymphocytic leukemia
  3. Polycythemia vera
  4. Primary myelofibrosis
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4.49) A patient's urine sample is positive for ketones. The patient probably has:
  1. advanced liver disease
  2. heart disease
  3. pernicious anemia
  4. uncontrolled diabetes
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4.50) A patient with fatigue and nausea has the following urinalysis results:
Test Result
pH 5.5
Glucose 0 mmol/L
GFR 31
UACR >6.9 mg/mmol
No blood or abnormal cells can be seen in the urine. Based on these results, which disease does the patient most likely have?
  1. Bladder cancer
  2. Diabetes
  3. Kidney disease
  4. Prostate cancer
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4.51) Which type of acidosis best explains the arterial blood gas results below?
Test Result
pH 6.73
PaCO₂ 59 mmHg
Bicarbonate 39 mmol/L
  1. Compensated metabolic acidosis
  2. Compensated respiratory acidosis
  3. Uncompensated metabolic acidosis
  4. Uncompensated respiratory acidosis
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4.52) Which condition is most consistent with the results below?
Test Result
Osmolality 290 mmol/L
Sodium 125 mmol/L
Total cholesterol 35.7 mmol/L
  1. Cushing's syndrome
  2. Hyperaldosteronism
  3. Hypothyroidism
  4. Pseudohyponatremia
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4.53) A patient's serum gives the following results:
Test Result
TSH Normal
Calcium High
Phosphate Low
Parathyroid hormone High
The patient most likely has which disorder?
  1. Hyperparathyroidism
  2. Hyperthyroidism
  3. Hypoparathyroidism
  4. Hypothyroidism
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4.54) A 36-year-old woman complains of fatigue, depression, and weight gain. The results of a thyroid function test are as follows:
Test Result Reference range
TSH 10.2 mIU/L 0.5–5.0 mIU/L
T4 2.1 pmol/L 8.0-18.0 pmol/L
Which thyroid problem best fits these results?
  1. Primary hyperthyroidism
  2. Primary hypothyroidism
  3. Secondary hyperthyroidism
  4. Secondary hypothyroidism
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4.55) A biopsy suspected of cancer is stained for calretinin. Examination under a microscope shows cells with a “fried egg” appearance. What are these cells?
  1. Adenocarcinoma
  2. Basal
  3. Mesothelial
  4. Squamous
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Section 5: Quality Management

5.1) A thermometer gives a reading of 100.0°C. What is the resolution of the thermometer?
  1. 0.1°C
  2. 0.4°C
  3. 1°C
  4. 4°C
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5.2) A data point that differs significantly from other data points is called a(n):
  1. outsider
  2. outlier
  3. nonconformist
  4. radical
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5.3) A test gives the following control values:
Day 1 2 3 4
Result (U/L) 1.2 1.5 1.8 2.1
These control values demonstrate a(n):
  1. outlier
  2. random variation
  3. repeating pattern
  4. trend
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5.4) What does the standard deviation tell you?
  1. How many errors are in the data set
  2. How spread out the data is
  3. The average value in the data set
  4. The number the data tends to cluster around
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5.5) If the mean for an analyte is 10.1 mg/dL and the standard deviation is 1.7 mg/dL, calculate a reference range that includes the values within two standard deviations of the mean.
  1. 2.3–4.7 mg/dL
  2. 6.7–13.5 mg/dL
  3. 8.4–11.8 mg/dL
  4. 9.8–10.5 mg/dL
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5.6) A test has a mean of 72 mmol/L and a standard deviation of 3 mmol/L. If all control values must fall within 3 standard deviations of the mean, which of the following values is outside the acceptable range?
  1. 62 mmol/L
  2. 71 mmol/L
  3. 78 mmol/L
  4. 80 mmol/L
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5.7) If you perform a test 100 times, how many of the results would you expect to be outside of +/-2 standard deviations?
  1. 3
  2. 5
  3. 20
  4. 95
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5.8) What is the probability of three consecutive control values exceeding ±2 standard deviations by chance alone?
  1. 1:400
  2. 1:1,600
  3. 1:8,000
  4. 1:16,000
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5.9) A thyroid stimulating hormone (TSH) quality control chart has the following data for the normal control:
Statistic Value
Count 43
Mean 2.4 mIU/L
2 SD 1.2 mIU/L
Calculate the coefficient of variation for the control.
  1. 25%
  2. 35%
  3. 40%
  4. 50%
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5.10) The _________ the coefficient of variation, the more _________ the values.
  1. higher, accurate
  2. higher, precise
  3. lower, accurate
  4. lower, precise
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5.11) A pipette gives a reading of 4.9 mL when the true value of the volume of liquid inside the pipette is 5.0 mL. What is the percent error?
  1. 2%
  2. 4%
  3. 6%
  4. 8%
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5.12) Which of these hematology results is critical?
  1. Hemoglobin: 5 g/dL
  2. INR: 2.9 seconds
  3. Neutrophils: 7×10⁹/L
  4. Platelets: 320×10⁹/L
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5.13) Which of these is a key principle of the lean management philosophy?
  1. Ideas flow from the top down
  2. It is better to under-communicate than to overcommunicate
  3. Staff must be accountable to achieve success
  4. Words speak louder than actions
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5.14) A lab technician is counting the number of colonies on an agar plate. She accidentally counts the same colony twice. What type of error is this?
  1. Environmental
  2. Instrumental
  3. Observational
  4. Theoretical
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5.15) Random errors mainly affect:
  1. accuracy
  2. external validity
  3. internal validity
  4. precision
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5.16) Which of these is a post-analytical error?
  1. A hemolyzed specimen
  2. An empty collection tube
  3. Incorrect information on the test request
  4. Results reported in the wrong units
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5.17) Which of these is a pre-analytical error?
  1. A light blue top tube filled only halfway
  2. A result reported on the wrong patient
  3. Incorrect calculation of test results
  4. Incorrect interpretation of results
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5.18) Where would you find the instructions for running quality controls for a specific assay?
  1. Laboratory quality manual
  2. Safety data sheet
  3. Safety manual
  4. Standard operating procedure
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5.19) Which of the following quality control results is acceptable for the L-pyrrolidonyl-β-naphthylamid (PYR) test?
  1. Citrobacter freundii: positive
  2. Enterococcus faecalis: negative
  3. Streptococcus agalactiae: positive
  4. Streptococcus pyogenes: negative
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5.20) Which term means the ability of a procedure to detect only a substance of interest instead of other substances?
  1. Analytical sensitivity
  2. Analytical specificity
  3. Diagnostic sensitivity
  4. Diagnostic specificity
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5.21) Precision indicates the:
  1. closeness of a result to the first standard deviation
  2. closeness of a result to the median value
  3. closeness of a result to the true value
  4. repeatability or reproducibility of a procedure
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5.22) Which term means the extent to which measurements agree with the true value?
  1. Accuracy
  2. Precision
  3. Reliability
  4. Reproducibility
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5.23) In a control run, two of 20 controls exceed two standard deviations above the mean. What does this indicate?
  1. Contamination of control material
  2. Random error due to poor precision
  3. Systematic error due to poor accuracy
  4. The control is normal, begin patient testing
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5.24) Which of these four pictures demonstrates high precision but low accuracy?
  1. A
  2. B
  3. C
  4. D
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5.25) The following quality control results were obtained: 13.1, 13.0, 13.1, 13.1, 13.0. Given that the reference range for the control sample is 6.0 g/dL plus or minus 0.5 g/dL, the results are:
  1. precise but not accurate
  2. accurate but not precise
  3. both accurate and precise
  4. neither accurate nor precise
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5.26) A screening test detects 250 cases of illness in 500 sick people and 120 cases of illness in 1,200 healthy people. Calculate the test's specificity.
  1. 10%
  2. 50%
  3. 70%
  4. 90%
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5.27) A screening test detects 700 cases of illness in 1,000 sick people and 400 cases of illness in 1,000 healthy people. Calculate the test's sensitivity.
  1. 30%
  2. 40%
  3. 60%
  4. 70%
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5.28) A new method for diagnosing fibromyalgia is trialled on 1,000 patients. The method detects 125 true positives, 25 false positives, 800 true negatives and 50 false negatives. Calculate the diagnostic specificity of the test.
  1. 97.0%
  2. 98.2%
  3. 98.9%
  4. 99.3%
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5.29) Calculate the positive predictive value for the data below.
True positives 82
True negatives 55
False positives 10
False negatives 5
  1. 83%
  2. 85%
  3. 87%
  4. 89%
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5.30) A cancer screening test has the following results:
True positives 100
True negatives 15
False positives 85
False negatives 0
The test shows high:
  1. accuracy
  2. reproducibility
  3. sensitivity
  4. specificity
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5.31) Which of these inventory management methods minimizes the risk of products expiring?
  1. First-In, First-Out
  2. Highest-In, First-Out
  3. Last-In, First-Out
  4. Lowest-Cost, First-Out
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5.32) 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
  3. Repeat the control sera on the next run
  4. Report the results with a disclaimer that they may be erroneous
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5.33) Which quality system essential (QSE) includes external and internal monitoring to verify that laboratory processes are meeting requirements?
  1. Assessments
  2. Continual improvement
  3. Nonconforming event management
  4. Process management
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5.34) Which quality system essential (QSE) includes meeting the expectations of physicians, patients, and the families of patients?
  1. Assessments
  2. Customer focus
  3. Facilities and safety
  4. Process management
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5.35) A laboratory technician is running a daily positive control to verify the reactivity of Coombs’ control cells. The technician mixes one drop of Coombs’ control cells with anti-IgG and then centrifuges the mixture. The result is an agglutination of 4+. What does this result indicate?
  1. The result is abnormal; discard the Coombs’ control cells and prepare a new batch
  2. The result is abnormal; discard the anti-IgG and order a new batch
  3. The result is abnormal; rerun the control at a faster centrifugation speed
  4. The result is normal
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5.36) In blood typing, anti-A may be dyed what colour as a quality control measure?
  1. Blue
  2. Green
  3. Red
  4. Yellow
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5.37) How often should reagent strips be tested with controls?
  1. Daily
  2. Weekly
  3. Monthly
  4. Every three months
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5.38) Which of these specimens should be rejected for testing?
  1. A blood glucose sample exposed to light
  2. A refrigerated blood sample for TSH testing
  3. A urine creatinine sample transported at room temperature
  4. A urine culture sample transported on ice
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5.39) Software that resides between the analyzer and the laboratory information system (LIS) is called:
  1. autoverification software
  2. infoware
  3. middleware
  4. standardization software
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5.40) What laboratory component keeps a record of test orders and test results?
  1. Analyzer
  2. Electronic medical record
  3. Laboratory information system
  4. Middleware
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Section 6: Critical Thinking

6.1) You have three specimens to collect: routine, preop, and fasting. What is the correct order of priority for collecting these specimens?
  1. Fasting, Preop, Routine
  2. Fasting, Routine, Preop
  3. Preop, Fasting, Routine
  4. Routine, Fasting, Preop
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6.2) A patient is extremely anxious about having her blood drawn. She tells you that she is afraid of needles. You do not have much experience drawing blood. What should you do?
  1. Ask an experienced phlebotomist to perform the draw for you
  2. Explain to her that you will use a small needle that barely hurts
  3. Tell her that it's not a big deal and that she shouldn't be afraid
  4. Use an ice pack to numb the site before drawing the specimen
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6.3) A phlebotomist is asked to collect a blood specimen from an inpatient but the patient is not wearing an ID band. What is the best thing to do?
  1. Ask a nurse for help identifying the patient
  2. Identify the patient by asking them to confirm their name
  3. Identify the patient by the name card on the door
  4. Refuse to draw the specimen and cancel the request
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6.4) A phlebotomist has finished drawing blood into a citrate tube for PT testing. However, the blood in the tube is below the minimum line. The phlebotomist should:
  1. fill another citrate tube partly full and mix the two tubes
  2. pour a little blood from another tube into the citrate tube
  3. repeat the procedure with a new citrate tube
  4. submit the tube for testing as usual
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6.5) If a patient is having blood drawn for a prothrombin time test, you might expect:
  1. the patient to be fasting
  2. the patient to bleed for a long time
  3. to have difficulty filling the tube
  4. to have to mix the tube more
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6.6) A lab assistant is wrapping an instrument for autoclaving but discovers the wrapper has a hole. What should the lab assistant do?
  1. Get a new wrapper
  2. Ignore the hole and continue wrapping the instrument
  3. Repair the hole with adhesive tape
  4. Throw the instrument away
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6.7) Leptocytes are found on a blood smear. Which of the following diseases is least likely?
  1. Alpha-thalassemia
  2. Hemoglobin C disease
  3. Iron deficiency anemia
  4. Spherocytosis
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6.8) A patient with type B+ blood requires an emergency blood transfusion. He receives three units of packed red blood cells from an O– donor. Shortly after the transfusion, he starts experiencing fever, nausea, hypotension, and shock. His condition worsens and he begins showing signs of hemoglobinuria, DIC, and kidney failure. Which transfusion reaction is the patient experiencing?
  1. Anaphylactic
  2. Circulatory overload
  3. Febrile
  4. Septic
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6.9) You are performing a rapid strep test on an eight-year-old girl. However, when you try to swab the back of her throat, she refuses to open her mouth. She says the swab scares her. What should you do?
  1. Force the swab into her mouth
  2. Scold her for behaving badly
  3. Swab her nose instead
  4. Talk to her about the test
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6.10) A patient arrives for an oral glucose tolerance test. She says she ate a few biscuits before coming to the test. What should you do?
  1. Arrange for the test to be rescheduled for another day
  2. Have her walk around to use up the sugar from the biscuits
  3. Start the test as the biscuits will not matter
  4. Wait an hour to ensure all the sugar is out of her bloodstream
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6.11) Which of these actions is NOT performed when performing quality control of a glucometer?
  1. Apply a drop of blood to the test strip
  2. Compare the result displayed by the glucometer with the expected value
  3. Insert a test strip into the glucometer
  4. Remove the test strip from the glucometer
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6.12) Which of these research methods is quantitative?
  1. Case study
  2. Experiment
  3. Grounded theory
  4. Phenomenological
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6.13) Which research method involves manipulating an independent variable to observe its effect on a dependent variable?
  1. Experimental
  2. Longitudinal
  3. Mixed
  4. Secondary data analysis
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6.14) Which of these would NOT be a reputable source for a literature review?
  1. Cumulative Index to Nursing and Allied Health Literature (CINAHL)
  2. Heart and Stroke Foundation
  3. Public Health Agency of Canada
  4. Wikipedia
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6.15) Content analysis is most often associated with which type of study?
  1. Correlational
  2. Experimental
  3. Qualitative
  4. Quantitative
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Section 7: Communication and Interaction

7.1) When drawing blood from a frightened child, which of these is the right thing to do?
  1. Explain the procedure to the child in simple terms
  2. Say nothing to the child and just perform the procedure
  3. Tell the child that the needle won't hurt
  4. Tell the child to be brave
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7.2) A lab assistant is chronically late and has poor work performance. These issues should initially be addressed by the:
  1. hospital director
  2. human resource department
  3. manager
  4. union
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7.3) What team practice involves team members expressing their thoughts, feelings, and opinions about recent work experiences?
  1. Collaboration
  2. Coordination
  3. Reflection
  4. Role clarification
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7.4) A lab assistant overhears two clinicians talking about a patient. What kind of risk is this?
  1. Accountability
  2. Infection
  3. Privacy
  4. Security
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7.5) Which of the following is an aspect of non-verbal communication?
  1. Articulation
  2. Gestures
  3. Tone
  4. Vocabulary
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7.6) Which of the following is an element of verbal communication?
  1. Body language
  2. Eye contact
  3. Facial expression
  4. Intonation
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7.7) Which zone of interpersonal space ranges from zero to 18 inches around a person?
  1. Intimate
  2. Personal
  3. Public
  4. Social
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7.8) When you are actively listening, where should you look?
  1. At the clock
  2. At the person speaking
  3. At the work in front of you
  4. At your notes
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7.9) Which term refers to communication through the use of physical distance or space?
  1. Kinesics
  2. Olfactics
  3. Proxemics
  4. Vocalics
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7.10) A member of the clergy is with a patient when you arrive to collect a routine specimen. What should you do?
  1. Ask the patient's nurse what you should do
  2. Come back after the clergy member has gone
  3. Fill out a form saying you were unable to collect the specimen
  4. Interrupt and explain you need to collect a specimen from the patient
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7.11) What learning process involves thinking about experiences and learning from them?
  1. Classical conditioning
  2. Concept learning
  3. Implicit learning
  4. Reflective practice
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Section 8: Professional Practice

8.1) What are standards of practice?
  1. A definition of competent behaviour for professionals
  2. Measures to ensure work is accurate
  3. Rules for how organizations must treat their employees
  4. Rules for students on work placements
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8.2) Which principle of the Canada Health Act is not patient-focused but rather the means of achieving the end to which the other four principles are directed?
  1. Accessibility
  2. Comprehensiveness
  3. Portability
  4. Public administration
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8.3) A lawyer asks a lab technician for copies of his client's test results. What should the lab technician do?
  1. Allow the lawyer to see the results on the computer
  2. Give the results to the lawyer immediately
  3. Have the lawyer sign a Medical Release Form and then release the results
  4. Tell the lawyer to contact the physician who ordered the tests
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8.4) A lab assistant witnesses a manager intentionally breaching a patient's confidentiality. What should the lab assistant do first?
  1. Ignore the breach
  2. Notify the local news station
  3. Notify the patient about the breach
  4. Seek guidance from the regulatory body
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8.5) The obligation of a person or organization to not disclose health information unless authorized by law or the patient is known as:
  1. accountability
  2. confidentiality
  3. privacy
  4. security
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8.6) A laboratory technician overhears two nurses talking about an unconscious patient. They are making inappropriate sexual remarks about the patient and what they would like to do to him if he were awake. What should the laboratory technician do?
  1. Do nothing since the patient is unconscious and unaware of what is being said
  2. Report the nurses' behaviour to the manager
  3. Share the incident on social media
  4. Tell the nurses that their behaviour is inappropriate
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8.7) What is Canada's federal data privacy law for private-sector organizations?
  1. HIPPA
  2. PHIPA
  3. PIPEDA
  4. WHMIS
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8.8) Medicare is:
  1. Canada's national health insurance program
  2. a private insurance system
  3. a regulating organization
  4. a representative of health professionals
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8.9) What is the national professional society for Canada's medical laboratory professionals?
  1. ASCLS
  2. CMLTO
  3. CSMLS
  4. MLPAO
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8.10) CSMLS certification is the entry-level requirement for medical laboratory technologists in all of the regulated provinces except:
  1. Alberta
  2. New Brunswick
  3. Nova Scotia
  4. Quebec
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8.11) The main disadvantage of Canada's universal health care system is:
  1. decreased wait time for medically necessary treatment
  2. increased rate of taxation to cover the costs of health services
  3. provinces are not able to determine how much they can spend on health care services and education programs
  4. the differences that exist between provincial plans
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8.12) Canada's health care system is best described as:
  1. a centralized, privately-funded system
  2. a privately funded health care system
  3. a set of ten provincial and three territorial health insurance plans
  4. one that delivers health care services to specific groups in Canada
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8.13) Which act is Canada’s federal legislation for publicly funded health care insurance?
  1. Canada Health Act
  2. Established Programs Financing Act
  3. Hospital Insurance and Diagnostic Services Act
  4. Medical Care Act
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8.14) PIPEDA is "consent-based". What does this mean?
  1. Organizations affected by the legislation must consent to its enforcement
  2. Organizations can collect any data from people because consent is always implied
  3. People must give consent before organizations can collect and use their personal information
  4. Those who collect and use information must consent to do so
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8.15) What are equalization payments?
  1. A direct transfer of money between provinces or territories
  2. A transfer of funds between regional authorities to ensure service in rural areas
  3. An allowance for provinces or territories with less money to provide the same level of services as richer jurisdictions
  4. An income tax charged to residents with higher income
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8.16) The Canadian act that provides the basis for the privacy of all personal information, including health information, is:
  1. CSA Model Code
  2. HIPPA
  3. PHIPA
  4. PIPEDA
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8.17) Which determinant of health includes smoking?
  1. Behaviour
  2. Environment
  3. Genetics
  4. Medical care
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