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Clotting Hemolysis Increased turnaround time Specimen misidentification The most likely consequence is specimen misidentification (specimens linked to the wrong patients), which could lead to incorrect diagnosis, inappropriate treatment, or delayed care.
Ask a coworker to witness her labeling the tubes Discard the tubes and schedule a redraw Phlebotomists should label collection tubes in the patient's presence. If the patient has left, it is no longer safe to label the tubes, so the phlebotomist should discard the tubes and schedule a redraw.Label the tubes immediately using the information from the requisition form Send the unlabelled tubes to the laboratory with a note of explanation
Add sodium citrate to the red-top tube Pour the blood sample into the correct tube Reject the specimen and recollect it in the correct tube Coagulation tests require light blue-top tubes. If you accidentally collect a coagulation test in a lavender-top tube instead of a light blue-top tube, you should reject the specimen and collect it in the correct tube.Relabel the lavender-top tube as a light blue-top tube
Dilute the sample to account for the trapped cells Gently stir the sample to break up the clot Reject the specimen and request a new one If an EDTA (lavender-top tube) sample has a clot, you should reject the specimen and request a new sample. Clots trap platelets and white blood cells, which leads to falsely low cell counts.Remove the clot with an applicator stick
Answer your coworker's question first Ask someone else to label the specimen Label the specimen first Labeling is the most critical step for preventing medical errors. Any break in concentration during this process can lead to mislabeling, which can cause patient harm. Therefore, you should label the specimen immediately.Redraw the specimen
214 mL The dilution formula isc1 × v1 = c2 × v2 where:- c1 is the initial concentration
- v1 is the initial volume
- c2 is the final concentration
- v2 is the final volume
c1 × v1 = c2 × v2 85 × 1,000 mL = 70 × v2 85,000 = 70 × v2 85,000/70 = v2 1,214 = v2 Therefore, the final volume of the solution is 1,214 mL. If the original volume is a liter (1,000 mL), 214 mL of water must be added to the original volume to make the final volume of 1,214 mL.528 mL 1,214 mL 1,528 mL
5 mL 10 mL 25 mL Using the dilution formula:c1 × v1 = c2 × v2 100 × v1 = 5 × 500 100 × v1 = 2,500 v1 = 2,500/100 v1 = 25 mL Therefore, you need 25 mL of 100x stock solution to make 500 mL of a 5x solution.50 mL
(solute mass / solution mass) × 100 (solute mass / solution volume) × 100 w/v stands for weight/volume. Weight refers to the weight (or mass) of the solute, and volume refers to the final volume of the solution. w/v is used for solids dissolved in liquid.(solution volume / solute mass) × 100 (solution volume / solute volume) × 100
(solute mass / solution mass ) × 100 w/w stands for weight/weight, referring to the mass (weight) of the solute and the final mass of the solution.(solute mass / solution volume) × 100 (solution mass / solute mass) × 100 (solution mass / solute volume) × 100
%(m/m) %(m/v) %(v/m) %(v/v) Liquids are typically measured in volume (milliliters or liters). When both the solute and solvent are liquids, a convenient way to express the concentration is as volume/volume percent. A shorter way to write this is %(v/v).
10 11 20 21 The dilution factor formula is:dilution factor = final volume/initial volume The question says the initial volume is 0.5 mL. We have to work out the final volume by adding the sample volume to the diluent volume:0.5 mL+ 10 mL = 10.5 mL Inserting these values into the formula:dilution factor = 10.5/0.5 = 21
0.9 g/L 8 g/L 8.9 g/L 9 g/L The concentration formula is:concentration = mass of solute/volume of solution The question says the mass of the solute is 4.5 g and the volume of the solution is 0.5 L. Therefore, the concentration is:concentration = 4.5/0.5 = 9 g/L
1 part specimen, 9 parts diluent A dilution of 1/10 means the specimen was diluted tenfold. In other words, the final volume of the solution is ten times higher than the volume of the specimen. To make a 1/10 dilution, you would typically mix 1 part specimen with 9 parts diluent, for a total of 10 parts.1 part specimen, 10 parts diluent 1 part specimen, 10.5 parts diluent 1 part specimen, 11 parts diluent
125 mL of concentrate and 375 mL of water 2 + 6 is a total of 8 parts. Therefore, the amount of concentrate needed:500 mL × 2/8 = 125 mL The amount of water needed:500 mL × 6/8 = 375 mL 150 mL of concentrate and 350 mL of water 175 mL of concentrate and 325 mL of water 200 mL of concentrate and 300 mL of water
5 g 10 g To find the grams of solute dissolved in a solution, multiply the solute concentration by the solution volume. The solute concentration is 5 g per 100 mL (5% m/v means there are 5 grams of solute per 100 mL of solution). The solution volume is 200 mL. Therefore, the calculation is:Mass = concentration × volume Mass = 5 g/100 mL × 200 mLMass = 0.05 × 200Mass = 10 g15 g 20 g
1% 10% 25% 50% To find the concentration of a liquid solute in a liquid solution, we use the following equation:concentration = solute volume/final solution volume . Inserting the values into the equation gives us:concentration = 100 mL/200 mL concentration = 0.5concentration = 50%
1/128 1/256 If the first tube has a dilution factor of 1/2 and each subsequent tube doubles the dilution, then the series continues as follows:- Second tube: 1/4
- Third tube: 1/8
- Fourth tube: 1/16
- Fifth tube: 1/32
- Sixth tube: 1/64
- Seventh tube: 1/128
- Eighth (final) tube: 1/256
1/512 1/1024
1 gram of solute in 1 mL of solution 1 gram of solute in 1 mole of solution 1 mL of solute in 1 mole of solution 1 mole of solute in 1 liter of solution A molar solution, often denoted as "M", is a solution that contains one mole of solute dissolved in a sufficient amount of solvent to make one liter of the solution.
58 mL 101 mL 391 mL A solute-to-solvent dilution ratio of 7:10 means the solution contains 7 parts solute and 10 parts solvent, making 17 parts in total. In other words, 7/17ths of the solution is solute. To find the volume of solute in a solution, multiply the volume of the final solution by the fraction of the solution that is solute:950 mL × 7/17 = 391 mL of solute 559 mL
Giving results to patients Performing tests that require judgment Preparing chemical solutions Preparing chemical solutions is the task of a laboratory assistant. Laboratory assistants perform basic tasks such as preparing solutions, handling specimens, and maintaining equipment. Supervising workers, giving results to patients, and performing tests requiring judgment are typical responsibilities of more advanced laboratory personnel, such as technicians, technologists, and managers.Supervising other workers
Refer the worker to the patient’s primary physician Refuse to discuss the patient’s information Workers should only have access to information if they are directly involved in the patient’s care. Therefore, in this situation, you must keep the patient's information private.Share the result but omit the patient's name Share the result only if the worker signs a confidentiality report
Contact the patients involved Delete the records immediately Monitor the staff member's activity for a week to gather evidence Report it to a supervisor The technologist should report the situation to a supervisor (or the data compliance officer) so it can be investigated and appropriate actions can be taken.
Ignore it Join the conversation Record the conversation in case it is needed as evidence Remind the coworker to stop Patient information must not be discussed in public areas (such as corridors, elevators, or waiting rooms) because other people may overhear it. The best action is to politely remind the coworker to stop.
Adaptability Confidentiality Health professionals have a duty to keep patient information confidential (private). They should not discuss patient information in public places, such as a hospital cafeteria, because other people could overhear it.Cultural humility Time management
Most recent vacation destination Performance reviews Employee personnel files typically contain documents such as hiring records, performance reviews, disciplinary actions and job descriptions.Political affiliation Web addresses of the employee's social media profiles
"Please hold while I notify the physician immediately.” "Please read the result back to me." "That is a hemoglobin of 5 g/dL for John Doe, MRN 12345." A read-back requires the receiver to repeat the information exactly as heard to verify accuracy. Choice C is the correct answer, as it is the only one that repeats the specific test value, the patient name, and the MRN.“Okay, that is a critical hemoglobin for John Doe, MRN 12345.”
Contact the patient to confirm the correct side Contact the surgical department In this situation, you should contact the surgical department so the clinician can clarify the situation. It may be a clerical error (someone wrote "left" instead of "right") or it may be that the surgeon biopsied the incorrect breast.Discard the biopsy and request a new one Discarding the specimen is wrong. You should keep the specimen in case it is from the correct breast.Process the specimen, but add a note in the file
Call the patient to ask for permission Give only general information Say that you cannot discuss patient information You must not share patient information with unauthorized people.Tell your neighbour whether the result is benign or malignant
Discard it down the sink Treat it as hazardous If a chemical is unlabelled, you cannot be certain what it is, so you should assume it is dangerous and treat it as hazardous.Use it if the color looks normal Use it only on non-urgent specimens
Ask the operating room to resolve the mismatch STAT specimens are urgent, but they must still be correctly identified before processing. The laboratory should contact the operating room or attending physician to resolve the mismatch first.Change the label to match the request form Change the request form to match the label Process it immediately
Ask the family member to sign a Release of Information form Give the result to the family member Refer the family member to the pathologist Refuse to release results without proper authorization Biopsy results are confidential. Family members do not have a right to receive biopsy results unless they are legally authorized or the patient has given permission.
The LIS will delete the record The bacteria will become resistant to antibiotics The healthcare team may not receive the result Results must be documented in the laboratory information system (LIS) so the healthcare team can use them.The result becomes automatically invalid
Ignore it if colonies are visible Inform the supervisor and document the issue In this situation, the technologist should tell the supervisor and document the issue.Re-incubate the plate at the correct temperature Re-incubating the plate at the correct temperature sounds logical, but the wrong temperature might have already killed certain bacteria or allowed others to overgrow.Report all results as preliminary
Correct the report and notify appropriate personnel The technologist should issue a corrected report and notify the appropriate healthcare provider or personnel.Delete the incorrect report from the system Do nothing because the report was already released Request a new patient sample and notify the patient
| Test | Result |
|---|---|
| Total cholesterol | 160 mg/dL |
| LDL | 100 mg/dL |
| HDL | 40 mg/dL |
0.25 4 The equation to calculate the total cholesterol to HDL ratio is:Total cholesterol/HDL Inserting the values into the equation gives us:160/40 = 4 50 150
Blood gas pH: 1 above the target value The acceptable range for blood gas pH is ±0.04 from the target value. A result 1 pH unit above the target value is therefore outside this range.Sodium: 10 mmol/L below the target value The acceptable range for sodium is ±4 mmol/L from the target value. A result 10 mmol/L below the target value is outside this range.Total calcium: 3 mg/dL below the target value The acceptable range for total calcium is ±1.0 mg/dL from the target value. A result 3 mg/dL below the target value is outside this range.Total cholesterol: 4% above the target value The CLIA acceptable range for total cholesterol is ±10% of the target value. Therefore, a result 4% above the target value is acceptable.
| Test | Result |
|---|---|
| Total protein | 6.6 g/dL |
| Albumin | 3.3 g/dL |
| Alpha₁ | 0.2 g/dL |
| Alpha₂ | 0.7 g/dL |
| Beta | 1.1 g/dL |
| Gamma | 1.3 g/dL |
0.9 1.0 The A/G ratio calculation is:A/G ratio = albumin/globulins whereglobulins = total protein – albumin Inserting the values into the equation gives us:A/G ratio = 3.3/(6.6 – 3.3) A/G ratio = 3.3/3.3A/G ratio = 11.1 1.2
Notify the appropriate clinical team Critical results must be reported immediately to the appropriate clinical team.Request a new specimen Rerun the sample to verify the result Wait for the other tests to be complete
Patient results may be inaccurate Quality control checks that the analyzer is working properly before patient specimens are analyzed. If quality control was not performed, the main concern is that patient results may be incorrect.The analyzer's warranty may be voided The laboratory will lose its accreditation The technician may have accidentally been exposed to a biological agent
The patient may have a life-threatening condition A critical lab value is a result that is extremely low or extremely high and may indicate a life-threatening condition. Laboratories must convey critical values immediately to the ordering physician or nurse so that treatment can start as soon as possible.The test is malfunctioning and needs to be calibrated The value is needed to calculate other lab results The value must be reported to the doctor within 24 hours
Before patient samples By a reference laboratory By a senior technologist The same as regular specimens Proficiency testing is where an independent provider sends a laboratory blinded samples (materials with unknown concentrations or properties). The laboratory processes these samples exactly like regular test specimens and submits their results to the provider. The provider then grades the results, allowing the lab to see its performance. Laboratories should treat proficiency testing samples exactly like regular specimens to accurately reflect the lab's performance.
competency assessment internal quality control method validation proficiency testing Proficiency testing is where an outside program sends the same specimens to different laboratories, and the laboratories’ results are compared. This helps show whether a laboratory's results are accurate and consistent with other laboratories.
Organizational quality change Systemic optimization theory Total quality management Total quality management (TQM) is the process of improving quality across the entire organization. It emphasizes that all departments are responsible for improving their operations.Universal process management
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.Using a balance that was not zeroed before use Using a scale that always reads 10 g too low Using a thermometer that always reads 2°C too high
Calibration Drift Drift occurs when successive readings become consistently lower or higher over time. Electronic equipment tends to be susceptible to drift.Offset error Unpredictability
Environmental Instrumental Observational Observational errors occur when an observer reads a measurement wrongly.Theoretical
Calculating test results incorrectly Interpreting results incorrectly Mislabeling a blood specimen Pre-analytical errors happen before analysis in the laboratory. Mislabeling a blood specimen would occur during this stage.Reporting a result on the wrong patient
A blood sample missing a label A lab technician forgetting a zero when performing a calculation A thermometer registering 102°C in boiling water instead of 100°C Scales that give a reading of 1.1 g when nothing is placed on them A zero error occurs when a measuring instrument should read zero but gives a reading other than zero instead. Scales that give a reading of 1.1 g when nothing is placed on them are an example of a zero error, because scales should give a reading of zero when nothing is placed on them.
A hemolyzed specimen An empty collection tube Incorrect information on the test request Results reported in the wrong units Post-analytical errors occur after the specimen has been analyzed. Reporting results in the wrong units is a post-analytical error, because it occurs after the specimen has been analyzed.
A specimen tube is mislabeled Splashover contaminates a gel card well The incubator temperature is consistently too hot A systematic error is a consistent problem caused by flaws in equipment or methodology. It affects results in the same direction. An incubator that is too hot is a systematic error because it biases all results in the same direction. The other options are examples of random error, which are caused by an unpredictable one-off variation or mistake.The technician makes a typo when entering a result into the LIS
accuracy Systematic error, not random error, mainly affects accuracy.external validity internal validity 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).
Clerical Post-analytical Random Systematic Because the anti-D control reactions are gradually weakening over several days, this suggests an ongoing problem, such as reagent deterioration. This is a systematic error, which is a repeated or consistent problem that affects results in a predictable way.
Benchmark Control Model Standard A standard is a material or solution with a known value or concentration. It can be used for calibration or comparison.
Calibrate the centrifuge Discard the reagents Mix the reagents together Record the QC results After the quality control (QC) is completed, the technologist should record the QC results according to the laboratory’s procedure.
calibration Calibration involves checking and adjusting a measuring instrument by comparing it to a known standard. This ensures that measurements are accurate and reliable.estimation graduation mensuration Mensuration means "measurement". Using a ruler to measure a length is an example of mensuration.
Measures used to monitor performance Quality indicators are metrics used to monitor how well processes, products, or services meet standards. Examples in clinical laboratories include sample rejection rate, turnaround time, and the number of misidentification errors.Physical strips that change color to reveal a chemical state Chemical indicators are physical strips that change color to reveal a chemical state.Reference samples used to verify the accuracy of tests Reference samples used to verify testing accuracy are controls.Tools used to adjust the accuracy of equipment Tools used to adjust the accuracy of equipment are calibrators.
C-reactive protein test Fume hoods Laboratory turnaround time Turnaround time is a frequent quality assurance indicator in laboratories. Turnaround time is the time it takes for the laboratory to analyze the specimens and dispatch the results.Thorough records of exposure incidents
Decontaminate the interior with bleach Re-run the last five patient samples Run proficiency testing Run quality control After corrective maintenance, quality control should be run. Quality control must give acceptable results before patient testing resumes.
To calculate the concentration of the patient's analyte To calibrate the instrument To ensure the testing process is working properly Controls verify that tests are performing accurately. For example, positive controls are supposed to produce a positive result, and negative controls are supposed to produce a negative result. If a positive control is negative or a negative control is positive, it implies there is a problem with the test.To establish the patient’s reference range
closely agree with the original result A blind duplicate is a second, identical sample that the laboratory staff do not know is a duplicate. Its result should closely agree with the result of the primary sample.fall below the detection limit of the instrument fall within the reference interval for the test match the result of the positive control
control A control is a substance with a known value and is used to monitor the accuracy and precision of laboratory tests. It helps ensure that the testing process is working correctly and that the results are reliable.reagent reference sample
Standards are prepared by the laboratory, while controls are provided by the manufacturer Standards are used for calibration, while controls check that the test is working correctly A standard is a substance that contains a highly precise, known concentration of an analyte. Standards are used to calibrate instruments. The instrument reads the standard and uses that data to accurately measure unknown patient samples. A control is a specimen with a predetermined target range. It is run alongside patient samples to verify that the system is functioning properly.Standards have unknown concentrations, while controls have known concentrations Standards measure test precision, while controls measure test accuracy
Laboratory quality manual A laboratory quality manual contains policies and procedures that support the laboratory's quality management system. It would not have detailed instructions for running assays.Safety data sheet Safety manual Standard operating procedure Standard operating procedures (SOPs) provide detailed step-by-step instructions for conducting specific laboratory tests or procedures, including the use of quality controls.
Critical value reporting time Critical value reporting time is how long it takes the laboratory to notify the appropriate healthcare provider after a critical result has been identified. It is a post-analytical quality indicator because reporting happens after the analysis.Insufficient specimen quantity rate The insufficient specimen quantity rate is the percentage of specimens that cannot be tested because they are too small. It is a pre-analytical quality indicator.Labeling errors Labeling errors is a pre-analytical quality indicator since labeling occurs before analysis.Specimen rejection rate The specimen rejection rate is the percentage of specimens that cannot be tested and are rejected. It is a pre-analytical quality indicator.
| Day | Reaction strength |
|---|---|
| 1 | 4+ |
| 2 | 4+ |
| 3 | 4+ |
| 4 | 2+ |
| 5 | 2+ |
| 6 | 2+ |
Dispersion Random error A random error would have no consistent pattern, like 4+, 2+, 4+, 3+, 4+, or just one or two irregular results, like 4+, 4+, 4+, 2+, 4+, 4+.Shift The pattern 4+, 4+, 4+, 2+, 2+, 2+ is a shift because the results suddenly move and do not change back.Trend A trend would be more gradual, such as 4+, 3+, 2+, 1+.
Eadie-Hofstee Hanes-Woolf Levey-Jennings A Levey-Jennings chart is a graphical tool used in quality control to check if laboratory tests are working properly. The x-axis represents the sequence of control runs. The y-axis shows each control result, with the mean and SD lines marked on the chart, making it easy to see how far off each result was from the mean.Lineweaver-Burk
A calibration standard made in the laboratory A control prepared from pooled patient specimens A control purchased from a manufacturer Commercial controls are prepared and supplied by a manufacturer, usually with expected values.A control used solely for marketing demonstrations
To determine the detection limit To establish a reference range To evaluate consistency between results A blind duplicate is a second, identical sample that is submitted alongside a primary sample, but labelled in a way that hides its identity from the laboratory. The results of the primary sample and the blind duplicate sample should be the same. If the results are different, it implies there is a problem with testing.To identify matrix interferences
American Association for Clinical Chemistry (AACC) American Clinical Laboratory Association (ACLA) Department of Energy (DOE) National Institute of Standards and Technology (NIST) NIST offers calibration services for various instruments, including thermometers.
corporate compliance critical thinking quality assurance Quality assurance helps ensure that processes produce reliable and accurate results. In laboratories, quality assurance involves monitoring, evaluating, and improving the entire testing process, from sample collection to final reporting.risk management
Accuracy Accuracy is how close a measurement is to the real value.Precision Precision is how close repeated measurements are to each other.Reliability Reproducibility
accurate reliable Reliability is how consistent the measurements are. If you measure the same thing many times, the test is reliable if the measurements are always the same.valid variable
When repeated measurements yield similar results Reliability means getting consistent results when you measure the same thing again. For example, imagine you are testing a patient's blood sugar level. The data is reliable if you get similar results every time you test the same blood sample.When the data is statistically significant When the measurements answer the research question When the measurements are close to the true value A result that is close to the true value is accurate.
are caused by random errors are close to the true value Accurate values are close to the true value, not precise values.are the same as the true value 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.
False negatives / (false negatives + true positives) False positives / (false positives + true negatives) True negatives / (true negatives + false positives) True positives / (true positives + false negatives) Diagnostic sensitivity is the ability of a test to identify people with a certain disease (true positives). The equation to calculate diagnostic sensitivity is:true positives/(true positives + false negatives)
To ensure accurate and reliable measurements Calibration means adjusting an instrument’s readings so they align with a known reference standard. This helps ensure measurements are accurate, consistent, and reliable.To ensure employees understand how to use equipment To prevent laboratory-acquired infections To protect workers from harm
Forward the samples to an outside laboratory Notify the inspecting authority Laboratories should never send proficiency testing (PT) samples to other laboratories for testing. Laboratories must test PT samples themselves. If your laboratory receives a PT sample from another laboratory for testing, do not test it. Notify your inspecting entity (CMS, state agency, or accreditation organization) instead.Test the samples immediately Test the samples the same way you test patient specimens
Inspections to prevent work-related accidents Testing for illegal drugs in a biological sample Tests to ensure workers have the skills and knowledge to perform their jobs The testing of unknown samples sent to the laboratory Proficiency testing is when a program sends unknown samples to laboratories to test. The labs return their results, which the program then grades. This helps labs check if their testing methods are accurate.
Give it to the most experienced technologist Process it the same way as patient specimens Laboratories should process proficiency testing samples in the same way as routine patient specimens. You should not give them special treatment or prioritize them above other specimens.Test it first, before other specimens Test it last, after all other work is complete
To calibrate new laboratory instruments To evaluate a laboratory's performance External quality assessment, also known as proficiency testing, is a process where an external agency sends unknown samples to a laboratory for testing, and the laboratory analyzes the samples and reports the results. This allows the agency to evaluate the laboratory's testing accuracy.To replace the need for daily controls To track the expiration dates of reagents
To evaluate a laboratory's testing accuracy Proficiency testing is an independent assessment of a laboratory's test results. It ensures that laboratories are performing tests to a high level of quality.To monitor the rate of equipment malfunctions To track the inventory levels of laboratory reagents To train new employees on laboratory techniques
Accept the run 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.Repeat the control sera on the next run Report the results with a disclaimer that they may be erroneous
Accept the control run Five consecutive values between the mean and +1 SD does not break any Westgard rule. Therefore, the control run can be accepted.Accept the control run, but make a note of the incident in the log file Reject the control run and take corrective action Rerun the control run
Inform the clinician that results are likely to be incorrect Prepare a new reagent Replace the equipment Report patient results A single result outside ±2 SD violates the1₂s Westgard rule, also known as the warning rule. However, this does not necessarily mean the run needs to be rejected. The 1₂s rule serves as a warning that there may be errors, and that the technician should inspect the control data for issues. If no other Westgard rule is violated and no error is found, patient results may be reported.
Amend the report and notify the clinical staff When an incorrect blood group result has already been released, the laboratory should amend the original report so there is a clear audit trail showing both the original and corrected results. They should also immediately notify clinical staff who may have acted on the incorrect information.Delete the original report and issue a new report Request a new sample and issue a new report Retest the original sample and issue a new report
Change the historical record to match the new result Report the current ABO result as the patient's blood group Report the historical ABO result as the patient's blood group Resolve the discrepancy You should investigate and resolve ABO discrepancies. This may involve repeating the test, checking patient/sample identification, reviewing records, and requesting a new specimen.
Administrative controls Elimination Engineering controls Substitution Substitution means replacing the hazard with a safer alternative.
All results will be legally invalid The new vial is now contaminated The test is now inaccurate There is no record of the failure By only documenting the passed QC, the technologist has hidden the failed AHG reagent vial and the action taken to fix the problem. It may be that other vials currently sitting in inventory are also defective, but without documentation, there is no clear way for the laboratory to know. All quality control failures and troubleshooting must be fully documented.
| Number | Result |
|---|---|
| 1 | 4+ |
| 2 | 4+ |
| 3 | 4+ |
| 4 | 4+ |
| 5 | 4+ |
Expected QC results D-positive control cells should react with anti-D reagent. Repeated 4+ reactions suggest the reagent is reacting strongly and consistently with the positive control cells, which is the expected quality control result.Post-analytical error Random error Systematic error
| Day | Reaction strength |
|---|---|
| 1 | 4+ |
| 2 | 4+ |
| 3 | 2+ |
| 4 | 4+ |
| 5 | 4+ |
| 6 | 4+ |
Random error A single unexpected quality control reaction, followed by a return to normal results, most likely suggests a random error or one-off problem.Shift A shift would be a sudden and permanent change in results, such as 4+, 4+, 4+, 2+, 2+, 2+.Systematic error Trend A trend would be a gradual change in results, such as 4+, 3+, 2+, 1+.
Add extra urine Estimate the volume of the missed sample Restart the 24-hour collection A 24-hour urine collection must include all urine passed during the collection period. If one sample is missed, the results may be inaccurate, so the patient should restart the collection with a new container.Submit the container and write “one sample missed” on the requisition
Only the courier Only the laboratory technician The courier and the laboratory technician Every time a chain of custody sample changes hands, the person giving it and the person receiving it must sign and date the chain-of-custody form.The laboratory manager and the laboratory technician
The name of the patient's doctor Chain of custody forms document the people who have handled the specimen. They require the following information:- Type of specimen
- Name and signature of the person who collected the specimen
- Date and time of collection
- Name of the recipient
- Signatures of everyone involved in the chain of possession, with dates and times the specimen changed possession
The name of the person who collected the specimen The time the specimen was collected The type of specimen collected
Ask the courier to complete a new form Fill out a new form yourself Reject the specimen Chain of custody forms help prevent tampering with a specimen. If a chain of custody form is missing, you cannot verify who collected the specimen, where the specimen came from, etc. Therefore, you would need a new specimen.Test the specimen, but add a comment
The courier's name is missing The specimen ID does not match the ID on the form A mismatch between the specimen ID and the chain-of-custody form ID is a serious issue. The laboratory must reject the specimen for testing because the specimen cannot be matched to the chain-of-custody form. The other documentation errors may need correction or review, but they do not automatically mean the specimen needs to be rejected.The specimen temperature box is unticked There is a digit error in the patient's ID number
Complete blood count Fetal fibronectin Free light chains test Legal paternity test A legal paternity test must follow a chain of custody to prove the sample came from the right man. This process makes the results valid for legal use, like in immigration cases. Other tests that require chain of custody documentation are legal blood alcohol tests and pre-employment drug screens.
Ask the courier to reseal the bottle Reject the specimen A broken seal could mean that someone has tampered with the specimen. The laboratory must reject the specimen for testing.Test the specimen, but add a comment Transfer the urine to a new, sterile container
Label it using the nurse’s information Let the nurse label it herself Reject it and request a new sample Blood samples must be identified and labelled at the patient’s bedside. Samples should not be labelled afterward based only on the nurse’s recollection, as this introduces the risk of misidentification, which can lead to ABO-incompatible transfusions.Test it, but with a comment about the missing label
Accept the sample, but write a note in the LIS Ask the phlebotomist to correct the label Correct the label Request a new sample When a specimen arrives with mismatched identifiers (for example, the name on the tube does not match the requisition), the sample must be rejected and a new properly labelled specimen collected. This is because there is no way to confirm that the sample belongs to the correct patient.
Allow the phlebotomist to load samples but not verify results Ask the phlebotomist to read the manual first Decline the phlebotomist's help In a laboratory, safety and accuracy are the highest priorities. Even in a short-staffed situation, only staff with proper training can use equipment.Quickly show the phlebotomist how to use the analyzer
The patient was fasting The specimen is at room temperature The specimen is clotted A complete blood count (CBC) measures red blood cells, white blood cells, and platelets. Clots "trap" these cells (especially platelets), which leads to falsely low counts and inaccurate results. For this reason, a clotted CBC specimen would be rejected.The specimen was collected in a lavender tube
Add a glycolysis inhibitor and run the sample Adding a glycolysis inhibitor would be useless because the glucose has already been consumed. A glycolysis inhibitor must be present in the tube at the moment of collection to be effective.Centrifuge the specimen and run the sample Request a new sample Once blood is drawn, the cells continue to use the glucose. At room temperature, glucose levels in a sample decrease by approximately 7% to 10% per hour. After 3 hours, the glucose reading would be significantly lower than the patient's actual level at the time of the draw. The best action is to draw a new sample.Shake the tube and run the sample
The LIS will generate an incorrect report The audit trail will show a timestamp mismatch The nursing unit did not receive the correct critical result The main issue is that the nursing unit did not receive the correct critical result. This is a serious issue because it could delay the patient's treatment. For example, the patient might receive the wrong antibiotic or not receive urgent treatment.The technologist failed to document the specimen source
Analytical Post-analytical Post-analytical errors occur after testing is finished. Failing to notify a doctor of a critical result is a post-analytical error because the notification of results occurs after testing is finished.Pre-analytical Quality control failure
The name of the laboratory director The patient's date of birth The patient’s room number The person notified When you communicate a critical result (to a nurse or a physician, for example), you should also document that the communication happened. In the documentation, you should include the result, the time, and the name of the person notified.
Delete the result Document that the result is in the LIS Nothing, because the result is already in the computer Phone the result and document the notification A critical result must be communicated according to the laboratory’s SOP. If phone notification is required, the technologist should phone the result to the appropriate person and document the notification.
To confirm the clinician has read the finalized report To confirm the receiver's identity To document the call in the patient's electronic chart To verify the receiver understood the information When a laboratory reports critical test results over the phone, the receiver should repeat the information back. This is called a readback. It verifies that the receiver understood the message.
Only the corrected result The correction, department, laboratory telephone number, and person who made the change The correction, patient's ID number, and technologist's initials The correction, reason for amendment, date, time, and person who made the change When a laboratory report is amended, the documentation must clearly show:- What was corrected
- Why the report was amended
- The date and time of the amendment
- Who made the change
Eliminating verbal communication Implementing escalation protocols An escalation protocol is a set of rules for what to do when a critical task isn't completed on time. For example, if a nurse cannot be reached for a critical value within 5 minutes, the protocol might require the lab to call the charge nurse. This ensures that critical results are communicated quickly.Increasing documentation requirements Retraining staff on sample collection techniques
Contact the clinical area Because blood has already been issued, the first priority is to contact the clinical area so the blood can be stopped or not transfused until the error is investigated.Delete the issue record and create a new record Repeat testing on the original sample Request a new sample
The laboratory’s turnaround time will increase The microorganisms could die before susceptibility testing occurs The report may be delayed The wrong patient may receive inappropriate treatment Reporting results under the wrong patient can cause patients to receive inappropriate treatment. In this case, the wrong patient might receive antimicrobial treatment that is ineffective against their infection, while the patient whose result was missed remains untreated.
The incubator temperature chart The laboratory's safety manual The original test requisition The technologist should compare the results with the original test requisition to make sure all the requested tests have been performed.The standard operating procedures
Ask the receiver to read back the result When giving a result by phone, the receiver should repeat the information to ensure they heard it correctly. This is called a "read-back" protocol.Confirm the patient's preferred pronouns Document the call in the laboratory information system Politely thank the receiver
To check that all tests were performed Comparing the results with the requisition ensures that all tests were performed. If a physician ordered a CBC, electrolytes, and glucose, but the report only shows the CBC, it means two tests are missing.To confirm that the specimen was collected in the correct vacutainer To finalize the diagnostic information To validate reference ranges
HIV HIV does not have a vaccine.Hepatitis A Hepatitis B OSHA's Bloodborne Pathogens standard requires employers to offer the Hepatitis B virus (HBV) vaccine to all workers who have occupational exposure to blood or other potentially infectious materials. HBV is transmitted through exposure to blood and other potentially infectious materials, and can cause a potentially life-threatening disease.MMR
Administrative controls Elimination Eliminating hazards is the most effective way of protecting workers. The hierarchy of controls, in order from the most effective action to the least effective action, is:- Elimination (removal of the hazard)
- Substitution (replacing the hazard)
- Engineering controls (isolating people from the hazard)
- Administrative controls (changing the way people work)
- Personal protective equipment
Engineering controls Substitution
Bloodborne pathogens Dangerous chemicals OSHA’s Hazard Communication Standard requires employers to inform workers about the hazards of dangerous chemicals used in the workplace.General safety hazards Miscommunication
Environment There are nine Globally Harmonized System (GHS) pictograms but OSHA only enforces the use of eight. Use of the ninth pictogram, Environment, is optional.Exclamation mark Flame over circle Gas cylinder
Administrative controls Engineering controls 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:- Elimination (most effective)
- Substitution
- Engineering controls
- Administrative controls
- Personal protective equipment (least effective)
Substitution
An employee who does not have to pay income taxes An employee who is exempt from overtime rules An exempt employee is an employee who does not receive overtime pay or qualify for minimum wage. They receive the same salary every pay period, no matter how many hours they work.An employee working on a temporary or seasonal basis An employee working remotely
Americans with Disabilities Act (ADA) The Americans with Disabilities Act (ADA) is a federal law prohibiting discrimination against people with disabilities. Title I of the ADA prohibits discrimination in employment.Civil Rights Act Equal Employment Opportunity Act (EEOA) Occupational Safety and Health Administration (OSHA)
Employment Non-Discrimination Act (ENDA) ENDA is proposed legislation that addresses discrimination based on sexual orientation and gender identity.Equal Employment Opportunity Act (EEOA) The Equal Employment Opportunity Act of 1972 is a U.S. federal law that strengthened the Civil Rights Act of 1964. It gave the Equal Employment Opportunity Commission (EEOC) the authority to take legal action against employers who discriminate based on race, color, religion, sex, or national origin. The law aimed to reduce workplace discrimination.Equal Pay Act Rehabilitation Act
Civil Rights Acts Equal Pay Act (EPA) Fair Labor Standards Act (FLSA) The Fair Labor Standards Act (FLSA) regulates whether employees are exempt or non-exempt. Exempt employees do not receive overtime pay and do not qualify for minimum wage. In contrast, nonexempt employees must be paid at least the minimum wage, plus overtime when they work more than 40 hours a week.Occupational Safety and Health Act (OSHA)
12 weeks Under the Family and Medical Leave Act (FMLA), eligible employees may take up to 12 weeks of unpaid leave within a 12-month period without risking job security. This leave can be taken for various reasons, including the birth and care of a newborn child, the adoption or foster care placement of a child, to care for an immediate family member with a serious health condition, or when the employee is unable to work due to a health condition.20 weeks 24 weeks 36 weeks
Environmental Protection Agency (EPA) National Institute for Occupational Safety and Health (NIOSH) Occupational Safety and Health Administration (OSHA) The Occupational Safety and Health Administration (OSHA) administers and enforces the Occupational Safety and Health Act.United States Public Health Service (USPHS)
Centers for Disease Control and Prevention (CDC) Department of Transportation (DOT) The Department of Transportation (DOT) regulates the safe transportation of hazardous materials across the U.S.Food and Drug Administration (FDA) National Highway Traffic Safety Administration (NHTSA)
Center for Global Health (CGH) Centers for Medicare and Medicaid Services (CMS) The Centers for Medicare & Medicaid Services (CMS) is a federal agency that administers Medicare and Medicaid. CMS has other responsibilities, including ensuring that clinical laboratories meet quality standards under the Clinical Laboratory Improvement Amendments.Health Resources and Services Administration (HRSA) Office of Public Health Science (OPHS)
The Attorney General The Office for Civil Rights The primary enforcer of HIPAA is the Office for Civil Rights, which is an agency of the Department of Health and Human Services.The Surgeon General The US Senate
Federal Laboratory Consortium (FLC) Food and Drug Administration (FDA) The FDA regulates in vitro diagnostic (IVD) tests to ensure they are safe and effective before they reach the market.National Institutes of Health (NIH) Occupational Safety and Health Administration (OSHA)
Equal Employment Opportunity Commission (EEOC) The Equal Employment Opportunity Commission (EEOC) is the federal agency that investigates workplace discrimination cases. They investigate complaints of discrimination based on race, color, religion, sex, national origin, disability, age, and genetic information.Fair Labor Association (FLA) Food and Drug Administration (FDA) Occupational Safety and Health Administration (OSHA)
Centers for Disease Control and Prevention (CDC) Environmental Protection Agency (EPA) The Environmental Protection Agency (EPA) sets the standards and guidelines for Hospital, Medical, and Infectious Waste Incinerators (HMIWI). The EPA's regulations for these incinerators are designed to reduce the emissions of harmful pollutants that can be released during the waste incineration process, thereby protecting public health and the environment.Food and Drug Administration (FDA) Occupational Safety and Health Administration (OSHA)
National Institute for Occupational Safety and Health (NIOSH) Occupational Safety and Health Administration (OSHA) The Occupational Safety and Health Administration (OSHA) is responsible for enforcing workplace safety and health regulations and ensuring that employers provide a safe workplace for their employees. This includes providing employees with safety training relevant to the specific hazards of the job.United States Department of the Interior (USDI) United States Office of Personnel Management (USOPM)
Food and Drug Administration (FDA) National Institutes of Health (NIH) Occupational Safety and Health Administration (OSHA) OSHA is responsible for setting and enforcing safety and health standards in the workplace to protect employees from hazards, injuries, and illnesses. It conducts inspections, provides guidance, and promotes safe working conditions across various industries.Office of Public Health Science (OPHS)
American Clinical Laboratory Association (ACLA) Clinical Laboratory Improvement Amendments (CLIA) Food and Drug Administration (FDA) The Federal Food, Drug, and Cosmetic Act (FD&C Act) authorizes the Food and Drug Administration (FDA) to oversee the safety of food, drugs, medical devices, cosmetics, and laboratory tests. This means the FDA may clear or approve laboratory tests before marketing, depending on the test and regulatory pathway.Occupational Safety and Health Administration (OSHA)
Centers for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH) NIOSH is a research and education institution. It does not enforce regulations.National Institutes of Health (NIH) Occupational Safety and Health Administration (OSHA) The Occupational Safety and Health Administration (OSHA) requires employers to provide workers with personal protective equipment (PPE) to protect against hazards at work.
Centers for Disease Control and Prevention (CDC) Clinical Laboratory Improvement Amendments (CLIA) CLIA is a legislative framework, not an agency.Food and Drug Administration (FDA) The FDA categorizes clinical laboratory tests by their complexity, from the least complex (waived tests) to the most complex (high-complexity tests).Occupational Safety and Health Administration (OSHA)
American Medical Association (AMA) Drug Enforcement Administration (DEA) Environmental Protection Agency (EPA) The federal agency responsible for regulating disinfectants for laboratory use is the Environmental Protection Agency (EPA). The EPA is an independent agency of the United States government tasked with environmental protection.Food and Drug Administration (FDA)
Employee Benefits Security Administration (EBSA) Employment and Training Administration (ETA) Equal Employment Opportunity Commission (EEOC) The Equal Employment Opportunity Commission (EEOC) enforces federal laws prohibiting discrimination in the workplace.Occupational Safety and Health Administration (OSHA)
American Medical Association (AMA) Centers for Disease Control and Prevention (CDC) Centers for Medicare & Medicaid Services (CMS) The Centers for Medicare & Medicaid Services (CMS) regulates all laboratory testing (except research) performed on humans. They also monitor the proficiency testing performance of clinical laboratories and enforce compliance with CLIA regulations.Food and Drug Administration (FDA)
Civil Rights Act Equal Pay Act Fair Labor Standards Act (FLSA) The Fair Labor Standards Act (FLSA) sets the federal minimum wage. The current federal minimum wage is $7.25 per hour, effective July 24, 2009.National Labor Relations Act (NLRA)
Americans with Disabilities Act Civil Rights Act The federal law that prohibits employment discrimination based on race, color, religion, sex, and national origin is the Civil Rights Act of 1964, specifically Title VII.Fair Labor Standards Act (FLSA) National Labor Relations Act (NLRA)
Clinical Laboratory Improvement Amendments (CLIA) CLIA is a federal law that sets laboratory testing standards to ensure the accuracy, reliability, and timeliness of test results. It requires laboratories to document their personnel's competency to ensure they are qualified to perform specific tests.Fair Labor Standards Act (FLSA) National Labor Relations Act (NLRA) Occupational Safety and Health Act (OSHA)
Americans with Disabilities Act (ADA) The Americans with Disabilities Act (ADA) requires healthcare organizations to provide full and equal access for patients with disabilities. For example, deaf patients may require a sign-language interpreter.Family and Medical Leave Act (FMLA) Health Care Right of Conscience Act (HCRCA) Health Insurance Portability and Accountability Act (HIPAA)
Digital Accountability and Transparency Act (DATA) Freedom of Information Act (FOIA) Health Insurance Portability and Accountability Act (HIPAA) The Health Insurance Portability and Accountability Act (HIPAA) includes privacy and security rules that govern the protection of health information.Privacy Act
Health Care Consent Act (HCCA) Occupational Safety and Health Act The Hazard Communication Standard of the Occupational Safety and Health Act gives workers the right to know about workplace hazards. It requires employers to inform and train employees about potential dangers and safety practices.Privacy Act SAFETY Act
CAN-SPAM Act Health Insurance Portability and Accountability Act (HIPAA) The Health Insurance Portability and Accountability Act (HIPAA) requires safeguards to protect health information, including health information sent by email.Occupational Safety and Health Act (OSHA) Privacy Act
Bloodborne Pathogens Standard The Needlestick Safety and Prevention Act (NSPA) amended OSHA's Bloodborne Pathogens Standard to strengthen protection for workers who are exposed to needles and other sharp medical devices.Confined Space Entry Standard Hazard Communication Standard Personal Protective Equipment Standard
Fair Labor Standards Act (FLSA) Federal Employees' Compensation Act (FECA) Occupational Safety and Health Act (OSHA) The Occupational Safety and Health Act (OSHA) includes provisions that protect employees from retaliation if they report unsafe working conditions or violations of safety standards. This encourages workers to speak out about hazards without fear of losing their jobs.Uniformed Services Employment and Reemployment Rights Act (USERRA)
Caution Caution signs are for hazards that could cause minor or moderate injury.Danger "Danger" is for hazards that will definitely cause serious injury or death if not avoided.Notice Warning "Warning" is for hazards that could cause serious injury or death.
Attention Caution Notice Warning The Globally Harmonized System (GHS) uses two signal words to indicate hazard severity:- "Danger" for severe hazards
- "Warning" for less severe hazards
Every three months Every six months Every year Every two years CLIA requires that all non-waived laboratories (laboratories performing moderate- or high-complexity testing) receive routine inspections every two years.
General supervisor The general supervisor is the person responsible for the day-to-day supervision of the laboratory and its staff.Laboratory director Technical supervisor Testing personnel
Every three months Every six months Under CLIA, calibration verification of test systems must be performed at least every six months.Every year Every two years
When they are CLIA certified When they have a Certificate of Compliance When they have six or fewer employees When they only perform waived tests Laboratories that perform only waived testing are generally exempt from CLIA proficiency testing (PT) because PT is only required for nonwaived tests.
Complete blood count Complete blood counts are moderately complex tests.Drugs of abuse testing Drugs of abuse tests are waived tests.Electrolyte profile Electrolyte profiles are moderately complex tests.Examination of a blood smear Examination of a blood smear is a high-complexity test.
Laboratory director The laboratory director is responsible for the overall operation of the laboratory. Their role includes employing personnel and ensuring compliance with regulations.Technical consultant The technical consultant is responsible for the technical and scientific oversight of the laboratory. They generally work on an as-needed basis.Technical supervisor The technical supervisor is responsible for the technical and scientific oversight of the laboratory.Testing personnel Testing personnel are the people who process specimens, perform laboratory tests, and report the test results.
Accreditation Compliance Registration Certificates of Registration are issued to allow laboratories to perform non-waived testing until the laboratory is surveyed. Once the laboratory is inspected and found in compliance, a final certificate of compliance or accreditation is issued.Waiver
3 CLIA divides tests into three categories of complexity: waived, moderate complexity, and high complexity.5 6 8
Conduct tests without patient consent Perform simple, low-risk laboratory tests A CLIA Certificate of Waiver only allows a laboratory to perform waived tests.Store controlled substances without a DEA license Use RoHS-exempt equipment
Laboratory technician Medical equipment repairer Technical consultant A moderate-complexity laboratory must have a technical consultant. The technical consultant is responsible for the technical and scientific oversight of the laboratory. Their responsibilities include verifying test methods to ensure accuracy and precision and helping to establish and maintain quality control and quality assurance programs.Test system manufacturer
cleared licensed nonwaived CLIA has three categories of tests:- waived
- moderate-complexity
- high-complexity
point-of-care
Complete blood count Immunoassay Peripheral smear Urine hCG test CLIA-waived tests are easy to perform and have a low risk of incorrect results. The urine hCG test is an example of a CLIA-waived test. The test uses a dipstick to detect hCG in urine. If hCG is present, it indicates pregnancy.
Clinical consultant Laboratory director The laboratory director is responsible for the overall operation and administration of the laboratory, including hiring personnel.Technical consultant Technical supervisor
For highly complex tests For tests with critical values When a traditional proficiency test is not available Ideally, laboratories should assess every analyte with traditional proficiency testing. However, if proficiency testing is unavailable, laboratories should use alternative assessment instead.When the laboratory is not yet CLIA-certified
6 CLIA '88 outlines six areas that must be included in a laboratory competency assessment program. These areas are:- Direct observation of routine patient test performance.
- Monitoring the recording and reporting of test results.
- Review of intermediate test results, QC records, proficiency testing results, and preventive maintenance records.
- Direct observation of the performance of instrument maintenance and function checks.
- Assessment of test performance through testing previously analyzed specimens, internal blind testing samples, or external proficiency testing samples.
- Assessment of problem-solving skills.
7 8 9
High complexity Moderate complexity Provider performed microscopy Waived Urinalysis dipsticks fall into the CLIA-waived category because they are simple to use and easy to interpret.
A salt solution A strong acid or strong base Acetic acid The conjugate salt A buffer is made by mixing a weak acid or weak base with its conjugate salt in a specific ratio.
1 2 10 For each one-unit change in pH, there is a tenfold increase in hydrogen ion concentration, so the acidity increases tenfold. This means a pH of 5 is ten times more acidic than a pH of 6.100
Anhydride Buffer A buffer is a solution that resists changes in pH when an acid or alkali is added to it.Compound Solvent
Acidic Solutions are termed acidic if their pH is less than 7, alkaline if their pH is greater than 7, and neutral if the pH is 7.Alkaline Basic Neutral
Carbon Hydrogen pH is the measurement of the hydrogen ion concentration in a liquid.Nitrogen Oxygen
0 1 3 7 The pH scale ranges from 0 to 14, where 0 is extremely acidic, 14 is extremely basic (or alkaline), and 7 is neutral (meaning neither acidic nor basic).
50% 68% For data distributed normally, 68% of data falls within one standard deviation of the mean.83% 95%
50% In a normal (bell-shaped) distribution, 50% of the data lie below the mean and 50% lie above it.This is shown in the image below. 
68% 75% 100%
| Mean | 5.8 |
| Median | 6.0 |
| Standard deviation | 0.25 |
5.30–6.30 To find the allowable range, use the formula mean ± (2 × SD):Upper limit = mean + (2 × SD) Therefore, the allowable range is 5.30–6.30.Upper limit = 5.8 + (2 × 0.25)Upper limit = 5.8 + 0.5Upper limit = 6.3 Lower limit = mean – (2 × SD)Lower limit = 5.8 – (2 × 0.25)Lower limit = 5.8 – 0.5Lower limit = 5.35.35–6.25 5.50–5.90 5.60–5.90
50% 68% 83% 95% For data distributed normally, 95% of the data falls within two standard deviations of the mean.
4.8–9.6 To find the range within two standard deviations, use the formula mean ± 2 × SD.Upper limit = mean + (2 × SD) Therefore, the range of values that falls within two standard deviations of the mean is 4.8–9.6.Upper limit = 7.2 + (2 × 1.2)Upper limit = 7.2 + (2.4)Upper limit = 9.6 Lower limit = mean – (2 × SD)Lower limit = 7.2 – (2 × 1.2)Lower limit = 7.2 – (2.4)Lower limit = 4.86.0–8.4 7.2–9.6 8.6–10.2
68% 83% 95% 99.7% For data distributed normally, 99.7% of data fall within three standard deviations of the mean.
1–9 2–8 3–7 In normally distributed data, approximately 95% of values fall within 2 standard deviations of the mean. The question says the standard deviation is 1. Therefore, two standard deviations are 2 (1 × 2). This means 95% of values will fall ±2 from the mean. Since the mean is 5, this means 95% of values will fall between 5±2, or 3–7.4–6
(Mean / standard deviation) × 100 (Standard deviation / mean) × 100 The coefficient of variation is calculated by dividing the standard deviation by the mean and multiplying the result by 100. For example, if the standard deviation is 3 and the mean is 30, the coefficient of variation is:( 3/30) × 100 = 0.1 × 100 = 10%(Standard deviation / variance) × 100 (Variance / mean) × 100
15% The equation for calculating the coefficient of variation is:Coefficient of variation = Substituting the values:( SD/mean) × 100Coefficient of variation = ( 1.2/8) × 100Coefficient of variation = 0.15 × 100Coefficient of variation = 15%30% 45% 60%
0.2% 4% 20% The equation for calculating the coefficient of variation is:Coefficient of variation = Since two standard deviations equal 8, the standard deviation is 4. Inserting the values into the equation gives us:( SD/mean) × 100Coefficient of variation = ( 4/20) × 100Coefficient of variation = 0.2 × 100Coefficient of variation = 20%40%
4.5 4.7 4.9 To calculate the mean, the first step is to add up all the values to find the total, which in this case is 49. The second step is to divide the total by the number of values:49/10 = 4.9 5.1
Average Coefficient of variation Mean Median The median is the middle number in a sorted list of numbers. For example, if a data set contains the values 1, 2, 3, 4, and 4, then the median is 3 because 3 is the middle number.
Average Coefficient of variation Mean Mode The mode is the number that appears most often in a set of numbers. So if a data set contains the values 1, 2, 2, 3, 4, 4, 4, and 4, then the mode is 4, because the number 4 appears the most times.
Biological safety cabinet Flammable storage cabinet Acetone is a highly flammable liquid and should ideally be stored in a flammable storage cabinet (a safe storage place for flammable materials).Freezer Refrigerator
In airtight containers Ethers form explosive peroxides when exposed to air and light. Therefore, ethers must be stored in the dark and in airtight containers.In the light In the refrigerator Underwater
Flammable safety cabinet Ethanol is a flammable substance and should be stored in a flammable safety cabinet to reduce the risk of fire.Freezer Fume hood Refrigerator
Environmental pictogram Expiration date Personal protective equipment (PPE) pictogram Phone number of the manufacturer or importer Labels for a hazardous chemical must contain the following:- Name, address, and phone number of the manufacturer or importer
- Product identifier
- Signal word
- Hazard statement(s)
- Precautionary statement(s)
- Pictogram(s)
"Fatal" Both "Warning" and "Danger" Only the “Danger” signal word If a chemical has a hazard that warrants a “Danger” signal word and another hazard that warrants the “Warning” signal word, then only “Danger” should appear on the label. A chemical label should only ever have one signal word – either "Warning" or "Danger" – no matter how many hazards the chemical has.Only the “Warning” signal word
Clean up the spill Move everyone to fresh air Turn off the flame Acetone is highly flammable. Your first action in the event of an acetone spill should be to remove sources of ignition to prevent a fire.Wash eyes with water
1:10 dilution of bleach The Centers for Disease Control and Prevention (CDC) recommends a 1:10 dilution of bleach for cleaning large blood spills. Bleach kills most pathogens effectively, including viruses, bacteria, and fungi. For small spills, a dilution of 1:100 can be used.70% isopropyl alcohol Antibacterial soap and water Povidone-iodine
Chemicals Cold sterilization uses liquid chemical solutions to sterilize instruments. The alternative to cold sterilization is hot sterilization, which uses heat.Cold air Ice Liquid nitrogen
Pour disinfectant onto the spill Put on PPE The typical steps for cleaning up a blood spill are:- Put on PPE such as gloves (this will protect you from contamination as you clean up the spill)
- Soak up as much of the spill as possible with disposable towels
- Apply the disinfectant to the spill and let it soak
- Clean the spill again with disposable towels
- Decontaminate any reusable equipment, such as dustpans and brushes
- Remove the PPE and wash your hands
Record the incident in the incident book Wash your hands
10% ethyl alcohol 40% ethyl alcohol 70% ethyl alcohol Alcohol is most effective as a disinfectant when it is diluted with water to a solution of 60–90% alcohol.100% ethyl alcohol
Alcohol Formaldehyde Hydrogen peroxide Sodium hydroxide Prions are proteins that cause rare and fatal brain diseases. They are extremely resistant to standard sterilization methods, including heat, radiation, and standard disinfectants such as alcohol and formalin. To neutralize prions, the infected material should be soaked in concentrated sodium hydroxide or sodium hypochlorite and then autoclaved.
Chlorine bleach Chlorine reacts with the ammonia in urine to form chloramine. Chloramine is a toxic gas that can cause coughing, irritation, and, in very severe cases, death. For this reason, chlorine-based disinfectants should not be used on urine spills.Hydrogen peroxide Isopropyl alcohol Povidone-iodine
Acetic acid Boric acid Sodium bicarbonate Weak acid spills should be neutralized with sodium bicarbonate (which is a weak base) and then cleaned up with a paper towel or sponge.Sodium hydroxide Sodium hydroxide is also an alkaline and therefore also neutralizes acids. However, sodium hydroxide is a strong alkaline and could cause injury. Therefore, sodium hydroxide should not be used to neutralize acid spills. Weak bases like sodium bicarbonate are safer.
in a fume hood in a poorly ventilated area Mercury vapors are toxic, and inhalation can lead to mercury poisoning. Mercury spills are especially dangerous in poorly ventilated areas.near sources of ignition near the flammable storage cabinet
Bleach Bleach does not neutralize radioactivity. It is used to decontaminate biological spills.Lead sheet Lead sheet is used for radiation shielding, not to clean spills.Paper towels Paper towels (or other absorbent material like absorbent pads or spill pillows) are used to absorb liquids and prevent spills from spreading. They are a common first step in managing a liquid spill.Soda ash Soda ash is for neutralizing acid spills, not radioactive spills.
12 psi at 115°C 12 psi at 120°C 15 psi at 112°C 15 psi at 121°C Autoclaves use saturated steam under a pressure of approximately 15 pounds per square inch (psi) to achieve a chamber temperature of at least 250°F (121°C).
Borosilicate Borosilicate glass has a high resistance to temperature change, making it suitable for autoclaving. For this reason, borosilicate glass is commonly used in laboratory equipment, such as beakers, flasks, and test tubes, which are often sterilized in autoclaves.Float Float glass is not highly resistant to thermal shock and is therefore not recommended for use in autoclaves.Lead Lead glass is susceptible to thermal shock and can break or crack under high temperatures and pressure, so it is not recommended for autoclaves.Soda-lime Soda-lime glass shatters easily, so autoclaving it is not recommended.
Cleaning Cleaning removes dirt and debris but does not necessarily kill microorganisms.Disinfection Disinfection kills most microorganisms but may not eliminate spores. The spore form of bacteria is difficult to kill with disinfectants.Sanitization Sanitization may reduce the number of microorganisms to a safe level but does not eliminate them.Sterilization Sterilization is a process that destroys all microbial life, including spores. Sterilization methods include moist heat (autoclaves) or dry heat (ovens).
To avoid damaging the oven To ensure complete sterilization If you open a dry-heat sterilizer during sterilization, the sterilizer will cool slightly, and the temperature drop may interrupt sterilization. For this reason, it is important to keep a dry-heat sterilizer closed throughout the sterilization cycle.To prevent moisture from entering the chamber To prevent oxygen from entering the chamber
Fire extinguisher Hand hygiene Standard Precautions are practices to prevent infection, such as hand washing, wearing PPE (like gloves and masks), sharps safety, cough etiquette, and proper cleaning and disinfection of equipment and surfaces.Keeping chemical containers closed Radiation shielding
The substance is highly radioactive The substance is extremely contagious The substance readily burns at normal temperatures The substance readily explodes The yellow quadrant conveys information about reactivity (how easily the chemical explodes). The number four in any quadrant on the NFPA hazard diamond indicates a severe hazard. Therefore, a number four in the yellow quadrant indicates a severe explosive hazard.
Blue On the NFPA hazard diamond, the health hazard is blue, the flammability hazard is red, and the reactivity hazard is yellow.Green White Yellow
The substance does not burn The substance only ignites after considerable preheating The red quadrant on the NFPA hazard diamond indicates the severity of a chemical's fire hazard, where: 0 = No fire hazard 1 = Requires significant preheating before burning 2 = Ignites if moderately heated 3 = Readily ignites under most ambient conditions 4 = Rapidly ignites even under very low ambient temperaturesThe substance ignites if moderately heated The substance can be ignited at normal temperatures
Can shock or cause acid damage Safety assessed Simple asphyxiant The letters SA on an NFPA hazard diamond stand for "simple asphyxiant". A simple asphyxiant is a gas that displaces oxygen in the air, potentially leading to unconsciousness or death due to lack of oxygen. Simple asphyxiants include helium, nitrogen, neon, argon, krypton, and xenon.Substance abuse
Continued exposure to the substance could cause temporary incapacitation or injury The blue quadrant represents health hazards. A number 2 in this quadrant indicates a moderate hazard to human health, and that continued exposure to the substance could cause temporary incapacitation or injury.The substance can be ignited at normal temperatures The substance is unreactive with water The substance reacts with water in an unusual or dangerous way
Blue Red White The NFPA hazard diamond is for hazardous chemicals and materials. It is divided into four quadrants: white (special hazards), blue (health hazards), red (fire hazards), and yellow (reactivity hazards).Yellow
Centi- Centi- means a hundredth (0.01).Kilo- Kilo- means a thousand (1,000).Micro- Micro- means a millionth (0.000001 or 10⁻⁶). Examples are the micrometer (0.000001 meters) and microliter (0.000001 liters).Nano- Nano- means a billionth (0.000000001).
10 100 1,000 The prefix kilo- means a thousand. For example, a thousand grams is a kilogram.10,000
1 hundredth 1 thousandth 1 millionth 1 billionth Nano- means one billionth (10⁻⁹). For example, one billionth of a meter is called a nanometer.
10⁹ 10⁻³ 10⁻⁶ The Greek letter μ (mu) represents micro-, a prefix meaning 10⁻⁶ (one-millionth). For example:- microgram (μg) = one-millionth of a gram
- micrometer (μm) = one-millionth of a meter
10⁻⁹
Grams Liters A liter is a cubic decimeter (a cube measuring 10 cm on all sides).Meters cubed Moles
Micro- Centi- Pico- Milli- Milli- means one-thousandth (0.001). For example, a millimeter is one-thousandth of a meter.
0.0005 μL 0.005 μL 5 μL 50 μL To convert from milliliters to microliters, multiply by 1,000:0.05 mL × 1,000 = 50 μL
Normal distribution The image shows a normal distribution curve, also known as a Gaussian distribution. In this type of curve, the mean, median, and mode are all equal and located at the center of the curve.Polynomial function Quadratic chart Reciprocal graph
Centers for Disease Control and Prevention (CDC) Centers for Medicare & Medicaid Services (CMS) Environmental Protection Agency (EPA) The federal agency that regulates the disposal of hazardous waste produced by laboratories in the United States is the Environmental Protection Agency (EPA). The EPA enforces regulations related to the handling, treatment, storage, and disposal of all hazardous waste.Food and Drug Administration (FDA)
Biohazard autoclave bag Recycling bin Regular garbage Sharps container Microtome blades are extremely sharp. You must discard used microtome blades in a sharps container, a heavy-duty container made of rigid plastic that prevents sharp objects from piercing through the sides.
Clean Water Act (CWA) National Environmental Policy Act (NEPA) Pollution Prevention Act (PPA) Resource Conservation and Recovery Act (RCRA) The Resource Conservation and Recovery Act (RCRA) is the main federal law governing the disposal of solid waste, including hazardous waste.
Empty medicine bottles Gauze packaging Sterile dressings Used blood tubes Regulated waste refers to materials that are potentially infectious or hazardous. Used blood tubes are regulated waste because they may contain blood. The other options are not typically classified as regulated waste, as they do not pose the same infectious or hazardous risk as used blood tubes.
Biohazard sharps container Used venipuncture needles are considered biohazardous sharps. Therefore, they must be discarded into a designated sharps container. This helps prevent needle-stick injuries.Glass disposal bucket Glass recycling bin Regular garbage
The amount of fuel that will burn before the fuel burns itself out The highest concentration of a vapor that can catch fire The upper flammability limit is the highest concentration of a vapor in air that can burn. Above this limit, there is not enough oxygen for the vapor to burn.The highest temperature at which a liquid can be stored safely The highest temperature that a chemical can reach when ignited
37.8°C 67.3°C 93°C The Occupational Safety and Health Administration (OSHA) defines a flammable liquid as any liquid with a flash point at or below 93°C.100°C
Cardboard boxes The fire extinguisher in the image is a water fire extinguisher. Water fire extinguishers can only be used on fires involving combustibles (wood, cardboard, paper, and textiles).Electrical equipment Methanol Oil bath
can be used on fires involving flammable liquids or gases The Class B symbol means an extinguisher can be used on fires involving flammable liquids or flammable gases (Class B fires).requires annual top-ups of type B fuel should be stored in a separate room from flammable chemicals uses kerosene to extinguish fires
Oxygen, heat, and fuel The fire triangle is the three components a fire needs to sustain itself: oxygen, heat, and fuel. If one of these elements is missing, a fire cannot start or will be extinguished.Oxygen, ignition, and fuel Rescue, Alarm, Escape Rescue, Alarm, Extinguish
Ready, Aim, Check, Extinguish Recover, Act, Control, Extinguish/Evacuate Rescue, Alarm, Confine, Extinguish/Evacuate The acronym RACE stands for Rescue, Alarm, Confine, and Extinguish/Evacuate. It refers to the steps to follow in a fire emergency.- First, you should rescue (R) anyone in immediate danger.
- Next, you should activate the fire alarm (A).
- After this, you should confine (C) the fire by closing all doors and windows.
- Finally, you should extinguish (E) the fire with a fire extinguisher or evacuate (E) the building if the fire is too dangerous.
Run, Activate, Coordinate, Extinguish/Evacuate
can extinguish electrical fires The electrical symbol (lightning bolt) indicates that the extinguisher is safe for use on electrical fires.cannot be used on electrical equipment carries a risk of electric shock requires charging before use
Acetone Acetone ignites easily and is highly flammable.Carbon tetrachloride Chloroform Saline
In a biological safety cabinet In a chemical fume hood Paraformaldehyde powder is a respiratory hazard because it releases toxic formaldehyde gas when heated and dissolved. Because of this inhalation hazard, it must be prepared inside a chemical fume hood.In the sink Under a laminar flow clean bench
Dilute the spill with water Evacuate the area Formaldehyde is a highly toxic chemical. It irritates the eyes, nose, and throat. It is also a known carcinogen. 35% formaldehyde is extremely concentrated, and a major spill, such as 500 mL, is dangerous because it can quickly fill the room with hazardous fumes. The priority is to evacuate the area and keep people away from the vapor.Put on PPE Record the incident in the incident log
Burnt sugar Rotten eggs Hydrogen sulfide is a colorless, flammable gas that smells like rotten eggs at low concentrations.Rotting meat Strong cheese
add the acid quickly to the water add the acid slowly to the water Always add acid to water, and never the reverse. Adding water to acid can make the solution splatter violently, causing acid burns to your skin or eyes.add the water quickly to the acid add the water slowly to the acid
Autoclave Biological safety cabinet Fume hood Some chemicals produce harmful vapors. The best way to limit your exposure to chemical vapors is with a fume hood. A fume hood is a ventilated enclosure that captures and removes vapors.Sealed room
Cover the burn with gauze moistened in sterile saline Flush the burn with water If acid or another chemical touches your skin, you should rinse it off with water immediately.Go to the emergency department Neutralize the acid with sodium bicarbonate
1 minute 5 minutes 10 minutes 15 minutes In the event of a chemical splash to the eyes, the eyes should be flushed with water for at least 15 minutes. This is critical to prevent long-term damage to the eyes.
Apply a burn ointment to his skin Pour baking soda onto his skin Seek emergency medical assistance Use the emergency safety shower If acid spills on the body, rinse the area with water immediately to wash off the acid. If a large area is affected, use the emergency safety shower.
Bloodborne pathogens Universal precautions are a standard set of guidelines to prevent the transmission of bloodborne pathogens.Dangerous chemicals Environmental hazards Radiation
BSL-1 Biosafety level 1 (BSL-1) is the lowest of the four biosafety levels and applies to low-risk microbes that pose little to no threat, such as nonpathogenic strains of bacteria.BSL-2 BSL-3 BSL-4
Blood Blood is not OPIM. Blood is its own distinct category. OPIM is defined as infectious material other than blood.Semen OPIM is material that may contain bloodborne pathogens. OPIMs include semen, vaginal secretions, and several internal body fluids.Urine Urine is not an OPIM unless it is visibly contaminated with blood.Vomit Vomit is not an OPIM unless it is visibly contaminated with blood.
employer Responsibility for identifying employees at risk of exposure to blood or Other Potentially Infectious Materials (OPIM) lies with the employer. According to the Bloodborne Pathogens Standard of the Occupational Safety and Health Administration (OSHA), employers must identify all employees who are at risk of exposure to bloodborne pathogens at work.government patient union
HIV HIV does not have a vaccine.Hepatitis B Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). It is one of the most common and serious bloodborne risks faced by healthcare workers because exposure can easily occur through needlestick injuries and contact with infected blood or bodily fluids. However, the risk is largely preventable through vaccination.Hepatitis C Hepatitis C does not have a vaccine.Tdap Tdap protects against tetanus, diphtheria, and pertussis. The bacteria that cause these diseases are not bloodborne pathogens. Tetanus is spread by soil/wound contamination, and diphtheria and pertussis are respiratory pathogens.
A flame A flame over a circle A gas cylinder The gas cylinder pictogram is a gas cylinder in a red diamond. This pictogram is for gases under pressure. Gases under pressure are dangerous because they can release large amounts of gas into the air quickly.The gas cylinder pictogram looks like this: 
An exploding test tube
Expiry date Health hazards Safety data sheets contain the health hazards associated with a chemical.Price Production date
8 10 12 16 Standard GHS safety data sheets have 16 sections. The sections are:- Identification
- Hazard identification
- Ingredients
- First-aid measures
- Fire-fighting measures
- Accidental release measures
- Handling and storage
- Exposure controls/Personal protection
- Physical and chemical properties
- Stability and reactivity
- Toxicological information
- Ecological information
- Disposal considerations
- Transportation information
- Regulatory information
- Other information
Angle head Cytospin Microhematocrit Capillary tubes are small, thin tubes used to collect or separate small amounts of blood. They are spun in a microhematocrit centrifuge. This type of centrifuge is designed specifically to spin capillary tubes.Refrigerated
Angle head Cytocentrifuge A cytocentrifuge is a special centrifuge that concentrates cells in fluid specimens onto a microscope slide so that they can be stained and examined. It has better preservation of cell morphology than other centrifuges.Microhematocrit Refrigerated
Ensure the centrifuge is balanced Always check that the centrifuge is balanced before turning it on. An unbalanced centrifuge can vibrate violently, damage equipment, and, in worst-case scenarios, cause injury or damage to the surrounding area.Open the cover The cover must be closed before starting the centrifuge.Place the centrifuge on a slanted surface Centrifuges should be on a flat surface, not a slanted surface.Uncover all liquid specimen tubes Tubes should stay capped to prevent spills and aerosols.
How fast the centrifuge spins RPM stands for revolutions per minute. It is the number of rotations the centrifuge completes in one minute. In other words, it indicates how fast the centrifuge’s rotor spins.How long the centrifuge spins for How many tubes the centrifuge can hold The maximum weight the rotor can safely handle
Ohmmeter Rheostat Tachometer A tachometer measures rotational speed, such as the speed of a centrifuge. Its units are often revolutions per minute (RPM). The word tachometer comes from tach- meaning "speed", and meter meaning "measure".Voltmeter
Electrical interference Unbalanced tubes The most common cause of excessive centrifuge vibration is unbalanced sample tubes. Even a slight imbalance between the weights of the samples will cause the centrifuge to vibrate and shake. This can damage the centrifuge.Uneven bench surfaces Variable voltage
Chlorinated water De-ionized water Deionized means ions have been removed. Ions are electrically charged atoms or molecules.Distilled water Flat water
Concentrated Diluted Saturated A solution in which no more solute can be dissolved is called a saturated solution.Soluted
Acoustic Electron Light The light microscope is the most common in clinical laboratories. While other types of microscopes, like electron microscopes, have their uses in clinical laboratories, they are not as widely used as light microscopes due to their higher cost, complexity, and limited applications.Scanning probe
Diaphragm Numerical aperture Rheostat The rheostat is a dial or knob that adjusts the voltage to the light source, making the bulb brighter or dimmer.Stage clip
Diaphragm The diaphragm, also called the iris diaphragm, controls how much light reaches the specimen. It has an adjustable hole that can be made smaller or larger to change the amount of light passing through the sample.Numerical aperture Objective lens Rheostat
2×, 10×, 50×, and 100× 2×, 20×, 50×, and 80× 4×, 10×, 40×, and 100× Most compound light microscopes have a scanning lens (4×), a low-power objective lens (10×), a high-power objective lens (40×), and an oil immersion objective lens (100×).5×, 20×, 40×, and 80×
Brightfield Electron Fluorescence Phase contrast A phase-contrast microscope is a special light microscope designed to enhance the contrast of unstained, transparent specimens, such as wet preparations of cells.
Condenser The condenser is a lens that focuses light on the specimen. It is used with higher magnifications.Diaphragm Objective lens Ocular lens
10x 100x 400x 1000x A total magnification of 1000x or higher is required to observe and differentiate microorganisms. This high magnification is necessary because microorganisms such as bacteria are typically very small, ranging from a few micrometers to a few hundred nanometers. Lower magnifications, such as 40x or 100x, are generally used to observe larger objects such as tissues and cells.
Clean the eyepiece If dirt moves when you rotate the eyepiece, this suggests the dirt is on the eyepiece. You can remove the dirt by wiping the lens with lens tissue.Clean the objective Open the iris Tighten the tension adjustment
2% The equation to calculate percent error is:(measured value − true value)/true value × 100 Inserting the values into the equation gives us:% error = (4.9 − 5.0)/5.0 × 100 In standard practice, negative percent errors are written as positive numbers, making −2% to 2%.% error = −0.1/5.0 × 100% error = −0.02 × 100% error = −2%4% 6% 8%
Beaker Beakers are simply containers for storing and mixing liquids. They are not designed to contain or deliver specific volumes.Erlenmeyer flask Erlenmeyer flasks are simply containers for storing and mixing liquids. They are not designed to contain or deliver specific volumes.Volumetric flask Volumetric flasks are designed to contain specific volumes, not deliver specific volumes.Volumetric pipette Calibrated pipettes (like volumetric pipettes) are designed to deliver specific volumes. A 100 mL pipette, for example, will deliver 100 mL.
Graduated Mohr Pasteur Volumetric The most accurate type of pipette is a volumetric pipette. Volumetric pipettes have a single graduation mark and are designed to dispense a single, precise volume of liquid.
The pipette can be filled with 10 mL in 25 seconds The pipette can deliver 10 mL in its primary tube and 25 mL in its secondary tube The pipette is calibrated to deliver 10 mL after a 25-second drain time 10 mL indicates the volume the pipette is designed to deliver. TD stands for "to deliver", meaning the specified volume is delivered after draining. 25 SEC is the time the pipette should be drained to ensure accurate delivery of the full 10 mL.You should wait 25 seconds between filling and dispensing the pipette
99.05–100.95 µL 99.2–100.8 µL An accuracy of +/- 0.8% means that the delivered volume could be off by up to 0.8% from the target value. For a 100 µL delivery, this means the delivered volume could be as low as 99.2 µL or as high as 100.8 µL.99.55–100.45 µL 99.85–100.15 µL
The last drop must be blown out A pipette with two etched rings is a "blow-out" pipette. This means after you have drawn up and dispensed the liquid, you need to blow out the remaining liquid clinging to the pipette walls by blowing with a rubber bulb.The pipette can hold 2 mL The pipette will deliver the measured amount of liquid only at 20°C The volume is measured at this point
Mohr Pasteur Serological Volumetric The pipette with a bulged-out portion in the middle is the volumetric pipette. The bulged-out portion in the middle is called the bulb. It holds most of the liquid so the pipette does not have to be an excessively long, thin tube.
At an angle At eye level To get accurate results with volumetric glassware, always read the bottom of the meniscus (the curved surface of a liquid) at eye level. Looking from above or below can lead to inaccurate readings.Just above eye level Just below eye level
Beaker Erlenmeyer flask Option a (beakers) and option b (Erlenmeyer flasks) are for mixing and transporting liquids. They are not used for making accurate measurements.Graduated cylinder Graduated cylinders are designed to measure large volumes of liquids, such as 24-hour urine volumes. They come in sizes such as 500 mL, 1,000 mL, and 2,000 mL.Graduated pipette Graduated pipettes can only measure small amounts of liquid accurately (5 mL, 10 mL, 25 mL, or 50 mL, depending on the pipette). Therefore, they would be inconvenient for measuring a large volume such as a 24-hour urine sample.
Disposable "Disposable pipette" could refer to a serological pipette or a transfer/Pasteur pipette, making the term too broad.Pasteur Pasteur pipettes are used to transfer small amounts of liquid. They are not typically calibrated to measure precise volumes.Serological Serological pipettes (also called graduated pipettes) have calibration marks that continue down to the tip.Volumetric Volumetric pipettes are designed to deliver a single, specific volume (e.g., 10 mL). They have a single calibration mark.
Infectious aerosols Biological safety cabinets use HEPA filters and controlled laminar airflow to protect laboratory workers from infectious aerosols, which are microscopic particles that suspend viruses, bacteria, or fungi in the air.Thermal burn injuries UV radiation Volatile chemical vapors
Once a year According to OSHA, biological safety cabinets must be tested and certified when first installed, after being moved, and at least once a year.Every 2 years Every 3 years Every 4 years
Electrostatic Fiberglass HEPA Biological safety cabinets generally use high-efficiency particulate air (HEPA) filters. These filters are highly effective at removing airborne particles, including most bacteria, viruses, and other biological agents. However, they do not remove chemical vapors.UV light
AR AR (analytical reagent) grade chemicals have the highest level of purity and are specifically made for precise analytical laboratory work where trace impurities could alter results.CP LR USP
Biological Chemical Formalin and xylene are chemicals, so they are classified as chemical hazards.Magnetic Radiation
A culture plate is moved to the incubator A specimen arrives leaking Leaking samples pose a biohazard risk and are usually rejected due to the risk of contamination. The laboratory must document the leaking sample and request a new specimen.A technician takes a scheduled 15-minute break The LIS autoverifies results
Repeating the same movement many times Repeating the same movement many times increases the risk of repetitive strain injury.Resting your arms on a hard surface Resting a body part on a hard surface is dangerous because it can constrict blood flow.Sitting in the same position for a long period of time Sitting in the same position for a long time can lead to pain, stiffness, and muscle weakness.Taking frequent breaks Taking breaks helps to prevent repetitive strain injuries.
Health needs evaluation Myers-Briggs type indicator Risk assessment Risk assessment is the systematic process of identifying and evaluating potential hazards. It involves determining the likelihood and consequences of these hazards and developing strategies to mitigate or manage the risks.Workplace danger evaluation
The key safety principles of working in a laboratory The steps for first aid The steps to operate a fire extinguisher PASS is a mnemonic for remembering the steps to operate a fire extinguisher. The letters PASS stand for pull, aim, squeeze, and sweep.- Pull: The first step is to pull the pin, which will allow you to discharge the extinguisher.
- Aim: The second step is to aim the fire extinguisher's nozzle at the base of the fire.
- Squeeze: The third step is to squeeze the lever to release the extinguishing agent.
- Sweep: The final step is to sweep the nozzle from side to side until the fire is out.
The warning signs of a stroke
Accident and incident recording form First aid assessment form Inspection report Risk assessment A risk assessment identifies the risks in a laboratory and sets out the laboratory's measures to mitigate these risks.
0.85% sodium chloride 10% ethanol 8.5% sodium chloride Water Water is referred to as the universal solvent because of its ability to dissolve a wide range of substances.
Identifying unexpected failures Repairing equipment after it fails Repairing equipment after it fails is called corrective maintenance.Servicing equipment before it fails Preventive maintenance is regularly scheduled maintenance to prevent failures in the future. In other words, preventive maintenance is fixing things before they break.Turning off machines when they are not in use
Commercial Commercial grade is the least pure. These chemicals often contain a significant amount of impurities.Laboratory Laboratory grade generally has a moderate level of purity.Reagent Reagent grade (also known as analytical reagent grade) is one of the highest grades of purity available for laboratory use. Reagent-grade chemicals have very low levels of impurities.Technical Technical grade has a lower level of purity than analytical grade. However, the impurities do not significantly affect the performance of industrial applications.
Analytical balance An analytical balance is a highly sensitive instrument that can measure small masses with a high degree of precision and accuracy.Desiccator PH meter Single pan balance
To accentuate changes in pH To make a solution more acidic To make a solution more basic To minimize changes in pH A buffer is a solution that resists changes in pH when acid or alkali is added to it. Its purpose is to keep a solution within the desired pH range.
Grams A triple beam balance measures mass and gives readings in grams.Kilograms Liters Milliliters
pH 1 pH 4 pH 7 When calibrating a pH meter, a neutral buffer of pH 7 is typically used first. This is followed by a buffer of pH 4 or pH 10.pH 10
Buffer solution Distilled water Refractometers are calibrated by placing drops of distilled water on the refractometer's prism and then adjusting the specific gravity scale to read 1.000.Healthy urine Hydrochloric acid
Deionization Distillation In distillation, water is boiled to create steam, which then condenses into purified water.Filtration Reverse osmosis
RCF = RPM × 1.144 × 10⁵ × r² RCF = RPM × 1.144 × 10⁻⁵ × r² RCF = RPM² × 1.118 × 10⁵ × r RCF = RPM² × 1.118 × 10⁻⁵ × r The equation to convert revolutions per minute (RPM) to relative centrifugal force (RCF) is:RCF = RPM² × 1.118 × 10⁻⁵ × r where:- RCF is the relative centrifugal force (in units of g)
- RPM is the speed (in revolutions per minute)
- 10⁻⁵ = 0.00001
- r is the rotational radius in centimeters
The duration of a blood cell count The time from specimen receipt to result reporting Turnaround time is the time from receipt of the specimen in the laboratory to the time the result is reported to the physician.The time required for sample preparation The time taken for instrument maintenance
Reagent A reagent is a substance or mixture used in chemical analysis or other reactions.Solute A solute is a substance added to a liquid (the solvent) to form a solution. In this case, the solute is potassium oxalate, because potassium oxalate is added to the water.Solution Solutions are a mixture of a solute and a solvent.Solvent A solvent is a liquid in which a solute is dissolved to form a solution. In the question, the distilled water is the solvent.
A comparison of a laboratory's results to those from an outside facility A comparison of a laboratory's results to the results from an outside facility is called External Quality Assessment (EQA).A comparison of current test results to previous results A delta check is a quality assurance measure used to identify significant changes in a patient's laboratory test results. It works by comparing a patient's current test result with previous results. If the difference between the current and previous results is too high, a delta check alert is triggered.An inspection to ensure all patients are wearing wristbands The verification of a patient's identity using at least three identifiers
Increasing the time it takes to perform key tasks Keeping frequently used equipment within easy reach Storing frequently used equipment in easy-to-reach places helps increase efficiency by reducing the time needed to access the equipment.Using an inconsistent labeling system Using paper files instead of digital files
Diluted Saturated Supersaturated Unsaturated Unsaturated solutions contain less solute than the maximum amount that can be dissolved. Unlike saturated solutions and supersaturated solutions, they can still dissolve more solute.
causes cells to grow When cells are placed in a hypertonic solution, water moves out of the cells, causing them to shrink.contains a higher concentration of solutes than another solution A hypertonic solution has a higher solute concentration compared to another solution.contains a lower concentration of solutes than another solution contains the same concentration of solutes as another solution
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About the MT(AAB) Basic Knowledge exam
The MT(AAB) Basic Knowledge exam is administered by the American Association of Bioanalysts (AAB). It evaluates foundational skills and knowledge of laboratory practices. It covers topics like general laboratory operations, regulatory compliance, patient confidentiality and information security, and laboratory administration.
The Basic Knowledge exam is the most important AAB exam. You must pass this exam before you can be certified in any discipline, whether Chemistry, Hematology, Immunology, Immunohematology, Microbiology, etc.
For example, if you want to be certified in Chemistry, you must pass the Basic Knowledge exam as well as the Chemistry exam.
Basic Knowledge is also included as one of the six parts of the MT(AAB) Generalist examination (Chemistry, Hematology, Immunology, Immunohematology, Microbiology, and Basic Knowledge).
Exam format
If you take Basic Knowledge as an individual examination, there will be 70 multiple-choice questions and you will have 90 minutes to complete the examination.
If you take the MT(AAB) Generalist examination, there will be 240 questions in total, including 40 Basic Knowledge questions.
You must score at least 60% to pass the Basic Knowledge exam.
Calculators, electronic devices, notes, books, and other reference materials are not permitted during the examination.
Exam content
The Basic Knowledge examination is approximately divided as follows:
- General operations knowledge: 30%
- Regulatory compliance: 55%
- Patient confidentiality and information security: 5%
- Administration: 10%
Topics on the exam
The topics below are based on previous AAB Basic Knowledge examination guidelines. They are a guide to the subjects that may be tested, but should not be treated as a definitive list of topics on the current examination.
General operations knowledge
- Laboratory equipment and instrumentation
- Centrifuges
- Pipettes
- Temperature-regulated equipment
- Microscopes
- Other equipment (e.g. biological safety cabinets, thermometers, etc.)
- Mathematics, weights, and measures
- Units of measurement
- Preparing solutions
- Dilutions
- Concentrations
- Mathematical calculations used in the laboratory
- Chain of custody
- Personnel policies and practices
- Orientation
- Job descriptions
- Competency assessment
- Performance evaluations
- Computers
- Reflex testing
- Quality control and quality assurance
- Accuracy and precision
- Coefficient of variation
- Control values
- Errors (pre-analytical, analytical, and post-analytical)
- Mean, mode, median, and range
- Standard deviation and confidence limits
- Analysis of quality control results
- Remedial or corrective actions
- Safety
- General lab safety
- Chemical safety
- Biological safety
- Personal protective equipment (PPE)
- Fire safety
- Electrical safety
Regulatory compliance
- Clinical Laboratory Improvement Amendments (CLIA)
- Levels of testing complexity
- Test categorization
- Laboratory inspections
- Proficiency testing
- Enrollment requirements
- Testing of proficiency testing samples
- Successful participation
- Patient test management
- Pre-analytical procedures
- Analytical procedures
- Post-analytical procedures
- Quality control requirements
- Procedure manuals
- Equipment maintenance
- Preventive maintenance
- Reagent labeling and storage
- Remedial actions
- Personnel qualifications and responsibilities
- Personnel competency assessment
- Complaint investigations
- Laboratory communication
- Occupational Safety and Health Administration (OSHA)
- Hazard Communication Standard
- Bloodborne Pathogens Standard
- Chemical Hygiene Plan
- Personal protective equipment (PPE)
- Hazardous materials
- Environmental controls
- Emergency action plans
- Fire precautions
- Fire evacuation plans
- Types of fire
- Types of fire extinguishers
- NFPA Hazard Diamond
- Electrical safety
- Radiation safety
- Environmental Protection Agency (EPA)
- Biohazardous waste
- Radioactive waste
- Environmental compliance
- Inspections
- Employment and labor laws
- Americans with Disabilities Act (ADA)
- Civil Rights Act
- Fair Labor Standards Act (FLSA)
- Family and Medical Leave Act (FMLA)
- Consolidated Omnibus Budget Reconciliation Act (COBRA)
- Workers' compensation
- Unemployment compensation
- Equal Employment Opportunity Commission (EEOC)
- Department of Transportation (DOT)
- Packaging and transportation of laboratory specimens
- Transportation of hazardous materials
Patient confidentiality and information security
- Health Insurance Portability and Accountability Act (HIPAA)
- Patient confidentiality
- Protection of laboratory information
- Appropriate release of patient information
- Computer and information security
Administration
- Personnel management
- Financial management
- Laboratory management
- Education
