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CLC Specimen Collection, Handling & Pre-Analytical Processes Flashcards

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  1. The pre-analytical phase of laboratory testing is considered the most error-prone phase. Which of the following is a common pre-analytical error?

    Answer: Hemolyzed specimen due to improper collection technique

    Hemolysis from improper venipuncture technique is one of the most frequent pre-analytical errors, which can falsely alter results for multiple analytes.

  2. According to CLSI guidelines, what is the recommended order of draw when collecting multiple tubes during a single venipuncture?

    Answer: Blood culture → citrate → SST → heparin → EDTA

    CLSI GP41 specifies the order: blood cultures first, then citrate (blue), then SST or plain red, then heparin (green), then EDTA (lavender) to prevent cross-contamination between additives.

  3. A laboratory consultant reviews rejection criteria and notes that a urine specimen for culture arrived in the laboratory 4 hours after collection without refrigeration. What is the appropriate action?

    Answer: Reject the specimen and request a new collection

    Unrefrigerated urine held more than 2 hours before culture is typically rejected because bacterial overgrowth invalidates culture results.

  4. Which anticoagulant tube is the correct choice for a prothrombin time (PT/INR) test?

    Answer: Sodium citrate (blue top)

    Sodium citrate (blue top) tubes are required for coagulation studies including PT/INR because citrate preserves clotting factors by chelating calcium.

  5. A phlebotomist collects a citrate tube but it is only 80% full. What is the most significant concern with this specimen?

    Answer: Altered blood-to-anticoagulant ratio affecting coagulation results

    Citrate tubes require a precise 9:1 blood-to-anticoagulant ratio; underfilling alters this ratio and leads to falsely prolonged coagulation results.

  6. Which specimen type is most appropriate for measuring ionized calcium?

    Answer: Whole blood collected in a heparinized syringe

    Ionized calcium is best measured in heparinized whole blood collected anaerobically, as EDTA chelates calcium and serum requires careful handling to avoid pH changes.