CMA Clinical Procedures and Specimen Handling 4 — Questions and Answers
Question 1: Which specimen requires special handling in a biohazard bag with a secondary container for transport?
- Urine dipstick for glucose only
- Blood specimens for any laboratory analysis (Correct answer)
- A non-infectious environmental swab
- A specimen from a completely healthy patient
Correct answer: Blood specimens for any laboratory analysis
All blood and body fluid specimens must be transported in sealed, leak-proof containers with biohazard labeling per standard precautions.
Question 2: A patient experiences a vasovagal syncope reaction during venipuncture. The FIRST action is to:
- Complete the draw quickly before the patient fully faints
- Remove the needle and have the patient lower their head between their knees or lie down (Correct answer)
- Apply a tourniquet tighter to prevent bruising
- Call 911 immediately
Correct answer: Remove the needle and have the patient lower their head between their knees or lie down
Removing the needle prevents injury, and lowering the head increases cerebral blood flow to resolve the vasovagal episode.
Question 3: For a 24-hour urine collection, the patient should be instructed to:
- Collect the first morning void, then all urine for the next 24 hours
- Discard the first morning void, then collect all urine for 24 hours ending with the next morning void (Correct answer)
- Refrigerate the container only at the end of collection
- Collect only random specimens throughout the day
Correct answer: Discard the first morning void, then collect all urine for 24 hours ending with the next morning void
The first morning void is discarded to establish a clear start time; all subsequent urine including the next day's first void is collected.
Question 4: When applying a sterile dressing to a wound, the medical assistant should handle the dressing:
- By the edges only with gloved hands
- Using sterile forceps or sterile gloves, touching only the outer surface (Correct answer)
- With clean (non-sterile) gloves since it will cover a wound
- Directly with bare hands if recently washed
Correct answer: Using sterile forceps or sterile gloves, touching only the outer surface
Sterile dressings must remain sterile; forceps or sterile gloves touching only non-contact surfaces prevent contamination.
Question 5: A patient needs a Pap smear specimen. Which fixative must be applied immediately after collection?
- Formalin 10%
- Normal saline
- Cytology fixative spray or liquid (e.g., CytoLyt) (Correct answer)
- Hydrogen peroxide
Correct answer: Cytology fixative spray or liquid (e.g., CytoLyt)
Cytology fixative must be applied within seconds to prevent air-drying artifact that makes cells uninterpretable.
Question 6: Which finding on a urine dipstick test requires immediate reporting to the physician?
- Trace protein in a pregnant patient
- Positive glucose in a known diabetic after a meal
- Large blood and positive nitrites with WBCs (Correct answer)
- Slightly elevated specific gravity after exercise
Correct answer: Large blood and positive nitrites with WBCs
Large blood, positive nitrites, and WBCs together indicate a likely urinary tract infection requiring prompt treatment.
Question 7: After performing an ear irrigation (cerumen removal), the medical assistant should:
- Pack the ear canal with dry cotton for 30 minutes
- Tilt the patient's head to drain the ear and gently dry the outer canal (Correct answer)
- Instill antibiotic drops immediately
- Recap the ear and schedule a follow-up in one week
Correct answer: Tilt the patient's head to drain the ear and gently dry the outer canal
Tilting the head allows residual water and loosened cerumen to drain, and the outer canal is gently dried to prevent moisture-related problems.
CMA Clinical Procedures and Specimen Handling 4
Which specimen requires special handling in a biohazard bag with a secondary container for transport?