CPC Specimen Collection Procedures & Chain of Custody 3 — Questions and Answers
Question 1: A donor provides a urine specimen with a temperature of 82°F (27.8°C). What should the collector do?
- Accept the specimen since it is close to the range
- Immediately send the specimen to the lab with a note
- Treat it as a refusal and document accordingly
- Have the donor provide a second specimen under direct observation and document the temperature discrepancy (Correct answer)
Correct answer: Have the donor provide a second specimen under direct observation and document the temperature discrepancy
A temperature outside the 90–100°F range gives reason to believe tampering occurred; the collector must note the discrepancy and may require a second collection under direct observation.
Question 2: Which specimen container is appropriate for collecting a blood specimen intended for blood alcohol content (BAC) analysis under forensic chain of custody?
- SST (serum separator tube)
- Gray-top tube with sodium fluoride and potassium oxalate (Correct answer)
- Lavender-top EDTA tube
- Light blue sodium citrate tube
Correct answer: Gray-top tube with sodium fluoride and potassium oxalate
Sodium fluoride inhibits glycolysis to preserve glucose/alcohol levels, and potassium oxalate acts as an anticoagulant, making gray-top tubes standard for BAC testing.
Question 3: Under DOT regulations, which of the following would constitute a 'refusal to test'?
- Donor takes more than 2 minutes to produce a specimen
- Donor requests a female collector
- Donor fails to provide a sufficient specimen volume after adequate time and fluids (Correct answer)
- Donor asks to read the chain-of-custody form before signing
Correct answer: Donor fails to provide a sufficient specimen volume after adequate time and fluids
If a donor cannot provide 45 mL within 3 hours despite consuming up to 40 oz of fluid, it is reported as a refusal (shy bladder failure is treated as a refusal under DOT rules).
Question 4: What is the primary reason specimen collection areas used for forensic/COC testing should have bluing agents added to toilet water?
- To deter biological contamination
- To prevent donors from diluting specimens with toilet water (Correct answer)
- To make the collection area more hygienic
- To facilitate measurement of urine pH
Correct answer: To prevent donors from diluting specimens with toilet water
Bluing agents make toilet water an obviously different color so that a donor cannot easily substitute it for urine without detection.
Question 5: When labeling a blood specimen tube at the point of collection, which information is MOST critical to include for chain-of-custody purposes?
- The collector's favorite lab reference number
- Patient/donor name, date and time of collection, and collector's initials (Correct answer)
- The patient's insurance information
- The test name and billing code
Correct answer: Patient/donor name, date and time of collection, and collector's initials
Accurate patient identification, collection date/time, and collector initials are the minimum required identifiers on COC specimen labels to maintain specimen integrity.
Question 6: Which of the following best describes a 'sentinel event' in the context of specimen collection?
- A specimen collected after regular business hours
- An unexpected occurrence that could seriously affect specimen integrity or patient safety (Correct answer)
- A specimen requiring extra processing steps
- A collection performed by a trainee under supervision
Correct answer: An unexpected occurrence that could seriously affect specimen integrity or patient safety
A sentinel event is an unanticipated event that could compromise specimen integrity or patient safety, triggering immediate investigation and corrective action.
Question 7: For a urine COC specimen collected at a collection site, the Federal CCF (Custody and Control Form) must be completed in how many copies?
- 2
- 3
- 5 (Correct answer)
- 7
Correct answer: 5
The Federal CCF is a five-part form; copies are distributed to the laboratory, MRO, employer, collection site, and retained by the donor.
CPC Specimen Collection Procedures & Chain of Custody 3
A donor provides a urine specimen with a temperature of 82°F (27.8°C).
What should the collector do?