CSC Treatment Protocols & Procedures 3 — Questions and Answers
Question 1: A urine specimen is reported as 'substituted' by the laboratory. This means the creatinine and specific gravity results were:
- Creatinine <2 mg/dL and specific gravity <1.0010 or >1.0200 (Correct answer)
- Creatinine <2 mg/dL and specific gravity 1.0010–1.0030
- Creatinine >200 mg/dL and specific gravity >1.0300
- Creatinine 2–20 mg/dL and specific gravity 1.0010–1.0030
Correct answer: Creatinine <2 mg/dL and specific gravity <1.0010 or >1.0200
A substituted result requires creatinine less than 2 mg/dL AND specific gravity less than 1.0010 or greater than 1.0200, indicating the specimen is not consistent with normal human urine.
Question 2: Under DOT procedures, which personnel is authorized to order a direct observation collection?
- The donor's supervisor
- The collector alone
- The MRO or DER based on specific triggers (Correct answer)
- Any certified collector on-site
Correct answer: The MRO or DER based on specific triggers
Direct observation collections are ordered by the MRO (for specific lab results) or the DER (for certain regulatory triggers), not unilaterally by the collector.
Question 3: When a collector must void a collection (e.g., because the donor left the collection area without permission), which form action is required?
- Destroy the CCF and start over with no documentation
- Complete the CCF, mark 'Test Cancelled,' and notify the DER (Correct answer)
- Send the CCF to the MRO with a 'Collector Error' notation
- File the CCF with the employer HR department
Correct answer: Complete the CCF, mark 'Test Cancelled,' and notify the DER
Even when a collection is cancelled, the collector must complete the CCF, mark the appropriate 'Test Cancelled' reason, and notify the Designated Employer Representative.
Question 4: A donor provides only 30 mL of urine on the first void attempt. The collector should:
- Send the partial specimen to the lab immediately
- Discard the specimen and document a refusal
- Keep the partial specimen and have the donor attempt to provide more (Correct answer)
- Split the 30 mL into two bottles and proceed
Correct answer: Keep the partial specimen and have the donor attempt to provide more
If a donor provides less than 45 mL, the collector retains the partial specimen in a closed container and allows the donor up to 3 hours to provide additional urine.
Question 5: For a pre-employment DOT drug test, who is responsible for ensuring the test is conducted before the employee performs safety-sensitive functions?
- The MRO
- The Substance Abuse Professional (SAP)
- The employer/DER (Correct answer)
- The collection site supervisor
Correct answer: The employer/DER
Under DOT regulations, the employer (acting through the DER) is responsible for ensuring a negative pre-employment result is received before the employee performs any safety-sensitive duties.
Question 6: Under 49 CFR Part 40, an 'adulterated' specimen is one that contains:
- A substance not expected in human urine that interferes with the test (Correct answer)
- A controlled substance above the cutoff concentration
- Dilute creatinine and specific gravity values
- Abnormally high creatinine above 300 mg/dL
Correct answer: A substance not expected in human urine that interferes with the test
An adulterated specimen contains a foreign substance or has an abnormal characteristic that interferes with the validity of the drug test, such as bleach or nitrites.
Question 7: When a collector seals a urine specimen, the tamper-evident tape must be placed so that it:
- Covers only the bottle cap
- Covers the bottle cap and extends onto the bottle label (Correct answer)
- Wraps around the entire bottle three times
- Is initialed only by the collector, not the donor
Correct answer: Covers the bottle cap and extends onto the bottle label
The tamper-evident seal must cover the bottle cap and extend onto the bottle itself so that any attempt to open the bottle will break the seal and be visible.
CSC Treatment Protocols & Procedures 3
A urine specimen is reported as 'substituted' by the laboratory.
This means the creatinine and specific gravity results were: