MLS Clinical Procedures & Protocols 2

Question 1

A patient's blood culture bottle flags positive after 18 hours. What is the FIRST action the MLS should take?

Accepted Answer

Subculture to blood agar and report Gram stain to clinician

Answer

Wait 24 hours before taking action

Answer

Discard and collect a new specimen

Answer

Perform susceptibility testing immediately without Gram stain

Question 2

Which anticoagulant is used in the light blue (sodium citrate) tube and what is its primary application?

Accepted Answer

Sodium citrate; coagulation studies

Answer

EDTA; complete blood count

Answer

Lithium heparin; chemistry panels

Answer

Potassium oxalate; glucose testing

Question 3

A urine dipstick shows 2+ protein but the SSA (sulfosalicylic acid) test is negative. What is the most likely explanation?

Accepted Answer

The protein is Bence Jones protein or immunoglobulin light chains

Answer

The specimen is contaminated with bacteria

Answer

The dipstick reagent strip has expired

Answer

The urine pH is too acidic for SSA to work

Question 4

During a venipuncture, blood stops flowing into the tube. Which corrective action should be attempted FIRST?

Accepted Answer

Slightly advance or withdraw the needle to reposition it

Answer

Remove the needle and start over at a new site

Answer

Apply a tourniquet more tightly

Answer

Switch to a smaller gauge needle

Question 5

Which specimen type is MOST appropriate for detecting anaerobic bacteria?

Accepted Answer

Deep wound tissue submitted in an anaerobic transport container

Answer

Nasopharyngeal swab in Amies transport medium

Answer

Mid-stream clean-catch urine

Answer

Sputum collected in a sterile cup

Question 6

A hemolyzed serum specimen is received for potassium testing. The MLS should:

Accepted Answer

Reject the specimen and request a recollect

Answer

Run the specimen and flag the result as hemolyzed

Answer

Centrifuge again to remove hemolysis

Answer

Dilute the specimen to reduce interference

Question 7

Which procedure is required before performing a finger stick on an infant younger than one year?

Accepted Answer

Warm the heel for 3–5 minutes and collect from the plantar surface

Answer

Apply topical EMLA cream for 60 minutes

Answer

Collect from the fingertip with a lancet shorter than 2 mm

Answer

Use the antecubital vein instead to avoid pain