MLS Patient Assessment & Documentation 2 — Questions and Answers
Question 1: A patient's requisition form lists the collection time as 0800, but the specimen arrives at the lab at 1400. What is the most appropriate action?
- Process the specimen immediately without notation
- Document the discrepancy and contact the ordering provider (Correct answer)
- Reject the specimen and order a recollection
- Accept the specimen and note 'delayed receipt' only if results are abnormal
Correct answer: Document the discrepancy and contact the ordering provider
Discrepancies between collection time and receipt time must be documented and the provider notified, as delays may affect result validity.
Question 2: Which of the following is the MOST reliable method for identifying a patient prior to specimen collection in an inpatient setting?
- Ask the patient to state their name and room number
- Check the name on the door or whiteboard
- Compare wristband information with the requisition using two identifiers (Correct answer)
- Confirm identity with the nursing staff
Correct answer: Compare wristband information with the requisition using two identifiers
Two-identifier verification using the patient wristband compared to the requisition is the standard for positive patient identification.
Question 3: An MLS receives a requisition with illegible handwriting for the test ordered. What should be done?
- Make an educated guess based on the diagnosis listed
- Perform the most common test for that diagnosis
- Contact the ordering clinician for clarification before processing (Correct answer)
- Return the requisition to the nursing station without action
Correct answer: Contact the ordering clinician for clarification before processing
Illegible orders must be clarified with the ordering clinician to prevent errors and ensure the correct test is performed.
Question 4: Which documentation is MOST critical to include when reporting a critical (panic) value?
- The time the result was reviewed by a supervisor
- The name of the person notified, time of notification, and value reported (Correct answer)
- The patient's insurance information and attending physician's name
- The instrument ID and reagent lot number used for the test
Correct answer: The name of the person notified, time of notification, and value reported
Critical value documentation must include who was notified, the time of notification, and the value reported to ensure a complete audit trail.
Question 5: A specimen labeled with only the patient's last name and room number is received in the lab. Per CAP standards, this specimen should be:
- Processed with a notation of the deficiency
- Rejected unless it is a stat specimen
- Rejected and a recollection requested with proper labeling (Correct answer)
- Forwarded to the charge technologist for a decision
Correct answer: Rejected and a recollection requested with proper labeling
CAP standards require a minimum of two patient identifiers on every specimen label; a specimen with only one identifier must be rejected.
Question 6: When reviewing a patient's medical record prior to phlebotomy, the MLS notes the patient is on warfarin. What is the primary concern for specimen collection?
- The anticoagulant may interfere with CBC tube selection
- Prolonged bleeding after venipuncture requires extended pressure time (Correct answer)
- Warfarin invalidates all coagulation test results
- A special transport medium is required for the specimen
Correct answer: Prolonged bleeding after venipuncture requires extended pressure time
Patients on warfarin have prolonged clotting times, so extended pressure must be applied after venipuncture to achieve hemostasis.
Question 7: What information is required on a chain of custody form for a forensic or medico-legal specimen?
- Collector's initials and specimen color only
- Each individual who handled the specimen, with date and time of transfer (Correct answer)
- Only the final receiving laboratory's signature
- The patient's social security number and insurance provider
Correct answer: Each individual who handled the specimen, with date and time of transfer
Chain of custody requires documentation of every person who handled the specimen, along with dates and times, to ensure specimen integrity for legal purposes.
MLS Patient Assessment & Documentation 2
A patient's requisition form lists the collection time as 0800, but the specimen arrives at the lab at 1400.
What is the most appropriate action?