Phlebotomy Test Quality Assurance and Quality Control 2

Question 1

Which of the following BEST describes the purpose of a quality assurance (QA) program in a laboratory?

Accepted Answer

To monitor and improve all processes affecting the quality and accuracy of patient test results

Answer

To ensure all laboratory equipment is calibrated monthly

Answer

To train new laboratory staff on equipment operation

Answer

To conduct random audits of phlebotomy technique only

Question 2

A QC control value plots at +2.3SD on the Levey-Jennings chart. According to Westgard rules, this result is:

Accepted Answer

A warning (1₂s violation)—investigate before running patient samples

Answer

A rejection requiring immediate corrective action

Answer

Within acceptable limits—no action required

Answer

An indication of random error requiring instrument recalibration

Question 3

A laboratory is investigating a systematic positive bias in sodium results compared to proficiency testing. Which of the following is MOST likely to be the cause?

Accepted Answer

Calibrator drift or incorrect calibration assignment

Answer

Random pipetting errors in individual samples

Answer

Expired control material causing erroneous results only in QC

Answer

Hemolysis in patient samples causing elevated sodium

Question 4

Proficiency testing (PT) is an EXTERNAL quality assessment tool that primarily evaluates:

Accepted Answer

The accuracy of a laboratory's test methods by comparing results with peer laboratories

Answer

Individual phlebotomist's specimen collection technique

Answer

Daily QC performance over a 30-day period

Answer

The laboratory's compliance with OSHA safety regulations

Question 5

A laboratory QA review finds that the specimen rejection rate for hemolysis has increased from 2% to 8% over the past month. The FIRST step in the quality improvement process is to:

Accepted Answer

Investigate the root cause by analyzing rejection data by phlebotomist, time of day, and patient unit

Answer

Immediately retrain all phlebotomists on hemolysis prevention

Answer

Report the increase to the medical director and close the investigation

Answer

Accept the new rate as reflective of sicker patients in the hospital

Question 6

Which of the following represents a POST-ANALYTICAL quality concern in phlebotomy and laboratory practice?

Accepted Answer

Failing to notify the provider of a critical value within the required timeframe

Answer

Using the wrong vacuum tube for the ordered test

Answer

Centrifuging a specimen at the wrong speed

Answer

Mislabeling a specimen tube at the bedside

Question 7

A laboratory implements a new centrifuge protocol and notices gel separator tubes processed under the new protocol have serum with red cell contamination visible above the gel barrier. This is MOST likely due to:

Accepted Answer

Centrifugation at insufficient speed or time, preventing complete separation

Answer

Tubes being centrifuged at too high a speed for too long

Answer

Tubes being stored upright instead of inverted during centrifugation

Answer

An error in the QC of the tube itself

Question 8

A laboratory's QA program identifies that STAT order turnaround times frequently exceed the 60-minute target. The MOST effective initial intervention is to:

Accepted Answer

Map the current STAT process to identify the specific step causing delay

Answer

Purchase additional laboratory analyzers immediately

Answer

Mandate that all STAT specimens be run before routine tests without exception

Answer

Increase the STAT TAT target to 90 minutes to reduce perceived failures