Clinical Chemistry
Chapter Exam Questions
Course Introduction
Clinical Chemistry is a branch of clinical pathology that involves the analysis of bodily fluids to diagnose and monitor disease. This course covers the principles and techniques used in the measurement of chemical components in blood, urine, and other biological specimens, including enzymes, hormones, electrolytes, and metabolites. Students will explore laboratory methodologies, instrumentation, quality control, and the interpretation of results within the context of health and disease. Emphasis is placed on understanding the clinical significance of laboratory findings, quality assurance in lab practices, and the integration of laboratory data into patient care.
Recommended Textbook
Linne Ringsruds Clinical Laboratory Science 7th Edition by Mary Louise Turgeon
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Chapter 1: Fundamentals of the Clinical Laboratory
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Q1) measures blood glucose and cholesterol levels
A)hematology
B)clinical chemistry
C)immunohematology
D)immunology and serology
E)microbiology
Answer: B
Q2) screens for viral diseases,for example,HIV
A)hematology
B)clinical chemistry
C)immunohematology
D)immunology and serology
E)microbiology
Answer: D
Q3) The federal legislation requiring strict confidentiality of patient results is:
A) Clinical Laboratory Improvement Act (CLIA '88).
B) Health Insurance Portability and Accountability Act (HIPAA).
C) National Certifying Agency.
D) combined state laws.
Answer: B
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Chapter 2: Safety in the Clinical Laboratory
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Q1) Which of the following legislative documents ensures that workers have safe and healthful working conditions?
A) Occupational Safety and Health Act
B) Hazard Communication Standard
C) Clinical Laboratory Improvement Act (CLIA)
D) Both a and b
Answer: D
Q2) The definition of a biohazard is:
A) chemicals that can burn the skin severely.
B) flammable substances.
C) potentially infectious materials or agents.
D) explosive liquids.
Answer: C
Q3) Standard Precautions is:
A) a term that has replaced the term Universal Precautions.
B) the process of treating all blood and body fluids as potentially infectious.
C) a safety precaution concerned with the handling of all patient specimens.
D) all of the above.
Answer: D
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Chapter 3: Quality Assessment and Quality Control in the Clinical Laboratory
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Q1) chronic shortage of qualified laboratory staff
A)active error
B)latent error
Answer: B
Q2) An example of a preanalytical error is:
A) specimen obtained from a wrong patient.
B) lack of frequent preventive maintenance.
C) reporting of laboratory results by phone.
D) poorly trained phlebotomists.
Answer: A
Q3) trend or drift
A)a gradual change in the control sample results
B)a sudden and sustained change in one direction in control sample values
C)when random error or lack of precision increases
Answer: A
Q4) failing to properly identify a patient prior to venipuncture
A)active error
B)latent error
Answer: A
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Chapter 4: Phlebotomy: Collecting and Processing Blood
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Q1) A popular at-home point-of-care test (POCT)is for ____ testing.
A) thyroid
B) glucose
C) electrolyte
D) cholesterol
Q2) Most mistakes in laboratory testing involve ____ errors.
A) preanalytical (pre-evaluation)
B) analytical (evaluation)
C) postanalytical (post-evaluation)
D) a combination of any of the above
Q3) The first tier of infection control for health care professionals is to use ____ precautions.
A) standard
B) contact
C) airborne
D) droplet
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Chapter 5: The Microscope
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Q1) The term ocular is another name for the microscopic ____ that magnifies an image.
A) objective
B) eyepiece
C) diaphragm
D) nosepiece
Q2) The numerical aperture (NA)is:
A) an index of the resolving power of a lens.
B) the distance from an object being viewed to the lens.
C) inscribed on each objective lens.
D) both a and b.
Q3) The magnifying powers of the usual microscope objectives are:
A) 5×, 10×, 20×.
B) 10×, 20×, 40×.
C) 10×, 40×, 80×.
D) 10×, 40×, 100×.
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Chapter 6: Systems of Measurement, laboratory
Equipment, and Reagents
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Q1) Solutions prepared from the most highly purified types of chemicals available are ____ solutions.
A) reagent
B) standard
C) molar
D) acidic
Q2) The purpose of a material safety data sheet (MSDS)is to provide information about:
A) possible hazards.
B) safe handling instructions.
C) storage and disposal of the specific chemical that it accompanies.
D) all of the above.
Q3) In the process of deionization,water is:
A) heated and cooled to liquefy the condensation.
B) passed through a resin column containing positively (+) and negatively (-) charged particles.
C) first heated and then passed through a resin column containing charged particles.
D) both b and c.
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Chapter 7: Laboratory Mathematics and Solution Preparation
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Q1) blank solution
A)a solution prepared from a stock solution and usually stored in the refrigerator
B)one that contains a known, exact amount of the substance being measured
C)one that contains reagents used in the procedure but not the substance to be measured
Q2) A significant figure should contain only the digits in a number needed to express the precision of the measurement.
A)True
B)False
Q3) In rounding off numbers:
A) when the digit next to the last one to be retained is less than 5, the last digit should be left unchanged.
B) when the digit next to the last one to be retained is greater than 5, the last digit is increased by 1.
C) if the additional digit is 5, the last digit reported is changed to the nearest even number.
D) follow all of the above.
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Chapter 8: Basic and New Techniques in the Clinical Laboratory
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Q1) 440-500
A)not visible (infrared light)
B)red
C)orange
D)yellow
E)green
F)blue
G)violet
H)not visible (ultraviolet light)
Q2) A popular at-home application of reflectance spectrophotometry in point-of-care testing (POCT)is:
A) blood volume estimation.
B) drug monitoring.
C) glucose monitoring.
D) pH determination.
Q3) Various enzymes are used in enzyme immunoassay.In order to be used,an enzyme must fulfill certain criteria,including no alteration by inhibitor with the system.
A)True
B)False
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Chapter 9: Delivery of Laboratory Testing From Point of
Care to Total Automation
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Q1) Which of the following is the sequence of major steps in automated analysis that mimic manual techniques?
A) Specimen collection and processing, specimen and reagent measurement and delivery, chemical reaction phase, measurement phase, and signal processing and data handling
B) Specimen and reagent measurement and delivery, specimen collection and processing, chemical reaction phase, measurement phase, and signal processing and data handling
C) Specimen collection and processing, specimen and reagent measurement and delivery, signal processing and data handling, chemical reaction phase, and measurement phase
D) Signal processing and data handling, specimen collection and processing, specimen and reagent measurement and delivery, chemical reaction phase, and measurement phase
Q2) highly complex
A)slide examinations of freshly collected body fluids
B)simple procedures with little chance of negative outcomes if performed inaccurately
C)usually nonautomated, requiring considerable judgment
D)more complex than waived, usually automated
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Chapter 10: Introduction to Clinical Chemistry
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Q1) A major benefit of point-of-care testing (POCT)for blood glucose is that it:
A) allows for immediate intervention.
B) does not require oversight by the laboratory.
C) can only be performed by laboratory personnel.
D) eliminates the need for glucose testing in the laboratory.
Q2) Which of the following conditions is least likely to contribute to an increased serum uric acid level?
A) Chemotherapy
B) Renal disease
C) Liver disease
D) Gout
Q3) metabolic alkalosis
A)decreased plasma bicarbonate
B)excess elimination of acid
C)acid-rich fluids are lost
D)decreased elimination of CO
Q4) Free T is ____ and thyroid stimulating hormone is ____ in hypothyroidism.
A) increased; decreased
B) decreased; increased
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Chapter 11: Principles and Practice of Clinical Hematology
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Q1) The maximum allowable time for determination of a WBC count,microhematocrit,or platelet count using blood that has been collected in EDTA is ____ hours,if it is refrigerated at 4° C.
A) 4
B) 8
C) 24
D) 48
Q2) RBCs that have a central area of hemoglobin are called:
A) spherocytes.
B) target cells.
C) microcytes.
D) discocytes.
Q3) mean corpuscular hemoglobin
A)\( (f L)=\frac{\operatorname{Hct} \times 10}{\operatorname{RBC}} \)
B)\( (p g)=\frac{\mathrm{Hb} \times 10}{\mathrm{RBC}} \)
C)\( (g / d L)=\frac{H b}{H c t} \times 100 \)
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Chapter 12: Introduction to Hemostasis
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Q1) factor IX
A)prothrombin
B)hemophilia B
C)von Willebrand's factor
D)fibrinogen
Q2) A prothrombin time assay should be conducted within ____ hours after specimen collection.
A) 2
B) 4
C) 8
D) 24
Q3) prothrombin group
A)factors II, VII, IX, and X
B)factors XI and XII, prekallikrein (Fletcher factor), and HMWK (Fitzgerald factor)
C)factors I, V, VIII, and XIII
Q4) A function or activity of platelets is to help activate and be a participant in plasma coagulation.
A)True
B)False
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Chapter 13: Renal Physiology and Urinalysis
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Q1) The first part of the routine urinalysis is the ____ examination.
A) physical
B) chemical
C) microscopic
D) either b or c
Q2) WBC casts
A)exposure to nephrotoxic substances
B)urinary tract infection
C)acute pyelonephritis
D)glomerular damage
Q3) Quality assessment of control specimens should include:
A) testing of all opened bottles of reagent strips or tablets each morning.
B) testing of each new bottle on opening.
C) recording data on the record sheet daily.
D) all of the above.
Q4) Urine should be examined ____ collection.
A) immediately after
B) within 30 minutes, if not refrigerated or suitably preserved at
C) within 2 hours if kept at room temperature after
D) within 24 hours if refrigerated after
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Chapter 14: Examination of Body Fluids and Miscellaneous Specimens
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Q1) Serous fluids:
A) have a composition that is unlike serum.
B) are contained within the closed cavities of the body.
C) are ultrafiltrates of plasma.
D) Both a and b are correct.
Q2) If CSF has a xanthochromic appearance,it can indicate bleeding:
A) within 30 minutes to 1 hour.
B) within 1 to 2 hours.
C) between 12 hours and 2 to 4 weeks.
D) within the past month.
Q3) An assay for fetal fibronectin (fFN)is performed,if the:
A) mother is having symptoms of premature labor.
B) fetus is suffering from hemolytic anemia.
C) parents want to know the gender of the fetus.
D) obstetrician wants to know if the fetus has a genetic disorder.
Q4) Synovial fluids should be collected:
A) into an anticoagulated tube.
B) into a non-anticoagulated tube.
C) using a sterile needle and syringe.
D) in all of the above ways.
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Chapter 15: Introduction to Microbiology
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Q1) Which of the following is a selective and differential medium for the recovery of gram-positive organisms?
A) Columbia colistin-nalidixic acid agar with blood (CNA)
B) Eosin-methylene blue agar (EMB)
C) MacConkey agar (MAC)
D) Xylose-lysine desoxycholate agar (XLD)
Q2) The microbiologist uses TSI and LIA agars to rule out stool pathogens,Salmonella and Shigella spp.The reactions observed are TSI: K/A,H2S+ and LIA: R/A.What should the technologist do next?
A) Report Salmonella spp. recovered
B) Report Shigella spp. recovered
C) Report normal stool flora
D) Repeat all testing
Q3) The Gram stain is used to differentiate bacteria that have similar morphologic features.The Gram stain method uses different reagents,including:
A) Gram iodine.
B) decolorization.
C) a counterstain.
D) all of the above.
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Chapter 16: Immunology and Serology
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Q1) plateau
A)no detectable antibody
B)antibody titer stabilizes
C)antibody is catabolized
D)antibody titer increases
Q2) The second line of body defense consists of:
A) neutrophils, tissue basophils, macrophages.
B) complement and lysozyme.
C) interferon.
D) all of the above.
Q3) Factors that influence an individual's defense against disease include status of general health.
A)True
B)False
Q4) decline
A)no detectable antibody
B)antibody titer stabilizes
C)antibody is catabolized
D)antibody titer increases
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Chapter 17: Immunohematology and Transfusion Medicine
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Q1) Fresh frozen plasma
A)Best used when oxygen-carrying capacity is needed
B)Rarely used but can meet a patient's need for volume replacement, oxygen-carrying capacity, and heat-labile coagulation factors
C)Used to treat multiple coagulation deficiencies
D)Used to treat hemophilia
Q2) Packed RBCs
A)Best used when oxygen-carrying capacity is needed
B)Rarely used but can meet a patient's need for volume replacement, oxygen-carrying capacity, and heat-labile coagulation factors
C)Used to treat multiple coagulation deficiencies
D)Used to treat hemophilia
Q3) Monoclonal factor VIII
A)Best used when oxygen-carrying capacity is needed
B)Rarely used but can meet a patient's need for volume replacement, oxygen-carrying capacity, and heat-labile coagulation factors
C)Used to treat multiple coagulation deficiencies
D)Used to treat hemophilia
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