1 of 210

Which of the following actions is part of a preventative maintenance for a

microtome?
Cleaning underneath the instrument
Lubricating the instrument
Changing the location of the instrument
Changing the blade on the instrument

2 of 210
Which of the following statements is consistent with the results given
below?
Sample Type Pleural fluid

Total nucleated cell count Markedly increased

Smear Numerous clumps of large cells without borders

Suspicious of malignant cells
Report as clotted specimen
Repeat the total nucleated cell count
Presence of the mesothelial cells

3 of 210
Given the following results, what is the calculated serum osmolarity
(mOsm/L)?

Urea: 4.2 mmol/L

Glucose: 5.9 mmol/L
Sodium: 127 mmol/L
137
147
264
268

4 of 210
Which of the following steps should be taken first when a co-worker
splashes urine in their eye?
Rinse eye with water for 20 minutes
Rinse eye with water for 10 minutes
Notify the supervisor
Rinse eye with water for 15 minutes

5 of 210
Which of the following staining techniques can be used to demonstrate
glycogen?
Alcian blue diastase
Alcian blue pH 2.5
Mucicarmine
Best carmine

6 of 210
Which of the following actions is taken first when a patient faints during
venipuncture?
Complete incident report
Apply ice pack
Continue with blood collection
Withdraw the needle

7 of 210
Which of the following social determinants of health contributes
to decreased employee wellness?
Improper posture
Eating less vegetables
Being bullied
Increased alcohol consumption

8 of 210
Which of the following antibodies correlate with the results given below?

Anti-H and anti-D

Anti-I and anti-K
Anti-i and anti-P₁
Anti-HI and anti-M

9 of 210
A technologist is testing a patient sample showing Gram positive cocci in
clusters using a latex agglutination method. What action should be
performed next given the results below?
Sample Test result

Staphylococcus aureus QC Visible large clumps

Staphylococcus epidermis QC No clumps seen

Patient sample Visible large clumps

Repeat the QC
Report isolate as Staphylococcus aureus
Perform tube coagulase
Report isolate as Staphylococcus epidermis

10 of 210
Which of the following antiseptics may compromise the results of a blood
alcohol concentration?
Tincture of iodine
Chlorhexidine gluconate
Hydrogen peroxide
Benzalkonium chloride

11 of 210
Which of the following items is required on a WHMIS Safety Data Sheet?
Composition of ingredients
Disposal considerations
Ecological information
Transport information

12 of 210
Which of the following actions should be taken when a real-time
polymerase chain reaction run for Influenza A gives the results below?
Reject run, repeat testing
Report all results
Report patient 2, repeat patient 1 and 3
Report patient 1 and 3, repeat patient 2

13 of 210
Which of the following conditions is consistent given these cerebrospinal
fluid results?
Predominant cell type Protein Glucose

Polymorphonuclear Elevated Low

Bacterial meningitis
Prion
Autoimmune disorder
Viral meningitis

14 of 210
Which of the following conditions correlates with the urine reagent strip
results below?

Bilirubin: +++
Urobilinogen: Normal
Pre-hepatic jaundice
Hepatic jaundice
Normal physiological condition
Post-hepatic jaundice

15 of 210
Which of the following antibodies correlates with the 10-cell panel results
given below?

Anti-P₁
Anti-M
Anti-Jkᵃ
Anti-Fyᵃ

16 of 210
What method of physical sterilization does an autoclave use?
Ionizing radiation
Incineration
Moist heat
Dry Heat

17 of 210
Which of the following elements is a component of process management?
Reporting hierarchy
Supplier qualifications
Change control
Safety programs
 18 of 210
Which of the following clinical conditions is consistent with the results
below?

APTT: Prolonged
Factor VIII assay: Decreased
Factor IX assay: Normal
Platelet count: Normal
Hemophilia C
Severe liver disease
Hemophilia A
Hemophilia B

19 of 210
Which of the following actions is taken first when the vancomycin
screening agar quality control result is consistently out of range?
Notify the supervisor
Repeat the test
Repeat the test using different media
Repeat QC using clinical isolate

20 of 210
Which of the following actions should be taken when a specimen for a
blood smear is received in red topped tube?
Centrifuge specimen
Perform smear with uncentrifuged sample
Add EDTA to sample before processing
Reject specimen

21 of 210
Which of the following best correlates with an absolute reticulocyte count
of 10 x 10⁹ /L?
Hereditary spherocytosis
Sickle cells anemia
Iron deficiency anemia
G6PD

22 of 210
Which of the following complete blood count parameters may be falsely
increased by nucleated red blood cells?
HGB
PLT
RBC
WBC

23 of 210
What quality system essentials includes assessment of staff competence?
Personnel
Process management
Continual improvement
Organization

24 of 210
What is the effect on sodium quality control results if the calibration
standards are over-diluted?
A negative shift
Increased imprecision
Decreased imprecision
A positive shift

25 of 210
Which of the following complete blood count results
requires immediate action?
HGB 50 g/L and PLT 20 x 10⁹/L
WBC 2.2 x 10⁹/L and HGB 90 g/L
WBC 2.2 x 10⁹/L and PLT 100 x 10⁹/L
RBC 5.53 x 10¹²/L and MCV 68 fL

6 of 210
Which of the following findings is commonly seen in a patient diagnosed
with severe liver disease?
Abnormal platelet function
Abnormal factor I synthesis
Abnormal factor VII synthesis
Abnormal levels of fibrin split products
27 of 210
Which of the following statements is correct given the prothrombin
time/activated partial thromboplastin time centrifuge quality control data
below?
Centrifuge Plasma PLT count

1 1 x 10⁹/L

2 0 x 10⁹/L

3 4 x 10⁹/L

4 12 x 10⁹/L
Only centrifuge 2 can be used for patient testing
Centrifuge 4 must not be used for patient testing
All centrifuges are acceptable for patient testing
Centrifuge 1, 2 and 3 must not be used for patient testing
28 of 210
Which of the following actions should be taken when tissue sections
stained with hematoxylin and eosin show pale cytoplasmic staining?
Check the pH of the eosin and adjust the sodium hydroxide if necessary
Check the pH of the eosin and adjust with acetic acid if necessary
Use heat during the staining process
Return the slides to the bluing reagent

29 of 210
Which of the following devices is used to input data into the laboratory
information system?
Projector
Software
Keyboard
Printer
30 of 210
How much NaCl (58.40 g/mol) is required to prepare 3L of 2.5 mol/L
solution?
146.00 g
175.20 g
219.00 g
438.00 g
31 of 210
Which of the following quality control results is acceptable for triple sugar
iron?
QC Test Organism Result

1 Salmonella enterica serotype Typhimurium Alkaline slant; acid butt; with H2S

2 E. coli Acid slant; acid butt; with H2S

3 Pseudomonas aeruginosa Alkaline slant; acid butt; no H2S

4 Klebsiella pneumoniae Acid slant; alkaline butt; no H2S

1
2
3
4
32 of 210
Which of the following urine elements may be easily confused
when Trichomonas vaginalis is non-motile?
Tyrosine crystals
Spermatozoa
RBC
WBC
33 of 210
Which of the following actions should be taken first when an outpatient is
physically combative prior to phlebotomy?
Indicate to the patient that the behaviour is inappropriate
Appreciate that the patient's character is flawed
Ensure that an exit is possible for both the technologist and the patient
Attempt to restrain the patient
34 of 210
Which of the following approaches are used to positively address conflict
within the workplace?
Compromise
Collaboration
Competition
Accommodation
35 of 210
Which of the following tests is considered time sensitive?
ALT
AST
LDL
LDH
36 of 210
Which of the following white blood cell morphologies indicates disease
progression in a patient with chronic lymphocytic leukemia?
Lymphocytes with a soccer-ball chromatin pattern
Smudge cells
Large abnormal lymphocytes
Lymphocytes with cytoplasm wrapping around RBCs
37 of 210
Which of the following actions should be taken next given the results
below?

Urine Sample: 1x10 CFU/mL 5

Gram stain: Gram positive cocci in clusters

Tube coagulase: Negative
PYR: Negative
Test isolate using ONPG
Test isolate using novobiocin
Report result as Staphylococcus aureus
Test isolate using oxacillin
38 of 210
Which of the following disinfectants is appropriate for the corresponding
situation?
Concentrated sodium hydroxide for benchtop after handling a sample with prions
Quaternary ammonium compound for mycobacteria
A 1:100 dilution of sodium hypochlorite for a biohazard spill control on the benchtop
A 1:10 dilution of sodium hypochlorite after using the microtome
39 of 210
What is the angle between the detector and the light path in turbidimetry?
0
15
30
90
40 of 210
What is the molal freezing point of a sample with an osmolality of 312
mOsm/Kg?
-5.580°C
-0.580°C
-0.0580°C
0.058°C
41 of 210
Given the following results, what is the osmolal gap (Osm/kg)?

Urea: 5.9 mmol/L

Glucose: 5.0 mmol/L
Sodium: 136 mmol/L
Measured osmolarity: 285 mOsm/L
2
5
6
11
42 of 210
What is the first step to take when a STAT glucose specimen arrives in the
laboratory?
Log in or accession
Refrigerate until processed
Centrifuge to stop glycolysis
Upload to testing instruments
43 of 210
Which of the following stains is used to demonstrate Mycobacterium
leprae?
Gram
Brown and Brenn
Fite
Grocott methenamine silver
44 of 210
Which of the following actions is acceptable if no reaction is obtained after
the addition of Coomb's control cells?
Record test results are invalid
Incubate for 15 minutes at 37°C
Add 2 drops of anti-human globulin and centrifuge
Incubate for 15 minutes at 22°C
45 of 210
What is the calculated osmolality (mOsm/L) given these results?

Sodium: 145 mmol/L

Glucose: 6.1 mmol/L
Urea: 4.2 mmol/L
135
155
161
300
46 of 210
While attempting Kohler illumination, the microscope field is too brightly
illuminated and shows poor resolution. What is the follow-up action?
Check that the field diaphragm is fully open
Check that the iris diaphragm is not fully open
Raise the condenser to the highest level
Lower the condenser to the lowest level
47 of 210
Which of the following first-aid measures is performed first on a burned
victim following a superficial burn?
Remove all clothing from the burned individual
Remove clothing surrounding burned area
Cover the burned area with dry bandage

48 of 210
Which of the following procedures must be completed before using a new
lot number of prothrombin time reagent?
Recalibration of instrument
Validation of therapeutic range
Establish geometric mean
Calibration verification
49 of 210
Which of the following components are part of verbal communication?
Gestures
Appearance
Posture
Tone
50 of 210
Which of the following interferents may cause a persistent detection of
Human Chorionic Gonadotrophia by immunoassay?
Matrix effect
Antibody excess
Antigen excess
Human anti-mouse antibodies
1 of 210
Which of the following behaviours demonstrates a para-verbal
communication barrier?
Interrupting a patient who is trying to communicate
Rolling eyes at patient who is anxious about phlebotomy
Making eye contact with a patient
Referring to a patient in a derogatory tone
52 of 210
Which of the following actions would correct rolling of the sections when
using the cryostat anti-roll plate?
Re-embed the frozen tissue
Re-face the block deeper into the tissue
Re-adjust the angle of the blade
Re-orient the block face
53 of 210
Which of the following actions should be taken first when the room
temperature rises from 22°C to 28°C in the hematology department?
Ship manual ESR to a different laboratory for analysis
Reject all ESR samples
Stop analyzing manual ESR samples and store at 4°C
Stop analyzing manual ESR samples and store at 37°C
54 of 210
Which of the following equations describes the relationship between
absorbance and transmittance?
A = 2+log%T
A = log%T-2
A = 2-log%T
A = log%T+2
55 of 210
Which of the following actions are the most appropriate when an inpatient
requiring phlebotomy lacks an identification bracelet?
Confirm identification verbally with the patient and perform blood draw
Confirm identification verbally with nursing staff and with the patient before blood draw
Ensure the nurse identifies patient and places identification bracelet on the patient
Ask the patient for verbal identification and confirm with the nursing staff after blood draw
56 of 210
A province passes a law that Canadians residing outside of this province
will not receive insured healthcare services. What Canadian Health Act
principle has been breached by the province?
Universality
Comprehensiveness
Portability
Accessibility
57 of 210
Which of the following activities describes when a schedule is created for
validation of a new analyzer?
Quality assessment
Quality assurance
Quality improvement
Quality control
58 of 210
Which of the following factors contributes to dark nuclear staining in a
hematoxylin and eosin?
Section left in hematoxylin too long
Eosin is too concentrated
Eosin pH greater than 5.0
Hematoxylin is depleted
59 of 210
What parasite appears as pear shaped, with an undulating membrane and
propelled by flagella in urine sediment?
Trichomonas vaginalis
Enterobius vermicularis
Giardia lamblia
Schistosoma haematobium
60 of 210
What volume of distilled water is required to prepare 200 mL of 0.4M HCl
solution from a 1M stock?
40 mL
80 mL
120 mL
160 mL
61 of 210
Which of the following results is expected when a yeast produces
blastoconidia, pseudohyphae and chlamydospores on corn meal agar?
Black pigment
Capsule positive
Germ tube positive
Mold at 22°C
62 of 210
Which of the following complete blood count analyzer conditions can
cause all hemoglobin values to be greater than 180 g/L?
Pinched lysing reagent tubing
Expired staining reagent
Plugged aperture
Expired diluent
63 of 210
What is the Gram stain appearance of organisms that cause vaginosis?
Large, Gram positive bacilli
Small, pleomorphic, Gram variable bacilli
Intracellular, Gram negative cocci in pairs
Small, budding yeast cells
64 of 210
Which of the following actions are taken given the following data?
Sample type CSF

Number of tubes 1

Volume 300 µL

Tests requested Cell count and differential

C&S

Glucose

Total protein
Request the ordering doctor prioritize testing
Complete C & S first, then glucose and total protein, then cell count and differential
Complete only the C & S
Inform the ward that the sample is rejected
65 of 210
Which of the following media is used to isolate a fastidious organism from
a urethral specimen?
Buffered charcoal yeast extract
Chocolate agar
Sheep blood
Bordet Gengou
66 of 210
What is the identification of the organism from a pediatric blood culture
given the results below?

Gram stain: Gram positive short bacilli

Growth on blood agar: Small beta hemolytic colonies
Catalase: Positive
PYR: Negative
Motility: Positive
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus agalactiae
Listeria monocytogenes
67 of 210
A bronchial washing specimen for routine bacterial, fungal and acid-fast
culture was received. The sample volume is insufficient to perform all the
requested tests. Which of the following actions should be performed?
Decrease the sample volume per culture plate to ensure the full culture request is fulfilled
Call the clinician to establish the priorities for culture
Establish the priorities for culture based on patient diagnosis
Cancel all the cultures requested
68 of 210
Which of the following adult patients may demonstrate microcytic red
blood cells in a smear given the results below?
Patient 1 Patient 2 Patient 3 Patient 4

HCT L/L 0.45 0.21 0.62 0.38

RBC (x10¹²/L) 5.0 2.5 8.6 4.5

1
2
3
4
69 of 210
Which of the following statements explains how lipemia may affect
hemostasis testing?
Fat particles interfere with all detection methods
Turbidity shortens mechanical detection methods
Turbidity prolongs photo-optical detection methods
Optical density is masked by the colour of the plasma
70 of 210
Which of the following factors is considered a key determinant of health?
Blood group
Ethical practice
Culture
Research
71 of 210
Which of the following anemias correlates with the red blood cell
histogram below?

Untreated iron deficiency

Beta thalassemia minor
Beta thalassemia major
Anemia chronic inflammation
72 of 210
Which of the following complete blood count results has the highest
priority?
WBC 2.2 x 10⁹/L and PLT 100 x 10⁹/L
WBC 2.2 x 10⁹/L and HGB 90 g/L
RBC 5.53 x 10¹²/L and MCV 68 fL
RBC 50 g/L and PLT 20 x 10⁹/L
73 of 210
Where should urine test strips be stored?
Cold, humid location
Refrigerator
Freezer
Dark, dry location
74 of 210
Which of the following complete blood count results best correlates with
pernicious anemia?
RBC 5.50 x 10¹²/L and HCT 0.358 L/L
RBC 3.00 x 10¹²/L and HCT 0.295 L/L
RBC 5.50 x 10¹²/L and HCT 0.583 L/L
RBC 3.00 x 10¹²/L and HCT 0.387 L/L
75 of 210
Which of the following conditions is consistent with the results given
below?
Osmolality: 285 mOsm/Kg
Sodium: 140 mmol/L
Normal health
Hyperaldosteronism
Hypoadrenalism
Pseudohyponatremia
76 of 210
Which of the following actions should be taken given the manual
cerebrospinal fluid hemocytometer data below?

Perform a dilution
Count increased area
Repeat both WBC and RBC counts
Repeat counts
77 of 210
Given the following data, how many quality control results are less than 2
standard deviation?

CV: 5%
Mean: 100.0

QC result 1: 90.0
QC result 2: 91.0
QC result 3: 93.0
QC result 4: 112.0
QC result 5: 92.0
0
1
2
3
78 of 210
Which of the following components is responsible for autoverification?
Output device
Analyzer
Server
Middleware
79 of 210
Which of the following actions should be taken when an analyzer is on
fire?
Use a type A extinguisher
Smother flames with a fire blanket
Use a type C extinguisher
Turn off analyzer
80 of 210
When should gastrointestinal specimens be pinned to prevent autolysis?
Before saline wash
After saline wash
Before fixation
After fixation
81 of 210
Which of the following actions should be taken in an emergency situation
when a technologist is asked to insert an intravenous line?
Refuse to perform the procedure
Obtain intravenous access in the antecubital area only
Perform procedure under nurse's supervision
Obtain intravenous access below the antecubital area
82 of 210
Which of the following actions should be taken first if the temperature of
the refrigerator used to store packed red blood cells is at 11°C?
Discard all packed red blood cell units
Check the recording thermometer chart
Issue packed red blood cells to patients
Disable the automatic alarm system
83 of 210
Which of the following actions should be taken first when a specimen
suspected of containing Clostridium botulinum is received?
Discontinue processing
Perform toxin assay
Notify public health laboratory
Culture the specimen anaerobically
84 of 210
Which of the following statements best describes the laboratory's role in
point-of-care testing?
Ensure all samples are repeated in the laboratory
Performance of all proficiency testing
Ensure only technologists perform testing
Monitor that QC procedures are being followed
85 of 210
Which of the following infectious agents requires airborne precautions?
Vancomycin resistant enterococcus
Hepatitis B virus
Clostridium difficile
Varicella Virus
86 of 210
A technologist is overwhelmed for repeatedly having to leave their
laboratory work to assist the phlebotomist. Which of the following actions
is appropriate?
Request a review of work load
Request hiring an additional phlebotomist
Request changing the job description
Refuse to leave the department
87 of 210
Which of the following factors would be the most likely cause for falsely
susceptible zone sizes in the Kirby Bauer method?
Disks are expired
Disks applied within 15 minutes of inoculation
Agar too thin
Inoculation suspension too turbid
88 of 210
What quality system essentials describes processes for managing supplies?
Assessments
Purchasing and Inventory
Equipment
Process Control
89 of 210
Which of the following quality control results is acceptable for Thayer-
Martin agar?
QC Test Organism Result

1 Neisseria sicca Inhibited

2 Neisseria meningitidis Inhibited

3 E. coli Growth

4 Proteus mirabilis Growth

1
2
3
4
90 of 210
Which of the following actions should be performed next given the quality
control data below?
Instrument 1 Instrument 2
PT and APTT PT and APTT

Daily QC >3 SD >3 SD

First repeat of daily QC >3 SD >3 SD

Second repeat of daily QC using new reagents and new QC

>3 SD >3 SD
material
Call service and perform patient testing on STAT samples
Retest with another new set of reagents and QC material
Recalibrate pipette used to reconstitute reagents
Perform patient testing and divide result by 3 prior to reporting

91 of 210
Which of the following complete blood count results
requires immediate action?
RBC 3.33 x 10¹²/L and MCV 122 fL
WBC 2.2 x 10⁹/L and HGB 90 g/L
RBC 5.53 x 10¹²/L and MCV 68 fL
WBC 60.0 x 10⁹/L and PLT 25 x 10⁹/L
92 of 210
Which of the following actions are considered inappropriate when working
in a team environment?
Disciplining employee in public
Having transparent communication
Praising employee in public
Addressing employee concerns
93 of 210
What peak is the molecular ion in the given hydrocarbon mass spectrum?
31
45
46
47
94 of 210
Which of the following results will be decreased in a patient with
hemolytic uremic syndrome?
Lactate dehydrogenase
Haptoglobin
Unconjugated bilirubin
Creatinine
95 of 210
Which of the following complete blood count results has the highest
priority?
WBC 2.2 x 10⁹/L and HGB 90 g/L
RBC 3.33 x 10¹²/L and MCV 122 fL
WBC 80.5 x 10⁹/L and PLT 25 x 10⁹/L
RBC 5.53 x 10¹²/L and MCV 68 fL
96 of 210
What volume of diluent is required to prepare 200 mL of working 2X
solution from a 50X stock solution?
4 mL
8 mL
192 mL
196 mL
97 of 210
Which of the following penalties is outside the scope of a professional
regulatory body?
Requirement for remedial training
Criminal conviction
Revocation of a membership
Imposition of a fine
98 of 210
What is the next step when an untransfused open unit of packaged red
blood cells is returned?
Check for hemolysis
Return to inventory
Return to the supplier
Discard the unit
99 of 210
Which of the following conditions correlates with the results given below?

HGB: 100 g/L

PLT: 12 x 10⁹/L
Smear: Increased polychromasia, Increased schistocytes
Aplastic anemia
Idiopathic thrombocytopenic purpura
Thrombotic thrombocytopenic purpura
Heparin induced thrombocytopenia
100 of 210
Which of the following quality indicators requires further investigation?
High percentage of O&P testing on inpatients
High percentage of sputum specimen demonstrating <25 epithelial cells/LPF
Low percentage of superficial wound specimens for anaerobic culture
Low percentage rate of blood culture contamination
101 of 210
Which of the following collection techniques can result in specimen
hemolysis?
Collecting from dorsal veins
Transporting tubes in a rack
Using too small of a needle diameter
Leaving the tourniquet on longer than one minute
102 of 210
Which of the following actions should be taken given the manual
cerebrospinal fluid hemocytometer data below?
Repeat QC cell counts
Perform a dilution on patient sample
Report patient WBC and RBC counts
Repeat patient cell counts
103 of 210
How much glucose (180.16 g/mol) is required to prepare 500 mL of 2
mol/L solution?
45.04 g
90.08 g
180.16 g
360.32 g
104 of 210
What mass spectrum peak is used to assign the relative abundance value of
100%?
M+
Base
Molecular ion
Fragmentation
105 of 210
Which of the following leukemias correlates best given the following
results?

WBC: 247.3 x 10⁹/L

Neutrophils: 42%
Lymphocytes: 2%
Monocytes: 2%
Eosinophils: 9%
Basophils: 5%
Metamyelocytes: 15%
Myelocytes: 15%
Promyelocytes: 6%
Blasts: 4%
Acute myeloid
Chronic myelomonocytic
Acute monoblastic
Chronic myelogenous
106 of 210
Which of the following situations results in a severe adverse reaction?
Group A Rh positive platelets transfused to a group O Rh negative patient
Group A Rh negative platelets transfused to a group A Rh positive patient
Group O Rh negative plasma transfused to a group O Rh negative patient
Group O Rh positive plasma transfused to a group A Rh negative patient
107 of 210
Which of the following quality system essentials includes processes for
reporting errors?
Nonconforming event management
Information management
Documents and records
Continual improvement
108 of 210
Which of the following set of organisms should be used to perform quality
control on the novobiocin disk test?
Staphylococcus aureus and Staphylococcus epidermis
Staphylococcus lugdunensis and Staphylococcus aureus
Streptococcus pyogenes and Streptococcus agalactiae
Staphylococcus aureus and Staphylococcus saprophyticus
109 of 210
Which of the following bacteria can be isolated using Colistin-nalidixic
acid agar?
Escherichia coli
Staphylococcus aureus
Moraxella catarrhalis
Pseudomonas aeruginosa
110 of 210
What action should be taken next given the following disk diffusion
susceptibility results on an isolate of Staphylococcus aureus?
Antimicrobial Zone size Resistance diameter
Cefoxitin 28 mm ≤ 25 mm

Erythromycin 10 mm ≤ 21 mm

Clindamycin 21 mm ≤ 19 mm

Penicillin 15 mm ≤ 31 mm
Change cefoxitin to resistant and report results
Report as a Methicillin Resistant Staphylococcus aureus
Perform a D-zone test
Perform a beta-lactamase
111 of 210
Which of the following items is a benefit of a laboratory information
system?
Enhances user knowledge
Ensures patient cooperation
Increases turnaround time
Reduces transcription errors
112 of 210
Which of the following actions should be completed when blood culture
specimens are being improperly collected?
Implement a solution
Evaluate the collection process
Reprimand employees
Perform employee evaluations
113 of 210
Which of the following specimens should be processed first?
STAT urine C & S
Joint fluid C & S
Sputum for mycology
Stool for Clostridium difficile testing
114 of 210
Which of the following actions should be taken when a technologist is
unable to scan a specimen labelled with a 2D bar code using the laser
scanner at their workstation?
Reboot the bar code scanner
Ensure the scan matrix is set to dual laser input
Reinstall the firmware on the bar code scanner
Find an image-based scanner
115 of 210
Which of the following results are in violation of the 1₂₅ Westgard quality
control rules?

Assay mean = 50.0

CV = 3%

Result 1: 45.9
Result 2: 42.9
Result 3: 64.3
Result 4: 53.6
Result 5: 48.2
Result 6: 46.7
Result 7: 50.3
Result 8: 48.3
Result 9: 57.2
Result 10: 46.8
Results 1, 2, 3 and 9
Results 4, 6 and 10
Results 2, 6 and 8
Results 3 and 9
116 of 210
What should the technologists do when they disagree with a policy
requiring them to check in every 2 hours with security?
Check in every 4 hours
Check in at the end of the shift and sign all check boxes at once
Follow the policy
Ignore the policy and check in with the nursing supervisor
117 of 210
Which of the following actions should be taken when a technologist
experiences sore wrists from the removal of multiple specimen caps?
Take frequent short breaks
Conduct a hazard assessment
Call in sick frequently
Document a work refusal
118 of 210
Which of the following actions can account for Gram positive kidney bean
shaped organism from a blood culture?
Omission of the decolourization step
Over decolourization of the smear
Omission of the counterstain step
Drying of the smear prior to staining
119 of 210
Which of the following statements is consistent with the results given
below?
Sample Type Pleural fluid

Total nucleated cell count Markedly increased

Cytospin with Romanowsky stain 85% Neutrophils

15% Monocytes
Few large cells, not in clusters, with a round and
abundant blue cytoplasm

Cytospin does not correlate to sample type

Presence of the mesothelial cells
Patient has a viral infection
Repeat the total nucleated cell count
120 of 210
Which of the following parameters is acceptable for quality control testing
of culture media?
Incubate test media under the same conditions as media inoculated with clinical specimen
Complex commercially prepared media does not need to be quality controlled by the user
Testing is performed using organisms with unknown phenotypic properties
Nutritive in-house prepared media does not need to be quality controlled
121 of 210
Which of the following actions should be taken when the last four MCV
results are elevated?
Telephone the results to the nurse
Perform a data check on each result
Release the results
Telephone the results to the physician
122 of 210
Given the following results, what is the calculated serum osmolarity
(mOsm/L)?

Urea: 21.4 mmol/L

Glucose: 7.3 mmol/L
Sodium: 133 mmol/L
162
190
295
302
123 of 210
Which of the following microscopes is used to examine wet preparation
for Trichomonas vaginalis?
Polarizing
Brightfield
Inverted
Fluorescence
124 of 210
Which of the following patient results require further investigation?

Patient 1
Patient 2
Patient 3
Patient 4
125 of 210
Which of the following complete blood count results has the highest
priority?
RBC 5.5 x 10¹²/L and MCV 68 fL
HGB 50 g/L and PLT 25 x 10⁹/L
WBC 6.0 x 10⁹/L and HGB 110 g/L
WBC 12.0 x 10⁹/L and PLT 125 x 10⁹/L
126 of 210
What is the sequence of reagents when performing a Gram stain?
Safranin, decolourizer, iodine, crystal violet
Safranin, iodine, decolourizer, crystal violet
Crystal violet, iodine, decolourizer, safranin
Crystal violet, decolourizer, iodine, safranin
127 of 210
Which of the following disorders correlates with the results given below?

PT 35 seconds; PTT 35 seconds

Hemophilia C
Early stages of liver disease
Anti-phospholipid syndrome
Hemophilia B
128 of 210
Which of the following actions should be taken first when a new co-
worker consistently fails to replenish analyzer reagents at the end of their
shift?
File a complaint with supervisor
Request a scheduling change
Discuss the concern with the co-worker directly
Request a continuous learning plan for the co-worker
129 of 210
What action should be taken if a fallopian tube specimen is embedded
longitudinally?
Re-process the sample
Re-embed the tissue transversely
Send the sample for microtomy
Consult with the pathologist
130 of 210
Which of the following actions is taken when xylene catches a fire on a
countertop?
Use a Class B fire extinguisher
Turn on extraction fan
Apply spill containment measures
Use a Class C fire extinguisher
131 of 210
What anticoagulant is used for blood culture collection?
SPS
ACD
Heparin
EDTA
132 of 210
Which of the following steps should be taken first when a co-worker
splashes serum in their eye?
Rinse eye with water for 20 minutes
Notify the supervisor
Rinse eye with water for 10 minutes
Rinse eye with water for 15 minutes
133 of 210
Which of the following aspects of non-verbal communication can be
considered a crime?
Aggressive tone
Invasive proxemics
Unconsented touching
Aggressive body language
134 of 210
Which of the following morphological findings correlates with chronic
blood loss?
Macrocytic normochromic
Macrocytic hypochromic
Microcytic hypochromic
Macrocytic hyperchromic
135 of 210
Which of the following reagents may be used as a xylene substitute?
Alkane
Benzene
Chloroform
Essential oil
136 of 210
What is the osmolality (mOsm/Kg) of 1 mol/L solution of urea (CH N O)
4 2

in 1 Kg of water?
125
1000
4000
8000
137 of 210
What is the positive predictive value for the data given below?

82%
84%
91%
92%
138 of 210
Which of the following statements describes the application of flow
cytometry in the classification of leukemia?
A specific bound fluorochrome is excited by multiple wavelengths of light that are analyzed
using photodetectors
A specific bound fluorochrome- labeled antibodies is excited by multiple wavelengths of light
that are analyzed using photomultiplier tubes
Cells are stained with fluorochrome- labeled antibodies and are counted while passing through a
laser beam
Cells are stained with fluorochrome- labeled antibodies and are counted while passing through an
impedance bath
139 of 210
Which of the following scenarios may result in criminal charges against a
technologist?
Restraining a combative patient to perform phlebotomy under physician's direction
Restraining an elderly patient who refuses to consent to phlebotomy
Refusing to perform a phlebotomy on a child
Refusing to perform phlebotomy due to a palliative advanced directive
140 of 210
Ingestion of which of the following substances may produce a false
positive test result for fecal occult blood testing?
Alcohol
Horseradish
Melon
Poultry
141 of 210
Which of the following condition correlates with an adult serum total
calcium concentration of 2.30 mmol/L?
Hypoalbuminemia
Normal health
Chronic renal failure
Hyperparathyroidism
142 of 210
Which of the following preventative measures should be taken when
microchatter is seen on an hematoxylin and eosin section?
Decrease dehydration time
Increase fixation time
Monitor endpoint of decalcification
Perform processor maintenance
143 of 210
Which of the following conditions correlates with the results given below?

Iron: 45 µmol/L
TIBC: 18 µmol/L
Ferritin: 552 µg/L
% Saturation: 100%
Anemia of chronic disease
Hemochromatosis
Iron deficiency anemia
Chronic infection
144 of 210
Which of the following situations describes a breach of confidentiality?
Calling a critical result to the patient care unit
Looking up previous assay results to validate a delta check
Discussing patient results with a spouse
Looking up patient medications in order to troubleshoot an assay interferent
145 of 210
Which of the following findings should be reported immediately?
Yeast seen in a vaginal smear
Staphylococcus aureus isolated from an incision swab
Acid fast bacilli seen in a sputum
Streptococcus agalactiae from a vaginal swab at twenty eight weeks gestation
146 of 210
Which of the following is a monochromator?
Interference filter
Wratten filter
Grating
Exit slit
147 of 210
What term describes a duplicate run on a sample that produces the
identical result?
Accuracy
Precision
Bias
Systematic error
148 of 210
Which of the following anemias correlates with the given results?

RBC: 3.30 x 10¹²/L

HGB: 110 g/L
HCT: 0.298 L/L
Thalassemia
Aplastic
Hereditary elliptocytosis
Hereditary spherocytosis
149 of 210
Which of the following factors may cause a delta check flag on a urea
result when using the urease enzymatic method?
The patient was pumping their fist during venipuncture
The patient was in supine position during venipuncture
Specimen was collected in sodium heparin
Specimen was collected in sodium fluoride
150 of 210
Which of the following signals is detected in pyrosequencing?
Chemiluminescence
Absorbance
Radioactivity
Fluorescence
151 of 210
Which of the following quality control results is acceptable for nitrate
reduction broth?
QC Test Organism Result

1 Proteus mirabilis Red after the addition of nitrate A and B reagents

2 Pseudomonas aeruginosa Red after the addition of zinc

3 Acinetobacter baumannii Colourless after the addition of zinc

Colourless after the addition of nitrate A and B

4 Klebsiella pneumoniae
reagents
1
2
3
4
152 of 210
What is the standard deviation given the following quality control results?

Result #1: 2.5

Result #2: 2.5
Result #3: 2.6
Result #4: 2.5
Result #5: 2.4
Result #6: 2.7
0.2
0.4
0.5
0.6
153 of 210
Which of the following actions is acceptable when performing Kirby
Bauer disk diffusion testing?
Swabbing entire area of the plate once to achieve a confluent lawn
Incubating plates within 30 minutes of disk application
Picking several colonies from a 48 h selective agar plate
Placing no more than 5 disks on a 100 mm plate
154 of 210
Which of the following procedures is used during blood collection for a
patient with a left side mastectomy?
Use butterfly when collecting
Collect from right side
Perform foot collection
Use discard tube
155 of 210
Which of the following chemicals is necessary to develop a blue colour in
a positive fecal occult blood test using a guaiac based card method?
Hydrogen peroxide
Hydrochloric acid
Sodium hydroxide
Acetic acid
156 of 210
Which of the following quality parameters is defined as a result that is
close to its true value?
Bias
Precision
Standard deviation
Accuracy
157 of 210
Which of the following tests is NOT affected by pneumatic tube transport?
Lactate dehydrogenase
Acid phosphatase
Alkaline phosphatase
Plasma hemoglobin
158 of 210
Which of the following actions will resolve the discrepancy in the results
below?

Test with anti-A₁ lectin

Perform plasma enhancement
Perform saline replacement
Test with acidified anti-B
159 of 210
Which of the following chemicals can be used to reduce bacterial
contamination in a waterbath?
Sodium azide
70% alcohol
Hypochlorite
Phenolic detergent
160 of 210
Which of the following results correlate with primary identifications of
chronic myelogenous leukemia?
Philadelphia chromosome negative and 5% blasts
BCR/ABL1 positive and 80% blasts
Philadelphia chromosome positive and 80% blasts
BCR/ABL1 positive and 5% blasts
161 of 210
What is the appropriate action given the control results below?

Record and report patient results

Repeat testing with different organisms
Repeat testing with fresh reagent
Check reagent expiry date
 162 of 210
Which of the following actions is the most appropriate when using a
cryostat to process a brain specimen with suspected Creutzfeldt-Jakob
disease?
Wear metal mesh gloves during processing
Defrost and decontaminate cryostat at the end of the day
Immediately decontaminate cryostate with 100% alcohol
Immediately decontaminate cryostat with sodium hydroxide
163 of 210
Which of the following results can be reported as target NOT detected,
given the following real-time polymerase chain reaction results?

2, 3, 6, 9, 10
3, 6, 7, 8
3, 6
2, 9, 10

164 of 210
Which of the following procedures must be completed before using a new
lot number of partial thromboplastin time reagent?
Verify heparin therapeutic range has been established
Recalibrate instrument
Verify lot number specific ISI
Verify geometric mean has been established
165 of 210
Which of the following precautions is required when working in a
biological safety cabinet?
Perform operations near the sash
Work from dirty to clean areas
Adjust the opening of the sash to eye level
Keep a disinfectant in the cabinet
166 of 210
Which of the following complete blood count results best correlate with
macrophages containing abundant Prussian blue stain?
RBC 5.95 x 10¹²/L and HCT 0.358 L/L
RBC 3.43 x 10¹²/L and HCT 0.250 L/L
RBC 2.88 x 10¹²/L and HCT 0.295 L/L
RBC 3.00 x 10¹²/L and HCT 0.387 L/L
For 1 point

167 of 210
Which of the following factors would be the most likely cause for falsely
resistant zone sizes in the Kirby Bauer method?
Agar too thick
Inoculum too light
Plate did not have confluent growth
Disks applied within 15 minutes of inoculation
168 of 210
Which of the following specimen orders prioritizes the processing of
microbiology specimens correctly?
CSF, blood culture, urine, swab in transport media
Rapid antigen testing, CSF, urine, stool in transport media
CSF, swab in transport media, surgical specimens, unpreserved stool
Blood culture, CSF, unpreserved stool, stool in transport media
169 of 210
Which of the following quality system essentials includes processes for the
handling of dangerous goods?
Equipment
Organization
Facilities and safety
Purchasing and inventory
170 of 210
How much glucose (180.16 g/mol) is required to prepare 450 mL of 5%
solution?
4.05 g
11.25 g
22.50 g
405.36 g
171 of 210
A patient demonstrated the presence of a cold antibody in their serum
which was subsequently tested against a panel of cells. Given the
following results, what is the most likely specificity of the antibody?

Anti-i
Anti-H
Anti-I
Anti-HI
172 of 210
Which of the following red blood cell morphologies correlates with
the initial diagnosis of acute blood loss?
Macrocytic hypochromic
Normocytic normochromic
Microcytic hypochromic
Macrocytic normochromic
173 of 210
Which of the following disorders correlates with the results given below?

PT 35 seconds; PTT 85 seconds

Liver cirrhosis
Anti-phospholipid syndrome
Hemophilia B
Hemophilia C
174 of 210
What turnaround time should be monitored to assess the effectiveness of a
newly installed pneumatic tube system?
Analytical
Post-analytical
Pre-analytical
Total
175 of 210
Which of the following actions may cause nerve damage during a
venipuncture procedure?
Apply a tourniquet on patient's wrist
Choosing the venipuncture location carefully
Probing blindly in the patient's arm
Entering a vein using the least number of attempts
176 of 210
Which of the following requirements must be included in the setup of laboratory
information system?
Identification code and password to each user
Specimen assigned a unique barcode label
LIS interfaced to electronic medical record
Instrumentation interfaced with the LIS
For 1 point

177 of 210
Which of the following microbiology specimens should be collected if
hemolytic uremic syndrome is suspected?
CSF
Preserved stool
Renal tissue biopsy
Mid-steam urine
 178 of 210
Which of the following laboratory requirements is expected to be followed
when receiving testing material submitted by an external proficiency
testing program?
Assay the testing material outside of the routine workflow
Assay the testing material in the same manner as patient samples
Assay the testing material on multiple analyzer platforms
Assay the testing material in duplicate
179 of 210
Which of the following activities is considered an external quality
assessment?
Reviewing a quality indicator
Performing daily quality control
Performing a scheduled calibration
Participating in accreditation
180 of 210
Which of the following procedures should be performed on a viscous
synovial fluid before performing a differential count?
Perform a 1/10 dilution with saline
Add 0.05% hyaluronidase to sample
Add 5% acetic acid
Warm specimen at 37°C
181 of 210
Which of the following conditions is consistent with 28% ringed
sideroblasts in a bone marrow aspirate?
Myelodysplastic syndrome
Anemia of chronic disease
Polycythemia vera
Iron deficiency anemia
182 of 210
Which of the following steps is taken first when aiming to improve an
existing laboratory process?
Analyze the process
Control the process
Design the process
Implement the process
183 of 210
Which of the following reactions will occur when using indirect
antiglobulin test reactive anti-Jkᵃ to phenotype patient cells with a positive
direct antiglobulin test?
Antihuman globulin will react with the antibody causing the positive DAT
Anti-Jkᵃ will trigger complement mediated hemolysis
Antihuman globulin will be neutralized by the antibody causing the positive DAT
Anti-Jkᵃ will be unable to bind due to the positive DAT
184 of 210
How much diluent is required to prepare 300 mL of 2.5X working solution
from a 50X stock solution?
6 mL
15 mL
150 mL
285 mL
185 of 210
What amount of glucose (180.16 g/mol) is required to prepare 2.5L of 2
mmol/L solution?
36.03 g
90.08 g
180.16 g
450.40 g
186 of 210
What is the first step to take when a mass casualty situation is reported on
a holiday at the technologist's workplace?
Wait for casualties to arrive in the emergency department to assess the situation
Activate the laboratory emergency plan
Call the paramedics for an assessment of the situation
Call Canadian Blood Services to request blood
187 of 210
What is the molal freezing point of a sample with an osmolality of 475
mOsm/Kg?
-0.088°C
-0.88°C
0.088°C
0.88°C
188 of 210
Which of the following actions should be taken when 3+ microcytes are
seen in the smear and the mean corpuscular volume is 98fL?
Report if RDW is normal
Send smear for pathology review
Make a new smear
Report all results except MCV
189 of 210
Which of the following tests requires that instructions be given to a patient
for collecting a clean-catch urine sample?
Osmolality
Pregnancy
Susceptibility
Cytology
190 of 210
How much glucose (180.16 g/mol) is required to prepare 300 mL of 5%
solution?
5.00 g
15.00 g
18.02 g
90.10 g
191 of 210
Which of the following characteristics correlate with a patient positive for
t(15;17)?
Increased schistocytes
Abnormal cells positive for CD34 and HLA-DR
Basophilia
Abnormal cells positive for non-specific esterase
192 of 210
Which of the following adverse reactions should be suspected when a rr
patient presents with a low hemoglobin three days after the infusion of
packed red blood cells?
Delayed hemolytic due to anti-c
Delayed hemolytic due to anti-Jkᵃ
Non-hemolytic due to anti-e
Acute hemolytic due to anti-C
193 of 210
What peak is the base peak in the mass spectrum given below?
14
31
46
47
194 of 210
Which of the following actions constitutes professional misconduct?
Failure to follow institutional SOP's
Persistent tardiness
Breach of confidentiality
Failure to complete workload on time
195 of 210
Which of the following factors is considered a key determinant of health?
Health research
Blood group
Social environment
Ethical practice
196 of 210
Which of the following anemias correlates with the given results?

RBC: 3.99 x 10¹²/L

HGB: 79 g/L
HCT: 0.275 L/L
Thalassemia
Hereditary spherocytosis
Hereditary elliptocytosis
Megaloblastic
197 of 210
Which of the following departments are biopsy specimens in formalin
delivered?
Hematology
Microbiology
Chemistry
Histology
198 of 210
Which of the following actions constitutes social caregiving?
Touching a patient's shoulder to comfort them
Raising the bed rails for a patient at the bed side
Turning off the light in a patient's room when requested
Performing phlebotomy on a patient

199 of 210
Which of the following consecutive results are in violation of the 225
Westgard quality control rules?

Assay mean = 120.0

CV = 5%

Result 1: 103
Result 2: 109
Result 3: 107
Result 4: 106
Result 5: 131
Result 6: 136
Result 7: 103
Results 1 and 2
Results 3 and 4
Results 5 and 6
Results 6 and 7
200 of 210
Which of the following actions is appropriate if a patient refuses to make
eye contact with the phlebotomist when they are asked to provide their
name?
Reflect on cultural differences before proceeding
Insist the patient make eye contact as a sign of respect
Ensure the patient makes eye contact before proceeding
Refuse to proceed with phlebotomy
 201 of 210
Which of the following actions should be taken when a newborn requires
an immediate transfusion of packed red blood cells given the results
below?

Issue Group O Rh negative packed RBCs

Repeat the DAT test on cord specimen
Issue Group A Rh positive packed RBCs
Perform an elution on maternal RBCs
202 of 210
Which of the following media and environment are required for the
isolation of mycobacteria?
Lowenstein-Jensen, anaerobic, 22°C
Lowenstein-Jensen, aerobic, 37°C
Buffer-charcoal- yeast-extract, anaerobic 22°C
Buffer-charcoal- yeast-extract, aerobic, 37°C
203 of 210
Which of the following personal protective equipment is donned when
performing venipuncture on a patient infected with Clostridium difficile?
Gown
N95 mask
Respirator
Face Shield
204 of 210
Which of the following hematoxylin solutions is ripened by a natural
process?
Mayer
Ehrlich
Gill
Harris
 205 of 210
Which of the following conditions may account for the results below?

PT: 13 s
APTT: 90 s
Mixing study: Not corrected
Unfractionated heparin therapy
Coumadin therapy
Factor VIII deficiency
Factor IX deficiency
206 of 210
Which of the following complete blood count parameters are affected by
lipemia?
HCT, MCV, MCHC
HGB, MCH, MCHC
RBC, HGB, HCT, MCV, MCH, MCHC
RBC, HCT, MCV, MCH, MCHC
207 of 210
After addition of ammonium hydroxide and ammonium oxalate during a
decalcification chemical endpoint test there is no visible precipitate. What
does this indicate?
Method is invalid
Decalcification is complete
Fixation time is in correct
Dehydration is incomplete
208 of 210
Which of the following sets of results is consistent with the organism that
is the most common cause of uncomplicated community-acquired urinary
tract infection?
Set 1
Set 2
Set 3
Set 4
209 of 210
What chemical is represented in the spectrum given below?

Carbon: 12.01
Hydrogen: 1.01
Oxygen: 16.00
Ethanol (C₂H₆O)
Methanol (CH₄O)
Ethylene glycol (C₂H₆O₂)
Acetone (C₃H₆O)
210 of 210
Which of the following activities is defined in calibration processes?
Recording maintenance activities
Performing maintenance activities
Following manufacturer's frequency recommendations
Recording routine service performed