Chapter 1: The Clinical Laboratory

Matching

Match the laboratory department with the test performed in that department:
A.	Identification of bacteria causing infection	
B.	Cholesterol testing	
C.	Testing for presence of antigens or antibodies	
D.	Evaluation of formed elements in blood	

____	1.	Hematology

____	2.	Chemistry

____	3.	Microbiology

____	4.	Serology

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	5.	A female patient is 2 weeks late for her regular menstrual period. She comes in to see Dr. Grace, who orders a pregnancy test to be performed by the medical assistant as the patient waits in the office. The medical assistant will perform the test using a kit that is very easy to use and interpret. The results will be available within a few minutes. This type of laboratory testing is known as:
A.	CLIA-waived testing	
B.	Reference-range testing	
C.	Diagnosis testing	
D.	Reference laboratory testing	

____	6.	If a throat culture and rapid strep screen are collected from someone with a sore throat, why are these tests ordered?
A.	To assign a diagnosis	
B.	Ongoing assessment of the patient’s progress and treatment	
C.	Prevention or early detection of a disease through screening	
D.	None of the above	

____	7.	Which information must be provided when filling out a laboratory requisition?
A.	The date of the next follow-up appointment	
B.	The name of the laboratory technician who is performing the procedure	
C.	The demographic information for the patient	
D.	Test results	

____	8.	The function of a laboratory report is to:
A.	Order the lab test	
B.	Bill for the lab test	
C.	Assign a diagnosis for the test ordered	
D.	Relay the test results to the ordering health-care provider	

____	9.	Specimen requirements for a laboratory test are listed in a:
A.	Laboratory report	
B.	Laboratory directory	
C.	Laboratory requisition	
D.	Laboratory quality-control record	

____	10.	The delivery of a laboratory report to the ordering physician is delayed due to a computer error. This is an example of a problem in which phase of laboratory testing?
A.	Preanalytical phase	
B.	Analytical phase	
C.	Postanalytical phase	
D.	Administrative analytical phase	

____	11.	Which of these documents is used first in the laboratory?
A.	Laboratory report	
B.	Laboratory directory	
C.	Laboratory requisition	
D.	Advanced Beneficiary Notice of Noncoverage	

____	12.	Which of the choices below is not a laboratory department?
A.	Morphology	
B.	Clinical Chemistry	
C.	Microbiology	
D.	Histology	

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____	13.	Which of the following tasks may be performed by a medical assistant working in a hospital laboratory?
A.	Specimen collection	
B.	Billing and coding	
C.	Testing at high levels of complexity	
D.	Processing microbiology samples	
E.	Performing simple CLIA-waived laboratory tests	
F.	Examination and assessment of microscopic specimens	

True/False
Indicate whether the statement is true or false.

____	14.	A 22-year-old male patient with insurance coverage through his place of employment will need to utilize an ABN for laboratory tests that are not covered.

Completion
Complete each statement.

	15.	The ability of a treatment to achieve the desired results may be known as its ______________.

Short Answer

	16.	What is an advantage of testing in a POL?

	17.	Which hospital laboratory department processes tissue samples for further examination?

	18.	What patient population may need to utilize an ABN so that the laboratory will be reimbursed for the services provided?

	19.	List two types of information that might be listed in a laboratory directory.

	20.	A patient asks the medical assistant why it is advantageous for the laboratory tests to be performed at the physician’s office instead of at the reference laboratory across the state. What are some of the reasons that the medical assistant may relate to the patient?

	21.	What are two reasons that laboratory testing may be performed?

Chapter 1: The Clinical Laboratory
Answer Section

MATCHING

	1.	ANS:	D	PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-1

	2.	ANS:	B	PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-1

	3.	ANS:	A	PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-1

	4.	ANS:	C	PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-1

MULTIPLE CHOICE

	5.	ANS:	A
Tests that are easy to perform and interpret in which a kit is used for the testing and the results are available within a few minutes are most likely CLIA-waived tests.

PTS:	1	KEY:	Blooms: Applying | Outcome: 1-1

	6.	ANS:	A
There are numerous reasons that a laboratory test may be performed, and in this case, the health-care provider needs to know whether this patient has strep throat or if there is another reason for these symptoms so that appropriate treatment can be started.

PTS:	1	KEY:	Blooms: Understanding | Outcome: 1-4	

	7.	ANS:	C
The text provides numerous pieces of information that must be on a laboratory requisition. The patient’s demographic information allows appropriate reference ranges to be established for the test results, and it also provides information necessary for reimbursement purposes.

PTS:	1	KEY:	Blooms: Understanding | Outcome: 1-6	

	8.	ANS:	D
A laboratory report provides the results and reference ranges to the health-care provider for interpretation.

PTS:	1	KEY:	Blooms: Understanding | Outcome: 1-9	

	9.	ANS:	B
Each of these documents has a specific function, but the laboratory directory is the database and/or book provided by the reference laboratory providing specimen requirements, criteria for specimen rejection, testing schedules, etc.

PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-1	

	10.	ANS:	C
All the procedures that occur before the test is performed are part of the preanalytical phase, those that are part of the testing process are part of the analytical phase, and those that occur after the test has been completed fall into the postanalytical phase category. The laboratory report is not created until after the test is complete, so this is part of the postanalytical phase.

PTS:	1	KEY:	Blooms: Analyzing | Outcome: 1-11		

	11.	ANS:	C
A laboratory requisition is used first to document which tests are ordered for a particular patient.

PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-9	

	12.	ANS:	A
The laboratory departments do not include morphology; this is a descriptive term used in reference to shapes of cells and microorganisms.

PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-3	

MULTIPLE RESPONSE

	13.	ANS:	A, B, D, E
A medical assistant working in a hospital laboratory may perform a variety of tasks. He or she cannot perform testing at high levels of complexity regardless of the place of work, and medical assistants are not qualified to perform assessment of microscopic specimens without advanced training.

PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-5	

TRUE/FALSE

	14.	ANS:	F
An ABN is only used for patients who are covered under Medicare.

PTS:	1	KEY:	Blooms: Evaluating | Outcome: 1-7		

COMPLETION

	15.	ANS:	
efficacy
Rationale: This is the definition of efficacy; in other words, how effective is the treatment?

PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-1	

SHORT ANSWER

	16.	ANS:	
One advantage may be that test results are available while the patient is still in the office, so treatment may begin much faster. Another advantage may be the ability to rule out a diagnosis quickly so that the health-care provider may research other alternatives for the patient’s treatment. Another advantage may be cost for the patient; CLIA-waived tests may be cheaper than the alternative testing performed at a large reference laboratory.
Rationale: If test results are available while the patient is still in the office, treatment may begin much faster. If an incorrect diagnosis is quickly eliminated, the health-care provider may research other alternatives for the patient’s treatment. The reduced cost for these testing procedures helps to make them even more attractive for the physician office laboratory environment.

PTS:	1	KEY:	Blooms: Evaluating | Outcome: 1-2		

	17.	ANS:	
Histology
Rationale: The Histology Department deals with tissues; each department has a specialty.

PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-3	

	18.	ANS:	
Those patients who have Medicare as their primary insurance coverage are the ones who may need to utilize an ABN.
Rationale: Only those patients with Medicare coverage will utilize this particular form.

PTS:	1	KEY:	Blooms: Understanding | Outcome: 1-7	

	19.	ANS:	
Answers may include the following: the specimen requirements; the storage instructions for the specimen after collection; the frequency that the test is performed; the clinical significance of the test; the reference ranges; the minimum acceptable specimen volume.
Rationale: The laboratory directory is a valuable resource to avoid incorrect specimen preparation, collection techniques, or processing techniques.

PTS:	1	KEY:	Blooms: Remembering | Outcome: 1-8	

	20.	ANS:	
Answers may vary, but they could include the following:
Faster results are available, so treatment may be started immediately.
The test may be less expensive.
Less specimen is often required for the test procedures.
Rationale: Appropriate communication with patients about testing procedures can alleviate anxiety and provide assurance about the quality of the services provided.

PTS:	1	KEY:	Blooms: Applying | Outcome: 1-2

	21.	ANS:	
Answers may vary, but they could include the following:
To assess the progress during treatment 
To detect a disease that is asymptomatic (screening)
To assign a diagnosis 
Rationale: Laboratory testing creates a positive impact on overall health and disease prevention and provides opportunities for faster, more specific treatment when a disease is detected.

PTS:	1	KEY:	Blooms: Understanding | Outcome: 1-4