Question 1

Why is a clean-catch midstream urine used for a urine culture as opposed to a clean-catch urine?
A) The first portion of the urine flow washes contaminants from the urethra and the next portion of urine is more representative of the bladder.
B) The name was changed, but the procedure remains the same and the entire amount of urine from the bladder is cultured.
C) No urine is free from contamination, so just wipe the external genitalia and void into the cup.
D) Catheterized specimens are also called clean-catch midstream urine specimen.

Accepted Answer

Instructions for urine collection must include an explanation of the clean-catch midstream urine specimen.A first morning specimen is preferred because it provides a more concentrated sample.The patient collects this specimen following cleansing of external genitalia to reduce the presence of indigenous florae.Patients are asked to void without collecting the first portion of the urine and instead to collect the middle portion.The first portion of the urine flow washes contaminants from the urethra and the midstream portion is more representative of the bladder.Personnel collecting catheterized specimens should also use this technique to eliminate organisms carried up the urethra during catheterization.

Question 2

The best way to minimize the amount of upper respiratory florae in a sputum specimen is to follow these procedures:
A) Cough up the specimen, then when the specimen gets to the lab, digest it with enzymes that will kill the normal florae.
B) When plating the specimen, ensure that the swab goes deep into the sample to get only bacteria present in the lower lung.
C) Have the patient rinse their mouth with water and expectorate with the aid of a really deep cough directly into a sterile container.
D) Have a respiratory tech decontaminate a patient's mouth and throat before the specimen is collected.

Accepted Answer

Rinsing the mouth will clean out most of the normal florae.A deep cough should gather as much purulent material as possible from the lower lung area.Using enzymes to digest the specimen will kill all bacteria in it,not just the normal florae.Sometimes the sputum is so thick that it is not possible to probe into the middle of the specimen to avoid any outer contaminating florae.It is not practical to have a respiratory tech disinfect a patient's mouth and throat before collecting a sputum specimen.

Question 3

What is the primary goal in the transportation of specimens to the laboratory?
A) To get the specimen to the lab by the end of the day
B) To maintain the specimen as near its original state as possible with minimal deterioration
C) To place the specimen in formalin and then transport it to the laboratory
D) To allow the specimen to sit, as long as it is delivered to the laboratory within 2 to 3 days after collection

Accepted Answer

The primary goal in the transportation of specimens to the laboratory is to maintain the specimen as near its original state as possible with minimal deterioration and to prevent risk to the specimen handler.Pathogens deteriorate rapidly if there is no food or the right environmental conditions.Formalin will kill most pathogens,so you do not want to place the specimen in formalin.Specimens should be transported to the laboratory ideally within 30 minutes of collection and preferably within 2 hours.

Question 4

How should specimen collection instructions be given to the patient to ensure collection of a good specimen for culture?
A) Verbally
B) Verbally, in many different languages
C) Verbally and written in English
D) Written, using simple language (in several languages) and pictures to help the patient understand the procedure as it is verbally explained

Accepted Answer

It is best to give the patient as much information as possible to collect the specimen.It is always good to read the procedure to the patient and show pictures to ensure they understand the procedure.This needs to be done in more than one language,because sometimes the patient does not speak English well and may not understand the procedure.

Question 5

The specimen of choice for detecting gastrointestinal pathogens is:
A) A urine specimen
B) Vomit
C) A swab of the anal area with no feces on it
D) A stool specimen

Accepted Answer

A stool specimen contains samples of the gastrointestinal tract,and any pathogens that may be there can be flushed out by the body.Urine specimens are good for diagnosing urinary tract infections.Vomit is not a good specimen because most gastrointestinal infections occur in the intestines and vomit comes from the stomach.A swab of the anal area with no feces on it will not reveal gastrointestinal pathogens.The most likely isolates from a swab of this type is skin florae.

Question 6

To perform a quality laboratory analysis,the laboratory needs specific information regarding the patient and the specimen.What can be a critical weak link in the specimen management process?
A) Poor specimen collection techniques
B) Incomplete information on the requisition
C) Poor-quality hospital information system
D) Poor-quality laboratory information system

Accepted Answer

To perform a quality laboratory analysis,the laboratory needs specific information regarding the patient and the specimen.All that the laboratory knows about the patient is learned from the requisition form.The less information that is provided,the more difficult it is for the laboratory to provide good patient care.Incomplete information on the requisition is often a weak link in the specimen management process.Complete and thorough requisitions can often lead the microbiology technologist to suspect certain pathogens based on the diagnosis or patient history.This will allow them to use specific media or make certain adjustments to the incubation in order to maximize recovery of the pathogen.

Question 7

Data generated by the laboratory is directly influenced by:
A) The quality of the specimen and its condition when received
B) The physician's decision to do the test
C) Quality control performed on a monthly basis
D) The air quality in the laboratory

Accepted Answer

The old adage of garbage in-garbage out applies here.High-quality specimens result in high-quality lab results.Even though the laboratory professional does not usually perform the preanalytic process of collecting microbiology specimens,it directly affects the outcome.

Question 8

The goal of the specimen collector when collecting specimens for culture should be to:
A) Make sure the specimen gets to the lab.
B) Avoid hurting the patient when collecting the specimen.
C) Maintain the viability of the living organisms at the site with minimal contamination.
D) Get the specimen quickly to get the doctor off the collector's back.

Accepted Answer

The specimens to be analyzed in the microbiology laboratory are likely to contain living organisms and the goal of the specimen collector must be to maintain the viability of these organisms with minimal contamination.That means the specimen needs to be delivered to the laboratory quickly so that the organisms do not die,taking your time when collecting the specimen to make sure you get a good one,and collecting the best specimen you can-even if it means inconveniencing the patient for just a little bit.

Question 9

A night tech is working in microbiology when a cerebrospinal fluid (CSF)specimen comes in.Almost simultaneously,the tech is called to the emergency department to draw blood on seriously injured car accident victims.How would the tech store the CSF until time permits to work on the CSF specimen?
A) Put the specimen in the refrigerator where it is good for 4 hours at 4° C.
B) Leave the specimen on the shelf where it is good for 6 hours at room temperature.
C) Pour the specimen into a tube of broth.
D) Place the specimen in a 35° C incubator for 6 hours.

Accepted Answer

Because CSF specimens are usually home to fastidious pathogens,creating an environment closest to that in the body will preserve the organisms the longest.So placing the specimen in a 35° C incubator for 6 hours will allow for maximum organism recovery.Leaving the tube in a refrigerator or at room temperature will cause the fragile organisms to die.CSF is always cultured according to protocol,and the entire specimen is never poured into a tube of broth to preserve it.

Question 10

To assist hospital personnel in collecting the highest quality specimen,the laboratory should:
A) Post the microbiology laboratory's phone numbers in each section so personnel can call with questions and problems.
B) Develop a well-written handbook and make it available at every patient care unit.
C) Allow personnel to go to the floor and collect all specimens.
D) Severely reprimand staff for not collecting specimens properly

Accepted Answer

The laboratory should establish policies for specimen management,and these must be distributed to all users and clients of microbiology laboratory services.A well-written handbook should be available at every patient care unit specifying the policies for specimen collection and transport,and test ordering.Training and education,such as in-services by the microbiology technologist,should be provided to the individuals collecting the specimens.

Question 11

If a test is not considered appropriate for the specimen,the following should happen:
A) Discipline the ward clerk for ordering the wrong test.
B) Discipline the nurse for ordering the wrong test.
C) Hold a training session to teach hospital staff about correctly ordering tests.
D) The laboratory needs to communicate with the physician to determine exactly what needs to be done.

Accepted Answer

The laboratory needs to communicate with the physician to find out what needs to be done.Disciplining the ward clerk and the nurse is not a solution to this problem.They do not know what are and what are not appropriate tests for each specimen.Because each situation is different,there is no need for a staff training session.

Question 12

The requisition form should provide all the following information EXCEPT:
A) Patient name or identification number
B) Patient age and gender
C) Patient home address
D) Specific anatomic site

Accepted Answer

The requisition form should contain the following information: patient name and identification number,patient age and gender,patient room number or location,physician name and address,specific anatomic site,date and hour of specimen collection,clinical diagnosis or relevant patient history,antimicrobial agents (if the patient is receiving),and name of individual transcribing orders.Patient address is not needed on the requisition.

Question 13

Swabs are appropriate for specimens collected from all the following sites EXCEPT:
A) Upper respiratory tract
B) External ear
C) Urine
D) Genital tract

Accepted Answer

In general,swabs are not recommended for collection because they do not provide sufficient quantity,are easily contaminated,and can become dried out,leading to a loss of organisms.Swabs are appropriate for specimens from the upper respiratory tract,external ear,eye,and genital tract.Swab collection systems are available that provide transport media and protect the specimen from drying.Urine cultures are always spread on a plate using a calibrated loop so that the technician can estimate the number of organisms present in the urine specimen.

Question 14

Proper identification of each specimen includes a label firmly attached to the container with all the following information EXCEPT:
A) Diagnosis
B) Name
C) Identification number
D) Date

Accepted Answer

Proper identification of each specimen includes a label firmly attached to the container with the following information: name,identification number,room number,physician,culture site,date of collection,and time of collection.

Question 15

A safe method of transporting aspirated material would be in:
A) A leak-proof bag
B) A tube of broth
C) An anaerobic transport system
D) A plastic container

Accepted Answer

Transporting personnel should refuse to transport specimens without the protection of a secondary container.Refusing to accept syringes with needles attached is also appropriate.The aspirated material could also be transferred to another sterile container with a tight lid or to an anaerobic transport container.

Question 16

All the following principles of specimen collection are fundamental to ensuring appropriate specimen management EXCEPT:
A) Collect the appropriate quantity of specimen.
B) Label the specimen accurately with the specific anatomic site and the patient information.
C) Select the correct anatomic site to collect the specimen.
D) It is acceptable to delay transport of the specimen to the laboratory if in transport media.

Accepted Answer

The following principles of specimen collection are fundamental to ensuring appropriate specimen management: if possible,collect the specimen in the acute phase of the infection and before antibiotics are administered; select the correct anatomic site to collect the specimen; collect the specimen using the proper technique and supplies with minimal contamination from normal florae; collect the appropriate quantity of specimen; package the specimen in a container designed to maintain the viability of the organisms and avoid hazards due to leakage; label the specimen accurately with the specific anatomic site and the patient information; and transport the specimen to the lab promptly or make provisions to store the specimen in an environment that will not degrade the suspected organism(s).

Question 17

Sputum specimens are often collected for the diagnosis of:
A) Acute pharyngitis
B) Bacterial pneumonia
C) Meningitis
D) Diverticulitis

Accepted Answer

Many types of bacterial pneumonia produce purulent material that is coughed up as sputum.This specimen may contain the pathologic agents producing the disease.Unfortunately,lower respiratory tract specimens are among the most difficult specimens to collect adequately because they are contaminated with oropharyngeal florae.

Question 18

All specimens must be transported:
A) In leak-proof secondary containers
B) In syringes with needles attached
C) In a tube of broth
D) In a latex glove

Accepted Answer

It is imperative that specimens collected for microbiology do not pose a safety hazard to those who handle them.Leaking containers and specimens with needles attached present the greatest hazards.All specimens must be transported in leak-proof secondary containers.A tube of broth and a latex glove are not leak-proof secondary containers.

Question 19

Why does a fecal sample for culture need to be collected in a leak-proof,nonsterile container?
A) Fecal samples can be runny and if the specimen leaks, this can present a biohazard.
B) Many types of bacteria call the intestinal tract home; the specimen cannot become contaminated.
C) Leak-proof containers are always sterile, so the container will be leak-proof as well as sterile.
D) Because DNA probes can determine resident florae from pathogenic bacteria.

Accepted Answer

There are many types of bacteria in a normal,healthy colon.With so much bacteria as normal florae,the risk of contamination is slight with a stool specimen.Stool specimens are evaluated for specific pathogens rather than identifying all bacteria present.

Question 20

If transport of the specimen is delayed,the specimen can be maintained by all of the following EXCEPT:
A) Preservatives
B) Transport or holding medium
C) Saltwater
D) Anticoagulants

Accepted Answer

Pathogens should be stored according to the best conditions to keep them viable.These include use of preservatives,anticoagulants,transport or holding medium,and even culture media.Organisms that are not cold sensitive can also be placed in the refrigerator to prevent degradation of the specimen.

Quiz 6: Specimen Collection and Processing

Why is a clean-catch midstream urine used for a urine culture as opposed to a clean-catch urine?

The best way to minimize the amount of upper respiratory florae in a sputum specimen is to follow these procedures:

What is the primary goal in the transportation of specimens to the laboratory?

How should specimen collection instructions be given to the patient to ensure collection of a good specimen for culture?

The specimen of choice for detecting gastrointestinal pathogens is:

To perform a quality laboratory analysis,the laboratory needs specific information regarding the patient and the specimen.What can be a critical weak link in the specimen management process?

Data generated by the laboratory is directly influenced by:

The goal of the specimen collector when collecting specimens for culture should be to:

A night tech is working in microbiology when a cerebrospinal fluid (CSF) specimen comes in.Almost simultaneously,the tech is called to the emergency department to draw blood on seriously injured car accident victims.How would the tech store the CSF until time permits to work on the CSF specimen?

To assist hospital personnel in collecting the highest quality specimen,the laboratory should:

If a test is not considered appropriate for the specimen,the following should happen:

The requisition form should provide all the following information EXCEPT:

Swabs are appropriate for specimens collected from all the following sites EXCEPT:

Proper identification of each specimen includes a label firmly attached to the container with all the following information EXCEPT:

A safe method of transporting aspirated material would be in:

All the following principles of specimen collection are fundamental to ensuring appropriate specimen management EXCEPT:

Sputum specimens are often collected for the diagnosis of:

All specimens must be transported:

Why does a fecal sample for culture need to be collected in a leak-proof,nonsterile container?

If transport of the specimen is delayed,the specimen can be maintained by all of the following EXCEPT: