Quality control MCQs - Case scenarios

Welcome to your Quality control MCQs - Case scenarios

While performing daily QC ,there was an outlier of 1(2S) (warning signal), the technician noted that probe of the machine was slightly damaged and he replaced it before performing the next IQC. What does this action of the technician qualify as?

a) Corrective action

b) Preventive action

c) Both corrective and preventive action

d) None of the above

Which of the following can be an ideal method to establish the lab mean?

a) Measure the QC material 20 times on 20 separate days.

b) Measure the QC material 4 times a day for 5 consecutive days.

c) Measure the QC material 2 times a day for 10 consecutive days.

d) Use the manufacturer’s provided data

A senior technician in a reference laboratory performed IQC in the morning and found an outlier, when the test was repeated the outlier corrected. The probable cause of the error is

a) Incorrectly calibrated device

b) Aged sensor of the device

c) Bubbles in reagents

d) Contaminated sample

Which of the following westgard rules is an indication of a systematic error?

a) 2(2S)

b) 1(2S)

c) R4S

d) 1(3S)

Which of the following statements is true about Standard Deviation Index(SDI)?

a) A SDI value of >1.5 requires no corrective / preventive action

b) It is used for peer-group comparison

c) Both

d) None of the above

Which of the following may cause an issue in processing and reporting EQAS(External quality assurance) results?

a) No shortage of reagents

b) Proper calibration of equipment before processing EQAS samples

c) Processing EQAS samples with routine samples

d) Storing reconstituted samples at 24 degree celsius

You are the director of a large hospital laboratory that is accredited by the College of American Pathologists (CAP). Which one of the following indicates how often your laboratory will be subject to a routine inspection by CAP?

A. Every 6 months.

B. Once every year.

C. Once every 2 years.

D. Once every 3 years.

Which one of the following is most characteristic of root cause analysis (RCA), regardless of the method that is used?

A. Identifies a single cause of the error.

B. Favors the subjective opinion of experts.

C. Results in an executable and quantifiable solution(s).

D. Seeks to identify and blame the specific person or group responsible.

According to CLIA regulations, which one of the following best indicates how often laboratories must perform QC evaluation (i.e., assay QC samples) for most assays that are performed 24 hours a day?

A. Once every 12 hours.

B. Once every 24 hours.

C. Every time the assay is performed.

D. Once every 48 hours.

10.

Which one of the following statements best describes proficiency testing?

A. A quality assessment tool that compares a patient’s previous results with current results.

B. A quality assessment tool that involves testing two levels of QC material before testing patient samples.

C. A quality assessment tool by which laboratories test samples with unknown results and compare their results.

D. A quality assessment tool that involves running calibrators every 6 months to ensure linear assay results.

1 out of 2

11.

A laboratory medical director is overseeing the implementation of a new hematology analyzer and is in the process of setting up delta checks for several complete blood cell count parameters. Which one of the following best describes a delta check?

A. It is a comparison of reference ranges across laboratories.

B. It is a quality measure by which a patient’s previous result is compared with the current one.

C. It is a quality measure by which samples are visually checked for hemolysis.

D. It is a level of an analyte thought to be life-threatening to the patient, requiring verbal notification to the ordering provider.

12.

The Levey-Jennings control chart for an assay performed in your laboratory is shown in Image 1. The chart indicates which type of analytical problem for this assay?

A. The assay is accurate but not precise.

B. The assay is precise but not accurate.

C. The assay is clinically useless.

D. The assay is neither precise nor accurate

13.

Quality control (QC) material is run at the start of each shift (in this case, for one shift per day) for all assays before testing patient samples. The QC results for several days for one of the assays are plotted on a Levey-Jennings chart shown in Image. Which one of the following best describes what this Levey-Jennings chart demonstrates?

A. Positive trending of QC results.

B. Negative trending of QC results.

C. Result interference by an unknown substance.

D. The use of an inappropriately narrow reference range.

14.

Which one of the following best describes how to plot a Levey-Jennings chart?

A. The x-axis as “Average value” and the y-axis as “% Difference.”

B. The x-axis as the “Gold standard method” and the y-axis as “Test method.”

C. The x-axis as “Calibrator level” and the y-axis as “% CV.”

D. The x-axis as “Run #” and the y-axis as “Concentration.”

15.

A supervisor informs you that the QC values for an assay performed in your laboratory have triggered the 8(1.5s) Westgard rule. Which one of the following types of type of analytical error does this most likely indicate?

A. Volume error.

B. User error.

C. Random error.

D. Bias trend

16.

Your laboratory receives a proficiency testing (PT) specimen from an approved provider of PT material for a particular analyte. Which one of the following choices best describes how the sample should be handled?

The PT samples should be specifically marked and personally walked through the testing procedure by the laboratory director or his or her designee.

B. The PT sample should be split; one aliquot should be run in your laboratory and the other aliquot should be sent to a reference laboratory to ensure concordant results.

C. The PT sample should be entered into your laboratory’s workflow and tested and resulted as with any other patient specimen.

D. The PT sample should be treated as any other patient sample. If send-out is required as a reflex for this analyte, your laboratory should send it out as per protocol.

17.

Which one of the following is the best definition of “unsuccessful” participation or performance in PT?

A. Failure to attain the minimum satisfactory score for an analyte, test, subspecialty, or specialty for a testing event.

B. Failure to submit the results of a testing event in the requisite amount of time.

C. A clerical error in reporting the results for a testing event.

D. Repeated unsatisfactory test scores for an analyte or for the entire testing event in a particular specialty or subspecialty on two consecutive PT events or two of three testing events.

18.

Which one of the following is the best example of a postanalytical error?

A. The patient results are manually entered into the wrong patient’s medical record.

B. The sample is drawn into an inappropriate tube.

C. The sample is run using a reagent lot that has expired.

D. The phlebotomist did not fill the tube completely on a sample sent for coagulation testing.

19.

An area supervisor from your laboratory asks you to review your QC rules. She says that QC is failing too frequently using the 12S Westgard rule and troubleshooting reveals no errors in the method. This has been the case over multiple reagent lots. You would like to maintain the sensitivity of the rule with regard to error detection but would also like to decrease the false-alert rate. Which one of the following is the most logical step?

A. Change to using the 13s rule.

B. Change to using the 81s rule.

C. Adopt a hybrid rule combining the 13s and 22s rules in a multirule scheme.

D. Rules are not necessary, and each QC value should be judged individually.

20.

Which one of the following methods best helps ensure the accuracy of a test?

A. Analyze samples from healthy subjects and determine the 95% prediction interval.

B. Compare samples between the test method and a reference method.

C. Analyze samples with a high value followed by samples with a low value.

D. Analyze a sample 20 times and determine the mean and SD.

2 out of 2

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