Mhmc Eve/Nite Shift Microbiology Competency

1.

Choose the answer that best describes this direct gram stain.

A.

Gram positive rods
B.

Gram positve coccobacilli
C.

Gram variable rods
D.

Gram positive cocci
E.

Gram negative coccobacilli and pmn's (polymorphonuclear cells)

Correct Answer
E. Gram negative coccobacilli and pmn's (polymorphonuclear cells)

Explanation
The organism in the above direct gram stain is Haemophilus influenza. It is typically seen in upper respiratory tract infections but can be associated with septicemia and meningitis. It is most accurately described as a gram negative coccobacilli.

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2.

You are working on the evening or nite shift and the Bactec 9120 instrument in microbiology begins to sound an alarm. What do you do first?

A.

Ignore the alarm, you are busy doing a routine specimen in the main lab.
B.

Quickly acknowledge the alarm on the Bactec instrument by pressing the flashing red bar at the bottom of the computer screen for the Bactec and then go to the instrument itself and removing the positive Bactec bottle for gram stain and plating.
C.

Take a quick break and then head to the Microbiology lab to start dealing with the alarming instrument.
D.

Call the microbiology supervisor, you have no idea how to shut that thing up.

Correct Answer
B. Quickly acknowledge the alarm on the Bactec instrument by pressing the flashing red bar at the bottom of the computer screen for the Bactec and then go to the instrument itself and removing the positive Bactec bottle for gram stain and plating.

Explanation
The correct answer is to quickly acknowledge the alarm on the Bactec instrument by pressing the flashing red bar at the bottom of the computer screen for the Bactec and then go to the instrument itself and remove the positive Bactec bottle for gram stain and plating. This is the appropriate response because the alarm indicates a potential issue with the instrument, and it is important to address it promptly. Acknowledging the alarm on the computer screen ensures that the issue is recorded, and removing the positive Bactec bottle allows for further testing and analysis to determine the cause of the alarm.

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3.

What plates/media do you set up for a positive blood culture bottle?

A.

BAP,CHOC, and CDC(in anaerobic pouch with indicator and anaerobic sachet) and a Gram stain
B.

Only do a gram stain
C.

Gram stain and BAP and CHOC
D.

BAP, CHOC AND MAC AND CDC (in anaerobic pouch with indicator and anaerobic sachet)
E.

Gram stain and BAP only

Correct Answer
A. BAP,CHOC, and CDC(in anaerobic pouch with indicator and anaerobic sachet) and a Gram stain

Explanation
When setting up a positive blood culture bottle, it is important to use specific plates/media to identify the microorganism causing the infection. The correct answer includes BAP (Blood Agar Plate), CHOC (Chocolate Agar Plate), and CDC (Columbia CNA Agar) in an anaerobic pouch with an indicator and anaerobic sachet. These plates/media provide suitable conditions for the growth of a wide range of bacteria and help in the identification of the microorganism. Additionally, performing a Gram stain is necessary to observe the morphology and arrangement of the bacteria in the sample.

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4.

Swabs that come to the lab ordered for Group B strep culture need to be put in ________broth and incubated for 18-24 hours.

Correct Answer
LIM
lim

Explanation
The correct answer is "LIM, lim" because these are the abbreviations for LIM broth, which is used for culturing Group B strep. The swabs need to be placed in LIM broth and incubated for 18-24 hours to allow for the growth and identification of the bacteria.

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4

5.

How would you report the following gram stain result?

A.

Gram positive cocci
B.

Gram negative cocci in chains
C.

Gram positive cocci in clusters
D.

Purple round cells
E.

Grapes

Correct Answer
C. Gram positive cocci in clusters

Explanation
This is a direct smear from a culture of staph epidermidis. The gram stain is most accurately described as gram positive cocci in clusters; but gram positive cocci is also acceptable.

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6.

It is 5:30pm and a nurse drops off a fresh stool in the basket in the main lab. You check the orders in meditech and you see that NO orders have yet been entered! You call the floor to ask them to enter an order for the specimen but you are told everyone is at dinner and the person answering the phone has no idea what the specimen was collected for? What do you do next?

A.

Slam the phone down and decide you need a break too and head to dinner.
B.

Note the collection time and date and then proceed to the microbiology lab and place specimen in each of the vials used for most stool studies, (ie: the green/or orange capped vial, the white/no preservative vial, and the pink/gray ova and parasite vials), Call the floor back in 30 minutes and ask to speak with the nurse taking care of that patient and have her enter the appropriate orders.
C.

Set the specimen aside and deal with it later, it is not your fault the floor did not enter the orders.
D.

Take the specimen to the Microbiology hood and leave it there until the floor decides to put the correct orders in.
E.

Leave the problem for the day shift microbiology techs/supervisor to figure out.

Correct Answer
B. Note the collection time and date and then proceed to the microbiology lab and place specimen in each of the vials used for most stool studies, (ie: the green/or orange capped vial, the white/no preservative vial, and the pink/gray ova and parasite vials), Call the floor back in 30 minutes and ask to speak with the nurse taking care of that patient and have her enter the appropriate orders.

Explanation
The nurse should note the collection time and date of the stool specimen and proceed to the microbiology lab. They should place the specimen in each of the vials used for most stool studies. After that, they should call the floor back in 30 minutes and ask to speak with the nurse taking care of the patient. The nurse should have her enter the appropriate orders for the specimen. This ensures that the specimen is properly processed and tested, despite the lack of orders entered by the floor.

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7.

Specimens that are collected in viral transport media can be processed for routine bacterial culture and sensitivity testing.

A.

TRUE
B.

FALSE

Correct Answer
B. FALSE

Explanation
Specimens collected in viral transport media are specifically designed and optimized for the preservation and transportation of viruses. These media do not support the growth of bacteria, making it unsuitable for routine bacterial culture and sensitivity testing. Therefore, the statement is false.

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8.

In a few sentences describe what you would do if you received an order from the floor for occult blood random testing on a stool.

9.

Specimens for the microbiology lab should be processed:

A.

As soon as time permits
B.

As a batch because this saves time and the length of incubation time in the microbiology incubators has no bearing on microbiology culture results.
C.

Whenever because they have the lowest priority when working as an evening/nite shift technologist
D.

Only by the microbiology day shift technologists
E.

None of the above

Correct Answer
A. As soon as time permits

Explanation
Specimens for the microbiology lab should be processed as soon as time permits to ensure accurate and timely results. Processing the specimens promptly helps to prevent any potential contamination or degradation of the samples, which could affect the microbiology culture results. It is essential to prioritize the processing of these specimens to maintain the quality and reliability of the laboratory's testing procedures.

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10.

A specimen collected from the Emergency Department for RSV, INFLUENZA A/B and RESPIRATORY VIRAL PROFILE needs to be sent down in three separate viral transport media containers.

A.

FALSE
B.

TRUE

Correct Answer
A. FALSE

Explanation
ONLY ONE VIRAL TRANSPORT SPECIMEN CONTAINER IS NECESSARY FOR PROCESSING ALL THREE TEST REQUESTS. KEEPING IN MIND THAT THE SPECIMEN NEEDS TO BE SAVED IN THE MICROBIOLOGY LAB SO THAT IT CAN BE SENT TO IU/CLARIAN FOR THE RESPIRATORY VIRAL PROFILE BY THE MICROBIOLOGY DEPARTMENT ON THE FOLLOWING SHIFT.

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