Part 1 Level 3 Dxh Competency
- 1.Mark, the DxH operator, is running the latron after a shutdown. The latron is out of specification. What should Mark do first?
- A.
Repeat with the same vial.
- B.
Repeat with a new vial.
- C.
Call service.
- 2.Mark runs the latron again with the same vial; it is out of specification again. What should Mark do?
- A.
Repeat with the same vial.
- B.
Repeat with a new vial.
- C.
Call service.
- 3.Mark runs the latron again with the new vial; it is out again. What should Mark do?
- A.
Repeat with the same vial.
- B.
Call the Superviser.
- C.
Call service.
- 4.Mark calls service. Service instructs Mark to bleach the appertures with a 15 minute dwell time. What must Mark do after he bleaches the appertures?
- A.
He must perform a Diluent Purge to remove the bleach.
- B.
He must do a Shutdown and run Daily Checks.
- C.
He must zap the apertures to drain and rinse the baths.
- 5.Mark, the DxH operator, receives a pediatric bullet of blood for analysis on the DxH. What is Mark's first step?
- A.
Mixed the specimen.
- B.
Check the specimen for clots.
- C.
Put the DxH in Single-Presentation mode.
- 6.Mark checks the pediatric bullet for clots and finds there are numerous fibrin strands in the specimen. What should Mark do?
- A.
Reject the specimen.
- B.
Remove the fibrin strands, vortex and run the specimen.
- C.
Incubate the specimen at 37 C for 30 minutes.
- 7.Mark rejects the specimen and requests a new specimen. The new pediatric bullet also has fibrin strands. What should Mark do?
- A.
Reject the specimen.
- B.
Remove the fibrin strands, vortex, repeat testing and TNP platelet count noting a blue top tube is needed due to fibrin strands.
- C.
Cancel the specimen and request a blue top tube.
- 8.Mark rejects the specimen and requests a new specimen. A third pediatric bullet is sent down. It also has fibrin strands. What should Mark do?
- A.
Reject the specimen.
- B.
TNP platelet count noting fibrin strand interference.
- C.
Cancel the specimen and note that the redraw must be venipuncture.
- 9.What is the most likely cause of the fibrin strands?
- A.
High platelet count
- B.
High fibrin content in the blood
- C.
Poor collection technique
- 10.Mark, the DxH operator has a STAT EDTA specimen from the ER which is labeled with a BNP label. Mark checks MediTech and discovers it needs both a CBCD and a BNP. What should Mark do?
- A.
Run the CBCD and after it is resulted give the specimen to Chemistry.
- B.
Call the floor and tell the nurse that he is cancelling the CBCD and that the nurse needs to reorder the CBCD and draw a new EDTA tube.
- C.
Give the specimen to Chemistry and run the CBCD when they are finished with it.
- 11.Mark decides to run the specimen before giving it to Chemistry. He puts it in a cassette and places it on the DxH. What will happen?
- A.
The DxH will not run the specimen because it has a BNP label on it.
- B.
The DxH will run the specimen using the default settings but it will not automatically cross the results to Remisol.
- C.
The DxH will run the specimen using the default settings and cross the results to Remisol but the results will get "held" at Remisol.
- 12.The results have an H & H Check Fail flag. What should Mark do first?
- A.
Nothing the BNP label caused the flag.
- B.
Centrifuge a small aliquot to check for lipemia.
- C.
Incubate the specimen at 37 C for 30 minutes.
- 13.Mark decides to perform a saline replacement on the lipemic specimen. What must he do before he starts the procedure?
- A.
Make a slide.
- B.
Incubate the specimen at 37 C for 30 minutes.
- C.
Verify the MCHC is elevated.
- 14.Mark performs a saline replacement on the lipemic specimen. Which parameter on the treated specimen must match the pre-treated specimen for the testing to be valid?
- A.
WBC count
- B.
RBC count
- C.
Platelet count
- 15.The treated specimen RBC result does not match the pre-treated specimen RBC result. What should Mark do now?
- A.
Just report out the WBC, PLTs and Hgb then TNP (Test Not Performed) rest of the results.
- B.
Add saline or RBCs until the result matches.
- C.
Repeat the Saline Replacement procedure from the beginning with a new aliquot of the lipemic specimen.
- 16.What comment must be appended to results when a Saline Replacement procedure is used during testing?
- A.
Saline Replacement performed.
- B.
Questionable results, a saline replacement had to be performed.
- C.
If the results are valid, there is no need to append a message.
- 17.What did Mark NOT do that he should have done?
- A.
Document in the communication log, the reason for the increased TAT.
- B.
Verify the results on the back-up DxH.
- C.
Notify the ER doctor that the TAT would be increased due to the lipemia.
- 18.Mark runs a CBC on the DxH, there is a flag on the printout indicating possible platelet clumping. What should Mark do first?
- A.
Request a new specimen.
- B.
Check the specimen for clots.
- C.
Vortex and rerun the specimen on the DxH.
- D.
Verify the platelet count on the smear.
- 19.Mark checked the specimen for clots. The specimen did not have any clots so Mark vortexed and reran the specimen on the DxH. The printout still had a flag indicating possible platelet clumps. Mark made a smear and verified on the smear that there were many platelet clumps. What should Mark do now?
- A.
TNP the platelet count result with a comment stating the platelet count appears to be adequate.
- B.
TNP the platelet count and request a new EDTA specimen.
- C.
TNP the platelet count and request a blue top tube for the platelet analysis.
- D.
Notify the nurse that the platelet count cannot be performed due to platelet clumping.
- 20.Mark received a blue top tube for platelet analysis on the DxH. There are no flags on the DxH's printout. What must Mark do prior to reporting out the platelet count?
- A.
Nothing, since there are no flags the result will autocross.
- B.
Verify the platelet count on a manual smear.
- C.
Multiply the platelet count on the printout by 1.1 to correct for sample dilution.
- D.
Reject the specimen only EDTA specimens can be run on the DxH.
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