CLINICAL LABORATORY SCIENCE
9TH EDITION
• AUTHOR(S)MARY LOUISE
TURGEON
TEST BANK
1
Reference
Ch. 1 — Fundamentals of the Clinical Laboratory — Clinical
laboratory overview / testing complexity
Stem
A clinician orders a CLIA-waived point-of-care glucose by
bedside glucometer and also requests a confirmatory
laboratory glucose measured on a hexokinase analyzer. The
bedside result is 220 mg/dL; hospital lab instrument returns
150 mg/dL from a venous sample drawn 15 minutes later.
Which laboratory-centered explanation is most likely?
,Options
A. Pre-analytical: capillary sample hemoconcentration from
prolonged tourniquet.
B. Analytical: inter-instrument calibration difference; hexokinase
under-recovers glucose.
C. Pre-analytical: timing and sample type difference (capillary vs
venous) and physiologic variability.
D. Post-analytical: transcription error in the bedside device
result.
Correct Answer
C
Rationales
Correct (C): Capillary (fingerstick) glucose often differs from
venous glucose due to physiologic and timing differences;
stress, recent food, and measurement site can raise capillary
readings. The 15-minute gap plus sample-type explains the
discordance and is the best laboratory-centered explanation.
A: Hemoconcentration from prolonged tourniquet affects
venous samples mainly; unlikely to produce higher capillary
reading.
B: Hexokinase is reference method and typically accurate;
instrument calibration differences seldom cause this magnitude
without QC flags.
D: Transcription errors are possible but bedside devices usually
transfer/display result; no evidence supports transcription here.
,Teaching Point
Capillary vs venous timing differences commonly explain POC vs
lab glucose discordance.
Citation
Turgeon, M. L. (9th ed.). Clinical Laboratory Science. Ch. 1.
2
Reference
Ch. 1 — Fundamentals — CLIA test complexity classification
Stem
A newly hired MLS must categorize four assays: quantitative
automated electrolyte panel (ISE), rapid influenza antigen
(lateral flow), Gram stain, and ELISA for HIV. Which set correctly
maps to CLIA complexity levels for laboratory staffing decisions?
Options
A. Moderate: ISE, ELISA; High: Gram stain; Waived: rapid
influenza.
B. Moderate: ISE; High: Gram stain, ELISA; Waived: rapid
influenza.
C. High: ISE, Gram stain; Moderate: ELISA; Waived: rapid
influenza.
D. Moderate: rapid influenza; High: ISE, ELISA; Waived: Gram
stain.
Correct Answer
B
, Rationales
Correct (B): Automated electrolyte (ion-selective electrode) is
typically moderate complexity; ELISA and Gram stain are high
complexity (interpretative microscopy and complex
immunoassay); lateral flow rapid influenza is CLIA-waived.
A: ELISA is high complexity, not moderate.
C: ISE is generally moderate, not high.
D: Gram stain is high complexity, not waived.
Teaching Point
Match assay method to CLIA complexity: waived lateral flow;
moderate for automated analyzers; high for microscopy/ELISA.
Citation
Turgeon, M. L. (9th ed.). Clinical Laboratory Science. Ch. 1.
3
Reference
Ch. 1 — Fundamentals — Laboratory accreditation and CAP
checklists
Stem
A lab preparing for a CAP inspection reviews QC records and
finds three months of acceptable control values for a chemistry
analyzer but no documented corrective actions for a single
shifted control value two months ago that remained within 2
SD. What is the best departmental response to meet CAP
expectations?
9TH EDITION
• AUTHOR(S)MARY LOUISE
TURGEON
TEST BANK
1
Reference
Ch. 1 — Fundamentals of the Clinical Laboratory — Clinical
laboratory overview / testing complexity
Stem
A clinician orders a CLIA-waived point-of-care glucose by
bedside glucometer and also requests a confirmatory
laboratory glucose measured on a hexokinase analyzer. The
bedside result is 220 mg/dL; hospital lab instrument returns
150 mg/dL from a venous sample drawn 15 minutes later.
Which laboratory-centered explanation is most likely?
,Options
A. Pre-analytical: capillary sample hemoconcentration from
prolonged tourniquet.
B. Analytical: inter-instrument calibration difference; hexokinase
under-recovers glucose.
C. Pre-analytical: timing and sample type difference (capillary vs
venous) and physiologic variability.
D. Post-analytical: transcription error in the bedside device
result.
Correct Answer
C
Rationales
Correct (C): Capillary (fingerstick) glucose often differs from
venous glucose due to physiologic and timing differences;
stress, recent food, and measurement site can raise capillary
readings. The 15-minute gap plus sample-type explains the
discordance and is the best laboratory-centered explanation.
A: Hemoconcentration from prolonged tourniquet affects
venous samples mainly; unlikely to produce higher capillary
reading.
B: Hexokinase is reference method and typically accurate;
instrument calibration differences seldom cause this magnitude
without QC flags.
D: Transcription errors are possible but bedside devices usually
transfer/display result; no evidence supports transcription here.
,Teaching Point
Capillary vs venous timing differences commonly explain POC vs
lab glucose discordance.
Citation
Turgeon, M. L. (9th ed.). Clinical Laboratory Science. Ch. 1.
2
Reference
Ch. 1 — Fundamentals — CLIA test complexity classification
Stem
A newly hired MLS must categorize four assays: quantitative
automated electrolyte panel (ISE), rapid influenza antigen
(lateral flow), Gram stain, and ELISA for HIV. Which set correctly
maps to CLIA complexity levels for laboratory staffing decisions?
Options
A. Moderate: ISE, ELISA; High: Gram stain; Waived: rapid
influenza.
B. Moderate: ISE; High: Gram stain, ELISA; Waived: rapid
influenza.
C. High: ISE, Gram stain; Moderate: ELISA; Waived: rapid
influenza.
D. Moderate: rapid influenza; High: ISE, ELISA; Waived: Gram
stain.
Correct Answer
B
, Rationales
Correct (B): Automated electrolyte (ion-selective electrode) is
typically moderate complexity; ELISA and Gram stain are high
complexity (interpretative microscopy and complex
immunoassay); lateral flow rapid influenza is CLIA-waived.
A: ELISA is high complexity, not moderate.
C: ISE is generally moderate, not high.
D: Gram stain is high complexity, not waived.
Teaching Point
Match assay method to CLIA complexity: waived lateral flow;
moderate for automated analyzers; high for microscopy/ELISA.
Citation
Turgeon, M. L. (9th ed.). Clinical Laboratory Science. Ch. 1.
3
Reference
Ch. 1 — Fundamentals — Laboratory accreditation and CAP
checklists
Stem
A lab preparing for a CAP inspection reviews QC records and
finds three months of acceptable control values for a chemistry
analyzer but no documented corrective actions for a single
shifted control value two months ago that remained within 2
SD. What is the best departmental response to meet CAP
expectations?
