FISCHBACH'S A MANUAL OF
LABORATORY AND DIAGNOSTIC TESTS.
11TH EDITION
• AUTHOR(S)FRANCES FISCHBACH;
MARGARET FISCHBACH; KATE STOUT
TESTBANKS
1)
Reference
Ch. 1 — Diagnostic Testing
Stem (2–4 sentences)
A 61-year-old patient is ordered a fasting blood glucose and
lipid profile. The nurse discovers the patient ate breakfast two
hours before specimen collection. Which action is the most
appropriate immediate nursing response?
A. Proceed with blood draw and annotate the chart that the
patient was not fasting.
B. Cancel the tests and order a HbA1c instead.
,C. Draw the specimen and report the results with a note to
repeat in 2 weeks.
D. Notify the laboratory to process as non-fasting and inform
the provider for a new order if fasting required.
Correct answer: D
Rationale — Correct (3–4 sentences)
Non-fasting specimens may alter lipid and glucose results; the
nurse should label/communicate that the specimen is non-
fasting and notify the provider to determine whether a repeat
fasting specimen is required. This preserves the specimen and
ensures appropriate interpretation and timing for repeat testing
per diagnostic protocols. Documentation and provider
notification reduce misinterpretation and unnecessary
treatment.
Rationale — Incorrect
A. Proceeding without notifying the provider or labeling risks
inappropriate interpretation.
B. Canceling and ordering HbA1c ignores provider prerogative;
HbA1c is complementary, not an automatic substitute.
C. Drawing and delaying a repeat without provider input may
lead to missed follow-up and unclear interpretation.
Teaching point (≤20 words)
Always document/follow up non-fasting specimens and notify
the provider when test timing is essential.
,Citation
Fischbach, F., Fischbach, M., & Stout, K. (2021). A Manual of
Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
2)
Reference
Ch. 1 — Diagnostic Testing
Stem
A newly admitted patient on warfarin requires an INR. The
laboratory notes a 2-hour delay between draw and analysis due
to transport issues. Which concern is most relevant when
reporting this INR?
A. No concern — INR is stable in whole blood for several hours.
B. Delay may alter results; delay and transport conditions
should be reported to the provider.
C. Repeat the draw immediately without informing the provider.
D. Notify the provider only if INR is within therapeutic range.
Correct answer: B
Rationale — Correct
Preanalytic delays and transport conditions can alter
coagulation test accuracy; nurses must communicate delays so
the provider can judge result validity and decide on repeat
sampling. Transparency about preanalytic variables ensures safe
anticoagulation management.
, Rationale — Incorrect
A. Coagulation tests can be affected by prolonged delays and
improper handling.
C. Repeating without provider discussion can cause
unnecessary blood loss and confusion.
D. The need to inform depends on process integrity, not just
whether the value is therapeutic.
Teaching point
Report preanalytic delays/conditions; they affect test validity
and treatment decisions.
Citation
Fischbach, F., Fischbach, M., & Stout, K. (2021). Ch. 1.
3)
Reference
Ch. 1 — Diagnostic Testing
Stem
A nurse collects a urine specimen but realizes the container was
not sterile (packaging torn). What is the best next step?
A. Send the specimen with documentation of contaminated
container.
B. Obtain a new, properly labeled, sterile specimen container
and recollect.
C. Add preservative to the current specimen and send to lab.
D. Refrigerate the specimen and send in 24 hours.
LABORATORY AND DIAGNOSTIC TESTS.
11TH EDITION
• AUTHOR(S)FRANCES FISCHBACH;
MARGARET FISCHBACH; KATE STOUT
TESTBANKS
1)
Reference
Ch. 1 — Diagnostic Testing
Stem (2–4 sentences)
A 61-year-old patient is ordered a fasting blood glucose and
lipid profile. The nurse discovers the patient ate breakfast two
hours before specimen collection. Which action is the most
appropriate immediate nursing response?
A. Proceed with blood draw and annotate the chart that the
patient was not fasting.
B. Cancel the tests and order a HbA1c instead.
,C. Draw the specimen and report the results with a note to
repeat in 2 weeks.
D. Notify the laboratory to process as non-fasting and inform
the provider for a new order if fasting required.
Correct answer: D
Rationale — Correct (3–4 sentences)
Non-fasting specimens may alter lipid and glucose results; the
nurse should label/communicate that the specimen is non-
fasting and notify the provider to determine whether a repeat
fasting specimen is required. This preserves the specimen and
ensures appropriate interpretation and timing for repeat testing
per diagnostic protocols. Documentation and provider
notification reduce misinterpretation and unnecessary
treatment.
Rationale — Incorrect
A. Proceeding without notifying the provider or labeling risks
inappropriate interpretation.
B. Canceling and ordering HbA1c ignores provider prerogative;
HbA1c is complementary, not an automatic substitute.
C. Drawing and delaying a repeat without provider input may
lead to missed follow-up and unclear interpretation.
Teaching point (≤20 words)
Always document/follow up non-fasting specimens and notify
the provider when test timing is essential.
,Citation
Fischbach, F., Fischbach, M., & Stout, K. (2021). A Manual of
Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
2)
Reference
Ch. 1 — Diagnostic Testing
Stem
A newly admitted patient on warfarin requires an INR. The
laboratory notes a 2-hour delay between draw and analysis due
to transport issues. Which concern is most relevant when
reporting this INR?
A. No concern — INR is stable in whole blood for several hours.
B. Delay may alter results; delay and transport conditions
should be reported to the provider.
C. Repeat the draw immediately without informing the provider.
D. Notify the provider only if INR is within therapeutic range.
Correct answer: B
Rationale — Correct
Preanalytic delays and transport conditions can alter
coagulation test accuracy; nurses must communicate delays so
the provider can judge result validity and decide on repeat
sampling. Transparency about preanalytic variables ensures safe
anticoagulation management.
, Rationale — Incorrect
A. Coagulation tests can be affected by prolonged delays and
improper handling.
C. Repeating without provider discussion can cause
unnecessary blood loss and confusion.
D. The need to inform depends on process integrity, not just
whether the value is therapeutic.
Teaching point
Report preanalytic delays/conditions; they affect test validity
and treatment decisions.
Citation
Fischbach, F., Fischbach, M., & Stout, K. (2021). Ch. 1.
3)
Reference
Ch. 1 — Diagnostic Testing
Stem
A nurse collects a urine specimen but realizes the container was
not sterile (packaging torn). What is the best next step?
A. Send the specimen with documentation of contaminated
container.
B. Obtain a new, properly labeled, sterile specimen container
and recollect.
C. Add preservative to the current specimen and send to lab.
D. Refrigerate the specimen and send in 24 hours.
