MRO PRACTICE QUESTIONS WITH
COMPLETE SOLUTIONS!!
, 1 of 107
Term
64. Lab reports methamphetamine 70,000 ng/dL; amphetamine
5,000 ng/mL; d-methamphetamine 5%; l-methamphetamine 95%.
Donor says he was using Vicks inhaler for congestion. MRO reports
this as:
Select all that apply.
A.Positive
B.Negative
C.Canceled - with explanation (no recollection)
D.Canceled - without explanation (recollect direct observation)
Give this one a try later!
B
Although the elimination rate can vary from 0.005 to 0.03 w/v per hour, 0.018 %
w/v per hour is considered to be average elimination rate. See slide 2 of the
Alcohol Testing and Toxicology presentation.
B
Both the codeine and morphine are under 15,000 ng/mL, so MRO verification as
a positive requires verification of unauthorized opiate/opioid use. In other words,
the burden of proof is on the MRO to justify verifying the result as positive. if the
levels were at or above 15,000 ng/mL, then the burden of proof would fall on the
donor to provide a legitimate medical explanation, e.g., a valid prescription.
Taking hydrocodone would not explain the presence of codeine at this level.
However, morphine at that 3000 ng/mL level could easily be caused by eating
poppy seed bagels or other foods containing poppy seeds or poppy seed
paste. Even if the donor does not report consuming poppy seed products, this is
still be reported as a negative result.
, A
The decision points for a substituted specimen are a creatine concentration
equal to 2 mg/dL but less than 20 mg/dl and a specific gravity of greater than
1.0010 but less than 1.0030. Please see slide 8 of the Laboratory Specimen Validity
Testing and DOT Rule 49 CFR Part 40 Section 40.93.
Given the creatinine was 1.9 mg/dL and specific gravity was 1.0009 this is a
substituted specimen and a MRO would report this as "Refusal to Test -
Substituted". i.e. answer A.
B
Though the level of high, the 95% of l-methamphetamine is consistent with
high doses of the older form of Vic's inhaler. One breakdown product of
methamphetamine is amphetamine, which was present in sufficient doses to
support use of Vic's. Negative.
Don't know?
2 of 107
Term
All of the following are usual components of an EAP program
EXCEPT:
A. Employee education
B. Supervisor training
C. Clinical assessment
D. Information and referral
E. Pre-employment drug testing
Give this one a try later!
, B
6-AM (6-acetylmorphine) is the initial metabolite of heroin and will itself
metabolize to morphine (slide 19 of the Toxicology presentation). 6-AM cannot
arise from any drug other then heroin (diacetylmorphine) and therefore its
presence in urine is conclusive proof of heroin use.
B, C & D
Please see slide 19 of the Toxicology presentation for heroin's metabolic
pathway. Diacetylmorphine is not a correct answer as it is heroin.
E
C
Hair testing provides the longest window of detection; generally at least 60-90
days for a head hair sample of 100 mg of hair.
Don't know?
3 of 107
Term
74. Breath and saliva testing devices used for DOT alcohol testing
must be on a Conforming Products List (CPL) published by:
A.SAMHSA
B. DOT Office of Drug and Alcohol Policy & Compliance (ODAPC)
C. National Highway Traffic Safety Administration (NHTSA)
D. Federal Motor Carrier Safety Administration (FMCSA)
E. National Association of Forensic Alcohol Testing Equipment
Manufacturers (NAFAT)
COMPLETE SOLUTIONS!!
, 1 of 107
Term
64. Lab reports methamphetamine 70,000 ng/dL; amphetamine
5,000 ng/mL; d-methamphetamine 5%; l-methamphetamine 95%.
Donor says he was using Vicks inhaler for congestion. MRO reports
this as:
Select all that apply.
A.Positive
B.Negative
C.Canceled - with explanation (no recollection)
D.Canceled - without explanation (recollect direct observation)
Give this one a try later!
B
Although the elimination rate can vary from 0.005 to 0.03 w/v per hour, 0.018 %
w/v per hour is considered to be average elimination rate. See slide 2 of the
Alcohol Testing and Toxicology presentation.
B
Both the codeine and morphine are under 15,000 ng/mL, so MRO verification as
a positive requires verification of unauthorized opiate/opioid use. In other words,
the burden of proof is on the MRO to justify verifying the result as positive. if the
levels were at or above 15,000 ng/mL, then the burden of proof would fall on the
donor to provide a legitimate medical explanation, e.g., a valid prescription.
Taking hydrocodone would not explain the presence of codeine at this level.
However, morphine at that 3000 ng/mL level could easily be caused by eating
poppy seed bagels or other foods containing poppy seeds or poppy seed
paste. Even if the donor does not report consuming poppy seed products, this is
still be reported as a negative result.
, A
The decision points for a substituted specimen are a creatine concentration
equal to 2 mg/dL but less than 20 mg/dl and a specific gravity of greater than
1.0010 but less than 1.0030. Please see slide 8 of the Laboratory Specimen Validity
Testing and DOT Rule 49 CFR Part 40 Section 40.93.
Given the creatinine was 1.9 mg/dL and specific gravity was 1.0009 this is a
substituted specimen and a MRO would report this as "Refusal to Test -
Substituted". i.e. answer A.
B
Though the level of high, the 95% of l-methamphetamine is consistent with
high doses of the older form of Vic's inhaler. One breakdown product of
methamphetamine is amphetamine, which was present in sufficient doses to
support use of Vic's. Negative.
Don't know?
2 of 107
Term
All of the following are usual components of an EAP program
EXCEPT:
A. Employee education
B. Supervisor training
C. Clinical assessment
D. Information and referral
E. Pre-employment drug testing
Give this one a try later!
, B
6-AM (6-acetylmorphine) is the initial metabolite of heroin and will itself
metabolize to morphine (slide 19 of the Toxicology presentation). 6-AM cannot
arise from any drug other then heroin (diacetylmorphine) and therefore its
presence in urine is conclusive proof of heroin use.
B, C & D
Please see slide 19 of the Toxicology presentation for heroin's metabolic
pathway. Diacetylmorphine is not a correct answer as it is heroin.
E
C
Hair testing provides the longest window of detection; generally at least 60-90
days for a head hair sample of 100 mg of hair.
Don't know?
3 of 107
Term
74. Breath and saliva testing devices used for DOT alcohol testing
must be on a Conforming Products List (CPL) published by:
A.SAMHSA
B. DOT Office of Drug and Alcohol Policy & Compliance (ODAPC)
C. National Highway Traffic Safety Administration (NHTSA)
D. Federal Motor Carrier Safety Administration (FMCSA)
E. National Association of Forensic Alcohol Testing Equipment
Manufacturers (NAFAT)
