CMLA Certification Exam — Questions and Answers

Question 1: Which statistical measure best represents the day-to-day variability of a QC control material?

Mean
Coefficient of variation (CV) (Correct answer)
Median
Reference range

Correct answer: Coefficient of variation (CV)

The CV expresses standard deviation as a percentage of the mean, making it the best measure for comparing variability across different analytes or concentrations.

Question 2: What does the prefix 'cyto-' mean?

Cell (Correct answer)
Tissue
Nucleus
Organ

Correct answer: Cell

The prefix 'cyto-' means cell, as seen in terms like cytology (study of cells) and cytoplasm.

Question 3: What is the role of proficiency testing in quality control?

To evaluate laboratory staff's ability and accuracy. (Correct answer)
To check if equipment is functioning.
To meet regulatory requirements only.
To improve laboratory efficiency.

Correct answer: To evaluate laboratory staff's ability and accuracy.

Proficiency testing in quality control evaluates the laboratory staff's ability and accuracy in performing tests. It involves testing unknown samples provided by an external agency and comparing the results to those of other laboratories. This external assessment helps identify areas for improvement, ensures consistent performance, and validates the competence of the laboratory personnel.

Question 4: What is the value of continuing education in phlebotomy for CMLA professionals?

It is primarily a social activity
It keeps professionals current with evolving standards and practices (Correct answer)
It replaces workplace experience
It is only needed for recertification

Correct answer: It keeps professionals current with evolving standards and practices

Continuing education ensures professionals stay current with the latest developments, standards, and best practices in their field.

Question 5: When a new reagent lot is placed into service, the laboratory should first:

Dispose of all remaining old-lot reagents
Contact the manufacturer for new control ranges
Run patient samples immediately to confirm performance
Perform parallel testing with the old and new lot before switching (Correct answer)

Correct answer: Perform parallel testing with the old and new lot before switching

Parallel testing of old and new reagent lots ensures equivalent performance before transitioning to the new lot to protect patient safety.

Question 6: What is the role of informed consent in medical terminology?

It protects only the provider
It is a mere formality
It ensures the patient understands and agrees to the plan (Correct answer)
It is only needed for surgery

Correct answer: It ensures the patient understands and agrees to the plan

Informed consent ensures patients understand the proposed interventions, alternatives, risks, and benefits before agreeing to proceed.

Question 7: Which anticoagulant is preferred for platelet function studies?

Sodium citrate (Correct answer)
EDTA
Heparin
Sodium fluoride

Correct answer: Sodium citrate

Sodium citrate is the preferred anticoagulant for platelet aggregation and coagulation studies.

Question 8: A laboratory worker accidentally splashes a potentially infectious sample on their lab coat. What is the FIRST action they should take?

Remove the coat and wash affected skin (Correct answer)
Apply an antiseptic to the coat
Complete an incident report
Notify the supervisor

Correct answer: Remove the coat and wash affected skin

Removing contaminated clothing and washing exposed skin immediately limits ongoing exposure to the infectious material.

Question 9: What does a Levy-Jennings chart primarily monitor in a clinical laboratory?

Patient result turnaround times
Quality control results over time to detect trends and shifts (Correct answer)
Equipment maintenance schedules
Inventory levels of reagents

Correct answer: Quality control results over time to detect trends and shifts

Levy-Jennings charts plot QC values over time, allowing laboratory staff to detect shifts, trends, and random errors visually.

Question 10: A reticulocyte count of 8% in a patient with hemolytic anemia indicates:

Aplastic anemia
Iron deficiency
Bone marrow failure
Appropriate bone marrow response (Correct answer)

Correct answer: Appropriate bone marrow response

An elevated reticulocyte count in hemolytic anemia indicates the bone marrow is compensating by increasing red cell production.

Question 11: A culture plate shows hemolysis where red blood cells are completely lysed, leaving a clear zone around colonies. This is classified as:

Gamma hemolysis
Alpha hemolysis
Delta hemolysis
Beta hemolysis (Correct answer)

Correct answer: Beta hemolysis

Beta hemolysis indicates complete lysis of red blood cells, producing a clear, transparent zone around the colony on blood agar.

Question 12: A yellow-top (ACD) tube is primarily used for:

Coagulation testing
Blood bank specimens and HLA typing (Correct answer)
Routine chemistry panels
Complete blood count

Correct answer: Blood bank specimens and HLA typing

ACD (acid citrate dextrose) tubes preserve cellular integrity and are used for blood bank and molecular/HLA testing.

Question 13: Which microscopic structure found in urine sediment is oval fat bodies associated with?

Nephrotic syndrome (Correct answer)
Bladder cancer
Urinary tract infection
Acute tubular necrosis

Correct answer: Nephrotic syndrome

Oval fat bodies are lipid-laden renal tubular cells seen in nephrotic syndrome due to heavy proteinuria and lipiduria.

Question 14: Which organelle is absent in mature red blood cells?

Cytoplasm
Nucleus (Correct answer)
Hemoglobin
Cell membrane

Correct answer: Nucleus

Mature red blood cells lack a nucleus, which was extruded during the final stages of erythropoiesis.

Question 15: Laboratory specimens should be transported within the facility in containers that are:

Leak-proof with a secondary containment bag (Correct answer)
Left open for rapid access by receiving personnel
Labeled only with the patient name
Wrapped in paper toweling to absorb spills

Correct answer: Leak-proof with a secondary containment bag

Specimens must be in leak-proof primary containers placed inside a secondary containment bag to prevent exposure if the primary container leaks.

Question 16: What should a medical laboratory assistant do before performing any internal maintenance on an automated analyzer?

Run a final QC cycle to document the pre-maintenance state only
Wear only gloves and proceed while the instrument is running
Notify administration and wait 24 hours before servicing
Power off the instrument and follow lockout/tagout (LOTO) procedures (Correct answer)

Correct answer: Power off the instrument and follow lockout/tagout (LOTO) procedures

LOTO procedures isolate the instrument from its energy source, preventing accidental activation and protecting the technician during internal maintenance.

Question 17: Which condition is characterized by involuntary muscle contractions in the arm during or after venipuncture and may result from hyperventilation?

Petechiae
Edema
Hematoma
Tetany (Correct answer)

Correct answer: Tetany

Hyperventilation causes hypocapnia and respiratory alkalosis, lowering ionized calcium and triggering tetanic muscle spasms.

Question 18: What does the suffix '-phagia' mean?

Eating or swallowing (Correct answer)
Speaking
Breathing
Urinating

Correct answer: Eating or swallowing

The suffix '-phagia' means eating or swallowing, as in dysphagia (difficulty swallowing) or polyphagia (excessive eating).

Question 19: According to CLIA regulations, how long must a laboratory retain QC records?

1 year
2 years (Correct answer)
5 years
6 months

Correct answer: 2 years

CLIA requires laboratories to retain QC records for a minimum of 2 years to allow review during inspections and accreditation surveys.

Question 20: Which QC approach involves using patient data statistics such as the average of normals (AON) to monitor analytical performance?

Westgard multirule approach
Patient-based real-time QC (PBRTQC) (Correct answer)
Levy-Jennings charting
Delta check method

Correct answer: Patient-based real-time QC (PBRTQC)

Patient-based real-time QC uses the statistical distribution of patient results to detect systematic errors without relying solely on traditional controls.

Question 21: In CMLA practice, what is the best approach to quality improvement in phlebotomy?

Copy what other organizations do without analysis
Make changes without measuring results
Use data-driven methods with measurable outcomes (Correct answer)
Wait for problems to occur before acting

Correct answer: Use data-driven methods with measurable outcomes

Data-driven quality improvement with measurable outcomes ensures that changes actually produce the intended improvements and can be verified.

Question 22: In the context of CMLA, what does evidence-based practice mean?

Following only personal experience
Using outdated methods because they are familiar
Integrating current best evidence with professional expertise (Correct answer)
Ignoring research findings

Correct answer: Integrating current best evidence with professional expertise

Evidence-based practice integrates the best available research evidence with professional expertise and patient values for optimal outcomes.

Question 23: Which ethical principle requires CMLA professionals to act in the patient's best interest?

Fidelity
Beneficence (Correct answer)
Justice
Autonomy

Correct answer: Beneficence

Beneficence is the ethical principle that obligates healthcare professionals to act in ways that promote the well-being and best interests of the patient.

Question 24: A requisition calls for a 'trough' drug level. When should this specimen be collected?

2 hours after drug administration
Immediately before the next scheduled dose (Correct answer)
30 minutes after drug administration
At any convenient time during the dosing interval

Correct answer: Immediately before the next scheduled dose

Trough levels represent the lowest drug concentration in the blood and must be collected immediately before the next scheduled dose.

Question 25: Which specimen requires transport in a biohazard bag with a separate compartment for the requisition form?

Only blood cultures
All clinical laboratory specimens (Correct answer)
Only specimens requiring refrigeration
Only urine specimens

Correct answer: All clinical laboratory specimens

OSHA and CLSI standards require all patient specimens to be transported in leak-proof biohazard bags with the requisition kept separate to prevent contamination.

Question 26: A laboratory refrigerator used to store patient specimens is found to also contain an employee's lunch. This situation violates which regulation?

OSHA Bloodborne Pathogen Standard prohibiting food storage where blood is present (Correct answer)
CAP accreditation standards on refrigerator capacity
FDA food safety guidelines
CLIA regulations on specimen storage temperature

Correct answer: OSHA Bloodborne Pathogen Standard prohibiting food storage where blood is present

OSHA's Bloodborne Pathogen Standard explicitly prohibits storing food or drink in refrigerators where blood or potentially infectious materials are kept.

Question 27: In the context of CMLA, what does evidence-based practice mean?

Using outdated methods because they are familiar
Following only personal experience
Ignoring research findings
Integrating current best evidence with professional expertise (Correct answer)

Correct answer: Integrating current best evidence with professional expertise

Evidence-based practice integrates the best available research evidence with professional expertise and patient values for optimal outcomes.

Question 28: In CMLA science preparation, what does homeostasis refer to?

Cell division
Energy production
The tendency to maintain stable internal conditions (Correct answer)
Rapid growth

Correct answer: The tendency to maintain stable internal conditions

Homeostasis is the process by which organisms maintain stable internal conditions necessary for survival despite external changes.

Question 29: In clinical chemistry, the term 'specificity' of a test refers to its ability to:

Reproduce consistent results
Correctly identify true negatives (Correct answer)
Measure a wide range of concentrations
Detect very small amounts of an analyte

Correct answer: Correctly identify true negatives

Specificity is the ability of a test to correctly identify individuals who do not have the condition, i.e., true negatives.

Question 30: Why is proper documentation important in quality control?

To ensure tests are not repeated.
It is not important.
For accountability, tracking, and future reference. (Correct answer)
To speed up the testing process.

Correct answer: For accountability, tracking, and future reference.

Proper documentation in quality control is essential for accountability, tracking, and future reference. It provides a clear, auditable record of all QC activities, including results, corrective actions, and equipment maintenance. This documentation is vital for troubleshooting, demonstrating compliance with regulations, and supporting continuous quality improvement.

Question 31: A urine dipstick shows a positive nitrite result. What does this most likely indicate?

Bacterial infection (Correct answer)
Kidney stones
Liver disease
Diabetes mellitus

Correct answer: Bacterial infection

Positive nitrite on dipstick indicates bacteria (typically gram-negative) have converted urinary nitrates to nitrites.

Question 32: What is the correct interpretation when a Levey-Jennings chart shows control values scattered randomly above and below the mean with large variability?

The method has a random error problem (Correct answer)
The method has acceptable systematic error only
The method is performing optimally
The method has calibration drift

Correct answer: The method has a random error problem

Wide, random scatter of control values above and below the mean indicates random error, often caused by pipetting inconsistencies, temperature fluctuations, or unstable reagents.

Question 33: Which approach is MOST important for CMLA professionals when applying technical procedures?

Following personal shortcuts developed through experience
Adhering to established protocols while adapting to specific conditions (Correct answer)
Applying the same technique in every situation without variation
Using the fastest method available regardless of standards

Correct answer: Adhering to established protocols while adapting to specific conditions

Technical procedures require adherence to established protocols as a foundation, with professional judgment to adapt appropriately to specific conditions. This balance ensures both consistency and effectiveness.

Question 34: The MCHC (Mean Corpuscular Hemoglobin Concentration) is calculated by dividing:

Hematocrit by RBC count
MCV by MCH
Hemoglobin by RBC count
Hemoglobin by hematocrit × 100 (Correct answer)

Correct answer: Hemoglobin by hematocrit × 100

MCHC is calculated as (Hemoglobin / Hematocrit) × 100, expressing average hemoglobin concentration per unit volume of red cells.

Question 35: How should a pipette calibration be verified after maintenance?

Aspirate and dispense air to check resistance
Test with a graduated cylinder
Perform gravimetric testing by weighing dispensed distilled water (Correct answer)
Pipette colored dye and visually inspect volume

Correct answer: Perform gravimetric testing by weighing dispensed distilled water

Gravimetric testing using distilled water's known density is the standard method for verifying pipette volume accuracy.

Question 36: A pipette calibration check shows it consistently delivers 2% less volume than the set value. This type of error is called:

Systematic (bias) error (Correct answer)
Proportional error only at low volumes
Random error
Gross error

Correct answer: Systematic (bias) error

A consistent directional offset across all measurements is a systematic or bias error, often correctable through recalibration.

Question 37: What is the most important factor in effective communication with patients regarding medical terminology?

Providing written instructions only
Speaking quickly to save time
Using clear, understandable language and confirming understanding (Correct answer)
Using medical jargon to appear professional

Correct answer: Using clear, understandable language and confirming understanding

Clear communication in understandable language, with confirmation of understanding, improves patient compliance and outcomes.

Question 38: What is the primary reason for using a winged infusion set (butterfly) in pediatric or geriatric patients?

Greater control and flexibility for small or fragile veins (Correct answer)
Elimination of the need for an order of draw
Larger gauge for higher flow rate
Faster blood collection than evacuated tubes

Correct answer: Greater control and flexibility for small or fragile veins

Butterfly needles allow the phlebotomist to stabilize the needle more precisely in small or delicate veins, reducing the risk of through-puncture.

Question 39: In CMLA practice, when should a patient's condition be reassessed?

Only at admission and discharge
Only when the patient requests it
At regular intervals and when status changes (Correct answer)
Once per week

Correct answer: At regular intervals and when status changes

Regular reassessment and reassessment upon status changes ensure that care plans remain appropriate and responsive to the patient's needs.

Question 40: When centrifuging potentially infectious specimens, which safety measure is mandatory?

Using safety-capped centrifuge tubes or sealed rotors (Correct answer)
Wearing only gloves with no additional PPE
Opening the lid immediately after stopping
Centrifuging at maximum speed to reduce time

Correct answer: Using safety-capped centrifuge tubes or sealed rotors

Safety-capped tubes or sealed rotors contain aerosols and prevent release of infectious particles if a tube breaks during centrifugation.

Question 41: A laboratory technician prepares a 1:10 dilution of a patient serum sample. If the original concentration of glucose is 200 mg/dL, what is the concentration in the diluted sample?

2 mg/dL
20 mg/dL (Correct answer)
2000 mg/dL
200 mg/dL

Correct answer: 20 mg/dL

A 1:10 dilution means 1 part sample in 10 parts total, so the concentration is divided by 10: 200 / 10 = 20 mg/dL.

Question 42: Which corrective action is most appropriate when a single control value fails the 1-3s rejection rule?

Adjust the mean on the Levey-Jennings chart to accommodate the outlier
Stop patient testing, investigate the cause, and repeat QC before reporting results (Correct answer)
Repeat only the failed control and average the two results
Continue patient testing while noting the failure in the logbook

Correct answer: Stop patient testing, investigate the cause, and repeat QC before reporting results

A 1-3s violation is a rejection rule requiring the laboratory to stop reporting, identify the root cause, resolve the issue, and confirm QC is acceptable before continuing.

Question 43: What is the purpose of inverting evacuated tubes after collection?

To separate serum from cells immediately
To increase blood volume in the tube
To remove air bubbles from the tube
To mix the blood with the additive and prevent clotting or ensure proper preservation (Correct answer)

Correct answer: To mix the blood with the additive and prevent clotting or ensure proper preservation

Gentle inversion mixes blood with anticoagulants or clot activators to ensure proper specimen processing.

Question 44: What is the proper action if you accidentally ingest a laboratory chemical?

Ignore it, your body will handle it.
Drink water to dilute it.
Immediately seek medical help and inform them of the chemical. (Correct answer)
Wait for the symptoms to appear.

Correct answer: Immediately seek medical help and inform them of the chemical.

Accidental ingestion of a laboratory chemical is a medical emergency that requires immediate professional medical attention. It is crucial to inform medical personnel of the specific chemical ingested, as this information is vital for them to administer the correct and most effective treatment. Delaying or attempting self-treatment can be extremely dangerous.

Question 45: The suffix '-gram' means:

Record or image (Correct answer)
Instrument used to record
Visual examination
Process of recording

Correct answer: Record or image

The suffix '-gram' means a record or image, as in electrocardiogram (ECG) which is the recorded image/tracing of heart activity.

Question 46: What is the best way to ensure the accuracy of test results?

Perform tests without calibration.
Use a random approach to testing.
Rely on assumptions to expedite testing.
Follow SOPs and maintain equipment. (Correct answer)

Correct answer: Follow SOPs and maintain equipment.

Following Standard Operating Procedures (SOPs) ensures consistency and adherence to established best practices in every step of the testing process. Regular maintenance and calibration of equipment guarantee that instruments are functioning correctly and providing accurate measurements. These practices are fundamental to minimizing errors and producing reliable test results in a laboratory setting.

Question 47: What is the correct procedure for cleaning laboratory equipment?

Let dirt build up before cleaning.
Rinse with water only.
Clean with any available detergent.
Use the appropriate cleaning agents as recommended. (Correct answer)

Correct answer: Use the appropriate cleaning agents as recommended.

The correct procedure for cleaning laboratory equipment involves using the appropriate cleaning agents as recommended by the manufacturer. Using unsuitable detergents can damage the equipment, leave residues, or fail to properly decontaminate it. Following specific recommendations ensures effective cleaning without compromising the instrument's function or integrity.

Question 48: The combining form 'erythr/o' refers to which color or cell type?

Red/erythrocytes (Correct answer)
Blue/basophils
Purple/thrombocytes
White/leukocytes

Correct answer: Red/erythrocytes

Erythr/o means red and refers to red blood cells (erythrocytes), derived from the Greek word for red.

Question 49: What should be done if quality control procedures reveal an equipment malfunction?

Use the equipment for low-importance tests.
Stop using the equipment until it is repaired or recalibrated. (Correct answer)
Ignore the malfunction and continue using the equipment.
Report the malfunction but keep using the equipment.

Correct answer: Stop using the equipment until it is repaired or recalibrated.

If quality control procedures reveal an equipment malfunction, it is critical to stop using the equipment until it is repaired or recalibrated. Continuing to use faulty equipment would compromise the accuracy and reliability of patient test results. This action ensures patient safety and maintains the integrity of the laboratory's diagnostic services.

Question 50: What does the combining form 'path/o' mean?

Disease (Correct answer)
Growth
Healing
Normal

Correct answer: Disease

Path/o means disease, as in pathology (study of disease) and pathogen (disease-causing organism).

Question 51: For a timed specimen such as a fasting glucose, what information is most critical to document?

The color of the tube used
The gauge of the needle used
The phlebotomist's employee ID only
The exact time of collection and patient's last food/drink intake (Correct answer)

Correct answer: The exact time of collection and patient's last food/drink intake

Timed specimens require accurate collection time and fasting duration to ensure clinically valid interpretation of results.

Question 52: What does a serum antibody titer measure?

The molecular weight of the detected antibody
The total protein concentration in serum
The rate of antibody synthesis per hour
The highest dilution of serum still showing a positive reaction (Correct answer)

Correct answer: The highest dilution of serum still showing a positive reaction

A titer is the reciprocal of the highest serum dilution that still yields a detectable (positive) reaction, reflecting relative antibody concentration.

Question 53: Why is it important to regularly inspect laboratory equipment?

It is not important.
To keep it clean.
To make it look good.
To prevent accidents and ensure accuracy. (Correct answer)

Correct answer: To prevent accidents and ensure accuracy.

Regularly inspecting laboratory equipment is important to prevent accidents and ensure the accuracy of test results. Inspections help identify wear and tear, malfunctions, or potential hazards before they lead to equipment failure or compromise sample integrity. This proactive approach maintains a safe working environment and reliable diagnostic outcomes.

Question 54: A urine pH of 8.5 in a freshly voided specimen may suggest:

Urinary tract infection with urease-producing bacteria (Correct answer)
High protein diet
Starvation
Diabetic ketoacidosis

Correct answer: Urinary tract infection with urease-producing bacteria

Urease-producing bacteria (e.g., Proteus) split urea into ammonia, raising urine pH to alkaline levels.

Question 55: According to CDC guidelines, which test is used to confirm a positive ELISA result in the two-tier testing approach for Lyme disease?

Complement fixation test
Bacterial culture of blood
Western blot (immunoblot) (Correct answer)
Polymerase chain reaction (PCR)

Correct answer: Western blot (immunoblot)

CDC recommends two-tier Lyme testing: sensitive ELISA screening followed by Western blot confirmation to detect specific Borrelia burgdorferi antibody bands.

Question 56: Which of the following is the MOST effective strategy to reduce healthcare-associated infections at the system level?

Increasing antibiotic prescribing to prevent secondary infections
Isolating all patients in private rooms regardless of diagnosis
Relying solely on PPE for all interactions
Implementing mandatory hand hygiene compliance monitoring programs (Correct answer)

Correct answer: Implementing mandatory hand hygiene compliance monitoring programs

Systematic hand hygiene compliance monitoring and feedback programs have the strongest evidence base for reducing healthcare-associated infection rates.

Question 57: Why is it important to know the location of emergency equipment in the laboratory?

So you can avoid using them.
So you can respond quickly in emergencies. (Correct answer)
It’s unnecessary as they are self-explanatory.
So you can impress others with your knowledge.

Correct answer: So you can respond quickly in emergencies.

Knowing the location of emergency equipment, such as eyewash stations, safety showers, and fire extinguishers, is vital for responding quickly and effectively during an emergency. Rapid access to these tools can minimize injuries and mitigate hazardous situations, potentially saving lives.

Question 58: The prefix 'brady-' means:

Fast
Slow (Correct answer)
Normal
Irregular

Correct answer: Slow

Brady- means slow, as in bradycardia (abnormally slow heart rate) or bradypnea (abnormally slow breathing rate).

Question 59: What is the role of a control group in scientific experiments related to CMLA?

To provide a baseline for comparison (Correct answer)
To receive the experimental treatment
To be eliminated from the study
To confirm the hypothesis

Correct answer: To provide a baseline for comparison

The control group provides a baseline against which the experimental group is compared to determine the effect of the variable being tested.

Question 60: Which risk management approach is MOST effective for CMLA professionals when evaluating potential workplace hazards?

Reactive analysis after incidents occur
Delegating all safety decisions to management
Relying solely on historical accident data
Proactive hazard identification and assessment (Correct answer)

Correct answer: Proactive hazard identification and assessment

Proactive hazard identification and assessment allows professionals to identify and mitigate risks before incidents occur, which is far more effective than reactive approaches that only address problems after they happen.

Question 61: A laboratory assistant notices the QC mean has gradually increased over 30 days. What is the most likely cause?

Improper sample collection
Clerical transcription errors
Random pipetting errors
Reagent deterioration or calibration drift (Correct answer)

Correct answer: Reagent deterioration or calibration drift

A gradual shift in the QC mean over time typically indicates reagent deterioration, instrument drift, or a calibration issue requiring investigation.

Question 62: What does the suffix '-lysis' mean?

Inflammation
Hardening
Destruction or breakdown (Correct answer)
Formation

Correct answer: Destruction or breakdown

The suffix '-lysis' means destruction or breakdown, as in hemolysis (breakdown of red blood cells) or urinalysis (breakdown/analysis of urine components).

Question 63: Which term describes a condition of abnormal cell development?

Hyperplasia
Aplasia
Metaplasia
Dysplasia (Correct answer)

Correct answer: Dysplasia

Dysplasia means abnormal development or growth, with 'dys-' meaning bad/abnormal and '-plasia' meaning formation/development.

Question 64: How should you store a blood sample after collection?

Leave it exposed to air.
Store it in the freezer.
Refrigerate it immediately or follow specific instructions. (Correct answer)
Store it at room temperature until tested.

Correct answer: Refrigerate it immediately or follow specific instructions.

After collection, blood samples should be refrigerated immediately or stored according to specific instructions to maintain their stability. Refrigeration slows down metabolic processes and degradation of analytes, preventing changes that could affect test results. Following specific instructions ensures optimal preservation for the intended tests.

Question 65: A calibration verification requires testing patient-like samples at a minimum of how many concentration levels?

Three levels (low, mid, high) (Correct answer)
Two levels (low and high)
Five levels across the full range
One level at the medical decision point

Correct answer: Three levels (low, mid, high)

CLIA requires calibration verification at a minimum of three levels (low, mid, and high) spanning the reportable range.

Question 66: A chemical spill of a corrosive acid on the skin should FIRST be treated by:

Rinsing with large amounts of water for at least 15 minutes (Correct answer)
Covering with a sterile dressing
Notifying the supervisor before any treatment
Applying a neutralizing base immediately

Correct answer: Rinsing with large amounts of water for at least 15 minutes

Immediate and prolonged water rinsing (≥15 minutes) dilutes and removes the acid before it causes further tissue damage.

Question 67: What is the primary unit of structure and function in living organisms studied in CMLA?

Organ
Tissue
Cell (Correct answer)
Molecule

Correct answer: Cell

The cell is the fundamental unit of structure and function in all living organisms, forming the basis of biological organization.

Question 68: The combining form 'ureter/o' refers to the tube that connects the:

Bladder to prostate
Bladder to urethra
Kidney to bladder (Correct answer)
Kidney to renal pelvis

Correct answer: Kidney to bladder

The ureter is the tube that carries urine from the kidney down to the urinary bladder.

Question 69: Why is quality control important in laboratory testing?

To ensure accuracy and reliability of results. (Correct answer)
To reduce the cost of testing.
To make the laboratory look efficient.
To increase testing speed.

Correct answer: To ensure accuracy and reliability of results.

Quality control is crucial in laboratory testing to ensure the accuracy and reliability of results. It involves a set of procedures designed to monitor the performance of analytical methods and equipment, identifying and correcting errors. This commitment to quality directly impacts patient diagnosis, treatment, and overall healthcare outcomes.

Question 70: A urine dipstick hemoglobin test is positive but no red blood cells are seen microscopically. What is the most likely explanation?

Contamination with menstrual blood
Urinary tract infection
Hemoglobinuria or myoglobinuria (Correct answer)
Laboratory error

Correct answer: Hemoglobinuria or myoglobinuria

A positive dipstick for blood without RBCs on microscopy suggests free hemoglobin or myoglobin in solution rather than intact cells.

Question 71: Which document specifies the manufacturer's recommended maintenance schedule for a laboratory instrument?

The instrument's operator or service manual (Correct answer)
The institution's infection control policy
The laboratory's standard operating procedure (SOP) only
The accreditation body's checklist

Correct answer: The instrument's operator or service manual

The operator or service manual provided by the manufacturer contains the recommended PM schedule, cleaning procedures, and part replacement intervals.

Question 72: The root word 'ren/o' or 'nephr/o' refers to the:

Liver
Kidney (Correct answer)
Lung
Heart

Correct answer: Kidney

Both ren/o and nephr/o refer to the kidney; renal pertains to the kidney, as does nephrology (study of kidney disease).

Question 73: A laboratory receives a proficiency testing challenge with five specimens. Under CLIA, how many must be reported to avoid a potential PT failure?

All five (100%)
At least three of five (60%) (Correct answer)
At least two of five (40%)
At least four of five (80%)

Correct answer: At least three of five (60%)

CLIA requires at least 80% satisfactory results on a PT challenge, but since graded on a score basis, typically 4/5 or 3/5 passing meets requirements depending on analyte-specific criteria.

Question 74: The abbreviation 'CBC' in laboratory medicine stands for:

Cellular Blood Composition
Complete Blood Chemistry
Complete Blood Count (Correct answer)
Comprehensive Biochemistry Chart

Correct answer: Complete Blood Count

CBC stands for Complete Blood Count, a common laboratory test that measures various components of blood including RBCs, WBCs, and platelets.

Question 75: The term 'antecubital' refers to the area:

Behind the knee
Above the shoulder
In front of the elbow (Correct answer)
Below the wrist

Correct answer: In front of the elbow

Antecubital means in front of the elbow; 'ante-' means before/in front of and 'cubital' refers to the elbow/forearm.

Question 76: Which organization publishes the primary guidelines for isolation precautions used in US hospitals?

FDA
CDC/HICPAC (Correct answer)
OSHA
The Joint Commission

Correct answer: CDC/HICPAC

The CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC) publishes the authoritative guidelines for isolation precautions in US healthcare settings.

Question 77: What does the prefix 'macro-' mean?

Many
Small
Few
Large (Correct answer)

Correct answer: Large

Macro- means large, as in macrocyte (abnormally large red blood cell) or macroscopic (visible to the naked eye).

Question 78: A laboratory is implementing a new hematology analyzer. Which validation study specifically confirms the analyzer produces equivalent results to the current method?

Method comparison study (Correct answer)
Linearity study
Imprecision study
Reference interval verification

Correct answer: Method comparison study

A method comparison study tests patient samples on both analyzers simultaneously to confirm the new instrument produces clinically equivalent results.

Question 79: The combining form 'hem/o' or 'hemat/o' refers to:

Urine
Bile
Blood (Correct answer)
Lymph

Correct answer: Blood

Hem/o and hemat/o both refer to blood, as seen in hematology (study of blood) and hemorrhage (bleeding).

Question 80: Which of the following describes proper autoclave loading to ensure effective sterilization?

Pack items tightly to maximize load capacity
Leave space between items to allow steam penetration (Correct answer)
Wrap all items in aluminum foil
Place all items in sealed containers

Correct answer: Leave space between items to allow steam penetration

Steam must contact all surfaces, so items must be spaced to allow full penetration throughout the load.

CMLA Certification Exam

The Certified Medical Laboratory Assistant (CMLA) certification validates the skills and knowledge required to perform pre-analytical and post-analytical tasks in a medical laboratory.

Questions

90 min

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70%

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