SIMULATE D MT LICE NSURE EXA MM CI.IN.

CHE MM SET A Pa g e l 1
LEMAR REVIEW HUB
CAL TECHNOLOGISTS SIMULATED LICENSURE REXAMINATION
CLINICAL CHEMI STRY SET A
NSTROCTIONS: Select the correct answer for each of the following question. Mark
One answer for each item by shading the box corresponding to the letter of
Your choice o n the answer sheet provided. STRICTLY NO ERASURES ALLOWED. Use
pencil no. 2.
n e process that encompasses all aspects of laboratory operation including
PaLlent 1 d e n t i f i c a t i o n , s p e c imen c o l l e c t i on, eguipmernt maintenance, and the
Teporting of pat ient results is:
a. Accuracy b. Reliaoi lity C. Quality assurance d. Quality control
2. T'he process that monitors each laboratory analysis, using material with known
constituent concentrations, in order to ensure the accuracy of the test
results is:
a. Pooled control C. Quality cont rol
b. Quallty assurance d. Accuracy monitoring
A
technique used t o detect unlikely combination of values.
a. Previous value check C. Patttern recognition
b. Alert check d. Randomi zed duplicate specimens
d . W h i c h of the following is a sample of known concentration is used to monitor
the testing processs?
C. Unassayed control
a. Assayed control tr mmrtr
b. Liquid cont rol d, Standard always t n i t pt Som
. A mean value of 100 and a standard deviation of 1.8 mg/dL were obtained from a
set of glucose measurements on a control solution. The 95 confidence
interval in mg/dL would be:
a. 94.6-105.4 C. 97.3-102.7 d. 98.2-101.8
b96.4-103.6
'6. The following five sodium control values (mEq/L) were obtained:
a 140, 135, 138, 140, 142 N
Calculate the coefficient of variation.
1.9 b 5.68 VunVt c. 2.78 d. 6.18
T h e purest type o f reagent water i s :
a TYpe I b. Type II C. TYPe III d. All are equal
9. Type of extinguisher for Class C Fires:
a. Hater,
b,
dry chemical,
Carvon dioxide,
loaded stream
dry chemical, halon
C.
d.
Metal X
None of these LEMAR
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C 9. Chemicals should be
a. Alphabetically, for easy accessibility
stored:

b. Inside a safety cabinet with proper ventilation

C ÀCcording to their chemical properties and classification
d. Inside a fune hood, i f toxic vapors can be released when opened

10.20°C F ( 1) /
68 d. 86
b. 53
. 2 5
S
C11.75°F C. 23.8 d. 32.6
a. 15.5 b. 21.0
small amount lett in the 1p
a2. It is used for nonviscOus fluid; self-draining
should not be blown out
a. Volumetric pipet C. Micropipettes
d. Pasteur pipet
b. Ostwald Folin
unacceptabl for laboratory testing when:
13. Blood specimens
LThere is no
are
patient name or identification number on the label.
The label on the request form and the label on the c o l l e c t i o n c o n t a i n e r do

not natch.
has been used ex. anticoagulant additive
Y. The wrong cOIlect1on t ube
i n s t e a d of tube for serum
b. 1 and 3 C. 2 and 3 d. 1, 2 and
a. a n d 2
14. The preferred length of the lancet for skin puncture should be to av01d

penetrating the bo ne.

C. 2.20 num d. 2.5 mn
a. 1.75 n b. 2.0 nun
Specimens that require chilling (4°C)
15. 3. BIOod gases 4. Renin
1. Amumonia 2. Lactic acid
C. 1 2 and 3 d. 1, 2, 3 and 4
a. 1 and 3 b. 2 and 4
16. The purest type of reagent water 1s:
C. TYpe IIl d. All are equal
a, Type I b. TYpe 1I
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LICENSURE AM
EXA CLIN. CHEM . SET A Pa g e 2

17.Analyt i
YCal
Y
testing performed (Outside the confines ofthelcentral laboratory
Dy nonlaboratorian personnel (nurses, respiratory t herapists etc.
.Poirnt of care
2 testing (POCT)
Decentralized testing
3. Near-patient testing
4. Alternate site test ing
a. 1 and 3 b. 2 a nd 4 C. 1, 2 and 3 1 , 2, 3 and 4
Colligative properties include all of the following, EXCEPT
a,Osmolality b. Vapor pressure C. Freezing point Osmot 1c pressure
19.Seer's law states that the concent rat ion of substance is (1)
proportional to the amount of light absorbed or (2) proportional to the
1ogarithm of the transmitted
light./ h
. Directly, inversely
C. Both directly proport ional
b. Directly, inversely
d. Both inversely proportional
b. inversely

The more light absorbed, the higher the concent ration of analyte in this
echnique of measuring the amount of light absorbed by a solution.
a. Atomic absorption C. Nephelometry
b. Fluoromet ry d. Spect rophotometry
T h e process by which fluorescence of an analyte i s reduced due to the excited
molecule losing some of its energy by interacting with other substances in
solution is known as:
a. lonization
Quenching C. Phosphorescence d. Self-absorption
2 2 . One sample lsequentiaII following another through the system so that different
analytical functions are being carried on simultaneously on more than one
sample best describes:
a. Automatic clinical analysis c . Continuous-flow analysis
b. Centrifugal analysis d. Dry-slide analysis
. D i r e c t injection of a sanple into very small diameter tubing, thus minimizing
lateral diffusion best describes:
a. Automatic clinical analys is C. Continuous-flow analysis
b. Centrifugal analysis d Flow-injection analysis
2 4 . Which analyzer requires that sanple and reagent be pipeted into separate
chambers in a rotor prior to the chemi cal analysis being performed?
a. Centrifugal b. Continuous flow C. DuPont aca d. Kodak dry slide
that can analyze patient samples for only those tests
25. specifically
An Lnstrument
ordered and can analyze stat samples by interrupting the normal
sequence of patient analyses is referred to as:
a. Bat ch analyzer c. Multtitest analyzer
b. Discrete analyzer Random-access analyzer
. 26. In a chemical reaction, the amount of product formed is measured at specific
related to the concentration of
intervals during a specif-ed period and then
Ehe analyte in the unknown. This type of measurement is known as:
a. Colorimetric b. End-point -penod Rate nks d. Ultraviolet
27. In a person with normal glucose metabolism, the blood glucose level usually
increases rapidly after carbohydrates are ingested but returns to anormal1
level after:
b. 45 minutes
a. 30 minutess C. 60 minutes d. 120 minutes
2 9 . Dubowski method for glucose utilizes:
Wa A. ortho-toluidine
a. Phosphomolybdic acid fghn
b. Arsenomolybdic acid L m d. Potassium ferricyanide ha)
is formed during the of pro-insulin to insulin.
conversion The
29.C-peptide
amount of circulating C-peptide provides
reliable indicators for pancreatic
in:
and insulin secretions (beta cell function). It is de creased
TYpe 1 DM
a. Insulinoma
b. Ingestion of hypoglyceic drugs d. Type 2 DM
for the quantitation of total protein in urine and
turbidimetric method used
30. A
cerebrospinal fluid specimens is
C. Cooma s s i e blue d. SSA
a. Biuret b. HABA
to be most sensitive
Which of the following nutritional markers has been found
031. and helpful indicator of nutritional status in very ill patients?
b. Trans f e r r i n CAlbumin d. Somat omed in C
aTransthyretin with:
levels may be associated
32. becreased

a
b,
Malnutrition
serum

Liver disease
albumin
d.
e.
Both
A B
B
and
and
C
C
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C. Kidney disease
that precipitates in acid solution but redissolves upon heating best
33. A protein
describes: C. Haptoglobin d. Transterrin
a. Albumin b. Bernce-Jones
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LICENSURE EXA M CLIN . CHE M . SET A Pa ge 3

34. Which dye may be used to stain serum protein fractions following
electrophoresis?
Amido black
b. Ponceau SS d. Both A and B
e. A, B and C
C. Fat red
C 35. The method of choicee for quantifying protein fractions foliowing
electophoresis is:
a.
Densitometry b. Fl uorometry C. Spectrophotometry d. Nephelometry
U b The acute-phase reactant that is able to inhibit enzymatic proteolysis 1S:
a. Alphai antitrypsin
b. Complement C. Haptoglobin d. Prealbumin
Creening procedure usefal in detecting PKU is: H ielonas
a. Copper reduction
C. Ferric chloride
b. Glucose oxidase
d. Nitroprusside
8.
Whi ch of the following
a. Nitrite poisoning
elevates carboxyhemoglobin 2
C. Sul fa drug toxicity
. Exposure to carbon monoxide d. Sickle cell anemia
ds.CDC reference method for determination of cholesterol:
a. Llebermann Burchardt reaction C. Cholesterol oxidase reaction
b. Salkowski reaction d, Abell, Levy and Brodie method
4 0 . When TAG and LDL-c are being measured, fasting becomes a requirement. Require
fasting of patients:
a. 2 to 4 hours b. 4 to 6 hours C. 6 to 8 hours 1 2 to 14 hou
4 A cholesterol QC chart has the following data for the normal control:
x mean of data
x 137 mg/dL 2x = 1, 918 mg/dL
2 SD = 6 mg/dL
N =14
The coefficient of variation for this control is:
a. 1.14% b. 4.38 2.198 d. 9.498
4 2 . The function of the majcr lipid Components of the very low densitY
ipoproteins (VLDL) is to transport:
a Cholesterol from peripheral cells to the liver
b. Exogenous triglycerides
C. Cholesterol and phospholipids to peripheral cells
dEndogenous triglycerides
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43. Which of the following laboratory values is considered a p o s i t i v e r i s k factor
for the occurrence of coronary heart disease?
a. HDL cholesterol > 60 mg/dL CHDL Ccholesterol < 35 mg/dL
b. LDL cholesterol < 130 mg/dL . Total cholesterol < 200 mg/dL
44. Which of the following would be most adversely affected by a nonfasting
sample?
a. HDL b. Cholesterol C. LDL d Triglycerides
appropriate fasting procedure when a Iipid study oE
45. What is the most
triglyceride, total cholesterol, HDL cholesterol, and LDL cholesterol tests
are ordered? P I pnFILE
a. 8 hours; notthing but water allowed
b. 10 hours; water, smoking, coffee, tea (no sugar or cream) allowed
c. 12 hours; nothing but water allowed
d. 16 hours; water, Smoking, coffee, tea (no sugar or cream) allowed
4 6 . Precipitating agents used to remove vLDL and LDL from serum so that only the
HDL cholesterol rema ins for measurement include all of the followi ng , except:
a. Citrate/fluoride C. Phosphotungstate/magnesium
b. Heparin/manganese d. Dextran sulfate
47.One nternational unit of enzyme activitý is the amount of enzyme that under
specified reaction conditions of substrate concentration, pH and temperature,
Causes usage of substrate at the rate of: katal 1mole sec
a. l millimole/minb. l nanomole/min C. 11Ctomole/min d.l picomole/min
the amount o reducing sugars produced by the hydrolysis of
45. This measures
Starch by the usual glucose methods. ClaSSiC r e ference method expressed in
Somogyi units.
a. Saccharogenic b. Chromogenic C. Amyloclasti d.Coupled-enZyme
4 9 . The r e ference method for determination of lipase
a. Tietz and Fiereck C Cherry Crandal

b. Peroxidase coupling d. Kar men

such as Zlnc for activity, this
50. When an enzyme requires aninorganic subs tance
substance is termed as a (ani:
C. Facilitator d. Regulator
a. Activator b. Coenzyme

In u d C
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LRHSIMU LATE D MT LICE N SURE EXA CLIN. CH E M . SET A Page I4

Usi. Which of the

following are considered primary tissue
phosphatase?
a.
sources of alkallne

Liver, bone, kidney C. Kidney, pancreas, heart

b.
Liver, heart, kidney d. Prostate, 1liver, bone
w n l c h of the following enzymes exhibits the least tissue
. ACP
b. AST speciIicy
0 Wnich of the
C. CK .LD
following may be associated with the creatine kinase isoenzymes?
a. CR-1 referted to a s
D. CR-3 CK-MM B o t h B and C
remains close to the origin during
C. CK-MM is found in skeletal electrophoresis e. A, B and C

Which of the
muscles
following enzymes is most userui in establishing the hhepatic
Origin of an elevated serum alkaline phosphatase?
. Alanine aminotransferase
u d . Gamna-glutamyl transpeptidase
b.
Aspartate aminotransferase"* e. Lactate dehydrogenase
C.
Ornithine carbamyltrans ferase
**. In
the Bessey-Lowry-Brock method for determining al kaline phosphatase
activity, the substrate used is: PM
a. Monophosphate C. Disodium phenylphosphate
b. Phenylphosphate
sE.BRegan isoenzyme has
Para-nitrophenylphosphate
as alkaline phosphatase that
the same properties
originates in the:
a. Skeleton b.
Intestine CI Kidney Placenta
W h i c h of the following may be classified as being a function of the 1iver ?
a. Detoxification of drugs d. Synthesi s of proteins
b. Excretion of bile acids
C. Metabolism of glucose
SAll of the above
5 8 . Increased blood ammonia levels may be associated with:
a. Hepatic encephalopathy d. Both B and C
Neurological changes
C. Coma
e. A, B and C
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59. Which of the following methods estimates the urine sugar concentration by
measuring total reducing substances?
a. Copper sulfate b.Glucose oxidase C. Hexokinase d. Ferricyanide
C60. A patient with insulinoma may exhibit dizziness and fainting attributab le to:
a. Acidosis b. Ketosis
CHypoglycemia dHyperglycemia
61.Which of the following tumor markers is'used to monitor persons with breast
cancer for recurrence of disease?
a. Catheps in-D CA-15-3
b. Retinoblastoma gene d. Estrogen receptor (ER)
C62. Which tumor marker is u s ed to determine the usefulness of trastuzu
(Herceptin) therapy for breast cancer?
a. PR b. CEA
CHER-2/neu d. Myc
53.Which electrolyte is significantly involved in the transmission of nerve
impulses ? FO
a. Iroon b. Phosphorus C. Potassiun d. Sodium
Porais um
1 . The composition of the electrode used to measure lood pH is:
a. Glass b. Plastic C. Platinum Valinomycin
5 5 . The role of calcium in body metabolism is that of:
a. Structural contribution to bone formation d. Both A and B
b. An activator of the coagulation system e A, B and c
C. transmission of n e r v e
Facilitating impulses
6 . The physiologically active form of calcium is:
a. Complexed b. Ionized C. Lipid-bound d. Protein-bound
e7. A hospitalized patient is experiencing increased neuromuscular irritabiity
(tetany). Which of the following tests should be ordered imunediately?
a Calciun b. Phosphorus C. BUN d. Giucose
E 8 . The formation of molybdenum blue conplex is associated with the quant i t a t ion
Ot:
a.CalCium b. Iron C. Magnesium d. Phosphate
E9Sodiun produces which color in a flame?
a. Red b. Violet C Yellow d. Magnesium
7 0 . Increased anion gap:
1. Uremia 3. Ketoacidosis
2. Poisoning by methanol 4. Hypoa lbuminemia
a. 1 and 3 b. 2 and 4 c. 1, 2 and 3 d. 1, 2, 3 and 4
71.Glucose tolerance factor contains the following trace e t a l :
a.Copper b. Chr omium C. Seleniun d. Zinc
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72.The following
ng metal is most
most associated
a. Aluminum assoias with the "dementia of dialysis":
b. Fluorinee C. Cadmi um d. Zinc
U Y 9 0 ) percent of the carbon dioxide present in the blood is in the f o r
of:
a. Bicarbonate ions
C. Carbonate
b. Dissolved CO d. Carbonic acid
od gas results are af fect ed by the gas mixture the pat ient 13 breathing and
Ythe patient's t e m p e r a t u r e . M e a s u r e m e n ts are routinely made at

.0 C b. 4 °C ranpUY C. 25 OC d. 37 C
75 ysema
1s likely to
patient
be in what
suffering
met abol
from
ic staler
fluid accumulation in the alveolar spaces

a. Respiratory acidosis C. Respiratory alkalosis

b. Met abolic acidosis d. Metabolic alkalosis

a 76. Which of the followi ng is the pr imary mechani sm of compensat ion for metabolae

acidosis?
a Hypervent i lation C. Release of epinephrine
R
Ai Al0 VDg Ju d. Bicarbonate excretion
b. Aldosterone release
'.Which of the following is the primary mechanism causing respiratory alkalo313?
C. Congestive heart failure
a. Renal failure
d. Too much bicarbonate
b. Hyperventilation

78. The neurohypophysis is the:

a. Hypothalamuus d. Thyroid gland
e. Posterior pituitary
b.Anterior pituitary
C.Pineal gland
9.The anterior pituitary produces all of the following hormones, except:
d. TSH
à. ACTH b. FSH SPTHH
activé and able to bind i t s receptor site,
8C. For a hormone to be biochemically
the hormone must be:
C. Bound to protein
a. Bound to glucose
b. Bound to lipoprotein F r e e , not bound to protein
1 . Which amino acid is directly involved in thyroid hormone synthesis?

a. Alanine b. Glutamine C. Threonine TYTOS Lne

function test. The best screening test.
e2.TSH test i s the most important thyroid
It is increased in:
3. Thyrotoxicosis due to pituitary tumor
1. Primary hypothyroidism t
2. Hashimoto' s thyroiditis 4. Primary hYperthyroidism
C. 1, 2 and 3 d. 1, 2, 3 and 4
a. 1 and 3 b. 2 and 4
of abnormal levels of
Normal functioning of the thyroid gland setting in the
M83. thyroxine-binding globulin. There is characteristic abnormality of the thyroid
hormones and a reduction in hormone binding to thyroxine-binding globulin.
a. Euthyroid sick syndrome C. Hashimoto thyroiditis
d. Graves disease
b.cretinism
condition with normal thyroid hormone levels
is a
e4.Subclinial hypothyroidism
and a TSH level.
Low C. Variable d. Normai
a. High b.
of
tests may be used in the dif ferentia diagnosis
85. Which of the following
depression? C. Metopirone inhibition test
a. ACTH stimulation test
b. Dexamethasone suppression test d. Metyrapone inhibition test

d 86. The parent substance in the

a. Cortisol b.
biosynthes is
Catecholamines
of androgens and estrogens i s :
C. Progesterone d,cholesterol
87. The biologically most active, naturally ocurring androgen 1s
C. Dehydroepiandrosteron
a. Androstenedionee

b. Epiandrosterone
d. Testosterone
immediate for the biogenesis of the
The amino acid that is the precursor
ee.
Catecholamine i s :
C. Tyrosine d. Phenylalanine
a. TIYptophan b. Threonine
89. All of the following biochemical changes are seen during pregnancy, except:
C. Increased FSH and LH
a. Decreased albunin
b. Increased alkaline phosphatase d. Increased estrogens

actions of angiotensin II include:

90. Major
renninn
a. I n c r e a s e d pituitary secreti on of
b. Increased parathyroid hormone secretion by the parathyroid
C.

d.
Increased

Decreased adrenal
vasoconstriction

secretion of al dosterone
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REVIEw HUB
 RH SIMU LATE D MT LI C ENSURE EXAM CLIN. CHEM .
S ET A Pa ge 6

91.
C Estrogen and
E progesterone
Ogesterone receptor assays are useful in assessi ng proghosis
which of the
receptOL dds

a.
Ovarian
following?
cancer d. Amenorrhea
92 b. Endomet riosis C. Breast cancer
POLOporphyrin or free erythrocyte protoporphyrin measurements a r e u s e r u l
tO assess
blood concent rations ot:
a. Lead
b 3.
b. Mercury
most serious effect
C. Ar senic d. Beryllium

a.
of methanol ingestion 13
Hallucinations b. Bli C. Psychosi s d. Liver damage
d sa narmacological parameters
ndness
that determine serum drug concentration:
1. Liberat ion 4. Metabol i sm
2. AbsorptiOn 5. Excret ion
3. Distribution
a. l and 3 C. 1, 2, 3 and 4 d. 1, 2, 3, 4 and 5
b. 2 and 4
9 5 . A cardiac glycos ide that is used in the treatment of congenital heart failure
the force and velocitY of myocardial c o n t r a c t i o n
nd arrhyt hmias by increasing
1s:
C. L i t h i um d. Phenytoin
a. Digoxin b. Acet aminophen
used for treatment of petit mal (absence seizure) and grand
mal.
6. It is
a. Theophylline C. Valproic acid (Depa kene)
b. Lithium d. Digoxin
The drug of choice for controlling petit mal (absence sei Zure)
.

d97.
a. Phenobarbital C. Vancomycin
b.
Carbamazepine
d. Ethosuximide (Zarontin)
cleanse the skin whendrawing blood for
may be used to
U98.All of the followáng
ethanol analysis, e x cept
C. Soap and water
a. Alcohol swab
b. Merthiolate d. Zephiran
modifiec structures that are analogs of prescription
199. Substances With
abused drugs are known as
pharma ceutlcals o r d. Toxic drugs
b. Generic drugs c. Trade drugs
a. Designer drugs
b 100. a.
Morphi ne
Cocaine
is the major m e t a b o l i t e of:
b. Heroin C. Marijuana d. Phnecyclidine

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