MLT ASCP PRACTICE ACTUAL EXAM
PAPER 2026 QUESTIONS WITH
ANSWERS GRADED A+
◍ Which one of the following statements about acetaminophen metabolism is
false?Choose the single best answer
A. It is metabolized in the kidney
B. It is largely metabolized in the liver to glucuronide and sulfonate
conjugates
C. A small amount is metabolized via cytochrome oxidase to a reactive
benzoquinoneimine intermediate
D. This intermediate becomes toxic to the liver once tissue glutathione
becomes depleted.
Answer: A; The benzoquinoneimine intermediate produced in the liver as a
result of hepatic cytochrome oxidase metabolism of acetaminophen is
responsible for hepatic necrosis via acylation of hepatic tissue. The
treatment of acetaminophen toxicity includes the use of N-acetylcysteine
(Mucomyst), which acts as a glutathione substitute. The risk of
hepatotoxicity is predicted with the Rumack-Matthew nomogram, which
uses the hours after ingestion and plasma acetaminophen level to predict the
probability of hepatotoxicity. Severe hepatotoxicity can be fatal.
◍ According to the 2010 ADA guidelines, HbA1C percent can be used as an
assay to diagnose diabetes.True/False.
Answer: T;The 2010 ADA Clinical Practice Recommendations added
measurement of HbA1C as a diagnostic assay for diagnosis of diabetes.
◍ A pregnant woman has routine coagulation testing performed. PT and aPTT
are normal. Her fibrinogen level is elevated at 450 (reference range
150-350) due to acute phase reactants during pregnancy. The other factor
, that may be elevated due to this is:.
Answer: FVIII
◍ Which of the following conditions would make a sample unsuitable for
lactic acid testing?Choose the single best answer
A. Movement of hand or arm during specimen collection
B. Received in the lab on ice
C. Centrifuged in a refrigerated centrifuge
D. Specimen centrifuged and plasma separated from cells less than 15
minutes after collection.
Answer: A;Movement of the muscles in the hand or arm during specimen
collection will falsely increase lactic acid concentration. A blood sample for
lactic acid testing should be placed on ice immediately after collection,
centrifuged within 15 minutes of collection, and plasma immediately
separated from cells following centrifugation. If possible, a refrigerated
centrifuge should be used.
◍ You are working in a clinical chemistry laboratory and are analyzing a
plasma glucose sample. The sample is flagged by the analyzer for being
"outside of linear range." You manually dilute the sample 1:2 and rerun it.
Again, you receive an "outside linear range" alert. You decide to perform a
different manual dilution. This time you manually dilute the original sample
again; this time using a 1:3 dilution. The instrument gives you a glucose
value of 150 mg/dL from this diluted sample. What is the actual patient
glucose result that you should report to the physician?Choose the single best
answer
A. 100 mg/dL
B. 400 mg/dL
C. 600 mg/dL
D. 450 mg/dL
E. 1200 mg/dL.
Answer: D;The correct response is option D: 450 mg/dl. A 1:3 dilution
entails mixing one part patient sample with two parts diluent, for a total
volume of 3 parts. In laboratory dilutions, the total volume is considered a
, dilution factor. The dilution factor in this question is 3. So a diluted sample
with a value of 150 would need to be multiplied by 3 to obtain the correct
final answer. 150 x 3 = 450 mg/dl.
◍ That portion of an enzyme which is separated from its cofactor is called
a(n):Choose the single best answer
A. Partial enzyme
B. Isoenzyme
C. Coenzyme
D. Apoenzyme.
Answer: D;A partial enzyme is not an actual term used in the laboratory. An
isoenzyme is a related enzyme with a different chemical structure. Finally, a
coenzyme is a non-protein molecule (often a vitamin) that helps an enzyme
become active.
◍ If glucose testing cannot be performed immediately, CSF should be stored".
Answer: in a freezer
◍ A low CSF glucose level is associated with all the following except:Choose
the single best answer
A. Hyperglycemia
B. Fungal meningitis
C. Toxoplasmosis
D. Hypoglycemia.
Answer: A; In hyperglycemia you would expect a normal or elevated CSF
glucose level- this question is asking where you would expect to see a
decreased (low) CSF glucose level, and in this case hyperglycemia would be
the one condition that is excluded (therefore the correct answer).
◍ Blood lactic acid concentration is an indicator of impaired circulation and
tissue oxygenation in critically ill patients. If circulation and tissue
oxygenation are impaired, blood lactic acid concentration will decrease
below the lower end of the established reference range.True/False.
Answer: False;Lactic acid will increase. When cells do not receive enough
oxygen because they are not receiving enough blood, they release excess
, lactic acid into the bloodstream. Organ failure as a result of septic shock
may be indicated by unexplained metabolic acidosis (low blood pH and low
bicarbonate level) and extremely elevated lactic acid, where blood pH is
<7.30 and plasma lactic acid is >1.5 times the upper limit of the laboratory's
established reference values.
◍ When should blood samples for trough drug levels be collected?Choose the
single best answer
A. 30 minutes after peak levels
B. 45 minutes before the next dose
C. 1-2 hours after the last dose
D. immediately before the next dose is given.
Answer: D;The trough drug level is drawn immediately before the next dose
is given as the drug level is expected to be the lowest in the body at this
point.
◍ Which of the following contributes to specific gravity but does NOT
contribute to osmolality?Choose the single best answer
A. protein
B. NaCl
C. urea
D. glucose.
Answer: A;The presence of large amounts of protein and glucose will alter
the specific gravity and should be considered when interpreting specific
gravity results. Osmolality measures the analytes in the following equation-
note that protein is not included in the calculation of osmolality. Osmolality
= 1.86 Na + (Glucose/18) + (BUN/2.8) + 9 (or) 1.91 Na + (Glucose/15) +
(BUN/2.25).
◍ Tissue injury in a systemic rheumatic disorders sch as systemic lupus
erythematosus is thought to be caused by:.
Answer: deposition of immune complexes
◍ The activation mechanism of the alternative complement pathway is
initiated differently from that of the classical pathway because, in the
PAPER 2026 QUESTIONS WITH
ANSWERS GRADED A+
◍ Which one of the following statements about acetaminophen metabolism is
false?Choose the single best answer
A. It is metabolized in the kidney
B. It is largely metabolized in the liver to glucuronide and sulfonate
conjugates
C. A small amount is metabolized via cytochrome oxidase to a reactive
benzoquinoneimine intermediate
D. This intermediate becomes toxic to the liver once tissue glutathione
becomes depleted.
Answer: A; The benzoquinoneimine intermediate produced in the liver as a
result of hepatic cytochrome oxidase metabolism of acetaminophen is
responsible for hepatic necrosis via acylation of hepatic tissue. The
treatment of acetaminophen toxicity includes the use of N-acetylcysteine
(Mucomyst), which acts as a glutathione substitute. The risk of
hepatotoxicity is predicted with the Rumack-Matthew nomogram, which
uses the hours after ingestion and plasma acetaminophen level to predict the
probability of hepatotoxicity. Severe hepatotoxicity can be fatal.
◍ According to the 2010 ADA guidelines, HbA1C percent can be used as an
assay to diagnose diabetes.True/False.
Answer: T;The 2010 ADA Clinical Practice Recommendations added
measurement of HbA1C as a diagnostic assay for diagnosis of diabetes.
◍ A pregnant woman has routine coagulation testing performed. PT and aPTT
are normal. Her fibrinogen level is elevated at 450 (reference range
150-350) due to acute phase reactants during pregnancy. The other factor
, that may be elevated due to this is:.
Answer: FVIII
◍ Which of the following conditions would make a sample unsuitable for
lactic acid testing?Choose the single best answer
A. Movement of hand or arm during specimen collection
B. Received in the lab on ice
C. Centrifuged in a refrigerated centrifuge
D. Specimen centrifuged and plasma separated from cells less than 15
minutes after collection.
Answer: A;Movement of the muscles in the hand or arm during specimen
collection will falsely increase lactic acid concentration. A blood sample for
lactic acid testing should be placed on ice immediately after collection,
centrifuged within 15 minutes of collection, and plasma immediately
separated from cells following centrifugation. If possible, a refrigerated
centrifuge should be used.
◍ You are working in a clinical chemistry laboratory and are analyzing a
plasma glucose sample. The sample is flagged by the analyzer for being
"outside of linear range." You manually dilute the sample 1:2 and rerun it.
Again, you receive an "outside linear range" alert. You decide to perform a
different manual dilution. This time you manually dilute the original sample
again; this time using a 1:3 dilution. The instrument gives you a glucose
value of 150 mg/dL from this diluted sample. What is the actual patient
glucose result that you should report to the physician?Choose the single best
answer
A. 100 mg/dL
B. 400 mg/dL
C. 600 mg/dL
D. 450 mg/dL
E. 1200 mg/dL.
Answer: D;The correct response is option D: 450 mg/dl. A 1:3 dilution
entails mixing one part patient sample with two parts diluent, for a total
volume of 3 parts. In laboratory dilutions, the total volume is considered a
, dilution factor. The dilution factor in this question is 3. So a diluted sample
with a value of 150 would need to be multiplied by 3 to obtain the correct
final answer. 150 x 3 = 450 mg/dl.
◍ That portion of an enzyme which is separated from its cofactor is called
a(n):Choose the single best answer
A. Partial enzyme
B. Isoenzyme
C. Coenzyme
D. Apoenzyme.
Answer: D;A partial enzyme is not an actual term used in the laboratory. An
isoenzyme is a related enzyme with a different chemical structure. Finally, a
coenzyme is a non-protein molecule (often a vitamin) that helps an enzyme
become active.
◍ If glucose testing cannot be performed immediately, CSF should be stored".
Answer: in a freezer
◍ A low CSF glucose level is associated with all the following except:Choose
the single best answer
A. Hyperglycemia
B. Fungal meningitis
C. Toxoplasmosis
D. Hypoglycemia.
Answer: A; In hyperglycemia you would expect a normal or elevated CSF
glucose level- this question is asking where you would expect to see a
decreased (low) CSF glucose level, and in this case hyperglycemia would be
the one condition that is excluded (therefore the correct answer).
◍ Blood lactic acid concentration is an indicator of impaired circulation and
tissue oxygenation in critically ill patients. If circulation and tissue
oxygenation are impaired, blood lactic acid concentration will decrease
below the lower end of the established reference range.True/False.
Answer: False;Lactic acid will increase. When cells do not receive enough
oxygen because they are not receiving enough blood, they release excess
, lactic acid into the bloodstream. Organ failure as a result of septic shock
may be indicated by unexplained metabolic acidosis (low blood pH and low
bicarbonate level) and extremely elevated lactic acid, where blood pH is
<7.30 and plasma lactic acid is >1.5 times the upper limit of the laboratory's
established reference values.
◍ When should blood samples for trough drug levels be collected?Choose the
single best answer
A. 30 minutes after peak levels
B. 45 minutes before the next dose
C. 1-2 hours after the last dose
D. immediately before the next dose is given.
Answer: D;The trough drug level is drawn immediately before the next dose
is given as the drug level is expected to be the lowest in the body at this
point.
◍ Which of the following contributes to specific gravity but does NOT
contribute to osmolality?Choose the single best answer
A. protein
B. NaCl
C. urea
D. glucose.
Answer: A;The presence of large amounts of protein and glucose will alter
the specific gravity and should be considered when interpreting specific
gravity results. Osmolality measures the analytes in the following equation-
note that protein is not included in the calculation of osmolality. Osmolality
= 1.86 Na + (Glucose/18) + (BUN/2.8) + 9 (or) 1.91 Na + (Glucose/15) +
(BUN/2.25).
◍ Tissue injury in a systemic rheumatic disorders sch as systemic lupus
erythematosus is thought to be caused by:.
Answer: deposition of immune complexes
◍ The activation mechanism of the alternative complement pathway is
initiated differently from that of the classical pathway because, in the
