2 PRINCIPLES OF BLOOD COLLECTION

Question 1

When the coagulation of fresh whole blood is prevented through the use of an anticoagulant, the straw-colored fluid that can be separated from the cellular elements is:
A. serum
B. plasma
C. whole blood
D. platelets

Answer 1

B. plasma

Question 2

Which characteristic is inaccurate with respect to the anticoagulant K3 EDTA?
A. removes ionized calcium (Ca2+) from fresh whole blood by the process of chelation
B. is used for most routine coagulation studies
C. is the most commonly used anticoagulant in hematology
D. is conventionally placed in lavender-stoppered evacuated tubes

Answer 2

B. is used for most routine coagulation studies

Question 3

Heparin inhibits the clotting of fresh whole blood by neutralizing the effect of:
A. platelets
B. ionized calcium (Ca2+)
C. fibrinogen
D. thrombin

Answer 3

D. thrombin

Question 4

The conventional color-coded evacuated tube stopper for EDTA anticoagulant is:
A. red
B. lavender
C. blue
D. green

Answer 4

B. lavender

Question 5

The conventional color-coded evacuated tube stopper for heparin is:
A. red
B. lavender
C. blue
D. green

Answer 5

D. green

Question 6

The conventional color-coded evacuated tube stopper for sodium citrate is:
A. red
B. lavender
C. blue
D. green

Answer 6

C. blue

Question 7

The conventional color-coded stopper when no anticoagulant or additive is present in an evacuated tube is:
A. red
B. lavender
C. blue
D. green

Answer 7

A. red

Question 8

List the following five procedural steps in the performance of a venipuncture in the correct sequence.

A. Select an appropriate site and prepare the site
B. Identify the patient, check test requisitions, assemble equipment, wash hands, and put on latex gloves
C. Remove tourniquet, remove needle, apply pressure top site, and label all tubes
D. Reapply the tourniquet and perform the venipuncture
E. Introduce yourself and briefly explain the procedure to the patient

Answer 8

E –> B –> A –> D –> C

Question 9

The appropriate veins for performing a routine venipuncture are the:
A. cephalic, basilic, and median cubital
B. subclavian, iliac, and femoral
C. brachiocephalic, jugular, and popliteal
D. saphenous, suprarenal, and tibial

Answer 9

A. cephalic, basilic, and median cubital

Question 10

A blood sample is needed from a patient with IV fluids running in both arms. Which of the following is an acceptable procedure?
A. Any obtainable vein is satisfactory.
B. Obtain sample from above the IV site
C. Obtain sample from below the IV site with special restrictions.
D. Disconnect the IV line
E. Do not draw a blood specimen

Answer 10

C. Obtain sample from below the IV site with special restrictions.

Question 11

The bevel of the needle should be held _________ in the performance of a venipuncture.
A. sideways
B. upward
C. downward
D. in any direction

Answer 11

B. upward

Question 12

A hematoma can form if:
A. improper pressure is applied to a site after the venipuncture
B. the patient suddenly moves and the needle comes out of the vein
C. the needle punctures both walls of the vein
D. all of the above

Answer 12

D. all of the above

Question 13

Phlebotomy problems can include:
A. the use of improper anticoagulants
B. misidentification of patients
C. improper angle of the needle or having the needle up against the side of the vessel wall
D. all of the above

Answer 13

D. all of the above

Question 14

Which of the following skin puncture areas is acceptable for the collection of capillary blood from an infant?
A. previous puncture site
B. posterior curve of the heel
C. the arch
D. medial or lateral plantar surface

Answer 14

D. medial or lateral plantar surface

Question 15

The proper collection of capillary blood includes
A. wiping away the first drop of blood
B. occasionally wiping the site with a plain gauze pad to avoid the buildup of platelets
C. avoiding the introduction of air bubbles into the column of blood in a capillary collection tube
D. all of the above

Answer 15

D. all of the above

Question 16

A peripheral blood smear can be prepared from:
A. EDTA-anticoagulated blood within 1 hour of collection
B. free-flowing capillary blood
C. citrated whole blood
D. both A and B

Answer 16

D. both A and B

Question 17

Identify the characteristic(s) of a good peripheral blood smear.
A. It progresses from thick at the point of origin to thin.
B. It has a blunt feathered termination.
C. The outer margins do not touch the edges of the slide.
D. All of the above.

Answer 17

D. All of the above.

Question 18

Poor blood smears can be caused by:
A. a delay in preparing the smear once the drop of blood has been placed on the slide
B. a drop of blood that is too large or too small
C. holding the pusher slide at the wrong angle and poor drying conditions
D. all of the above

Answer 18

D. all of the above

Question 19

If a blood smear is too long, the problem can be resolved by:
A. decreasing the angle of the pusher slide
B. increasing the angle of the pusher slide
C. using a larger drop of blood
D. pushing the slide slower in smearing out the blood

Answer 19

B. increasing the angle of the pusher slide

Question 20

The examination of bone marrow is useful in:
A. diagnosing a bleeding disorder
B. diagnosing some disorders associated with erythrocytes and leukocytes
C. diagnosing acute leukemias
D. both B and C

Answer 20

D. both B and C

Question 21

Appropriate bone marrow aspiration sites in an adult are:
A. the anterior and posterior iliac crest
B. the sternum and posterior iliac crest
C. the tibia and sternum
D. both A and B

Answer 21

D. both A and B

Question 22

A basic staining effect imparts a(n) ___________ color to blood cells.
A. orange-red color
B. pink-lilac color
C. blue-purple color
D. no effect

Answer 22

C. blue-purple color

Question 23

An acidic staining effect imparts a(n) __________ color to blood cells.
A. orange-red color
B. pink-lilac color
C. blue-purple color
D. no effect

Answer 23

A. orange-red color

Question 24

A neutrophilic staining effect imparts a(n) ___________ color to blood cells.
A. orange-red color
B. pink-lilac color
C. blue-purple color
D. no effect

Answer 24

B. pink-lilac color

Question 25

Wright’s stain is a(n) __________ stain.
A. Romanowsky-type
B. non-Romanowsky type

Answer 25

A. Romanowsky-type

Question 26

If a blood smear stains too red on microscopic examination of a Wright-stained preparation, possible causes include that:
A. the staining time was too long
B. the stain was too basic
C. the buffer was too acidic and the exposure time was too short
D. the buffer was too basic and the exposure time was too long

Answer 26

C. the buffer was too acidic and the exposure time was too short