Blackboard Tests Flashcards

1
Q

Which organization has a list of entry-level phlebotomist competencies that are addressed in the chapter?

National Healthcareer Association (NHA)

American Society of Phlebotomy Technicians (ASPT)

National Phlebotomy Association (NPA)

National Association for Accreditation of Clinical Laboratory Sciences (NAACLS)

A

National Association for Accreditation of Clinical Laboratory Sciences (NAACLS)

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2
Q

Which of the following categories would be an inpatient setting?

Acute-care hospital

Mobile blood-donation van

Home health agency

Emergency care centers

A

Acute-care hospital

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3
Q

Which of the following is one of a phlebotomist’s clinical duties?

Manipulate small objects, tubes, and needles

Use medical terminology appropriate for patients and coworkers

Print/collate/distribute laboratory requisitions and reports

Withdraw blood into the correct containers/tubes in the correct order

A

Withdraw blood into the correct containers/tubes in the correct order

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4
Q

It is best to transport routine blood specimens to the laboratory within:

45 minutes.
2 hours.
1 hour.
4 hours.

A

45 minutes.

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5
Q

Which of the following actions helps the phlebotomist to listen actively?

Use an encouraging phrase like “You can tell me about that later.”

Avoid excessive eye contact

Plan your next remark while the patient is speaking

Notice body language

A

Notice body language

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6
Q

Which of the following is recommended to reduce collection errors and ensure quality in the phlebotomy services?

Silent pauses in the conversation to mentally review what has been said

A periodic review of the laboratory’s collection procedures and policies

Role-reversal exercises for internal and external stakeholders

An annual review of insurance companies and employers that pay for services

A

A periodic review of the laboratory’s collection procedures and policies

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7
Q

Approximately how many minutes does it take for a specimen without additives to clot?

10
30
60
15

A

30

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8
Q
Which term describes anemia that results when excessive amounts of blood are taken from a patient?
Diabetic
Hemolytic
Iron deficiency
Iatrogenic
A

Iatrogenic

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9
Q

Which phase of the laboratory process involves the duty of requesting a repeat blood test?

Analytical
Specimen processing
Preanalytical
Postanalytical

A

Postanalytical

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10
Q

Maintaining Quality Control on phlebotomy supplies and equipment is part of which phase of laboratory testing?

Postexamination
Examination
Preanalytical
Postanalytical

A

Preanalytical

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11
Q

Which statement about medical malpractice insurance is TRUE?

Health care staff in the hospital or clinical laboratory is always covered by a blanket malpractice insurance policy.

As a hospital employee, phlebotomists are represented by the hospital’s attorney in malpractice cases.

All health care workers should examine the possibility of malpractice suits and the need for malpractice insurance from a personal standpoint.

Only physicians can be sued for medical malpractice; other health care workers are considered “legally immune.”

A

All health care workers should examine the possibility of malpractice suits and the need for malpractice insurance from a personal standpoint.

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12
Q

Which term means a set of principles or values based on religious or moral teachings that guide a person’s actions?

Ethics
Laws
Maxims
Standards

A

Ethics

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13
Q

Nasir is a 15-year-old patient at the hospital. Who has the right to release his laboratory results?

The laboratory supervisor
The physician
Only the patient
The patient’s parent/guardian

A

The patient’s parent/guardian

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14
Q

________ is failure to provide proper care, resulting in injury to others.

A

Negligence

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15
Q

What is defined as “failure to provide proper care, resulting in injury to others”?

Slander
Assault
Negligence
Criminal action

A

Negligence

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16
Q
The legal term for improper care of a patient by a member of the health care team resulting in injury to the patient is:
battery.
assault.
litigation.
malpractice.
A

malpractice.

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17
Q

A phlebotomist let her friend use her institutional ID password to log on to the laboratory computer to check her mother’s laboratory test results. This is:

okay because her friend is also a phlebotomist in the clinical laboratory and an employee of the health care institution.

okay because it is her mother.

a violation of FDA.

a violation of HIPAA.

A

a violation of HIPAA.

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18
Q

What percentage of laboratory errors occur during the preanalytical (specimen collection and handling) phase?

75%
45%
63%
33%

A

75%

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19
Q

Which term refers to the conduct of the average health care worker in the community?

Standard of care
Implied consent
Discovery
Informed consent

A

Standard of care

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20
Q

Daria is a phlebotomist who became infected with HIV due to a needlestick that happened at work during a patient blood draw. She will probably be covered by workers’ compensation benefits as long as she can demonstrate:

that she was properly trained.

a causal connection between her infection and her employment.

that no malpractice has occurred.

an ethical basis for her claim.

A

a causal connection between her infection and her employment.

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21
Q

Which common issues in lawsuits against health care providers could be avoided by returning the patient’s bed rails to the raised position after blood collection?

Failure to monitor training and education

Failure to ensure patient safety

Documenting and reporting of incidents

Improper treatment and performance of treatment

A

Failure to ensure patient safety

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22
Q

Professional negligence in blood collection is:

informed consent.
malice.
implied consent.
malpractice.

A

malpractice.

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23
Q

What is a nonmedical reason for which medical records are used?

Monitor continuous patient care

Record of illness and treatment

Communication between physician and the health care team

Quality improvement

A

Quality improvement

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24
Q

All of the following are ways to avoid malpractice litigation EXCEPT:

regularly participating in continuing education programs.
properly handling all HIPAA communications without violation.
disposing of laboratory tests in the regular trash.
obtaining consent for the collection of blood specimens.

A

disposing of laboratory tests in the regular trash.

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25
Which of the following might result in a negligence law suit for a health care worker such as a phlebotomist? Discontinuing blood draw when patient faints HIPAA training and signed agreement Emotional distress Providing lab results to the patient
Emotional distress
26
A 4-year-old girl who refused to have her blood collected was locked in a room by a health care worker and was forced to have her blood collected. This is an example of: informed consent. misdemeanor. invasion of privacy. assault and battery.
assault and battery.
27
The federal regulations that are enforced to ensure the quality and accuracy of clinical laboratory testing is covered by: HIPAA. Food and Drug Administration (FDA). Environmental Protection Agency (EPA). CLIA.
CLIA.
28
Before a patient's laboratory test results can legally be released, the patient must: express verbal consent over the telephone or in person. provide written consent. provide his/her attorney's consent. tell his/her physician or nurse practitioner that it is okay.
provide written consent.
29
``` Which of the following covers the privacy and confidentiality of every patient's medical information? EPA FDA HIPAA CLIA ```
HIPAA
30
CLIA essentially applies to: every clinical laboratory testing facility in the United States. those clinical laboratories in hospitals with more than 200 beds. those clinical laboratories in health care institutions with more than 500 beds. every clinical laboratory testing facility in the United States that has molecular diagnostic procedures.
every clinical laboratory testing facility in the United States.
31
What would blood flow from an artery look like? Bright red blood spurting in a pulsating flow A slow even flow of a small amount of blood A steady slow flow of dark red blood A spurting flow of a small amount of dark red blood
Bright red blood spurting in a pulsating flow
32
If a patient's burn is described as "proximal to the elbow," where would the location be? Between the wrist and the elbow Under the elbow Near the wrist Between the elbow and the shoulder
Between the elbow and the shoulder
33
The network of blood vessels that includes arteries, veins, and capillaries is called the: cardiovascular system. hematopathology. endocrine system. integumentary system.
cardiovascular system.
34
Which of the following is the root word meaning "blood"? Cardio- Erythro- Hemo- Patho-
Hemo-
35
Which of the following is a suffix meaning "to view"? -opsy -itis Anti- Homeo-
-opsy
36
Which of the following is a prefix meaning "same or similar"? -opsy -itis Anti- Homeo-
Homeo-
37
Which of the following is the root word meaning "heart"? Cardio- Erythro- Hemo- Endo-
Cardio-
38
The term "microbiology" refers to the study of: bacteria and fungi. tumors or cancer. antibodies in the serum. glands and hormones.
bacteria and fungi.
39
Another term for a "steady-state" condition is: preanalytical. hematopathology. hemostasis. homeostasis.
homeostasis.
40
Which gases are exchanged in the capillaries? Nitrogen and argon Nitrogen and helium Potassium and carbon monoxide Oxygen and carbon dioxide
Oxygen and carbon dioxide
41
If there is a large bandage covering "a superficial wound on the anterior side of the shoulder," what type of wound is it and where would the location be? Deep wound on the back side of the shoulder Deep wound on the front side of the shoulder Wound on the surface of the skin located on the front side of the shoulder Wound on the surface of the skin located on the back side of the shoulder
Wound on the surface of the skin located on the front side of the shoulder
42
Which of the following can be collected from a sample that is eliminated naturally? Blood Bone marrow Pus Sputum
Sputum
43
Which of the following is a prefix meaning "against"? -opsy -itis Anti- Homeo-
Anti-
44
Which term refers to fluid from the joints? Pleural fluid Cerebrospinal fluid Synovial fluid Pericardial fluid
Synovial fluid
45
What type of patient positioning is preferred for performing a venipuncture on hospitalized patients? Prone Supine Seated Lateral recumbent
Supine
46
Which of the following is a suffix meaning "inflammation"? -opsy -itis Anti- Homeo-
-itis
47
Why is venous blood dark red in color? Because it is oxygen-rich Because it travels away from the heart Because it travels toward the heart Because it lacks oxygen
Because it lacks oxygen
48
The term "oncology" refers to the study of: pathogens. the stomach wall. antibodies in the serum. tumors or cancer.
tumors or cancer.
49
Which of the following is the root word meaning "red"? Hemo- Cardio- Patho- Erythro-
Erythro-
50
The term "serology" refers to the study of: antibodies in the serum. tumors or cancer. sign language. integumentary.
antibodies in the serum.
51
The HICPAC recommendation for transmission-based precautions to provide respiratory protection from exposure to droplets is to use a mask ________ of the patient. when in the ward in the room within 10 feet within 3 feet
within 3 feet
52
Health care-acquired infections result when the ________ is complete. mode of transmission mode of microorganism translation chain of aseptic technique chain of infection
chain of infection
53
A chemical compound used to remove or kill pathogenic microorganisms is a/an: disinfectant. antiviral compound. antifungal antiseptic. antiseptic.
disinfectant.
54
Which type of precautions is used to prevent the spread of tuberculosis? Air and temperature precautions Disinfectant precautions Airborne precautions Droplet precautions
Airborne precautions
55
________ can be used on the skin, while ________ is too corrosive. Bleach/chlorhexidine Antiseptic/disinfectant Formaldehyde/triclosan Disinfectant/iodophor
Antiseptic/disinfectant
56
Chemical disinfectants are regulated by the: HIPAA. CLIA. EPA. CDC.
EPA.
57
A typical place that fomites would be found in the blood collection area is: a sterile bandage. chlorhexidine. a door knob. isopropyl alcohol.
a door knob.
58
Chemicals used to remove or kill pathogenic microorganisms are ________.
disinfectants
59
Health care-associated infections are called ________ infections. reservoir pediatric nosocomial transmission-based
nosocomial
60
``` When removing the isolation PPE, the first item to take off is the: gloves. shoe covers. gown. mask. ```
gloves.
61
The three cardinal principles of self-protection from radiation exposure are shielding, distance, and: time. PPE. inoculation. preventative maintenance.
time.
62
Which of the following agencies require health care facilities to protect workers exposed to biological hazards? FDA OSHA HIPAA EPA
OSHA
63
Pertussis transmission is decreased by ________ type of precaution.
droplet
64
For infection control, host susceptibility is increased by: fomite exposure. standard precautions. speeding the patient's recovery. handwashing.
fomite exposure.
65
Malaria is an example of a(n) ________, infectious organisms found in body fluids. bloodborne pathogens universal precautions bacteria administrative risk factor
bloodborne pathogens
66
The yellow quadrant of the DOT Hazardous Materials warning sign refers to what kind of hazard? Reactivity/instability Fire Health Specific
Reactivity/instability
67
Contact precautions are used for diseases such as: tuberculosis. whooping cough. herpes simplex. pneumonia.
herpes simplex.
68
How many links does the chain of infection have? 4 5 6 7
6
69
NFPA stands for the: National Fire Protocol Association. National Flammability Protective Association. National Fire Protection Association. Neutral Flammability Procedure Area.
National Fire Protection Association.
70
For patients whose immune systems are suppressed, some hospitals can provide a protective environment, which is also called: airborne isolation. droplet isolation. contact precautions. reverse isolation.
reverse isolation.
71
What would indicate to the laboratory that a doctor is ordering a lab test on an emergency basis and needs the results immediately? ER notation on the test request Bar code on the patient identification armband STAT notation on the test request Notation on the door of the patient's room
STAT notation on the test request
72
Specimens that must be kept at normal body temperature until the test is performed should be stored at: 98°C. 37°C. 75°C. 25°C.
37°C.
73
The "Five Cs" of medical records documentation include: concise, complete, clear, correct, and chronologic. clear, correct, creative, comprehensive, and candid. competent, consistent, clear, concise, and correct. comprehensive, cryptic, chronologic, concise, and complete.
concise, complete, clear, correct, and chronologic.
74
CLSI guidelines notes that "blood sample" and "blood specimen" should be considered different things. Which of the following is the CLSI definition of "specimen"? A portion of a blood sample that has been removed/separated from the original tube after initial processing (centrifugation) and is considered to be identical to all other portions of the original serum, plasma, urine, or cerebrospinal fluid The total amount of blood in an individual's body, based on weight, and that can be calculated for any size person The discrete portion of a body fluid (e.g., blood or urine), breath, hair, or tissue taken for examination or analysis of one or more characteristics (analytes), to determine the character of the patient's body One or more parts (e.g., blood or tissues) taken from a system (the patient's body) and intended to provide information on the system
The discrete portion of a body fluid (e.g., blood or urine), breath, hair, or tissue taken for examination or analysis of one or more characteristics (analytes), to determine the character of the patient's body
75
Which of the following will increase the likelihood of detecting pathogenic bacteria in blood, sputum, or urine specimens? Placing the specimen in a culture medium as quickly as possible Delivering the specimen to the lab by drone Labeling the specimen as a potential biohazard Using a reputable courier service to transport it from the hospital lab to an offsite lab
Placing the specimen in a culture medium as quickly as possible
76
Excessive, vigorous mixing of a blood specimen with an additive can lead to: hemoglobin. hemolysis. hematopoiesis. hematoma.
hemolysis.
77
Which specimen should be kept at normal body temperature? Cryofibrinogen Gastrin Pyruvate Ammonia
Cryofibrinogen
78
Abnormally low or high clinical laboratory test results are called: STAT tests. critical values. therapeutic ranges. nondisclosure values.
critical values.
79
Which of the following is a photosensitive analyte? Sodium Cryofibrinogen Bilirubin Potassium
Bilirubin
80
Glycolytic action is ________, which can interfere with the laboratory analysis of some analytes. the breakdown of glucose in the blood a natural form of centrifugation anticoagulation caused by drugs such as aspirin the breakdown of fat cells in the blood
the breakdown of glucose in the blood
81
Chilling a specimen can delay: centrifugation requirements. white cell maturation. red cell maturation. clotting time.
clotting time
82
Normal room temperature is: 37-40°C. 37-40°F. 20-25°C. 20-25°F.
20-25°C.
83
For ordering a laboratory test, which of the following information is required? Patient's name and unique identifier Patient's marital status Preferred vein from which to draw the specimen Name of the nurse who is in charge of the patient
Patient's name and unique identifier
84
How should blood specimen tubes be centrifuged? For over an hour unless there is a STAT request on file After clotting is complete and with a secure top As many times as it takes to get the correct separation First come, first served, regardless of the numbers
After clotting is complete and with a secure top
85
For transportation of specimens from remote ambulatory sites to the laboratory, which of the following is a recommend guideline? Keep thermolabile specimens no cooler than room temperature. Use the same safety equipment that is used in a hospital environment. Tubes with additives should be gently inverted 5-10 times prior to blood draw. Keep photosensitive analytes in clear containers.
Use the same safety equipment that is used in a hospital environment.
86
During the postcentrifugation period, all specimen tubes should be stored: in a warm location. in a slanted position for visual clarity. in an upright position with a secure closure. inside the refrigerator, with the cap down to keep it moist.
in an upright position with a secure closure.
87
Compared to a hospital computerized system for ordering laboratory tests, a manual (paper) system is more: cost effective. prone to accounting mistakes. prone to transcription mistakes. efficient.
prone to transcription mistakes.
88
How should a laboratory worker correct an error in a patient's clinical record that appears on a paper document? Remove the entire page and show it to the physician immediately. Remove the entire page and have it reprinted with the correct result. Mark a single line through the incorrect result and write "error." Use correction fluid to delete an incorrect result.
Mark a single line through the incorrect result and write "error."
89
A phlebotomist walks into a patient's hospital room with a handwritten laboratory request to collect a blood specimen. The patient does not have an armband but is conscious. When asked his name, the patient's verbal response does not match the written request. What should the phlebotomist do? Look for an identification tag on the bed. Resolve the identification discrepancy before proceeding. Check the patient's driver's license then collect the blood. Call the doctor to confirm the identification.
Resolve the identification discrepancy before proceeding.
90
What is the purpose of a gel inside the specimen collection tube? Gel acts as a barrier between serum/plasma and cells. Gel warms the specimen. Gel extends clotting time. Gel acts as a preservative.
Gel acts as a barrier between serum/plasma and cells.
91
The color coding for needles indicates the: blood test that can be performed with that needle. gauge size. length of needle. anticoagulant.
gauge size.
92
Green-topped tubes used for collecting specimens for cytogenetic studies must: contain thrombin-based clot activator. be sterile. be used for STAT procedures. be used for blood-smear collection.
be sterile.
93
Which of the following vacuum blood collection tubes contains sodium fluoride? Gray-topped tube Yellow-topped tube Red-topped tube Royal blue-topped tube
Gray-topped tube
94
Which color tube is used for blood bank collections? Gray Pink Green Royal blue
Pink
95
Which of the following is a collection and dilution unit? Monovette BMP LeukoChek BD Quikheel BD Vacutainer
BMP LeukoChek
96
Which of the following tests uses blood collected in a tan-topped tube? Glucose ALT CK Lead
Lead
97
Which of the following tests uses specimens collected in a light blue-topped collection tube? BUN APTT AST glucose
APTT
98
Which of the following additives prevent coagulation of blood by removing calcium and forming insoluble calcium salts? Ammonium heparin, sodium citrate, potassium oxalate EDTA, lithium heparin, sodium citrate Sodium fluoride, lithium heparin, EDTA EDTA, potassium oxalate, sodium citrate
EDTA, potassium oxalate, sodium citrate
99
The yellow-topped vacuum blood collection tube has which of the following additives? EDTA Sodium citrate Ammonium heparin Sodium polyanethol sulfonate
Sodium polyanethol sulfonate
100
What size of needle is used for collecting donor units of blood? 23-gauge 21-gauge 25-gauge 18-gauge
18-gauge
101
Which of the following blood collection tubes has a glycolytic inhibitor? Red-topped tube Green-topped tube Light blue-topped tube Gray-topped tube
Gray-topped tube
102
Which of the following is the vacuum blood collection tube of choice for glucose testing? Royal blue-topped tube Gray-topped tube Purple-topped tube Light blue-topped tube
Gray-topped tube
103
The green-topped blood collection tube can be used to collect blood for: hemoglobin testing. hematocrit testing. cytogenetic studies. blood cultures.
cytogenetic studies.
104
Which of the following is the best for the sterile blood collection for nutritional studies? Royal blue-topped tube Red-topped tube Yellow-topped tube Gold-topped tube
Royal blue-topped tube
105
Which of the following tests usually requires blood collected in a royal blue-topped vacuum blood collection tube? CBC Trace elements Cortisol Lactate dehydrogenase
Trace elements
106
Which of the following will help prevent accidental needlesticks when drawing blood from a patient whose veins are too fragile to use a vacuum tube? BD SafetyGlide™ BD Vacutainer® Barricor BD Vacutainer® Passive Shielding BD BACTEC™ Culture Vial
BD SafetyGlide™
107
Yellow-topped tubes are used to collect blood for: CK. blood gases. PT. blood cultures.
blood cultures.
108
Which of the following is the vacuum blood collection tube of choice for CBC blood collection? Red-topped tube Gray-topped tube Yellow-topped tube Purple-topped tube
Purple-topped tube
109
The black-topped tube used to determine the erythrocyte sedimentation rate contains which of the following additives? Sodium heparin EDTA Sodium citrate Potassium citrate
Sodium citrate
110
Which of the following is found in special sterile vacuum tubes used for molecular diagnostic studies? Clot activator Thrombin K2EDTA Lithium heparin
K 2EDTA
111
Which of the following is an increase in red blood cells and other cells and solids in the blood caused from loss of fluid in the tissues around the venipuncture site? Hemoconcentration Septicemia Sclerosis Hemolysis
Hemoconcentration
112
A solid mass derived from blood constituents that can occlude a vein is: angiography. thrombus. petechiae. lymphostasis.
thrombus.
113
Testing for triglycerides requires the patient to be in a(n): nonfasting condition. sclerosed state. basal state. upright posture.
basal state.
114
A hemolyzed specimen can lead to falsely increased results for: hematocrit. RBC count. iron. hemoglobin.
iron.
115
Which of the following occurs as the result of inflammation and disease? Fomites Syncope Hemoconcentration Sclerosed veins
Sclerosed veins
116
Which of the following is a likely cause of allergic reaction in a patient having a blood draw? Chlorhexidine Gauze square Alcohol Edema
Alcohol
117
If a patient will be having a test that requires fasting, the health care worker must tell the patient to continue to ingest: fruit juice. solid food. water. sodium.
water
118
It is possible to collect blood from an IV line that is already inserted, but this increases the risk of: hemolysis. fomites. edema. thrombi.
hemolysis
119
After the needle is inserted for a venipuncture, if the blood begins to squirt out in pulses, it is likely that: the patient has petechiae. the patient has a low red blood cell count. a vein has been penetrated by the needle. an artery has been penetrated by the needle.
an artery has been penetrated by the needle.
120
Which of the following would be an explanation for turbid serum? Ingestion of sugar Bacterial contamination Ingestion of fatty substances Release of hemoglobin
Ingestion of fatty substances
121
Avoid taking blood from areas on a patient's body affected by ________ because the specimen may become contaminated with fluid. occlusions scleroderma edema obesity
edema
122
Abnormalities or medications that affect ________ can cause excessive bleeding after venipuncture. lipemia coagulation petechiae hemolysis
coagulation
123
________ is the sudden and transient loss of consciousness caused by a lack of oxygen to the brain that results in an inability to stay in an upright position. Occlusion Petechiae Fomite Syncope
Syncope
124
A basal state occurs: in the early morning, about 12 hours after food intake. in the evening, 3 hours after food intake. after dinner. in the afternoon, 2 hours after ingestion of lunch.
in the early morning, about 12 hours after food intake.
125
A health care worker notices that the tube is filling properly at first, but then the blood entering the tube starts to slow and stops flowing. This is a sign that: the patient has fainted. the patient's triglycerides are dangerously elevated. the patient's vein has collapsed. the patient is having a neurological complication.
the patient's vein has collapsed.
126
Tourniquet pressure that is too tight or lasts too long can result in: excessive specimen removal. falsely elevated test results. sclerosed veins. syncope.
falsely elevated test results.
127
A blood clotting abnormality such as thrombocytopenia can sometimes be detected by seeing: petechiae on the patient. fomites on the patient. the patient faint in the venipuncture procedure. edema at the area of a mastectomy.
petechiae on the patient.
128
What can be a problem for the phlebotomist in working with an obese patient? The patient may have difficulty understanding instructions. The patient may become disoriented and uncooperative. It may be difficult to visualize or palpate the patient's veins. The patient's veins may have excessive scar tissue.
It may be difficult to visualize or palpate the patient's veins.
129
A ________ occurs when the area around a venipuncture site starts to swell and blood is leaking into the tissues. fomite hematoma syncope episode hemolytic episode
hematoma
130
The term "three-way match" refers to patient identification by means of: stated name must match the requisition and the armband. three forms of paper identification. stated name must match the requisition and the bed label. three forms of computerized identification.
stated name must match the requisition and the armband.
131
If there is a large bandage covering "a deep wound on the dorsal side of the right wrist," where is the wound and where would the preferred venipuncture location be? The wound is on the back side of the right wrist and venipuncture should be done on the front side of the right wrist. The wound is on the antecubital surface of the right wrist and venipuncture should be in the antecubital area of the left arm. The wound is on the front side of the right wrist and venipuncture should be done on the antecubital surface of the right arm. The wound is on the back side of the right wrist and the venipuncture should be in the antecubital area of the left arm.
The wound is on the back side of the right wrist and the venipuncture should be in the antecubital area of the left arm.
132
Which of the following is a situation that requires extra caution in patient identification? Obese patient Twins Multiple personality Stress
Twins
133
A phlebotomist walks into a patient's room to collect a routine blood specimen. The patient is asleep What should the phlebotomist do? Call the supervisor. Come back later when the patient is awake. Quietly take the specimen without waking the patient. Wake the patient and confirm identity.
Wake the patient and confirm identity.
134
For a patient with sensitive skin, which of the following is the preferred method for caring for the puncture site? Gauze pad, secured with medical adhesive tape Cotton ball over puncture site, secured with self-adhering wrap Gauze wrapped around the arm, secured with self-adhering wrap Self-adhesive bandage over the puncture site
Gauze wrapped around the arm, secured with self-adhering wrap
135
During a blood collection, the patient complains that the procedure is very painful. What should the phlebotomist do? Reassure the patient that the procedure will be over quickly. Remove the needle from the patient's arm and find an alternate site on the foot. Remove the needle and reinsert it at a better angle. Stop the procedure immediately and remove the needle.
Stop the procedure immediately and remove the needle.
136
A phlebotomist entered a hospital room to collect a routine blood specimen using a butterfly system for a coagulation test. The phlebotomist noticed that the patient had just finished lunch. What extra step should a phlebotomist take? Indicate the nonfasting condition on the requisition. Use a discard tube before filling the coag tube. Warm the venipuncture site prior to the needlestick. No extra steps are required.
Indicate the nonfasting condition on the requisition.
137
A phlebotomist was having trouble finding a vein on a hospitalized patient, even after leaving the tourniquet on for a couple of minutes, and dangling the patient's arm off the side of the bed. The phlebotomist decided to warm the site and try again later. Which step was inappropriate? Dangling the patient's arm Warming the site Trying again at a later time Leaving the tourniquet on too long
Leaving the tourniquet on too long
138
The CLSI recommendation for blood specimen collection is limited to 1% to 5% of total blood volume within: 8 weeks. a 2 to 4 hour period. 8 days. a 24-hour period.
a 24-hour period.
139
What should happen immediately following blood collection at a patient's bedside or in the ambulatory setting? Transporting specimen to lab Verifying identification Washing hands Labeling specimens
Labeling specimens
140
If a patient is burned near the right elbow, where would the preferred venipuncture location be? Back side of the right wrist Under the right elbow Left arm's antecubital area Left hand fingerstick
Left arm's antecubital area
141
What is the first thing the phlebotomist should do if the patient faints? Apply an ammonia inhalant (smelling salts) Lay the patient flat Finish the blood draw procedure Remove the tourniquet
Remove the tourniquet
142
The phlebotomist sees that the patient is having blood drawn for several purposes, requiring tubes with a yellow top, a purple top, a red top, and a green top. Which tube should be used first? Yellow Green Purple Red
Yellow
143
Blood ________ specimens should always be drawn first, when collecting several specimens.
culture
144
According to CLSI, the preferred sites for venipuncture are found: in the antecubital area of the arm. adjacent to the bicipital aponeurosis. in the flexor digitorum longus. in the upper arm, just below the shoulder.
in the antecubital area of the arm.
145
Which of the following is important to know to avoid confusing veins and arteries? Veins pulsate, are more elastic, and have a thick wall. Arteries pulsate, are more elastic, and have a thick wall. The median cubital vein is more prominent than the cephalic artery. The median cubital artery is more prominent than the cephalic vein.
Arteries pulsate, are more elastic, and have a thick wall.
146
Evacuated tube systems and winged infusion systems (butterfly systems) both ________, as recommended by CLSI. allow blood to flow directly into the collection tubes make acceptable alternatives to the preferred syringe method should be used only on alternative draw sites should be used without tourniquets
allow blood to flow directly into the collection tubes
147
Which of the following is NOT ACCEPTABLE as a form of identifying the patient? Name Patient's chart Date of birth Government-issued ID with photo
Patient's chart
148
To avoid hemolysis, remove the tourniquet after: at least 2 minutes. no more than 1 minute. no more than 30 seconds. no less than 5 minutes.
no more than 1 minute.
149
A phlebotomist walks into a neonatal patient's room to collect a blood specimen. There is a woman sitting in a chair, holding the baby. The bathroom door is closed and someone can be heard inside. What should the phlebotomist do before taking the sample? Document the identity of the woman, ask her to identify the baby, and compare that identification with the baby's ID band. Call security to hold the woman until the mother comes out of the bathroom. Ask the patient if it is okay for the family to step outside during the procedure. Come back later when the family is gone.
This one is an odd duck of an answer. The "correct" answer is to call security, but the *actual* answer is to ask the identity of the woman.
150
The average depth of a skin puncture for a small child is ________ mm. less than 1 less than 2 between 2.0 and 2.5 between 2.5 and 3.0
less than 2
151
Patients with diabetes can check their own ________ levels at home using a fingerstick test. blood glucose CBC blood alcohol hemoglobin and hematocrit
blood glucose
152
What is the preferred method of collecting blood from infants and neonates? Capillary Artery puncture Venipuncture Vein drip
Capillary
153
Skin puncture procedures are NOT recommended for: patient's receiving IV therapy. blood cultures. routine hematology tests. POCT.
blood cultures.
154
A phlebotomist was supposed to perform a skin puncture on a patient but the patient had very cold hands. What should the phlebotomist do next? Apply a tourniquet Warm the hand Proceed with the skin puncture Asking the patient to clench/unclench his/her fist
Warm the hand
155
How many times can the puncture apparatus (lancet or sharp) be used for fingersticks on the same patient? Once Twice Three times Four times
Once
156
Why are bandages after a skin puncture not recommended for babies? They do not prevent infections. There is a risk of swallowing the bandage. It might make the puncture site unusable. They hurt too much when removed.
There is a risk of swallowing the bandage.
157
The phlebotomist is about to do a capillary puncture procedure on a 35-year-old man in his hospital room. She notices that she only has brought a pediatric puncture device with her supplies. Is it acceptable to use this device? Yes, any puncture device will work on an adult (but not vice versa). No, it is too likely to accidentally puncture a bone, causing osteochondritis. No, it will probably not produce enough blood to complete the collection. Yes, as long as she is careful not to puncture the bone.
No, it will probably not produce enough blood to complete the collection.
158
A phlebotomist is going to collect a blood specimen for hemoglobin and hematocrit from a hospitalized patient. The patient has a full cast on both arms extending to the wrist. What should the phlebotomist do? Collect the blood from the ankle Page the doctor to double check the order Perform a fingerstick and document the collection site Come back later
Perform a fingerstick and document the collection site
159
If a patient is known to have poor peripheral circulation, what type of specimen collection will NOT work well for her? Butterfly technique Fingerstick technique Normal venipuncture using evacuated tubes Syringe technique
Fingerstick technique
160
Blood film on a slide should have: three parallel lines. serrated edges. a feathered edge. ridges but no holes.
a feathered edge.
161
Which of the following is a situation in which a fingerstick procedure is recommended? Collection is for coagulation study. Patient has fragile veins. Patient is dehydrated. Patient has poor peripheral circulation.
Patient has fragile veins.
162
When cleansing a skin puncture site, it is most important to wipe the area: then allow it to dry. by rubbing for a minute in concentric circles. from top to bottom three times. while visualizing a vein.
then allow it to dry
163
________ fluid forms within tissue layers and gaps. Interstitial Venule Arteriole Capillary
Interstitial
164
Which device is used for a heelstick on a premature infant? BD Microtainer Quikheel Lancet (pink) BD Microtainer Quikheel Lancet (teal) BD Microtainer Contact-Activated Lancet (pink) BD Microtainer Contact-Activated Lancet (blue)
BD Microtainer Quikheel Lancet (pink)
165
The phlebotomist is going to collect a small blood sample from a patient. He notes that the patient's veins are being "saved for therapy." What technique should he use to collect the sample? Fingerstick technique Butterfly technique Venipuncture using evacuated tubes Syringe technique
Fingerstick technique
166
When filling multiple microcollection tubes with capillary blood, which of the following should be completed LAST? Other tubes with additives EDTA specimens for hematology tests Blood gases Serum tubes
Serum tubes
167
Generally speaking, capillary blood has more ________ than ________ because of the stronger pressure. arterial blood/venous blood hemoglobin/interstitial fluid venous blood/arterial blood interstitial blood/intrastitial fluid
arterial blood/venous blood
168
What is the preferred choice for a fingerstick location? Fourth finger of the dominant hand Third finger of the nondominant hand Third finger of the dominant hand Fourth finger of the nondominant hand
Third finger of the nondominant hand
169
One reason that skin punctures are more beneficial to children than venipunctures is that they: can be performed while the patient is asleep. do not worry the parents as much. assure that the patient will not faint. retain blood volume.
retain blood volume.
170
The increase in the population of debilitating conditions such as Alzheimer's and Parkinson's is likely to increase POC testing by: venipuncture. skin puncture. arterial puncture. smartphone.
skin puncture.
171
As a person ages, muscles tend to shrink, so the angle of penetration for venipuncture should be ________ than usual. deeper longer faster shallower
shallower
172
Blood spot testing for neonatal screening to detect metabolic and genetic abnormalities occurs on blood collected within: 72 hours. 24 hours. three weeks. three days.
72 hours.
173
Which of the following is NOT a normal acceptable intervention to alleviate pain when performing venipuncture on an infant? Pacifier Lidocaine injection EMLA cream Oral sucrose
Lidocaine injection
174
Which type of venipuncture equipment is more appropriate for an older patient with fragile veins? Distal phalanx Syringe EMLA Safety butterfly needle
Safety butterfly needle
175
What physical condition associated with aging can make venipuncture more difficult? Thinning skin Larger muscles Lowered sensitivity to allergens Lowered bladder control
Thinning skin
176
Many older patients may take medications that ________, so the phlebotomist should be sure bleeding has stopped after the venipuncture procedure. require disinfectants interact polypharmaceutically are considered biohazards thin blood
thin blood
177
Sometimes a child must be briefly restrained to take a blood specimen. For toddlers, the ________ position works best, with the child on the parent's lap. prone supine horizontal vertical
vertical
178
In the collection of blood cultures from infants, which of the following is the preferred antiseptic to use prior to blood collection? 70% isopropyl alcohol Chlorhexidine gluconate Betadine Iodine
Chlorhexidine gluconate
179
Microcapillary skin punctures help avoid overcollecting from pediatric patients, which can result in the need for: platelet clumping. additional collection tubes. packed-blood-cell transfusion. blood pH imbalance.
packed-blood-cell transfusion.
180
The phlebotomist arrives at the patient's room to do a blood collection procedure. Because the patient is ________ old, the phlebotomist knows to do a heelstick. 9 hours 74 years 14 months 8 years
9 hours
181
When performing a pediatric venipuncture with a butterfly needle, the recommended gauge is: 23 × 3/4 inch. 17 × 1/4 inch. 19 × 1/2 inch. 20 × 1 inch.
23 × 3/4 inch.
182
When conducting a blood collection in an older person's home, the phlebotomist should: ask the patient to dispose of used supplies properly. positively identify the patient. document if the patient is asleep during the procedure. place the patient in a comfortable standing position.
positively identify the patient.
183
When working with a pediatric patient, the phlebotomist should be sure to: ask about the child's previous experience with blood collection. avoid using dolls or puppets that might frighten the child. reassure the parent by avoiding excessive eye contact. ask the parent to leave the room.
ask about the child's previous experience with blood collection.
184
Which age group is most likely to be embarrassed to show fear when venipuncture is performed on them? 13 to 17 years old 6 to 12 years old 1 to 3 years old 3 to 5 years old
13 to 17 years old
185
Loss of taste, smell, and feeling can cause an older person to be malnourished and ________, which can affect venipuncture. homebound dehydrated allergic anxious
dehydrated
186
When using EMLA as a local anesthetic for a child with difficult veins, what should the phlebotomist be sure to do? Discontinue the blood collection attempt. Use a pediatric-size face mask. Anesthetize two separate locations. Hold the child in a supine position.
Anesthetize two separate locations.
187
A major medical error that can occur from a neonatal heelstick is: PKU. congenital adrenal hyperplasia. osteomyelitis. toxoplasmosis.
osteomyelitis
188
The phlebotomist has a 72-year-old patient named Helga Schmidt. How should the phlebotomist address this patient? Honey Frau Schmidt Ms. Schmidt Helga
Ms. Schmidt
189
Children older than 3 respond well to ________ to lessen distress at the prospect of a blood draw. a hearty manner privacy emotional mirroring distraction
distraction
190
The HemoCue beta-glucose analyzer can obtain test results from capillary, arterial, or venous blood to measure a patient's ________ level. blood glucose hematocrit hemoglobin creatinine
hemoglobin
191
The ________ represents the volume of circulating blood that is occupied by red blood cells. hemoglobin level prothrombin hematocrit blood glucose value
hematocrit
192
Which of the following evacuated tubes is preferred for the collection of a blood culture specimen? Yellow-topped evacuated tube Green-topped evacuated tube Speckled-topped evacuated tube Light blue-topped evacuated tube
Yellow-topped evacuated tube
193
The ________ artery in the leg can be used for ABG collections but is the last choice for an arterial puncture site. radial brachial femoral dorsal
femoral
194
During the glucose tolerance test, an adult patient ingests 75 or 100 grams of glucose. The patient's blood glucose level should return to normal within ________ minutes. 15 60 45 120
120
195
The term ________ refers to an artificial shunt in which the vein and artery have been fused through surgery. nebulizer cannula catheter fistula
fistula
196
Which of the following is another term that means "point-of-care testing"? Off-site testing On-demand testing Centralized laboratory testing Patient-focused testing
Patient-focused testing
197
Which of the following would probably lead to deferral of a person from blood donation? A recent tattoo in the pit of the elbow Pulse of 70 when taken at wrist Body weight between 120 and 140 Hemoglobin value of 38%
A recent tattoo in the pit of the elbow
198
When swabbing the arm in concentric circles prior to a blood culture, it is important to: wipe gently. use only 70% isopropyl alcohol swabs. avoid iodine and iodine products. scrub with friction.
scrub with friction.
199
Which of the following tests performed on people with diabetes requires the patient to be fasting for 8 to 12 hours? A1C Postprandial glucose test HbA1C GTT
GTT
200
Blood cultures are often performed on patients who have: high blood pressure. possible hematoma. suspected prediabetes. fevers of unknown origin.
fevers of unknown origin.
201
Which of the following is POC device to measure coagulation? EQC CoaguChek XS Plus System. Actalyke XL Modified Allen Coag
CoaguChek XS Plus System.
202
Which of the following can cause a serious problem in relation to point-of-care testing? Patient has drunk water within 8 hours of the test Alcohol was allowed to dry on patient's arm Reagents are out of date Patient is identified by only three measures
Reagents are out of date
203
A cannula: is found at the fusion of a vein and an artery. is a tubular instrument used to gain access to venous blood. is an artificial shunt that provides access to arterial blood. monitors heparin therapy during cardiac procedures and dialysis.
is a tubular instrument used to gain access to venous blood.
204
________ provide useful information about the respiratory status and the acid-base balance of patients with pulmonary disease or disorders. Standard dimension Standard deviation Arterial blood gases Standard distance
Arterial blood gases
205
What is one of the most widely used applications of POC testing of a blood sample? Cardiac puncture Blood vessel cannulation Pregnancy test Blood glucose monitoring
Blood glucose monitoring
206
When conducting a(n) ________, a positive or negative result (based on color) can be seen within 5 to 10 seconds. routine urinalysis modified Allen test creatinine clearance test glucose tolerance test
modified Allen test
207
For the brief physical examination that is required to determine whether a blood donor is in generally good health, the donor's systolic blood pressure should measure no higher than: 200 mm Hg. 80 mm Hg. 180 mm Hg. 100 mm Hg.
180 mm Hg.
208
Blood glucose levels are frequently measured for patients undergoing: therapeutic phlebotomy. treatment for diabetes mellitus. blood cultures. donor blood collections.
treatment for diabetes mellitus.
209
A phlebotomist is going to use a glucose monitoring device to test patients' blood sugar levels. How can she be sure instrument is providing the most accurate results? Take readings from 5 glucometers and average the results. Clean the glucometer in the autoclave after each patient. Obtain a daily control value. Use a new glucometer for each patient.
Obtain a daily control value.
210
``` ________ occurs when hemoglobin is released and plasma becomes tinged with pink or red. Hemolysis Thrombosis Lymphodema Hemophilia ```
Hemolysis