Blackboard Tests Flashcards
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)
National Association for Accreditation of Clinical Laboratory Sciences (NAACLS)
Which of the following categories would be an inpatient setting?
Acute-care hospital
Mobile blood-donation van
Home health agency
Emergency care centers
Acute-care hospital
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
Withdraw blood into the correct containers/tubes in the correct order
It is best to transport routine blood specimens to the laboratory within:
45 minutes.
2 hours.
1 hour.
4 hours.
45 minutes.
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
Notice body language
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 periodic review of the laboratory’s collection procedures and policies
Approximately how many minutes does it take for a specimen without additives to clot?
10
30
60
15
30
Which term describes anemia that results when excessive amounts of blood are taken from a patient? Diabetic Hemolytic Iron deficiency Iatrogenic
Iatrogenic
Which phase of the laboratory process involves the duty of requesting a repeat blood test?
Analytical
Specimen processing
Preanalytical
Postanalytical
Postanalytical
Maintaining Quality Control on phlebotomy supplies and equipment is part of which phase of laboratory testing?
Postexamination
Examination
Preanalytical
Postanalytical
Preanalytical
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.”
All health care workers should examine the possibility of malpractice suits and the need for malpractice insurance from a personal standpoint.
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
Ethics
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
The patient’s parent/guardian
________ is failure to provide proper care, resulting in injury to others.
Negligence
What is defined as “failure to provide proper care, resulting in injury to others”?
Slander
Assault
Negligence
Criminal action
Negligence
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.
malpractice.
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 violation of HIPAA.
What percentage of laboratory errors occur during the preanalytical (specimen collection and handling) phase?
75%
45%
63%
33%
75%
Which term refers to the conduct of the average health care worker in the community?
Standard of care
Implied consent
Discovery
Informed consent
Standard of care
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 causal connection between her infection and her employment.
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
Failure to ensure patient safety
Professional negligence in blood collection is:
informed consent.
malice.
implied consent.
malpractice.
malpractice.
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
Quality improvement
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.
disposing of laboratory tests in the regular trash.
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
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.
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.
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.
Which of the following covers the privacy and confidentiality of every patient's medical information? EPA FDA HIPAA CLIA
HIPAA
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.
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
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
The network of blood vessels that includes arteries, veins, and capillaries is called the:
cardiovascular system.
hematopathology.
endocrine system.
integumentary system.
cardiovascular system.
Which of the following is the root word meaning “blood”?
Cardio-
Erythro-
Hemo-
Patho-
Hemo-
Which of the following is a suffix meaning “to view”?
-opsy
-itis
Anti-
Homeo-
-opsy
Which of the following is a prefix meaning “same or similar”?
-opsy
-itis
Anti-
Homeo-
Homeo-
Which of the following is the root word meaning “heart”?
Cardio-
Erythro-
Hemo-
Endo-
Cardio-
The term “microbiology” refers to the study of:
bacteria and fungi.
tumors or cancer.
antibodies in the serum.
glands and hormones.
bacteria and fungi.
Another term for a “steady-state” condition is:
preanalytical.
hematopathology.
hemostasis.
homeostasis.
homeostasis.
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
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
Which of the following can be collected from a sample that is eliminated naturally?
Blood
Bone marrow
Pus
Sputum
Sputum
Which of the following is a prefix meaning “against”?
-opsy
-itis
Anti-
Homeo-
Anti-
Which term refers to fluid from the joints?
Pleural fluid
Cerebrospinal fluid
Synovial fluid
Pericardial fluid
Synovial fluid
What type of patient positioning is preferred for performing a venipuncture on hospitalized patients?
Prone
Supine
Seated
Lateral recumbent
Supine
Which of the following is a suffix meaning “inflammation”?
-opsy
-itis
Anti-
Homeo-
-itis
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
The term “oncology” refers to the study of:
pathogens.
the stomach wall.
antibodies in the serum.
tumors or cancer.
tumors or cancer.
Which of the following is the root word meaning “red”?
Hemo-
Cardio-
Patho-
Erythro-
Erythro-
The term “serology” refers to the study of:
antibodies in the serum.
tumors or cancer.
sign language.
integumentary.
antibodies in the serum.
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
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
A chemical compound used to remove or kill pathogenic microorganisms is a/an:
disinfectant.
antiviral compound.
antifungal antiseptic.
antiseptic.
disinfectant.
Which type of precautions is used to prevent the spread of tuberculosis?
Air and temperature precautions
Disinfectant precautions
Airborne precautions
Droplet precautions
Airborne precautions
________ can be used on the skin, while ________ is too corrosive.
Bleach/chlorhexidine
Antiseptic/disinfectant
Formaldehyde/triclosan
Disinfectant/iodophor
Antiseptic/disinfectant
Chemical disinfectants are regulated by the:
HIPAA.
CLIA.
EPA.
CDC.
EPA.
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.
Chemicals used to remove or kill pathogenic microorganisms are ________.
disinfectants
Health care-associated infections are called ________ infections.
reservoir
pediatric
nosocomial
transmission-based
nosocomial
When removing the isolation PPE, the first item to take off is the: gloves. shoe covers. gown. mask.
gloves.
The three cardinal principles of self-protection from radiation exposure are shielding, distance, and:
time.
PPE.
inoculation.
preventative maintenance.
time.
Which of the following agencies require health care facilities to protect workers exposed to biological hazards?
FDA
OSHA
HIPAA
EPA
OSHA
Pertussis transmission is decreased by ________ type of precaution.
droplet
For infection control, host susceptibility is increased by:
fomite exposure.
standard precautions.
speeding the patient’s recovery.
handwashing.
fomite exposure.
Malaria is an example of a(n) ________, infectious organisms found in body fluids.
bloodborne pathogens
universal precautions
bacteria
administrative risk factor
bloodborne pathogens
The yellow quadrant of the DOT Hazardous Materials warning sign refers to what kind of hazard?
Reactivity/instability
Fire
Health
Specific
Reactivity/instability
Contact precautions are used for diseases such as:
tuberculosis.
whooping cough.
herpes simplex.
pneumonia.
herpes simplex.
How many links does the chain of infection have?
4
5
6
7
6
NFPA stands for the:
National Fire Protocol Association.
National Flammability Protective Association.
National Fire Protection Association.
Neutral Flammability Procedure Area.
National Fire Protection Association.
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.
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
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.
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.
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
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
Excessive, vigorous mixing of a blood specimen with an additive can lead to:
hemoglobin.
hemolysis.
hematopoiesis.
hematoma.
hemolysis.
Which specimen should be kept at normal body temperature?
Cryofibrinogen
Gastrin
Pyruvate
Ammonia
Cryofibrinogen
Abnormally low or high clinical laboratory test results are called:
STAT tests.
critical values.
therapeutic ranges.
nondisclosure values.
critical values.
Which of the following is a photosensitive analyte?
Sodium
Cryofibrinogen
Bilirubin
Potassium
Bilirubin
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
Chilling a specimen can delay:
centrifugation requirements.
white cell maturation.
red cell maturation.
clotting time.
clotting time
Normal room temperature is:
37-40°C.
37-40°F.
20-25°C.
20-25°F.
20-25°C.
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
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
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.
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.
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.
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.”
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.
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.
The color coding for needles indicates the:
blood test that can be performed with that needle.
gauge size.
length of needle.
anticoagulant.
gauge size.
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.
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
Which color tube is used for blood bank collections?
Gray
Pink
Green
Royal blue
Pink
Which of the following is a collection and dilution unit?
Monovette
BMP LeukoChek
BD Quikheel
BD Vacutainer
BMP LeukoChek
Which of the following tests uses blood collected in a tan-topped tube?
Glucose
ALT
CK
Lead
Lead
Which of the following tests uses specimens collected in a light blue-topped collection tube?
BUN
APTT
AST
glucose
APTT
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
The yellow-topped vacuum blood collection tube has which of the following additives?
EDTA
Sodium citrate
Ammonium heparin
Sodium polyanethol sulfonate
Sodium polyanethol sulfonate
What size of needle is used for collecting donor units of blood?
23-gauge
21-gauge
25-gauge
18-gauge
18-gauge
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
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
The green-topped blood collection tube can be used to collect blood for:
hemoglobin testing.
hematocrit testing.
cytogenetic studies.
blood cultures.
cytogenetic studies.
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
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
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™
Yellow-topped tubes are used to collect blood for:
CK.
blood gases.
PT.
blood cultures.
blood cultures.
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
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
Which of the following is found in special sterile vacuum tubes used for molecular diagnostic studies?
Clot activator
Thrombin
K2EDTA
Lithium heparin
K 2EDTA
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
A solid mass derived from blood constituents that can occlude a vein is:
angiography.
thrombus.
petechiae.
lymphostasis.
thrombus.
Testing for triglycerides requires the patient to be in a(n):
nonfasting condition.
sclerosed state.
basal state.
upright posture.
basal state.
A hemolyzed specimen can lead to falsely increased results for:
hematocrit.
RBC count.
iron.
hemoglobin.
iron.
Which of the following occurs as the result of inflammation and disease?
Fomites
Syncope
Hemoconcentration
Sclerosed veins
Sclerosed veins
Which of the following is a likely cause of allergic reaction in a patient having a blood draw?
Chlorhexidine
Gauze square
Alcohol
Edema
Alcohol
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
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
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.
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
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
Abnormalities or medications that affect ________ can cause excessive bleeding after venipuncture.
lipemia
coagulation
petechiae
hemolysis
coagulation
________ 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
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.
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.
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.
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.
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.
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
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.
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.
Which of the following is a situation that requires extra caution in patient identification?
Obese patient
Twins
Multiple personality
Stress
Twins
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.
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
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.
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.
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
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.
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
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
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
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
Blood ________ specimens should always be drawn first, when collecting several specimens.
culture
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.
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.
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
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
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.
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.
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
Patients with diabetes can check their own ________ levels at home using a fingerstick test.
blood glucose
CBC
blood alcohol
hemoglobin and hematocrit
blood glucose
What is the preferred method of collecting blood from infants and neonates?
Capillary
Artery puncture
Venipuncture
Vein drip
Capillary
Skin puncture procedures are NOT recommended for:
patient’s receiving IV therapy.
blood cultures.
routine hematology tests.
POCT.
blood cultures.
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
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
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.
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.
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
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
Blood film on a slide should have:
three parallel lines.
serrated edges.
a feathered edge.
ridges but no holes.
a feathered edge.
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.
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
________ fluid forms within tissue layers and gaps.
Interstitial
Venule
Arteriole
Capillary
Interstitial
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)
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
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
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
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
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.
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.
As a person ages, muscles tend to shrink, so the angle of penetration for venipuncture should be ________ than usual.
deeper
longer
faster
shallower
shallower
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.
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
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
What physical condition associated with aging can make venipuncture more difficult?
Thinning skin
Larger muscles
Lowered sensitivity to allergens
Lowered bladder control
Thinning skin
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
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
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
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.
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
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.
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.
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.
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
Loss of taste, smell, and feeling can cause an older person to be malnourished and ________, which can affect venipuncture.
homebound
dehydrated
allergic
anxious
dehydrated
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.
A major medical error that can occur from a neonatal heelstick is:
PKU.
congenital adrenal hyperplasia.
osteomyelitis.
toxoplasmosis.
osteomyelitis
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
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
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
The ________ represents the volume of circulating blood that is occupied by red blood cells.
hemoglobin level
prothrombin
hematocrit
blood glucose value
hematocrit
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
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
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
The term ________ refers to an artificial shunt in which the vein and artery have been fused through surgery.
nebulizer
cannula
catheter
fistula
fistula
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
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
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.
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
Blood cultures are often performed on patients who have:
high blood pressure.
possible hematoma.
suspected prediabetes.
fevers of unknown origin.
fevers of unknown origin.
Which of the following is POC device to measure coagulation?
EQC
CoaguChek XS Plus System.
Actalyke XL
Modified Allen Coag
CoaguChek XS Plus System.
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
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.
________ 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
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
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
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.
Blood glucose levels are frequently measured for patients undergoing:
therapeutic phlebotomy.
treatment for diabetes mellitus.
blood cultures.
donor blood collections.
treatment for diabetes mellitus.
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.
\_\_\_\_\_\_\_\_ occurs when hemoglobin is released and plasma becomes tinged with pink or red. Hemolysis Thrombosis Lymphodema Hemophilia
Hemolysis
