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Hematology > Blood Specimen Collection > Flashcards

Blood Specimen Collection Flashcards

1
Q

Which step in the CLSI procedure for venipuncture is part of standard precautions?
a. Wearing gloves
b. Positively identifying the patient
c. Cleansing the site for the venipuncture
d. Bandaging the venipuncture site

A

Wearing gloves

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2
Q

Select the needle most commonly used in standard venipuncture in an adult:
a. One inch, 18 gauge
b. One inch, 21 gauge
c. One-half inch, 23 gauge
d. One-half inch, 25 gauge

A

One inch, 21 gauge

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3
Q

For a complete blood count (hematology) and measurement of prothrombin time (coagulation), the phlebotomist collected blood into lavender stopper and green stopper tubes. Are these specimens acceptable?
a. Yes, EDTA is used for hematologic testing and heparin is used for coagulation testing.
b. No, although EDTA is used for hematologic testing, citrate, not heparin, is used for coagulation testing.
c. No, although heparin is used for hematologic testing, citrate, not EDTA, is used for coagulation testing.
d. No, hematologic testing requires citrate and coagulation testing requires a clot, so neither tube is acceptable.

A

b. No, although EDTA is used for hematologic testing, citrate, not heparin, is used for coagulation testing.

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4
Q

The vein of choice for performing a venipuncture is the:
a. Basilic, because it is the most prominent vein in the antecubital fossa
b. Cephalic or accessory cephalic, because it is the least painful site
c. Median or median cubital, because it has the lowest risk of damaging nerves in thearm
d. One of the hand veins, because they are most superficial and easily accessed

A

c. Median or median cubital, because it has the lowest risk of damaging nerves in the arm

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5
Q

The most important step in phlebotomy is:
a. Cleansing the site
b. Identifying the patient
c. Selecting the proper needle length
d. Using the correct evacuated tube

A

Identifying the patient

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6
Q

The venipuncture needle should be inserted into the arm with the bevel facing:
a. Down and an angle of insertion between 15 and 30 degrees
b. Up and an angle of insertion less than 30
degrees
c. Down and an angle of insertion greater than 45 degrees
d. Up and an angle of insertion between 30 and 45 degrees

A

Up and an angle of insertion less than 30
degrees

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7
Q

Failure to obtain blood by venipuncture may occur because of all of the following except:
a. Incorrect needle positioning
b. Tying the tourniquet too tightly
c. Inadequate vacuum in the tube
d. Collapsed vein

A

Tying the tourniquet too tightly

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8
Q

What is the recommended order of draw when the evacuated tube system is used?
a. Gel separator, nonadditive, coagulation, and blood culture
b. Additive, nonadditive, gel separator, and blood culture
c. Nonadditive, blood culture, coagulation, and other additives
d. Blood culture, coagulation, nonadditive, and gel separator or other additives

A

Blood culture, coagulation, nonadditive, and gel separator or other additives

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9
Q

Which one of the following is an acceptable site for skin
puncture on infants:
a. Back curvature of the heel
b. Lateral or medial plantar surface of the heel
c. Plantar surface of the heel close to the arch of the foot
d. Middle of the plantar surface of the heel

A

Lateral or medial plantar surface of the heel

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10
Q

An anticoagulant is an additive placed in evacuated tubes to:
a. Make the blood clot faster
b. Dilute the blood before testing
c. Prevent the blood from clotting
d. Ensure the sterility of the tube

A

Prevent the blood from clotting

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11
Q

Which one of the following is a reason for specimen rejection:
a. Clot in a red stopper tube
b. Specimen collected for blood cortisol in the morning
c. Specimen in lavender stopper tube grossly hemolyzed
d. Room number is missing from the specimen tube label

A

Specimen in lavender stopper tube grossly hemolyzed

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12
Q

One legal area of concern for the phlebotomist is:
a. Breach of patient confidentiality
b. Failure to obtain written consent for phlebotomy
c. Entering a patient’s room when the family is present
d. Asking an outpatient for his or her full name in the process of identification

A

Breach of patient confidentiality

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13
Q

Some physiologic factors that can contribute to preanalytical variation in test results

A

Posture, Diurnal Rhythm, Exercise, Stress, Diet, and Smoking

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14
Q

Refers to daily body fluid fluctuations that occur with some constituents of the blood

A

Diurnal Rhythm

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15
Q

Results in a shift of body water from inside the blood vessels to the interstitial spaces

A

Posture

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16
Q

Increases the various constituents in the blood such as creatine, total protein, creatine kinase, myoglobin, aspartate aminotransferase, white blood cell count and HDL-cholesterol

A

Exercise

17
Q

Anxiety and excessive crying in children can cause a temporary increase in the white blood cell count

A

Stress

18
Q

Includes fasting before blood draw

A

Diet

19
Q

Patients who practices this before blood collection may have increased white blood cell counts and cortisol levels

A

Smoking

20
Q

Order of Draw for Venipuncture

A

Blood culture tube
Coagulation tube
Serum tube
Heparin tube
EDTA tube
Sodium fluoride with or without EDTA or oxalate

21
Q

Order of Draw for Skin Puncture

A
  • Tube for blood gas analysis
  • Slides, unless made from specimen in the EDTA microcollection tube
    EDTA microcollection tube
  • Other microcollection tubes with anticoagulants
  • Serum microcollection tubes
22
Q

Requirements for a Quality Specimen

A
  1. Patient properly identified
  2. Patient properly prepared for draw
  3. Specimens collected in the correct order and labeled correctly
  4. Correct anticoagulants and other additives used
  5. Specimens properly mixed by inversion, if required
  6. Specimens not hemolyzed
  7. Specimens requiring patient fasting collected in a timely manner
  8. Timed specimens drawn at the correct time
23
Q

Reasons for specimen rejection

A
  • Test order requisition and the tube identification do not match.
  • Tube is unlabeled, or the labeling, including patient identification number, is incorrect.
  • Specimen is hemolyzed.
  • Specimen was collected at the wrong time.
  • Specimen was collected in the wrong tube.
  • Specimen was clotted, and the test requires whole blood or plasma.
  • Specimen was contaminated with intravenous fluid.
  • Specimen is lipemic.
24
Q

The process of formation and development of blood cells is
termed:
a. Hematopoiesis
b. Hematemesis
c. Hematocytometry
d. Hematorrhea

A

Hematopoiesis

25
Q

During the second trimester of fetal development, the primary site of blood cell production is the:
a. Bone marrow
b. Spleen
c. Lymph nodes
d. Liver

A

Liver

26
Q

Which one of the following organs is responsible for the
maturation of T lymphocytes and regulation of their expression of CD4 and CD8?
a. Spleen
b. Liver
c. Thymus
d. Bone marrow

A

Thymus

27
Q

The best source of active bone marrow from a 20-year-old
would be:
a. Iliac crest
b. Femur
c. Distal radius
d. Tibia

A

Iliac crest

28
Q

Physiologic programmed cell death is termed:
a. Angiogenesis
b. Apoptosis
c. Aneurysm
d. Apohematics

A

Apoptosis

29
Q

Which organ is the site of sequestration of platelets?
a. Liver
b. Thymus
c. Spleen
d. Bone marrow

A

Spleen

30
Q

Which one of the following morphologic changes occurs
during normal blood cell maturation:
a. Increase in cell diameter
b. Development of cytoplasm basophilia
c. Condensation of nuclear chromatin
d. Appearance of nucleoli

A

Condensation of nuclear chromatin

31
Q

Which one of the following cells is a product of the CLP?
a. Megakaryocyte
b. T lymphocyte
c. Erythrocyte
d. Granulocyte

A

T lymphocyte

32
Q

What growth factor is produced in the kidneys and is used
to treat anemia associated with kidney disease?
a. EPO
b. TPO
c. G-CSF
d. KIT ligand

A

EPO

33
Q

Which one of the following cytokines is required very early
in the differentiation of a hematopoietic stem cell?
a. IL-2
b. IL-8
c. EPO
d. FLT3 ligand

A

FLT3 ligand

34
Q

When a patient has severe anemia and the bone marrow is unable to effectively produce red blood cells to meet the increased demand, one of the body’s responses is:
a. Extramedullary hematopoiesis in the liver and spleen
b. Decreased production of erythropoietin by the kidney
c. Increased apoptosis of erythrocyte progenitor cells
d. Increase the proportion of yellow marrow in the long bones

A

Extramedullary hematopoiesis in the liver and spleen

Hematology (1 decks)

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