ch 8 Flashcards

1
Q

The physician has ordered a PTT. What additive is in the evacuated tube you would use to draw this order?

EDTA

Sodium citrate

Heparin

Potassium oxalate

A

Sodium citrate

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2
Q

The physician has ordered a CBC w/ Diff. What additive is in the evacuated tube you would use to draw this order?

EDTA

Sodium citrate

Heparin

Potassium oxalate

A

EDTA

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3
Q

Your laboratory requisition indicates that you are to draw a BMP, CBC, PT and Fasting Glucose, STAT. If you decide to draw the samples by routine venipuncture, what would be the correct order of draw?

Light Green, Gold, Lavender, Gray.

Gold, Light Blue, Lavender, Gray.

Light Blue, Gold, Lavender, Gray.

Light Blue, Light Green, Lavender, Gray.

A

Light Blue, Light Green, Lavender, Gray.

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4
Q

Transfer adapters:

Are available with female connectors only

Are available with male connectors only

Are available in designs that can accommodate blood culture bottles

Are used with multisample needles

A

Are available in designs that can accommodate blood culture bottles

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5
Q

Which of the following statements reguarding transfer adapters is most correct?

Transfer adapters may only be used when transfering blood from a syringe to an evacuated tube.

Transfer adapters may only be used when using a butterfly needle.

Transfer adapters can be used instead of evacuated tube holders.

Transfer adapters may be used when transfering blood from a syringe to an evacuated tube or when collecting samples using a buterfly needle.

A

Transfer adapters may be used when transferring blood from a syringe to an evacuated tube or when collecting samples using a butterfly needle.

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6
Q

Vacutainer® and Microtainer® systems are manufactured by:

Becton-Dickinson

Greiner Bio-One

Sarstedt

Johnson & Johnson

A

Becton-Dickinson

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7
Q

Vacuette® and MiniCollect® systems are manufactured by:

Becton-Dickinson

Greiner Bio-One

Sarstedt

Johnson & Johnson

A

Greiner Bio-One

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8
Q

Who manufactures a closed blood collection system that allows the user to collect venous blood by either syringe aspiration or the vacuum principle?

Becton-Dickinson

Greiner Bio-One

Sarstedt

Johnson & Johnson

A

Sarstedt

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9
Q

You are collecting a venous blood sample from a pediatric patient. Which of the following tubes would be most appropriate?

A solid gold Vacutainer® tube.

A Greiner Bio-One lavender tube with a white ring.

A gold Microtainer® tube.

Light Green Sarstedt S-Monovette® device.

A

A Greiner Bio-One lavender tube with a white ring.

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10
Q

You are collecting a capillary blood sample from an adult patient. Which of the following tubes would be most appropriate?

A solid gold Vacutainer® tube.

A Greiner Bio-One lavender tube with a white ring.

A gold Microtainer® tube.

Light Green Sarstedt Microvette tube to Light Green Sarstedt S-Monovett

A

A gold Microtainer® tube.

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11
Q

You received a requisition to collect blood specimens from a patient. You will use the evacuated tube method and collect the following tubes to fulfill the requisition: Lavender-topped tube, Light-blue-topped tube, and a SST tube. What is the correct order of draw?

Lavender-topped tube, Light-blue-topped tube, and Gold or Red/Black (SST) tube.

Gold or Red/Black (SST) tube, Lavender-topped tube, and Light-blue-topped tube.

Gold or Red/Black (SST) tube, Light-blue-topped tube, and Lavender-topped tube.

Light-blue-topped tube, Gold or Red/Black (SST) tube, and Lavender-topped tube.

A

Light-blue-topped tube, Gold or Red/Black (SST) tube, and Lavender-topped tube.

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12
Q

You just received a requisition to collect blood from Mrs. Johnson in Room 318. Upon palpating Mrs. Johnson’s veins, you have determined she has small, fragile veins. You decided the best method for drawing her blood would be with a syringe and a butterfly needle. Upon checking the requisition you see the following tubes are required to complete the order. They are: Light-blue-topped tube, Lavender-topped tube, and Green-topped tube. In what order would you transfer the blood from the syringe using a transfer device into the evacuated tubes?

Green-topped tube, Lavender-topped tube, and Light-blue-topped tube.

Lavender-topped tube, Light-blue-topped tube, and Green-topped tube.

Light-blue-topped tube, Green-topped tube, and Lavender-topped tube.

Green-topped tube, Light-blue-topped tube, and Lavender-topped tube.

A

Light-blue-topped tube, Green-topped tube, and Lavender-topped tube

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13
Q

A requisition for a blood draw on Mr. Al K. Seltzer in Room 555 was just given to you. After surveying Mr. Seltzer’s arms and hands, you have determined his veins are too small and fragile for a venipuncture. However, upon checking the requisition you see the following tests to be collected: CBC, Lipids, and STAT Glucose. So you have decided the best method to use to collect Mr. Seltzer’s blood is to do a capillary/dermal puncture. What tubes would you select for the draw and in what order would you fill them?

Lavender-topped tube, Gold (SST) tube, and Light-green-topped tube.

Gold (SST) tube, Lavender-topped tube, and Light-green-topped tube.

Light-green-topped tube, Lavender-topped tube, and Gold (SST) tube.

Lavender-topped tube, and Light-green-topped tube, Gold (SST) tube.

A

Lavender-topped tube, and Light-green-topped tube, Gold (SST) tube.

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14
Q

Which tube contains the anticoagulant EDTA and is used to collect a blood specimen for a CBC?

Lavender-topped tube

Light-blue-topped tube

Green-topped tube

Gray-topped tube

A

Lavender-topped tube

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15
Q

You have a requisition for a STAT chemistry test. Which tube do you need to collect and what additive does it contain?

Light-blue-topped tube with sodium citrate.

Yellow-topped tube with ACD.

Green-topped tube with heparin (sodium, lithium or ammonium) or Green-topped tube (light green, green/black speckled) with lithium heparin and thixotropic gel.

Gray-topped tube with sodium fluoride and potassium oxalate.

A

Green-topped tube with heparin (sodium, lithium or ammonium) or Green-topped tube (light green, green/black speckled) with lithium heparin and thixotropic gel.

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16
Q

You work in a medical clinic and have a patient who comes once a week to have her Coumadin levels checked. There is an order for blood to be collected for a PT. What tube and additive would be used to collect this blood specimen?

Gold or Red/Black speckled tube containing a clot activator and a thixotropic separator gel.

Pink-topped tube containing EDTA.

Light-blue-topped tube containing sodium citrate.

Yellow-topped tube containing SPS.

A

Light-blue-topped tube containing sodium citrate.

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17
Q

You do blood draws at several area nursing homes each morning. You drew blood glucose levels from three patients at your first stop. What tube was the best choice to use in this situation and what additive is contained in the tube?

Pink-topped tube with EDTA.

Gray-topped tube with sodium fluoride and potassium oxalate.

Red-topped tube with no additive or with a clot activator.

Yellow-topped tube with ACD.

A

Gray-topped tube with sodium fluoride and potassium oxalate.

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18
Q

One of the patients in the hospital where you work has been experiencing fever spikes today and has blood cultures ordered. What tube and additive should the phlebotomist use?

Red-topped tube with no additive or a clot activator.

Gray-topped tube with sodium fluoride and potassium oxalate.

Pink-topped tube with EDTA.

Yellow-topped tube with SPS (sodium polyanethol sulfonate).

A

Yellow-topped tube with SPS (sodium polyanethol sulfonate).

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19
Q

You have a patient in need of a blood transfusion. Prior to the transfusion being started, the patient’s blood must be typed and cross-matched to ensure the correct blood is given to the patient. What tube and additive should the phlebotomist use?

Red-topped tube with no additive or a clot activator.

Gray-topped tube with sodium fluoride and potassium oxalate.

Light-blue-topped tube with sodium citrate.

Pink-topped tube with EDTA.

A

Pink-topped tube with EDTA.

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20
Q

What tube would the phlebotomist use to collect blood for a common test performed in the chemistry section such as protein?

Lavender-topped tube

Gold or Red/Black speckled (serum separator/SST tube)

Light-blue-topped tube

Pink-topped tube

A

Gold or Red/Black speckled (serum separator/SST tube)

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21
Q

Because a blood culture requires a sterile environment be created at the puncture site, which of the following should be used to clean the puncture site prior to venipuncture?

Soap and water

Diluted bleach

Betadine, iodine, or chlorhexidine

Cleaning is not necessary because the skin is naturally free of bacteria

A

Betadine, iodine, or chlorhexidine

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22
Q

What should the phlebotomist use to create a pressure bandage on a patient with fragile skin such as a young child or the elderly after a venipuncture?

Gauze pad and adhesive tape.

An adhesive bandage.

No bandage is necessary because bleeding will stop immediately after needle withdrawal.

Gauze pad covered with either roller gauze or Coban is wrapped entirely around the arm so tape is not placed on the skin.

A

Gauze pad covered with either roller gauze or Coban is wrapped entirely around the arm so tape is not placed on the skin

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23
Q

When performing a dermal puncture, if the patient’s fingers or the heel feel cool to the touch, what should the phlebotomist do to help increase blood flow to the site?

Use a warm towel, cloth or heel warmer packet to warm the site.

Squeeze or massage the finger or heel for 30 seconds.

Use a lancet with a puncture depth of 2.5 mm.

Apply an ice pack to the puncture site for at least 15 seconds.

A

Use a warm towel, cloth or heel warmer packet to warm the site.

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24
Q

The phlebotomist has three venipunctures left to perform toward the end of his/her shift. The phlebotomist realizes that he/she has only one tourniquet left, and that the time it would take for him/her to get more would make him/her late for an after-work appointment. What should the phlebotomist do?

Use the same tourniquet on all three patients without cleaning.

Clean the tourniquet between each patient and use it on all three patients.

Throw the tourniquet away after use on the first patient and secure additional tourniquets for the remaining patients.

Tie the fingers of a glove around the patient’s arm creating a tourniquet.

A

Throw the tourniquet away after use on the first patient and secure additional tourniquets for the remaining patients.

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25
Q

In assembling a double-pointed needle onto an evacuated tube holder, you notice the seal on the needle is broken. What should you do with the needle?

The phlebotomist should assume the needle is not sterile and discard it in a sharps container.

Go ahead and use it.

Check the expiration date. If within the expiration date, go ahead and use it.

The phlebotomist should check for blood on the needle. If no blood is apparent, go ahead and assume the needle is safe to use.

A

The phlebotomist should assume the needle is not sterile and discard it in a sharps container.

26
Q

Which of the following tubes is it most important to fill to the designated fill level?

Light-blue-topped tube

Lavender-topped tube

Green-topped tube

Red-topped tube

A

Light-blue-topped tube

27
Q

When drawing blood by venipuncture for trace elements such as lead, mercury, aluminum or zinc, which tube would be the best choice?

Pink-topped tube

Green-topped tube

Gray-topped tube

Royal blue-topped tube

A

Royal blue-topped tube

28
Q

Which microcollection container would you use for collecting blood for prothrombin time (PT), activated partial thromboplastin time (APTT) or partial thromboplastin time (PTT)?

Light-blue-topped tube

Red-topped tube.

Green-topped tube.

There is no light-blue-topped tube available for dermal/capillary puncture procedures.

A

There is no light-blue-topped tube available for dermal/capillary puncture procedures.

29
Q

An adhesive bandage is placed over the venipuncture puncture site to stop the bleeding. A patient should be told to hold the arm straight and apply pressure for ________ minutes and can remove the bandage in ________ minutes.

1 to 2 minutes; 5 minutes

8 to 10 minutes; 10 to 15 minutes

3 to 5 minutes; 15 to 20 minutes

6 to 8 minutes; 25 minute

A

3 to 5 minutes; 15 to 20 minutes

30
Q

How long is it acceptable to leave a tourniquet on the patient while collecting blood without causing changes in the laboratory test results?

One minute

Two minutes

Five minutes

There is no time limit on the amount of time a tourniquet can be left on the patient.

A

One minute

31
Q

What size needle is acceptable to use for drawing donor units of blood?

20 gauge

23 gauge

21 gauge

16 gauge

A

16 gauge

32
Q

Which of the needle gauges is most commonly used for drawing blood by venipuncture on infants and small children?

20 gauge

23 gauge

21 gauge

16 gauge

A

23 gauge

33
Q

What type of needle(s) can be used with a syringe?

Double-pointed needles

Hypodermic needles or butterfly needles

Lancet needles

A needle is not used on a syringe

A

Hypodermic needles or butterfly needles

34
Q

What type of needle is used to perform a venipuncture with an evacuated collection system?

Hypodermic needle

Lancet needle

Double-pointed needle

No needle is used with the evacuated tube holder

A

Double-pointed needle

35
Q

Why do evacuated tubes have an expiration date?

To indicate the date of manufacture.

To indicate the additive and vacuum may not perform as intended past that date.

To indicate when the tube was purchased.

To indicate when the tube will explode.

A

To indicate the additive and vacuum may not perform as intended past that date.

36
Q

What is the maximum puncture depth that should be used for a dermal puncture?

1 cm

1 mm

2 cm

2 mm

A

2 mm

37
Q

How do microhematocrit tubes fill with blood?

Vacuum pull

Capillary action

Suction is applied on one end to pull blood in

Gravity pulls the blood into the tub

A

Capillary action

38
Q

What is the purpose of the color-tipped band around the microhematocrit capillary tube?

Indicates the type of additive, if any, present in the tube.

It is present just for decoration.

Indicates what type of blood is collected in each tube.

It is a fill line indicating where you need to stop filling the tube.

A

Indicates the type of additive, if any, present in the tube.

39
Q

What are some common hematology tests that are performed in a lavender-topped tube containing EDTA?

Sodium, protein, and lipids.

Electrolytes, enzymes, and prothrombin time (PT).

Complete blood cell count (CBC), differential, and reticulocyte count.

Glucose, alcohol, and activated partial thromboplastin time (APTT).

A

Complete blood cell count (CBC), differential, and reticulocyte count.

40
Q

Examples of trace elements that may be collected in a royal blue-topped tube include:

Vitamins B, C, and D

Sodium, potassium, calcium

Lead, mercury, and zinc

Folic acid, iron, and iodine.

A

Lead, mercury, and zinc

41
Q

What kind of gloves are usually used for routine blood collection procedures?

Sterile gloves

Rubber gloves

Non-sterile gloves

Gloves are not required

A

Non-sterile gloves

42
Q

Why should the gloves used for the collection of blood specimens NOT contain powder?

Powder does not cause any problem with blood specimens.

Powder can become a contaminant in or on the specimen during blood collection.

Powder can be messy and get on your clothing.

Powder makes the gloves harder to put on.

A

Powder can become a contaminant in or on the specimen during blood collection.

43
Q

How often should the phlebotomist decontaminate his/her hands?

Phlebotomists should decontaminate hands only before ingesting food.

Phlebotomists should decontaminate hands upon removing gloves and before donning new gloves for procedures with next patient.

Phlebotomists should decontaminate hands every 5 minutes.

Phlebotomists should decontaminate hands only when visibly soiled.

A

Phlebotomists should decontaminate hands upon removing gloves and before donning new gloves for procedures with next patient.

44
Q

What is commonly used to clean a puncture site prior to needle insertion for routine blood draws?

Alcohol prep pad saturated with 70% isopropyl alcohol

Iodine

Diluted bleach

Warm running water is sufficient

A

Alcohol prep pad saturated with 70% isopropyl alcohol

45
Q

What length needles are commonly used for venipuncture?

1/2-inch

2-inches

3/4-inch to 1-1/2 inch

1-3/4 inch to 2-inches

A

3/4-inch to 1-1/2 inch

46
Q

What is the purpose of an anticoagulant?

It causes blood to clot.

It causes blood cells to rupture.

It prevents blood from clotting.

It causes blood to become very thick.

A

It prevents blood from clotting.

47
Q

Why is it important to invert or mix microcollection tubes containing anticoagulants immediately after collection?

It causes the blood to clot quickly.

It causes blood cells to rupture.

It prevents blood from clotting.

It causes blood to become very thick.

A

It prevents blood from clotting.

48
Q

When should a discard tube be drawn during venipuncture?

When blood is drawn with the evacuated tube method.

When blood is drawn with a syringe.

When blood is drawn by dermal puncture.

When blood is collected using a winged infusion set and an evacuated tube.

A

When blood is collected using a winged infusion set and an evacuated tube.

49
Q

The order of filling tubes when using a syringe transfer device is:

Yellow-topped tube (SPS), Light-blue-topped tube, Red- or Gold-topped tube (clot activator or clot activator and gel separator), Green-topped tube, Lavender-topped tube, and Gray-topped tube

Yellow-topped tube (SPS), Lavender-topped tube, Green-topped tube, Red- or Gold-topped tube (clot activator or clot activator and gel separator), Light-blue-topped tube, and Gray-topped tube

Light-blue-topped tube, Yellow-topped tube (SPS), Red- or Gold-topped tube (clot activator or clot activator and gel separator), Gray-topped tube, Green-topped tube, and Lavender-topped tube

Red- or Gold-topped tube (clot activator or clot activator and gel separator), Light-blue-topped tube, Yellow-topped tube (SPS), Green-topped tube, Lavender-topped tube, and Gray-topped tube

A

Yellow-topped tube (SPS), Light-blue-topped tube, Red- or Gold-topped tube (clot activator or clot activator and gel separator), Green-topped tube, Lavender-topped tube, and Gray-topped tube

50
Q

When activating the safety device over a needle, all the following should be done EXCEPT:

Use a one-handed technique

Do not attempt to activate the device with the other hand

Keep fingers away from the point of the needle

Recap the needle using a two-handed technique.

A

Recap the needle using a two-handed technique.

51
Q

Which laboratory section would process the yellow-topped tube containing the additive SPS?

Blood Bank

Chemistry

Coagulation

Microbiology

A

Microbiology

52
Q

In which laboratory section would you most commonly find the light-blue-topped tube being processed?

Chemistry

Coagulation

Blood Bank

Immunology

A

Coagulation

53
Q

A gray-topped tube used to test for glucose or alcohol would be processed in which laboratory section?

Chemistry

Blood Bank

Microbiology

Hematology

A

Chemistry

54
Q

A pink-topped tube containing EDTA is processed in which laboratory section?

Chemistry

Blood Bank

Hematology

Coagulation

A

Blood Bank

55
Q

A lavender-topped tube containing EDTA is processed in which section of the laboratory?

Chemistry

Microbiology

Hematology

Coagulation

A

Hematology

56
Q

What is the primary difference in an evacuated tube with a solid color top versus a translucent-color topped tube of the same color?

The translucent color-topped tube draws a full volume while the solid color-topped tube draws a lesser volume.

There is no difference in the two tubes.

The solid color-toped tubes draw a full volume while the translucent color-topped tubes draw a lesser volume.

The solid color-topped tubes contain a different additive than the translucent color-topped tubes.

A

The solid color-toped tubes draw a full volume while the translucent color-topped tubes draw a lesser volume.

57
Q

Green-topped tubes containing heparin are most commonly processed in which laboratory section?

Chemistry

Blood Bank

Hematology

Microbiology

A

Chemistry

58
Q

Why is EDTA the anticoagulant of choice for use in hematology tests?

It alters the size and shape of blood cells and causes clumping of the platelets.

It causes stains to change colors when preparing blood smears or slides.

It maintains the size and shape of cells better than other anticoagulants.

It is not the anticoagulant of choice for use in hematology testing.

A

It maintains the size and shape of cells better than other anticoagulants.

59
Q

Which additive is an antiglyocolytic agent and what tube is it found in?

EDTA-Lavender topped-tube

Sodium citrate - Blue topped tube

Sodium fluoride - Yellow topped tube

Sodium fluoride-Gray-topped tube.

A

Sodium fluoride-Gray-topped tube.

60
Q

Why is there no light-blue-color topped tube (sodium citrate) for use in dermal/capillary punctures?

Sodium citrate would cause the blood to clot in the capillary tube.

The coagulation system is activated during the dermal puncture procedure and would cause erroneous test results.

There are capillary tubes equivalent for all the evacuated tubes.

Sodium citrate would cause the blood cells to hemolyze.

A

The coagulation system is activated during the dermal puncture procedure and would cause erroneous test results.

61
Q
A