Final Flashcards
An N-95 respirator must be worn when entering the room of a patient who has which type of precaution sign on the door?
Airborne
Another name for blood bank is….
Immunohematology
Which department is responsible for administering oxygen therapy?
Respiratory therapy
A sign posted on the door of a patient in contact isolation states that all who enter the room must use soap and water to wash their hands before leaving the room. This sign that the patient may be infected with a spore-forming microbe such as ….
Clostridium Difficile
Outpatient phlebotomy, such as in a physician’s office or patient care service center, will be assigned a code for reimbursement using which national coding system?
CPT
To comply with the latest HazCom revision, the label of a hazardous chemical must include a ….
All options are correct
An example of employee screening for infection control is….
PPD testing
What are the credentials for an ASCP- certified phlebotomist?
PBT
Electrolyte testing includes
sodium, potassium
The term used to describe sophisticated and highly complex medical care…
Tertiary care
which type of contact infection transmission involves transfer of an infectious microbe to the mucous membranes of a susceptible individual by means of a cough or sneeze?
Droplet
Which of the following is an example of negative kinesics?
Frowning
The OSHA HazCom Standard is also commonly called the …
RIght-to-Know law
Which of the following is an example of a barrier to effective communication with a patient?
All of the options are correct.
Which of the following is an example of a work practice control that reduces the risk of exposure to bloodborne pathogens?
Hand decontamination
A body fluid splash to the eyes requires the victim to immediately flush eyes with water or sterile saline for…
10 minutes
The main principles involved in radiation exposure
exposure time, distance, and shielding.
Class C fires…
involve electrical equipment
Which of the following is not one of the code words in the NFPA order of a cation in the event of fire?
Smother
A phlebotomist who gets the specimen for the doctor even if he or she must take shortcuts is exhibiting ?
unprofessionalism
Federal law requires that hepatitis B vaccinations be made available to employees assigned to duties with occupational exposure risk….
within 10 working days of initial assignment.
What is the FIRST thing the phlebotomist should do in the event of an accidental needlestick?
Wash the site with soap and water for at least 30 seconds.
Which of the following is an example of a confirming response to a patient?
I understand what you must be feeling.
Vaccination against HBV involves
a dose of vaccine, a second dose 1 month later, a third dose 6 months later.
In what instance might a patient be placed in protective isolation?
The patient has severe burns.
The term “phlebotomy” is derived from Greek words that, literally translated, mean ….
vein incision
Proof of participation in workshops to upgrade skills required by some agencies to renew certification is called…
CEUs
Which duty is not performed by local public health agencies?
Licensure of healthcare personnel
Which of the following communicates unprofessionalism?
Intense odor of cologne
The Needlestick Safety and Prevention Act directed OSHA to revise the BBP standard in all of the following areas except…
availability of vaccination against HBV for all employees
CLSI guidelines state that scrubs or slacks worn in the lab should be how far off of the floor?
1 to 1.5 inches
The area of the lab where testing is performed to detect infectious disease and the antibodies produced in response to infection is called…
immunology
What does acknowledging a patient’s beliefs, customs,knowledge, attitudes exemplify?
Diversity awareness
What is another name for “medical laboratory scientist”?
Medical technologist
Which type of PPE must be removed after leaving the patient’s room and closing the door?
Respirator
With which other hospital department would the laboratory coordinate therapeutic drug monitoring?
Pharmacy
What is the proper order for putting on the following protective clothing?
gloves goggles mask gown
Gown first, then mask, then goggles, gloves last.
Occupational exposure to bloodborne pathogens can occur if which of the following happens while the healthcare worker is performing his or her duties?
All of the options are correct
According to standard first aid procedures, severe external bleeding is best controlled by…
applying direct pressure.
What is not a phlebotomist’s duty?
Starting intravenous (IV) lines
Examples of nosocomial infections include….
when a catheter site of a patient in ICU becomes infected.
The purpose of “ protective” isolation is to….
protect patients who are highly susceptible to infection.
It is improper telephone protocol to…
hang up on angry callers.
According to CLSI standards, which of the tubes listed below is filled last when using a syringe?
EDTA
The priority designation for a test request is based on all of the following EXCEPT... Age and gender diet restriction patient condition timed collection
age and gender
What would be the system of choice to identify laboratory specimens from an unconscious, unidentified woman in the Emergency room?
Use a three-part identification band and labels.
A phlebotomist arrives to draw a specimen from an inpatient. The patient’s door is closed. What should the phlebotomist do ?
Knock softly, open it slowly, and ask permission to enter.
The slanted tip of the needle that enters the vein is called the
bevel.
A tube with a green stopper normally contains….
Heparin.
The patient asks if the specimen about to drawn is for a diabetes test. How should the question be answered?
Say, “It’s best to discuss that with the doctor.”
Using which of the following communication strategies before obtaining a blood specimen from a child demonstrates poor technique?
Telling the child it won’t hurt.
Heparin prevents blood from clotting by….
inhibiting thrombin.
Never leave a tourniquet on for more than….
1 minute.
A request is given to draw a specimen from an inpatient by the name of John Doe. Which of the following is an acceptable way to confirm the patient’s identity?
Match the ID band and requisition with the patient’s verbal statement of ID.
Which of the following is classified as a disinfectant? Benzalkonium chloride Isopropanol Povidone-iodine Sodium hypochlorite
Sodium hypochlorite
Which of the following substances is a biocide? Hydrogen peroxide Isopropyl alcohol Povidone iodine All of the options are correct.
All of the options are correct.
An inpatient is sound asleep when the phlebotomist arrives to draw a blood specimen. What should the phlebotomist do?
Wake the patient gently to avoid a startle reaction.
Which of the following is an example of a potential permucosal exposure to biohazardous microorganisms?
Rubbing an eye with a contaminated glass.
A phlebotomist collects a light-blue top, lavender-top, and gray- top tube from an inpatient. Respectively, which of the following additives do the tubes most likely contain?
Citrate, EDTA, sodium fluoride
What is the recommended angle of needle insertion for an antecubital vein and a hand vein, respectively?
30 degrees or less, 10 degrees or less
The tests performed in the following department are typically collected in a tube with a light-blue stopper.
Coagulation
A rapid serum tube contains…..
Thrombin
When nitrile or vinyl strap tourniquets become soiled with blood, it is best to…
Throw them away.
The tube additive that is responsible for the most carryover problems is …
ethylenediaminetetraacetic acid.
The following tests have all been ordered at the same time on different inpatients. Only one phlebotomist is on duty. Which test should the phlebotomist collect first?
STAT electrolytes in the ER.
What may happen if you mix a specimen too vigorously?
Hemolysis.
A phlebotomist starts to perform a venipuncture. As the needle touches the skin, the patient moves his arm. The phlebotomist is startled and pulls the needle away from the arm. How should the phlebotomist proceed after apologizing to the patient?
Replace the needle, clean the site, warn the patient, and finish the draw.
Which needle gauge has the largest lumen?
18
If a venipuncture site is still bleeding after 5 minutes the phlebotomist should…
alert the patient’s nurse or other healthcare provider
Which additive is usually present in a tube with a lavender stopper?
EDTA
The solution normally used to clean the site before routine venipuncture is…
70% isopropanol
An unconscious patient is not wearing an ID band. There is an ID band taped to the patient’s IV pole with information that matches the requisition. What should the phlebotomist do?
Only draw the specimen after an ID band has been applied.
Doing which of the following during the vein selection process is bad for the specimen?
Allowing the patient to pump her fist.
What is the proper blood-to additive ratio for a light-tube collected for a coagulation test?
9:1
The purpose of an antiglycolytic agent is to…
Preserve glucose
The patient is just finishing a big breakfast as the phlebotomist arrives to draw a fasting specimen. What should be phlebotomist do?
Check with the patient’s nurse to see if the specimen should still be collected.
Which of the following is the job of a student phlebotomist?
Letting the patient know that you are a student phlebotomist.
How can you tell that you are in a vein when using a needle and a syringe ?
You will normally see blood appear in the hub or the needle.
What is the most important factor in choosing which gauge needle to use for venipuncture?
Size and Condition of the vein.
What is the best way for a newly trained phlebotomist to handle a venipuncture on a patient with needle phobia?
Ask an experienced phlebotomist to do the draw.
The phlebotomist has made two unsuccessful attempts to collect a fasting specimen from an outpatient. What should the phlebotomist do next?
Ask another phlebotomist to collect the specimen.
The first step in the testing process begins when the ….
test is ordered by the healthcare provider.
When using a winged infusion blood collection set, if the first tube is an additive tube, it is important to collect a few milliliters of blood into a nonadditive tube first to…..
maintain proper blood-to additive ratio.
An additive tube should be mixed…
as soon as it is removed from the holder.
Glass particles present in serum separator tubes….
enhance clotting.
You must collect a routine hematology test, a coagulation test, and a STAT chemistry test. Which of the following are tubes you would most likely use, listed in the correct order of draw?
Light-blue top, Green-top, purple-top.
An elderly patient arrives at an outpatient clinic for a blood draw. He is accompanied by his daughter who mentions that he is hard of hearing. HOw should the phlebotomist proceed?
Speak distinctly in a normal tone of voice.
What is the most critical error a phlebotomist can make?
Misidentifying a patient specimen.
A tourniquet used for venipuncture procedures should be…
applied 3 to 4 inches above the intended venipuncture
tight enough to slow venous flow but not affect arterial flow
snug or slightly tight, but not uncomfortable to the patient
All options are correct.
Which instance most closely resembles basal state?
A patient who has just awakened at 0600 after fasting all night.
A patient who has been lying down for an hour.
A patient who has just arrived for a fasting blood test.
A patient who has worked all night but did not eat at work.
A patient who has just awakened at 0600 after fasting all night.
You most draw a promtime specimen from a patient with IVs in both arms. Which of the following is the best thing to do? Draw the specimen above the IV. Draw specimen below the IV. Draw the specimen from an ankle vein. Draw the specimen from the IV.
Draw the specimen below the IV.
Which of the following is the BEST way to avoid reflux when drawing a blood specimen?
Full tubes from bottom up
Do not use overfill additive tubes
Use the correct order of draw
All options are correct
Fill tubes from bottom up.
Which of the following vascular access devices is placed in a peripheral vein for the purpose of blood collection and administration of medication ? Fistula Heparin lock Implanted port PICC
Heparin lock
A fistula is a(n)…
Permanent fusion of an artery and vein.
You have no choice but to draw a specimen from a site with a hematoma.Where should you obtain the specimen?
Distal to the hematoma.
A tube fails to fill with blood during a venipuncture. Which of the following might lead you to think that the vein has collapsed l?
The vein disappears when you engage the tube
Why do pregnant patients have lower reference ranges for red blood cell counts?
Body fluid increases in pregnancy,diluting red blood cells.
Levels of which analyte can differ by 50% or more between morning and late afternoon?
Cortisol.
It is not a good idea to collect a CBC specimen from a screaming from a screaming infant because the
white blood count may be falsely elevated.
An arm that is paralyzed has
Lost muscle function
If a patient is complaining of sharp radiating pain from the needle insertion site, the phlebotomist should
Immediately terminate venipuncture
If blood is drawn too quickly from a small vein, the vein will have a tendency to ….
Collapse.
Which situation is the best way to tell that you may have accidentally punctured an artery? A hematoma starts to form. The blood obtained is dark red. The blood pulses into the tube. There is no way to tell.
The blood pulses into the tube
Tests influenced by diurnal variation are often ordered as __________ tests, and it is important to collect them as close as possible to the time order.
timed
how long before obtaining blood for testing should drugs known to interfere with blood test be discontinued?
4-24 hours
Prolonged tourniquet application may cause a change in blood composition primarily because of
hemoconcentration.
A phlebotomist has attempted twice to draw a partial thromboplastin time (PTT) specimen from a patient with difficult veins .Both times the phlebotomist has been able to draw only a partial tube. What should the phlebotomist do?
Have another phlebotomist attempt to draw the specimen .
When a test requires a fasting specimen, but the serum is _______,it is clue that the patient is not fasting.
lipemic
Tattooed areas should be avoided because
Fresh tattoos sites may be more prone to infection
Tattoos can mask an adverse reaction to the draw
There could be an undetected infection in that area
All options are correct.
All options are correct.
The creatinine rate decrease in elderly patients due to a normal decline in
Kidney function
The purpose of wiping away the first drop of blood from skin puncture is to…
Eliminate tissue fluid contamination
It is necessary to control depth of lancet insertion during capillary puncture to avoid
Injuring the heel bone.
Why are EDTA SPECIMENS obtained before other specimens when collected by skin puncture?
To minimize the effect of platelet clumping
Which of the following is the safest area for infant heel puncture?
Lateral plantar surface
Capillary puncture blood most closely resembles
Arterial blood.
If the alcohol is still wet when a capillary when a capillary puncture is made It can…
All options are correct.
What is the purpose of warming the site before skin puncture?
It increase blood flow up to seven times.
A laboratory report form should indicate when a specimen has been collected by
Some test result vary with specimen source
Capillary puncture blood reference ranges are higher for what analytes
Glucose
Which microtube would be used to collect a specimen for CBC?
Purple top.
Capillary puncture is the preferred method of obtaining blood from infants because
All options are correct.
What is PKU? .
A hereditary inability to metabolize phenylalanine
Capillary punctures that are deeper than recommended are more painful because pain increase in abundance below
2.4 mm
Where is the preferred capillary site?
middle finger.
Why are capillary blood gasses less durable than ABGs
All options are correct.
What is the CLSI recommended maximum depth of heel puncture?
2.0 mm
Why should a lab report form indicate the fact that a specimen has been collected by capillary puncture?
Because test results can vary depending on method of collection
What causes a microhematocrit tube to fill with blood?
Capillary action
A capillary puncture should be done rather than a venipuncture in all of the following situations except when
a light blue top is needed.
Which of the following scenarios represent correct capillary puncture technique
Puncturing perpendicular to fingerprint whorls
What does the term “calcaneus” mean?
Heel bone.
According to CLSI, _________is the recommended blood culture site skin disinfectant for infants 2 months and older.
Chlorhexidine gluconate
Which of the following specimens needs to be chilled?
Ammonia
Applications software called “middleware”…
Accepts data downloaded from POC instruments
The process of entering a password and gaining access to a computer is called …
logging on.
What is the recommended disinfectant for blood culture sites in infants 2 months and older?
Chlorhexidine gluconate
Transporting blood specimens with the stopper up has nothing to do with…
Maintaining the sterility of the sample.
Which of the following is used by the laboratory to identify a specimen through the testing process?
Accession number
Critical values(test values that are consider life threatening) are also called
Panic values
An autologous blood transfusion is a transfusion of blood
Donated by the patient for the patient
_________ is the permanent computer memory that instructs the computer to carry out user requested operations.
ROM
ARD or FAN blood culture bottles
Remove any antibiotics that are in the blood.
TDM is used by physicians to
Determine a beneficial drug dosage for a patient.
Use of one of the newer technologies,RFID, is emerging in healthcare as a
Method of specimen identification
Of the following tests, which is MOST likely to result in fatal consequences if the patient is misidentified?
Type and crossmatch
A pneumatic tube is a
Pressurized air transportation system
Which test requires a specimen with 9:1 blood to anticoagulant?
Prothrombin time
A barcode is a ….
Series of bars and spaces representing numbers or letters
To prevent introducing a contaminating substance into a trace- element collection, it is suggested that the phlebotomist…
Draw it by itself using a syringe or evacuated tube system.
Which on of the following tests could be collected using a tube other than a trace element-free tube?
Sodium
The preferred sample for parentage testing is..
Buccal swab
The accumulation of _____ in the blood can cause metabolic acidosis.
lactate
Clinical and Laboratory Standards INstitute and Occupational Safety and Health Administration guidelines do NOT require specimen transport bags to have
shock-resistance features.
When performing a GTT, the timing should begin…
as soon as the patient finishes the drink.
Which statement describes proper centrifuge operation?
Place tubes of equal size and volume opposite one another for balance.
Which test is used to monitor heparin therapy?
ACT
Which of the following collection circumstances is LEAST likely to result in delayed clotting of a serum sample?
Collection was difficult, hemolyzing red cells.
Which of the following specimens are least likely to require special handling?
Cholesterol and uric acid
When collecting a blood culture specimens directly from a butterfly into blood culture bottles, which should be filled first?
aerobic
Which of hte following would NOT be considered a preanalytical error?
Misreporting patient results
According to CLSI, the maximum time limit for separating serum or plasma from cells is
2.0 hours from time of collection.
Which of the following represents improper aliquot preparation?
Carefully pouring the contents into the aliquot tube.
A blood smear from an EDTA specimen should be made
within 1 hour of collection.
What type of specimens must be processed before routine specimens?
All options are correct.
Which of the following is the best way to prepare routine blood specimen tubes for transportation to an offsite lab?
Seal the tubes in plastic bags
For which condition is a unit of blood withdrawn from a patient as treatment…
hemochromatosis
A 2-hour postprandial specimen should be drawn
2 hours after the patient finishes eating a meal
Which specimen can be centrifuged immediately upon arrival in specimen processing?
Calcium in a green top tube
Which test requires strict antisepsis procedure before specimen collection?
Blood culture.
Which of these is a source of preanalytical error that occurs before specimen is collection?
Dehydrated patient
A specimen would most likely be accepted for testing despite which of the following problems?
No phlebotomist initials.
Which of the following activities is least likely to take place in central processing or triage?
analysis and reporting
A noninvasive transcutaneous method is available to measure
neonatal bilirubin
Which one of the following statements about autologous donations is NOT true?
Unused autologous units may be used by other patients
The CAP requires QC for many waived tests to be performed…
when the test manufacturer specifies
All POC glucose analyzers approved for hospitals use have which of the following in common?
All options are correct.
The hormone detected in a positive urine pregnancy test is….
HCG
An example of a preanalytical error happening during specimen processing is
inadequate centrifugation
The most critical aspect of blood culture collection is
skin antisepsis
All of the following are included in the DOT’s 10 Steps to Collection Site Security and Integrity EXPECT…
ensure that video monitoring equipment is working during specimen collection.
Which organization develops standards for specimen handling and processing?
CLSI
A chain of custody is…
a special protocol used when collecting forensic specimens
What type of additive is recommended for collecting an ethanol test specimen?
Sodium fluoride.
A test sample that is not recommended to be sent in a pneumatic tube is
serum potassium
Which of hte following tubes can be used to collect blood for a type and crossmatch?
ETS gray top
PInk top
Royal blue top
Gel barrier
pink top.
