I Flashcards
The patients who are performing stool guaiac testing at home should be instructed not to eat… in the days leading up to and during the test.
Red meat
The number associated with all documents and specimens connected to a particular requisition is known as the…
Accession number.
Which of the following is true of patient fasting?
If it extends beyond 14 hours it may produce inaccurate test results.
Hemolysis can occur when the phlebotomist:
Draws a syringe plunger back forcefully.
Which fingers are best suited for capillary blood collection
The ring finger and middle finger.
A patient is being tested for various vitamin levels.
Which of the following is true?
The tubes should be protected from light.
When an order is marked
STAT it should be collected:
Within 10 minutes, as soon as possible.
This venipuncture site poses the lowest risk for nerve or artery involvement, and is generally well anchored:
The median cubital vein.
If a tourniquet has been left on the arm for more than one minute, how long should it remain off the arm before it is reapplied?
Two minutes.
Electrolytes and complete blood count are ordered for a patient who must have blood collected by capillary puncture. Th collect tubes to use, in the correct order, would be tubes to use, in the
correct order, would be:
EDTA, serum.
Blood for newborn metabolic screening is collected:
On filter paper printed with circles for each blood drop.
A blade-style lancet should be held at a… angle to a patient’s fingerprint whorls when performing capillary collection.
90 degree
A blade-style lancet should be held at a… angle to a patient’s fingerprint whorls when performing capillary collection.
90 degree
Which of the following
techniques is an acceptable way to make a patient’s veins appear more prominently?
Place a warm pack over the antecubital area for 3-5 minutes.
When is a bandage applied to venipuncture site?
After bleeding has stopped.
If a patient has orders for therapeutic drug monitoring and must have blood drawn at trough medication levels, when should her blood be drawn?
Within 10 minutes before next dose.
CLSI standards for patient identification include asking a patient to…
State and spell.
In which of the following ways can a phlebotomy technician help to prevent iatrogenic anemia?
By performing draws carefully and avoiding the need for redraws.
Shop method
An endocrinologist has ordered a thyroid panel and fasting blood glucose tests for a patient. Which of these choice represents a possible tube choice?
SST tube and sodium fluoride/ oxalate tube.
The area of the foot used for infant heel stick is known as the
Lateral or medial plantar surface.
What step immediately follows removing the needle from a venipuncture site?
Activating the needle’s safety mechanism.
Which of the following is true of labeling aliquot tubes?
Each one should be labeled with the patient’s identifying information.
A patient who uses a cane or walker is at a higher risk for this type of hazard:
Uneven walkways and tripping hazards.
The following tests may be related to assessing kidney health:
Renal panel, 24-hour urine collection.
_____is an organization that develops standards of practice for
laboratories worldwide.
CLSI.
Drawing blood from… is usually considered to be beyond the scope of practice for entry-level phlebotomy technicians.
Arteries.
Adhesive bandages are never placed on
Patients under 2 years of age.
Which set of adaptations is appropriate when drawing blood from a pediatric patient?
Use of a higher gauge needle, removing any sharp or
potentially dangerous objects from within the patient’s reach, and never leaving the patient alone at the drawing station.
Some swabs are
transported in a tube with a(n)… that must be… to release liquid.
Ampule, crushed.
which of the following equipment has an expiration date that must be checked prior to use?
Point-of-care test strips.
for routine testing after
she has expressed that
she does not wish to
have the procedure
performed may be
considered.
Battery
Most collection tubes should be centrifuged within… of collection.
Two hours
How should a vein be anchored before venipuncture?
By placing the thumb of the nondominant hand 1-2 inches
below the venipuncture site and pulling firmly but gently toward the wrist.
After centrifuging a specimen that does not have a separator gel, when should the liquid portion of the specimen be removed from the solid portion?
Immediately.
A split specimen is often created for purposes of… testing
Drug.
Which of the following tasks related to point-of-care testing devices may be performed by a phlebotomy technician?
Recording quality control measurements in a daily log.
When should a
phlebotomy technician label and initial tubes
drawn from patients in hospital rooms?
Right after completing the draw and in the presence of the patient.
Gray-topped tubes typically have two additives. What are the actions of these tow additives?
Anticoagulant and antiglycolytic.
When a patient is in an isolation room, where should the phlebotomy technician doff any required PPE?
Inside the patient’s room right before exiting.
Which of the following are effects of warming a capillary puncture site?
Improved blood flow and arterialization of the blood.
A patient indicates that phlebotomy technicians have always had the best luck drawing blood from his right arm, but no suitable site can be found in the right arm after visual inspection and palpation. What should the phlebotomy technician do next?
Draw from the patient’s hand.
Which of the following patients is most likely to require use of a syringe and transfer device?
An 80-year old man.
Hemolysis of a capillary specimen is most likely to have resulted from
“Milking” the finger during collection.
Sharp, shooting pain during venipuncture is a possible sign of what complication?
Nerve involvement
If a phlebotomy
technician is not able to read a note made on a manual requisition form, she should…
Contact the ordering provider for clarification.
The bloodborne illness that has most commonly affected healthcare workers is
Hepatitis B.
Coagulation studies are ordered for a patient whose veins require use of a butterfly assembly.
Which of the following is true?
A discard tube should be started first, then a light blue filled completely.
Which of the following is permitted during blood donation collections but
should not be done during routine venipuncture collections?
Opening and closing the hand during collection.
When should gloves be removed and replaced?
Always between patients.
Accidental artery puncture should be avoided for the following reason:
It can be more difficult to stop arterial bleeding.
In addition to causing pain for the patient, probing for a vein can result in…
Hematoma
Which set of regulations deals with how laboratories are staffed and what tests they can perform?
CLIA.
When a patient’s veins are difficult to access, how many attempts at venipuncture should a phlebotomy technician make before seeking help from other qualified personnel?
Two
Pediatric patients and patients in intensive care are at the highest risk for iatrogenic anemia.
Pediatric, intensive care.
If a patient’s veins seem difficult to access, one appropriate adaptation is to
Ask the patient to dangle his arms for 3 minutes without the tourniquet in place.
The anticoagulant action of this tube additive can be reversed with the addition of calcium:
Sodium citrate.
Which of the following situations always requires written permission from a physician?
Drawing blood from either arm or hand of a patient who has had a double mastectomy and drawing blood from an ankle or foot
Which of the following is the best response to a patient who is afraid of needles?
You might find it easiest to look away while I get the equipment ready. I’ll tell you before I actually perform the procedure.
During centrifugation of a specimen the centrifuge becomes very hot and then bursts into flames.
The power cord is plugged in behind the centrifuge. How should the phlebotomy technician operating the centrifuge respond?
He should leave the area and immediately activate the fire alarm.
Which of the following is one acceptable way of confirming a patient’s identity?
Checking the name and date of birth on a wristband on the patient’s wrist against his stated name and date of birth.
Just as a needle is
removed from a patient’s arm, the patient has a coughing fit and the phlebotomy technician is accidentally stuck with the needle. What should the phlebotomy technician do after
placing the needle in the sharps container?
Wash the injury with soap under running water for 15 minutes.
One effective method to help control healthcare associated infection is
Using facility-approved disinfectants to clean reusable items like point-of-care testing devices.
One effective method to help control healthcare associated infection is
Using facility-approved disinfectants to clean reusable items like point-of-care testing devices.
Which of these items may be reused between patients with proper cleaning?
A phlebotomy wedge.
One effective method to help control healthcare associated infection is
Using facility-approved disinfectants to clean reusable items like point-of-care testing devices.
One effective method to help control healthcare associated infection is
Using facility-approved disinfectants to clean reusable items like point-of-care testing devices.
A patient begins to experience a seizure during a blood draw.
What should be the phlebotomist’s first response?
Too remove and sheathe the needle.
Which of these tests is an entry-level phlebotomy technician most likely to be trained to perform in its entirety?
Testing urine with a dipstick.
Which of the following is a significant difference between midstream and routine urine specimen?
The area around the urethra is cleaned before collecting a midstream specimen.
Hemoconcentration may be caused by…
Leaving a tourniquet in place for too long.
A patient’s chart indicates that her veins are thin, fragile, and frequently collapse. A total of 5 mL of blood needs to be drawn for various tests.
Which of the following techniques would be best for drawing blood from this patient?
Venipuncture using a 23-gauge butterfly needle and syringe/ transfer device.
Facility policy states that no more than 5% of a patient’s blood may be drawn in 20 days. What is the maximum amount of blood than can be drawn from an 9-pound infant in a month?
16 mL
Which of the following will help a phlebotomy technician avoid having a patient’s vein roll away when the needle is inserted?
Anchoring the site from below, using the thumb to pull toward the wrist.
Collection tubes with… should not be used for therapeutic drug testing.
Separator gel.
Blood pulsing into collection tubes is an indication that:
The needle has truck an artery.
A phlebotomist needs to collect gold, pink, and green-topped tubes by venipuncture. Which order is correct?
A phlebotomist needs to collect gold, pink, and green-topped tubes by venipuncture. Which order is correct?
Which of these tasks is typically considered within a phlebotomy technician’s scope of practice?
Creating peripheral blood smear slides drawing blood, performing a throat culture and drawing blood from the dorsal aspect of the hand using a syringe and transfer device.
If, after centrifuging a specimen, a phlebotomist notices a pink or red tint to the serum, the specimen is likely…
Hemolyzed.
When can a phlebotomy technician puncture the patient’s skin for either venipuncture or capillary puncture?
After the site has been cleaned and has dried.
If, after centrifuging a specimen, a phlebotomist notices a pink or red tint to the serum, the specimen is likely…
Hemolyzed.
For which of the
following tests commonly performed on newborns should an amber micro collection tube be used?
Bilirubin.
A patient whose veins must be preserved for medical interventions such as chemotherapy may have blood tests conducted on:
Blood taken from capillaries.
Glucose challenge tests are routinely performed on what patient population?
Pregnant women.
If blood is taken from a collection tube to perform a peripheral blood smear, what type of tube should be used?
Lavender top.
What is the maximum angle at which a venipuncture needle should be inserted when drawing blood from a patient who is obese?
30 degree.
Which of these statements is true?
Citrate tubes must be filled to at least 90% capacity.
Chain of custody documentation is required when a test:
May be used in legal proceedings.
Chain of custody documentation is required when a test:
May be used in legal proceedings.
In which of the following situations must a
phlebotomy technician ask nursing staff to complete a blood draw?
A hospitalized patient’s chart indicates blood should only be taken from a central port.
After introducing herself, confirming the patient’s identity and matching it to the requisition, what should a phlebotomy technician do?
Explain the procedure to the patient.
A transfer device allows blood to be safely transferred from… to…
A syringe, evacuated tubes.
Which of these choices lists lab tests in the order in which tubes would be drawn to conduct the tests?
Thyroid panel, complete blood count, glucose.
How is a five-year-old child most likely to be positioned for venipuncture?
In a parent or guardian’s lap.
If a patient asks a
phlebotomy technician for her opinion about the doctor who ordered his tests, the phlebotomy technician should…
Politely decline to offer any opinion.
If a patient asks a
phlebotomy technician for her opinion about the doctor who ordered his tests, the phlebotomy technician should…
Politely decline to offer any opinion.
The Needlestick Safety and Prevention Act requires that employers…
Involve staff in the selection of safer medical devices.
When passing another phlebotomy technician’s drawing station a PBT
overhears him telling the patient that if she does not extend her arm, he will have to extend it for her and strap it down for the draw. What is the passing PBT’s best course of action?
Politely ask the coworker to pause for a moment, then immediately find a supervisor to intervene.
Where is venipuncture most commonly
performed if no suitable site can be found in the
antecubital are of either of the patient’s arms?
The dorsal aspect of one of the patient’s hands.
A patient with measles is in an airborne infection isolation room. When drawing blood from this patients, a phlebotomy technician will need to
wear:
An N95 respirator.
When a phlebotomy technician begins work at a facility, the employer must offer this protection against bloodborne pathogens:
A free hepatitis B vaccine.
A CLIA waived test may not be performed by the following laboratory personnel:
Personnel who are not trained in its use.
Which of the following processes is part of appropriate medical asepsis in a laboratory?
Thoroughly cleaning a venipuncture sited with 70% isopropyl alcohol.
Which of the following is instruction that should be given to a patient who will be collecting a 24-hour urine specimen?
Collect the urine in the hat and then transfer it carefully to specimen container.
Most blood chemistry tests are performed on specimens collected in either
Serum tubes or heparin tubes.
Orders indicate a patient needs coagulation
studies, a lipid panel, and a complete blood count.
Which of these tubes will be needed ?
Lavender top, Tiger top, Light blue top.
When performing venipuncture on a school-age child, which needle gauge is the best choice?
23
A phlebotomist is drawing blood for a glucose tolerance test.
What process is avoided by using gray-topped collection tubes?
Glycolysis.
Veins carry blood … the heart and arteries carry blood…
Toward, away from.
During a blood draw on an elderly patient, the patient’s vein collapses when the first tube is inserted. Which of the following is the best option for completing the draw?
Try a tube with a smaller volume.
Which of the following tubes contains an anticoagulant that acts by inhibiting thrombin?
A heparin tube.
Specimen drawn for testing cold agglutinins must be
Drawn in warmed tubes and kept at body temperature.
At what temperature should a specimen drawn to for cryofibrinogen testing be held?
37 degrees C
Which of the following tests cannot be performed on capillary blood?
Erythrocyte Sedimentation Rate (ESR).
Which of the following tests cannot be performed on capillary blood?
Erythrocyte Sedimentation Rate (ESR).
A new patient is seated at the drawing station before the phlebotomist realizes he forget to label and initial the collection tubes from the last patient. What would be his best course of action?
Excuse himself and try to catch the last patient before she leaves the facility, then label and initial the tubes in her
presence.
Why is it especially important that a
phlebotomy technician take care when drawing from a patient who is quadriplegic?
The patient is unable to alert the phlebotomy technician to pain that might signal nerve involvement.
In which of the following situations should a phlebotomy technician report a point-of-care testing result that is in the critical value range?
Any time a result is in critical value range, even if the repeated test is normal.
Micro clotting of an anticoagulated specimen may occur if the
phlebotomy technician does not…
Use gentle inversions to mix the specimen with the tube additive immediately after it is collected.
Micro clotting of an anticoagulated specimen may occur if the
phlebotomy technician does not…
Use gentle inversions to mix the specimen with the tube additive immediately after it is collected.
……… is an illness spread by droplets.
Influenza.
……… is an illness spread by droplets.
Influenza.
When a patient enters a phlebotomist drawing station, how can the phlebotomist best communicate a positive, professional attitude?
By greeting the patient, introducing himself by name and title, and inviting the patients to be seated.
Capillary blood will flow more easily when this is done prior to capillary puncture:
The site is warmed for 3-5 minutes.
The veins in both arms of a patient who is obese are difficult for a
phlebotomy technician to palpate and the patient is complaining of pain from the standard disposable tourniquet applied to her arm. Which steps might help the phlebotomy technician locate a vein and improve comfort for the patient?
Remove the tourniquet, ask the patient to dangle her arms for several minutes, and then use a blood pressure cuff inflated to just below the patient’s diastolic blood.
A patient has orders for a fasting blood glucose test. What should the phlebotomy technician do before inspecting the patient’s arms for an acceptable venipuncture site?
Ask the when she last had anything to eat or drink other than water.
A patient has orders for a fasting blood glucose test. What should the phlebotomy technician do before inspecting the patient’s arms for an acceptable venipuncture site?
Ask the when she last had anything to eat or drink other than water.
In which of the following situations should a phlebotomy technician consult a Safety Data
Sheet?
She splashes a disinfecting solution on her skin.
If a facility’s policy is to collect tan-topped tubes along with tubes with the same additive, they should be collected in the same order as they should be collected in
the same order as
Lavender-topped tubes.
If a facility’s policy is to collect tan-topped tubes along with tubes with the same additive, they should be collected in the same order as they should be collected in
the same order as
Lavender-topped tubes.
A lancet designed for heel stick on a full-term infant usually punctures at a depth of…
1.0 mm
Using liquid controls to test point-of-care devices is effective
because…..
It tests the device using analytes of known composition.
Blood flow slows and then stops while a
phlebotomy technician is halfway through drawing a citrate tube. After adjusting the needle gently forward and backward, the technician is not able to restore the flow. What should he do?
Try a second citrate tube; if the second tube does not fill, perform a second venipuncture at a new site.
Which set of differences is true of the collection of donor blood as compared to routine venipuncture for diagnostic testing?
A larger needle is used and the patient is first given a brief medical exam.
Capillary blood gas testing is ordered on a newborn infant. Where and how should the specimen be drawn?
From the lateral or medial plantar surface of the foot by a capillary puncture.
In which of the following cases should a
phlebotomy technician seek out interpretation services?
A patient does not speak English and is accompanied by her 10-year-old grandson who speaks fluent English.
In which of the following cases should a
phlebotomy technician seek out interpretation services?
A patient does not speak English and is accompanied by her 10-year-old grandson who speaks fluent English.
Which of the following is within the range of
common micro collection tube volumes?
0.5 mL
A patient with a DNR order in place becomes unresponsive during the course of a blood draw.
The phlebotomy technician should…
Discontinue the blood draw and immediately call for help.
Which of the following is a HIPAA violation?
Failing to log out of a patient record on a visible screen before calling the next patient in.
How should a
phlebotomy technician respond if, after a site is selected and cleaned and equipment prepared, the patient pushes down his sleeve and clutches his arm to his chest?
She should ask the patient if he has concerns she can address or if he would like to talk to his doctor.
Which of the following information on a requisition form is essential for a phlebotomy technician to match exactly with information provided by the patient?
Complete date of birth.
Disposable tourniquets are intended to be used…
On one patient only.
After assembling the ETS and double-checking that he has the correct tubes gathered for a venipuncture draw, a phlebotomy technician realizes that he forgot to remove the tourniquet after site selection. He knows that it has been in place for more than one minute. If he continues with the draw, what is one possible consequence?
The specimens collected will not produce accurate test results.
After assembling the ETS and double-checking that he has the correct tubes gathered for a venipuncture draw, a phlebotomy technician realizes that he forgot to remove the tourniquet after site selection. He knows that it has been in place for more than one minute. If he continues with the draw, what is one possible consequence?
The specimens collected will not produce accurate test results.
An infant’s blood volume may be approximated by multiplying the child’s … by ….
Weight in kilograms, 80.
An infant’s blood volume may be approximated by multiplying the child’s … by ….
Weight in kilograms, 80.
Two sets of blood culture bottles are to be filled for a patient. Which of the following is true?
The sets must be filled from two different venipuncture site.
Two sets of blood culture bottles are to be filled for a patient. Which of the following is true?
The sets must be filled from two different venipuncture site.
When performing a draw on an inpatient with a recent mastectomy, the phlebotomy technician finds that an IV is running in the arm on the non-mastectomy side. Which site should the
phlebotomy technician use?
A site distal to the IV on the non-mastectomy side.
When performing a draw on an inpatient with a recent mastectomy, the phlebotomy technician finds that an IV is running in the arm on the non-mastectomy side. Which site should the
phlebotomy technician use?
A site distal to the IV on the non-mastectomy side.
Of the three veins
commonly assessed for venipuncture, which is considered the least favorable?
The basilic vein.
An emergency room physician directs a phlebotomist to draw blood from an unconscious patient of unknown identity. This is…
Legal under the concept of implied consent.
When is a sharps
receptacle considered to overfilled according to
OSHA standards?
When it is more that 3/4 full.
Scars cover the arms and hands of a patient whose requisition requires CBC and electrolytes. After finding no acceptable venipuncture site on either arm or hand, the phlebotomy technician sees that the scarring does not extend to the fingertips. Which of the following is true?
The phlebotomy technician can do a capillary draw and document that where the blood was collected and why.
Scars cover the arms and hands of a patient whose requisition requires CBC and electrolytes. After finding no acceptable venipuncture site on either arm or hand, the phlebotomy technician sees that the scarring does not extend to the fingertips. Which of the following is true?
The phlebotomy technician can do a capillary draw and document that where the blood was collected and why.
A phlebotomy technician is performing a
venipuncture collection on a young adult and needs to draw a citrate tube, a serum separator tube, and an EDTA tube.
The citrate tube and SST fill quickly. The EDTA tube fills partway and then blood flow stops.
What is the most likely explanation?
The tube’s vacuum is compromised.
A phlebotomy technician is performing a
venipuncture collection on a young adult and needs to draw a citrate tube, a serum separator tube, and an EDTA tube.
The citrate tube and SST fill quickly. The EDTA tube fills partway and then blood flow stops.
What is the most likely explanation?
The tube’s vacuum is compromised.
When a blood culture is ordered along with other tests, which tube is filled first?
Yellow SPS.
When a blood culture is ordered along with other tests, which tube is filled first?
Yellow SPS.
Which of these patient reactions should be documented, but is not a cause for discontinuing a draw or likely to affect analytes?
Petechiae.
A phlebotomy technician asks a patient to state and spell his name. He says, “Chris Morgan, C-H-R-I-S M-O-R-G-A-N.” The name listed on the requisition is “Criss Morgan.” What should the phlebotomy technician do?
Call the ordering provider to resolve the issue and get a new requisition with the correct spelling if the spelling was an error.
When drawing a specimen for an ammonia test, what should a phlebotomy technician have ready for specimen transportation?
An Ice slurry.
Blood exits the heart through the body’s largest artery, the
Aorta.
A requisition calls for the following tests: CBC, CMP, and PTT. Which of the following reflects the proper order of draw?
Citrate (blue top), SST (red top), and EDTA (lavender).
A phlebotomy technician at a primary care clinic is performing venipuncture on a patient with
suspected influenza. The patient is wearing a mask.
What PPE should the technician wear?
Gloves and a mask.
A phlebotomy technician at a primary care clinic is performing venipuncture on a patient with
suspected influenza. The patient is wearing a mask.
What PPE should the technician wear?
Gloves and a mask.
A patient report that during a previous blood draw he felt lightheaded and almost passed out.
What should the
phlebotomy technician do?
Perform the draw with the patient reclined or in a supine position.
