NHA Flashcards
best method for a phlebotomy tech to collect a blood specimen from an older adult pt who has fragile and easy to collapse veins
the tech should id that a syringe minimizes pressure on fragile veins and help prevent collapsing
A phlebotomy tech is preparing to obtain a blood specimen from a pt for an erythrocyte sedimentation rate test. the tech should select a collection tube that has a top with which of the following colors
lavender
A phlebotomy tech is preparing to obtain a blood specimen from a pt who had a right sided mastectomy. which of the following sites should the tech select
opposite arm of a mastectomy
which of the following actions should a phlebotomist take to maintain compliance with HIPPA
ensure pt confidentiality by clearing phone numbers and emails from the office equipment
the tech should verify that the requisition includes which of the following info
specimen id code
a phlebotomist should use a capillary collection instead of a venipuncture in which of the following situations
when veins are inaccessible due to IVs, scarring, or burns
what is the max amount of blood a tech can draw from a newborn who weighs 3 kg at one time when the max allowable volume is 1%
3 mL
3 kg100 = 300 mL total blood volume
300 .01= 3 mL
which of the following troponin T levels should the tech immediately report to the provider
0.3 ng/ml
which of the following should the tech take after collecting an ammonia or ABG specimen
place the tube in ice
What antiseptic should you use on a pt who is allergic to alcohol
chlorhexidine
of the following is an identifier for a specimen as long as it remains in the lab
accession number
which of the following actions should the tech take prior to performing the venipuncture
check the requisition form for duplicate test orders
for a health 10 month old infant which of the following sites should the tech select for a routine CBC
either heel
a tech should ID that which of the following is the 1st step in the blood collection procedure
test requisition
what ppe should you use for a pt which active tb
n95 respirator
A unconscious pt is brought to the ER and several blood test are ordered. Which type of consent has the phlebotomist recieved
implied consent
what side do you apply blood when collecting capillary blood drops on filter paper
printed side
which of the following actions should tech take to locate a vein using the warming technique
encase the warm towel in a plastic bag
what temp should a semen sample be transported at
36 to 38 degrees C
what are semen samples collected in
sterile container
when should a semen sample be brought back to the lab
2 hour
what position should you put a pt who will faint when you draw their blood
lying down
what should be done to specimens being transferred to a reference lab in hot weather
put in a box with cold packs and biohazard label
What needle size is used for collecting donor units of blood
18
what are small red spots on a pt arm after applying a tourniquet
petechiae
A phlebotomy tech is preparing to obtain a blood specimen from a pt who had a left sided mastectomy and an IV on her right side. where should they perform the draw
below the IV
where should the specimen be put in when you are transporting them to the lab
lockable container
what is going on when the pt reports experiencing a sharp, painful, and tingling sensation going down her arm
nerve injury
what additive is used for a series of tests on a pt’s serum
thrombin
a tech is preparing to collect a vancomycin peak level for a pt in an in pt setting. Which of the following actions should the tech take prior to collecting the blood specimen
ask the attending nurse if the pt’s vancomycin dose schedule is accurate
what action is a tech required to take before leaving a pt’s room
initial and mark the date and time on each tube drawn
if you can’t find the vein after applying a tourniquet what should you do
dangle the arm for 1 to 2 mins
Following the CLSI workflow pathway what should be done in post examination phase
enter critical lab data
when should blood be drawn for a trough level of medication
15 mins before the pt next dose
what should be used if the pt sensitive to latex
nitrile gloves
what is used to clean items that have been contaminated with blood
diluted sodium hypochlorite
what device should you use for a pt with difficult to access veins in the hand
hand immobilizer
what ppe do you use on a pt with scabies
gown
what type of urine collection is used for a urine culture and sensitivity test
clean catch midstream
what ppe do you use on pt in an out pt setting
gloves
what ppe do you remove 1st from an isolation room
gloves
what should you do to pt who worked out before they came to the lab
let them rest for a least 15 mins before the venipuncture
what should you do if a red top fills but the light blue top tube slows and does not fill completely
insert a new light blue tube to see if it will fill
what action should be done to a urine specimen from a pt for a pre employment drug test
specimen should contain at least 45 mL of urine
what should you tell a child that asks if it will hurt
you will feel a small prick
what additive is used to collect a CBC
EDTA
what should the tech do to keep a vein from collapsing
use a small needle
what is the first thing you should do when you see a coworker get shocked from an instrument
shut off power to the instrument
what directions should you give to a pt that is collecting a sputum specimen
breathe deeply and then cough up a specimen into the container
what should you do when you see a hematoma developing at the site
release the tourniquet and stop the draw
why is the order of draw different for a capillary collection from venipuncture
increased rate of coagulation
how long should you rinse a chemical splash
15 min
for a cholesterol POC test what value should be reported immediately to the provider
300 mg/dL
why should you look at both arms
the median cubital vein could be more accessible on one side than the other
what should you do when a pt says they’re dizzy and light headed
remove the tourniquet and needle
how long should you wait before drawing a peak level of medication
2 hrs after administration
what ppe should you use with a pt with cutaneous diphtheria
mask
gloves
for a WBC count POC test what value should be reported immediately to the provider
1.8 mm^3
what antiseptic is used in a routine venipuncture
isopropyl alcohol
what should the tech do when they enter a pt room
communicate name and department affiliation to the pt
what additive is used to perform a chromosome analysis
heparin
why do you centrifuge a serum Specimen before transport to an outside reference lab
cells must be separated from the serum
what ppe do you use for a pt with pneumonia
mask
what color tube is used for a sodium level collection
green
what is an example of implied consent
rolling up shirtsleeve
how often should a tech perform a QC test on a glucometer in the lab
everyday
what color tube is used for a thyroid study test
speckled
how do you anchor a vein
use the thumb to anchor the vein 5 cm below the picture site
what color tube is used for a routine chem test that requires serum
SST
what vein should you attempt to draw from 1st
median cubital
to avoid hemolysis what precaution should the tech take
ensure the alcohol at the insertion site has dried
what color signifies a health hazard in the national fire protection association 704 marking system
blue
what should you do to a pt that states that this is their 1st blood draw
describe the procedure to the pt
why should you allow the antiseptic to dry
alcohol requires time for antiseptic action to take effect
according to OSHA standards which of the following vaccines must employers offer to their techs at no cost
hep B
which of the following sources for pt ID should a phlebotomy tech use in an in pt setting
verbal and wristband
what is the correct way to tie a tourniquet
tuck a partial loop of tourniquet underneath the tourniquet
what should you do if a collection bag for a blood donation only fills halfway and the vein collapses
use a new collection bag to draw a new unit of blood
what should you do when you are obtaining a blood culture specimen from an adult pt
withdraw the blood into a sterile safety syringe
a tech is preparing a peripheral blood smear from a pt’s capillary blood. what action should be done
use the 2nd drop of blood that emerges from the puncture
what specimen need to be protected from the light
vitamin B6
what tube is collected 1st in a dermal sample
lavender
where should you tie the tourniquet when you see that there is a sore on the arm
tie it over the pt sleeve
what should you do if a pt begins to seize
Discontinue the draw
when should a phlebotomy tech perform external liquid controls for QC on a CLIA waived glucose POC test
when a new lot # or kit is opened
what kind of consent is a pt extends his arm and turn his head away
implied consent
what should be done 1st when you get a needle stick injury
wash the puncture site with soap and water
what additive is used for a PT/PTT test
sodium citrate
what should you do if you see that pt’s lab results are ready
inform them to contact the ordering provider to obtain the results
what is the last piece of PPE a tech should remove
mask
what procedure should a tech follow chain of custody guidelines
paternity testing
blood alcohol
when should you replace the sharps container
2/3 full
how should you remove gloves from a venipuncture procedure
remove the 1st glove so that is turns inside out during removal
what test results are affected when a tech uses povidone iodine to cleanse a site for dermal puncture
potassium
what action should a tech take when washing their hand at the beginning of their shift
use enough soap to form a lather
How do you collect a sputum Specimen
Spit thick secretions into the container after coughing deeply.
What additive in a tube should be filled 1st
Sodium citrate
Correct order of draw for gray, green, and lavender tubes
Green, lavender, gray
If a pt is becoming pale and diaphoretic what is the pt a risk for
Syncope
what does SD stand for
standard deviation
if the Phlebotomy tech has a sensitivity to latex what should they do
Wear nitrile gloves instead of latex gloves.
what could possible happen if a tube is mislabeled on a blood bank specimen
A transfusion reaction
what should you do if the pt’s last name on the requisition does not match the pt’s provided id
Contact the ordering provider to correct the requisition form.
how should you apply the antiseptic solution
Back and forth strokes
where should an older adult pt who has difficult to access veins be drawn from
Dorsal veins
HIPPAA protects _____
Patients’ information
what regulation ensures that a phlebotomy tech is proficient to perform job duties and responsibilities
CLIA
what should make sure of if you are drawing a fasting glucose and albumin Specimen
Make sure the patient has fasted for the past 8 to 12 hr.
what are the first 3 steps of a venipuncture procedure
Assess the site, cleanse the site, and insert the needle
describe the technique of a venipuncture procedure
Position the needle at a 30° angle in the same direction as the vein and with the bevel up.
what should you tell a pt that tells you they faint when they get their blood drawn
“I will perform the draw while you are lying down.”
what additive is in blood culture tubes
Sodium polyanethol sulfonate
why should you invert anticoagulant tubes
Hemolysis
what should you do if you need to collect a stat Specimen but the nurse and doc are talking to the pt
Introduce yourself to the patient and the health care team members.
how can you tell if urine Specimen is tampered with
The temperature of the specimen is 30° C (86° F).
how often should QC be done on POC testing instruments
Daily
what should you use to collect a newborn’s bilirubin level
an amber-colored microcontainer.
what is the max amount of blood a tech can draw from a adolescent pt who weighs 42.6 kg at one time when the max allowable volume is 1%
40 mL
what additive prevents the breakdown of glucose
Sodium fluoride
what will happen to a stat Specimen that does not have the pt’s ID # on the tube
Reject the specimen.
how many times do you invert the tubes
Eight to ten times
what should you do if you are explaining the venipuncture procedure to a pt but they look confused
Rephrase the information for the patient.
how long can you leave a tourniquet on
No longer than 60 seconds
how do you label a Specimen
at the time of collection and in the presence of the patient
within what time should a newborn blood spot test screening card be done
Within 72 hr
what is the next step after removing the needle
Engage the needle safety device.
what is the total blood volume of a infant who weighs 3.3 kg
240 to 330 mL
what sample should be collected 1st
Blood cultures
why should a tech avoid drawing from the leg or foot of pt with diabetes
These areas are more susceptible to infection.
where should you draw an older adult pt for a capillary collection
The distal phalanx of either middle finger
what is a goal of joint commission
Identify patients correctly.
what should you tell a pt that you are collecting a blood donation
Instruct the donor to open and close his hand gently throughout the collection.
What is required for a tech to obtain from a potential blood donor
Complete medical history
what should you do after you insert the needle
Push the first collection tube gently into the holder.
What color tube should be collected 1st for a blood assay
Yellow-topped tube
what should you do when you enter a pt’s room and they are sleeping
Wake the patient before collection
what would cause in a grossly hemolyzed specimen
Using an incorrect needle gauge
what should you do when the pt reports a sharp pain radiating down their arm
Release the tourniquet and remove the needle.
What should you do to a pt that reports feeling faint after you have removed the tourniquet and needle
Have the patient put her head between her legs.
why should you document the total volume of blood drawn from a pt
To determine if the patient is at risk for developing iatrogenic anemia
what antiseptic is used for a clean catch urine Specimen
Mild antiseptic soap
The tourniquet is placed and tech has cleansed the puncture site what should be done next
Ask the patient to make a fist.
what OSHA requirement must a tech do when performing a venipuncture
Wear gloves when contact with blood is anticipated.
what type of transmission precaution should a tech use for mycobacterium tuberculosis
Airborne precautions
what should you do 1st to a pt who is in shock and bleeding profusely from his leg
Apply direct pressure to the wound.
what should you do if you obtain 2 readings of 17 mg/dL when performing a glucometer test for a pt
Perform a set of liquid controls.
what should you do if a pt’s wristband is attached to their IV stand
Hold the draw until the nurse has attached a wristband to the patient.
what is the most common POC test performed at home and in medical facilities
Glucose
what should you tell a pt that is collecting a fecal occult specimen
Avoid taking ibuprofen
what should the tech do to verify the quality of venipuncture supplies before beginning a draw on a adult pt
inspect the integrity of the needle’s seal.
before a venipuncture what info should the tech request from the pt
The patient’s full name and date of birth
what condition has emergency first aid of maintaining an open airway, controlling bleeding, and keeping the pt warm
Shock
what info should a tech document when adhering to chain of custody guidelines
Identity of everyone who had possession of the specimen
what should you do if you are preparing to draw a blood sample for a glucose tolerance test and notices an empty breakfast plate on a bedside table
Ask the patient when he last ate or drank.
what is the correct procedure for a heel puncture for neonatal screening
Saturate each circle with one drop of blood.
how do you properly dispose of a bag of contaminated items from a collection area
Place the bag inside a second hazardous waste bag outside of the room.
what should the tech do when reporting lab results
Send the results to the patient’s ordering provider.
the joint commission recommends using the pt full name and
Medical record number
what should a tech do before removing the needle
Disengage the tube from the adapter.
for a basal state blood collection how long should the pt not consume food for
12 hr
normal glucose range
70 to 126 mg/dL.
for a needle stick injury how many hours should the tech initiate post exposure prophylaxis
24 hrs
what task is within a phlebotomy tech’s scope of practice
Providing instructions to patients for specimen collection
what materials should a tech bring to do a blood culture
An aerobic bottle and an anaerobic bottle
what should the tech do 1st when preforming a finger stick
Confirm the identity of the patient.
what is the best method to collect a blood specimen from an older adult pt who has fragile easy to collapse veins
Choose a syringe and butterfly assembly and transfer to an ETS tube.
what action should a phlebotomist take to prevent needle stick injuries
Replace a sharps container that has reached its fill line.
what should you say before you perform a venipuncture
“Your provider has requested this test.”
how do you prepare a peripheral blood smear
Place a 1 mm drop of blood one-half inch from the edge of the slide
what materials do you need for a hand draw
Winged infusion set and adapter
why should a phlebotomist place a Specimen in a biohazard bag for transport to an outside lab
The biohazard bag prevents a possible exposure incident.
what equipment should you use on a pt with small, rolling veins
Winged infusion set
what should you do if a pt tells you they are HIV positive
Perform the venipuncture.
what could cause a hemolyzed specimen
Shaking a collection tube vigorously.
what should you use on a pt the is severely allergic to latex
Use a blood pressure cuff and inflate it to 40 mm Hg.
what color tube is used for a lactic acid test
gray-topped tube.
what should you tell a pt collecting a semen specimen for fertility potential
Protect the specimen from exposure to bright light.
what type of consent is when a pt is alone and unresponsive
Implied consent
when updating a QC record what info should the tech include
Expiration date
what should you use to clean several drops of blood on drawing chair
1:10 bleach
A pt states that he is a difficult draw and request a skin puncture. the test ordered is a PTT. what should the tech perform
A syringe draw transferred into a light blue vacuum tube
what should you do if you get a result that is in the critical value range
Report the result to the patient’s provider.
In which situation can the tech collect blood from the pt’s finger
The ordered test can be performed on a capillary specimen.
what type of transmission precaution should a tech use for clostridium difficile
Contact precautions
A tech collects multiple specimens from a premature infant what could be a result of this
Iatrogenic anemia
what comfort zone is a tech introducing herself and explaining the venipuncture procedure
Personal
what professional characteristics is a tech using sterile technique and demonstrates proper hygiene
Attention to cleanliness
what PPE is used for droplet precautions
Mask
what antiseptic is used for a blood alcohol level test
Soap and water
what temp should blood specimens be stored at
2° to 8° C (35.6° to 46.4° F)
what should you do to a pt with diabetes that says they want to be drawn from the inside of the wrist
Attempt to draw from the antecubital region.
what instructions should you give to a pt collecting a 24 hr urine specimen
Discard the first void of the morning.
A Phlebotomy tech is preparing to collect a blood Specimen from the anticubital site of a pt. Which of the following devices can be used to help stabilize the arm for the collection
Phlebotomy wedge
What should be done after the tourniquet is placed and the tech has cleaned the puncture site?
Uncap the needle and inspect it.
