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MED ASSISTANT NCCT INTERACTIVE REVIEW > Phlebotomy > Flashcards

Phlebotomy Flashcards

1
Q

The physician orders a prothrombin time. Which tube should be used to collect the specimen?

A

Light blue

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2
Q

Which types of additives is present in an EDTA tube?

A

Anticoagulant

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3
Q

Which tube should the medical assistant select in collecting a blood sample for a Complete Blood Count (CBC)?

A

Lavender top, ethylenediaminetetraacetic acid additive

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4
Q

What is the additive in the light blue top tube

A

Sodium citrate

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5
Q

Filling evacuated tubes to the indicated level results in the correct ratio of

A

Additive to blood

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6
Q

Which of the following tests is drawn in an EDTA tube for the hematology department of the laboratory?

A. BMP
B. HCG
C. PTT
D. HGB

A

HGB

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7
Q

Which of the listed tubes can contain ethylenediamine tetraacetic acid?

A. Yellow
B. Royal blue
C. Gray
D. Red

A

Royal blue

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8
Q

EDTA is an

A

Anticoagulant

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9
Q

A test tube with which of the following colored stoppers has a glycolytic inhibitor?

A. gray
B. green
C. lavender
D. light blue

A

Gray

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10
Q

Which of the following actions should the medical assistant take to prevent hemolysis of a blood specimen in an EDTA tube?

A. Store the tube in the refrigerator after the specimen has been collected.
B. Use a 25 gauge needle or smaller to collect the specimen.
C. Allow the tube to stand for 20 minutes prior to processing.
D. Gently invert the tube after collecting the specimen.

A

Gently invert the tube after collecting specimen

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11
Q

A patient is at the lab for their weekly PT/INR. Which of the following tubes should the medical assistant collect for this test?

A. red top
B. lavender top
C. light blue top
D. green top

A

Light blue top

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12
Q

The phlebotomist is drawing plain red, lavender, and blue top tubes. Upon completion of the blood draw, the phlebotomist noticed that an order that requires a SST has been missed. What would be the next action?

A. Stick the patient again to obtain all the tubes necessary
B. Use a syringe and take some blood from one of the other tubes
C. Put a sticker on the blue tube and tell the CLS to share the specimen
D. Share the plain red top specimen for the SST test.

A

Share the plain red top specimen for the SST test.

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13
Q

When collecting specimens for alanine aminotransferase (ALT) or aspartate aminotransferase (AST), avoid gray-topped sodium fluoride tubes because the anticoagulant

A. destroys many enzymes.
B. forms calcium salts which bind the enzymes.
C. contains chemical constituents similar to the enzymes, falsely increasing the reported value.
D. causes hemolysis.

A

destroys many enzymes

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14
Q

A physician asked you to draw a INR on Mr. Jones which tube and additive would you choose

A. Light Blue, Sodium Citrate
B. Light Blue, Sodium Heparin
C. Gray, Sodium Citrate
D. Gray, Sodium Heparin

A

Light Blue, Sodium Citrate

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15
Q

A phlebotomist is staffing the outpatient clinic at a remote site. There is a centrifuge at the site, but it is not functional. The courier will be arriving to pick-up all samples collected at 1300, and will deliver to the testing laboratory at 1500. A patient arrives at 1200 with orders for Complete Blood Count, Prothrombin Time, and Basic Metabolic Panel. Which tubes should the phlebotomist use for blood collection?

A. Lavender, Blue, Red
B. Lavender, Blue, Gray
C. Lavender, Blue, Red, Green
D. Lavender, Blue, Green, Gray

A

Lavender, Blue, Green, Gray

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16
Q

Which of the following tests monitor anticoagulation therapy?

A. PT and PTT
B. T3 and T4
C. Hgb and Hct
D. ABO and Rh

A

PT and PTT

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17
Q

Since special precautions are needed for patients with Vascular Access Devices, which of the following devices are contraindicated for any type of blood draws?

A. Arterial line catheter
B. Central venous catheter
C. PICC Line catheter
D. Fistula

A

Fistula

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18
Q

Patient has a DVT in left arm and the patient is also on blood thinners, where would be the best site for drawing blood?

A. Draw right arm and hold for 5 minutes
B. Draw left arm and hold for 5 minutes
C. Draw right foot and hold for 3 minutes
D. Draw left foot and hold for 3 minutes

A

Draw right arm and hold for 5 minutes

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19
Q

An entry level medical assistant goes to collect blood from a 70-year-old woman with diabetes who had a mastectomy of the left breast. The medical assistant notices a PICC line in the patient’s right arm. For this specimen collection, the medical assistant should

A. draw the specimen from the left arm.
B. draw the specimen from the PICC line.
C. draw the specimen from one of the ankles.
D. ask a nurse to collect the specimen.

A

ask a nurse to collect the specimen.

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20
Q

A phlebotomist has received a requisition for a PT/aPTT to evaluate the patient for Von Willebrand’s disease. Because of the patient’s potential diagnosis, the phlebotomist should be sure to

A. hold pressure on the draw site until bleeding has stopped.
B. call the doctor to confirm collection site.
C. collect the specimen from the hand to avoid edema.
D. use a blood pressure cuff to apply consistent pressure.

A

hold pressure on the draw site until bleeding has stopped.

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21
Q

The medical assistant is asked to draw blood from a patient with an I.V. whose opposite, left arm is inaccessible. Drawing blood from which of the following sites would be appropriate without a physician’s approval?

A. Draw from the ankle
B. Draw from the I.V. line
C. draw from the right arm proximal to the I.V. site
D. draw from the right arm distal to the I.V. site

A

draw from the right arm distal to the I.V. site

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22
Q

When inserting a needle during venipuncture, the bevel should be in which of the following positions in relation to the vein?

A. up
B. down
C. left
D. right

A

Up

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23
Q

When performing a venipuncture on an infant, the amount of blood taken from the infant should be monitored to avoid

A. septicemia
B. polycythemia
C. venous thrombosis
D. anemia

A

Anemia

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24
Q

Which of the following characteristics applies to veins

A. Transports blood from peripheral tissues directly to the lungs
B. Carry blood that is normally blue in color
C. Have thicker walls than arteries
D. Have valves to prevent backflow of blood

A

Have valves to prevent backflow of blood

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25
Q

Which of the following statements best describes the reason antecubital veins are most desirable to use when performing venipuncture?

A. These veins are more flexible and allow for large bore needles.
B. These veins have thin walls, making it easier to penetrate with the needle.
C. The tissue surrounding these veins is less sensitive, making the procedure less painful.
D. The veins are the most superficial and are therefore easier to see.

A

The tissue surrounding these veins is less sensitive, making the procedure less painful.

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26
Q

While performing a venipuncture, immediately before removing the needle, the medical assistant should

A. activate the needle safety mechanism.
B. release the tourniquet.
C. gently invert the evacuated tubes.
D. apply a gauze pressure dressing

A

release the tourniquet.

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27
Q

A phlebotomist has received a requisition to collect a blood specimen on patient in isolation. When entering the patient’s room, which should the phlebotomist do first?

A. put on the gloves
B. put on the mask
C. put on the gown
D. put on gloves, a mask, and a gown. The order is not important.

A

put on the gown

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28
Q

A phlebotomist has received a requisition to collect a blood culture. Using a butterfly, three milliliters of blood is collected. Into which of the following bottles is the proper dispensation of the specimen?

A. place all three mLs in the aerobic bottle
B. place all three mLs in the anaerobic bottle
C. place 1.5 mLs in the aerobic bottle followed by 1.5 mLs in the anaerobic bottle
D. recollect the specimen

A

place all three mLs in the aerobic bottle

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29
Q

A phlebotomist inserts a needle into a patient’s vein and notices there is no blood flow into the tube. The needle is positioned against the wall of the vein. How should the phlebotomist proceed?

A. Retract the needle slightly, remove the tube, and insert needle deeper
B. Relax the needle’s angle slightly, and insert new tube
C. Withdraw the needle completely, and begin procedure again from the beginning
D. Insert the needle deeper in the opposite direction, and insert new tube

A

Relax the needle’s angle slightly, and insert new tube

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30
Q

Capillary blood specimens are typically collected on patients that

A. are extremely obese.
B. are dehydrated.
C. have poor peripheral circulation.
D. have peripheral edema

A

Are extremely obese

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31
Q

Capillary blood specimen collections are contraindicated in patients with

A. peripheral edema.
B. severe burns.
C. extreme obesity.
D. very difficult veins.

A

peripheral edema.

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32
Q

When performing a fingerstick on a patient, the phlebotomist must pay close attention to the extremity that has been compromised by

A. dry skin, bug bites, and coldness.
B. circulation, swelling, and infection.
C. swelling, infection, and dry skin.
D. circulation, dry skin, and infection.

A

circulation, swelling, and infection.

33
Q

After a patient’s skin is punctured to obtain a blood glucose level, what should be the phlebotomist’s next step?

A. Use the first drop of visible blood, and place it onto the test strip.
B. Use an alcohol pad to wipe away the first drop.
C. Use a sterile gauze pad to remove the first drop.
D. Squeeze the fingertip, and place the large blood drop onto the test strip.

A

Use a sterile gauze pad to remove the first drop.

34
Q

. A patient with an order for a blood draw presents with burns covering both arms. Which of the following is the medical assistant’s best option for collecting the largest amount of blood for this patient?

A. microtainer tube
B. capillary tube
C. PKU (Guthrie) card
D. evacuated tube

A

microtainer tube

35
Q

For which of the following patients is the use of an adhesive bandage contraindicated?

A. adult with hemophilia
B. immunocompromised child
C. adolescent with sickle cell anemia
D. newborn with hyperbilirubinemia

A

newborn with hyperbilirubinemia

36
Q

The medical assistant is collecting a sample on a 2 year old outpatient by finger stick. Following the collection, the medical assistant holds firm pressure on the site until bleeding has stopped. How should the medical assistant proceed?

A. Put a cartoon character bandage on the site.
B. Bandage with a pressure wrap.
C. Bandage with gauze and tape.
D. Do not bandage the site.

A

Do not bandage the site.

37
Q

Forceful shaking of blood in an evacuated collection tube will cause which of the following complications?

A. hemostasis
B. hemoconcentration
C. hemolysis
D. contamination

A

Hemolysis

38
Q

To help prevent a hematoma at the site after drawing blood, which of the following actions does the medical assistant take?

A. ask the patient to make a fist
B. clean the site with an alcohol prep
C. apply direct pressure with cotton gauze
D. have the patient bend the elbow to hold cotton gauze on the site

A

apply direct pressure with cotton gauze

39
Q

After performing a venipuncture on a patient the medical assistant notices the patient is bending his elbow to hold the gauze in place. This action is contraindicated because bending the elbow is likely to

A. create a hematoma.
B. cause hemostasis.
C. cause bacterial infection.
D. result in hemorrhage.

A

create a hematoma.

40
Q

At what time should a test tube be labeled with the patient’s identification?

A. before entering the patient’s room
B. after leaving the patient’s room
C. before leaving the patient’s room, before drawing the blood
D. before leaving the patient’s room, after drawing the blood

A

before leaving the patient’s room, after drawing the blood

41
Q

After a phlebotomist has successfully followed all the steps for blood collection, the patient informs the phlebotomist that he tends to bleed longer than the average person. What would be the next course of action for the phlebotomist?

A. confirm hemostasis and apply paper tape
B. apply extra gauze with non-adhering tape and wait for hemostasis
C. confirm hemostasis and apply gauze and non-adhering tape
D. apply gauze and tape and tell patient not to bend his arm for 20 minutes

A

confirm hemostasis and apply paper tape

42
Q

After a phlebotomy draw, the phlebotomist realizes the tourniquet was on the patient’s arm for an extensive length of time. Which of these is the most common complication?

A. Hemolysis
B. Hemoconcentration
C. Hematoma
D. Hematocrit

A

Hemoconcentration

43
Q

The patient reports feeling faint, and slumps forward during a venipuncture. After calling for assistance, which of the following actions should the medical assistant take next?

A. remove the needle
B. remove the tourniquet
C. continue obtaining the specimen
D. activate the needle safety mechanism

A

remove the tourniquet

44
Q

The medical assistant collects blood for a test that requires a blood smear. What is the terminology that would indicate that the sample clumped (therefore requiring a redraw)?

A. coagulation
B. thrombocytosis
C. hemolysis
D. thrombosis

A

coagulation

45
Q

A syringe is preferred over a vacuum collection device when

A. the patient’s veins are fragile.
B. the sample must be drawn from a large antecubital vein.
C. many tests have been ordered and multiple tubes must be drawn.
D. collecting a sample for newborn PKU screening

A

the patient’s veins are fragile

46
Q

After centrifuging a blood specimen, the medical assistant notes the serum has a reddish appearance. Which of the following has occurred?

A. The finding is normal.
B. The specimen is contaminated with neutrophils.
C. A buffy coat has formed and discolored the serum.
D. The specimen is hemolyzed.

A

The specimen is hemolyzed.

47
Q

The laboratory requisition indicates that you are to collect a venous blood specimen for hematology CBC testing, serum chemistry testing, and coagulation studies. What is the proper order of collection for these tubes?

A. Red, light blue, lavender
B. Yellow, red, light blue
C. Light blue, red, lavender
D. Red, lavender, yellow

A

Light blue, red, lavender

48
Q

The phlebotomist is drawing blood from a patient that is taking blood thinners. Which of the following is a necessary piece of additional equipment to have at the drawing station?

A. paper tape
B. elastic gauze
C. non-adhering bandage
D. adhesive tape

A

non-adhering bandage

49
Q

centrifuge functions in which of the following ways?

A. slowly warms a refrigerated blood specimen to room temp
B. magnifies cellular blood components
C. measures the amount of glucose in a patient’s blood
D. rotates to separate components of a patient’s blood

A

rotates to separate components of a patient’s blood

50
Q

The phlebotomist should send a specimen collected in a yellow stopper tube with SPS additive to which of the following laboratory departments?

A. microbiology
B. immunohematology
C. chemistry
D. hematology

A

microbiology

51
Q

Which of the following tube tops contain silica particles to enhance clotting and a thixotropic gel to assist in the separation of serum and blood cells?

A. Marbled red and grey
B. Lavender
C. Green
D. Blue

A

Marbled red and grey

52
Q

Which of the following Vacutainer tubes is routinely used for hematology testing?

A. Red-topped
B. Green-topped
C. Yellow-topped
D. Lavender-topped

A

Lavender-topped

53
Q

Which of the following tests is required in all 50 states to screen newborns for metabolic disease?

A. HIV
B. RSV
C. PKU
D. Rh Factor

A

PKU

54
Q
  1. Which of the following forms is the medical assistant responsible for having the patient sign when a specimen is being collected for substance abuse screening for employment?

A. advance directive
B. chain-of-custody
C. informed consent
D. release of medical Information

A

chain-of-custody

55
Q

During processing, the centrifuge rotor lid should be kept

A. closed to maintain an airtight seal.
B. unlocked to promote safe access to contents.
C. open to allow optimum visibility.
D. partially vented to release pressure.

A

closed to maintain an airtight seal.

56
Q

Which of the following actions by the medical assistant demonstrates safe use of a centrifuge?

A. Ensure all specimen tubes are uncapped.
B. Open at timed intervals to monitor proper function.
C. Open the centrifuge during operation to ensure the separation of blood cells from serum.
D. Balance the tube load to prevent breakage.

A

Balance the tube load to prevent breakage.

57
Q

In which of the following time frames should a tourniquet be routinely released on a patient while performing a blood draw?

A. within 30 seconds
B. within one minute
C. within three minutes
D. within five minutes

A

within one minute

58
Q

A medical assistant has active symptoms of the common cold. Under which of the following conditions may he perform venipuncture?

A. The medical assistant may not perform venipuncture with an active cold.
B. The medical assistant may perform venipuncture provided the patient is wearing a mask.
C. The medical assistant may perform venipuncture provided he is wearing a mask and afebrile.
D. The medical assistant may perform routine venipuncture as usual

A

The medical assistant may perform venipuncture provided he is wearing a mask and afebrile.

59
Q

Which of the following is an appropriate alternative to using a rubber tourniquet when attempting a venipuncture on a known patient who is difficult to obtain a sample from?

A. blood pressure cuff
B. non-adherent gauze
C. hypoallergenic tape
D. elastic bandage

A

blood pressure cuff

60
Q

Which of the following additives protects serum from interacting with red blood cells after a specimen has been centrifuged?

A. sulfosalicylic acid
B. gel separators
C. clot activators
D. anticoagulants

A

gel separators

61
Q

The appropriate needle gauge to use for most venipuncture collections is

A. 15.
B. 18.
C. 21.
D. 24.

A

21

62
Q

The physician orders a sedimentation rate for a patient recovering from an infection. This is indicated on the lab requisition as which of the following?

A. EBV
B. ESR
C. CRP
D. INR

A

ESR

63
Q

Venipuncture on the foot is performed in which of the following locations?

A. medial plantar surface
B. posterior curvature
C. dorsal pedis
D. anterior curvature

A

dorsal pedis

64
Q

What is the laboratory abbreviation for calcium?

A. CA
B. cal
C. Ca
D. CAL

A

Ca

65
Q

Which of the following items is more commonly found on a phlebotomy tray?

A. multi-sample needle
B. normal Saline
C. 5/8 inch needle
D. sterile water

A

multi-sample needle

66
Q

The medical assistant is instructed to perform a capillary stick for newborn screening. Which of the following collection devices should the medical assistant use?

A. heel stick lancet
B. needle and syringe
C. evacuated tube
D. finger stick lancet

A

heel stick lancet

67
Q

Which of the following sites should the medical assistant use for newborn screening blood collection?

A. plantar surface of the heel
B. antecubital fossa
C. superficial scalp vein
D. lateral surface of the great toe

A

plantar surface of the heel

68
Q

A 2 week old infant has been brought to the lab for a repeat PKU/neonatal screening. Which of the following collection procedures is appropriate to collect the specimens?

A. venipuncture using evacuated tube system
B. venipuncture using winged infusion set
C. capillary using dermal puncture lancet
D. capillary using heel puncture lancet

A

capillary using heel puncture lancet

69
Q

Which patient description is correctly matched with the appropriate site selection?

A. A 53-year old female that has had a double mastectomy has a specimen collected on the palmar side of the wrist.
B. A two-day old male has a specimen collected from central section of the plantar surface of the heel.
C. A two-year old female has a specimen collected from the palmar surface of the distal phalanx of the fifth finger.
D. A 53-year old male with a central line has a specimen collected from the dorsal side of the hand.

A

A 53-year old male with a central line has a specimen collected from the dorsal side of the hand.

70
Q
  1. A medical assistant needs to draw a bilirubin on a jaundiced infant. The medical assistant should

A. collect the specimen in an amber tube to protect from light.
B. wrap the specimen in a heel warmer to keep at body temperature.
C. chill the specimen to slow metabolism and stabilize the analyte.
D. run the specimen STAT.

A

collect the specimen in an amber tube to protect from light.

71
Q

Which of the following evacuated tubes should the medical assistant select for collection of electrolytes?

A. blue-top
B. green-top
C. grey-top
D. lavender-top

A

green-top

72
Q
  1. After several minutes of searching the medical assistant can only palpate a small vein. The patient is prepared and the venipuncture is performed. The blood is filling the tube, but slows and then stops even though the patient and medical assistant remained still. Which of the following actions should the medical assistant take?

A. Advance the needle slightly because the needle is no longer in the vein.
B. Pull back slightly because the needle has gone through the vein.
C. Use a smaller tube because the vein has collapsed.
D. Slightly turn the needle because the bevel is partly through the vein.

A

Use a smaller tube because the vein has collapsed.

73
Q

After the phlebotomist puts on latex gloves and ties a non-latex tourniquet on the patient’s arm, the patient indicates that he is highly allergic to latex. Which of the following is the phlebotomist’s best course of action?

A. Remove the tourniquet, change to non-latex gloves and proceed with the same tourniquet.
B. Change to non-latex gloves and use a new tourniquet.
C. Wash hands, change to non-latex gloves, and proceed with the same tourniquet.
D. Remove the tourniquet, wash hands, change to non-latex gloves and use a new tourniquet.

A

Remove the tourniquet, wash hands, change to non-latex gloves and use a new tourniquet.

74
Q

Which of the following arteries provides direct blood flow to the foot?

A. dorsalis pedis
B. popliteal
C. brachial
D. femoral

A

dorsalis pedis

75
Q

The phlebotomist needs to draw routine labs. The skin preparation for this procedure would be.

A. Sterilize the site by using a circular motion from the center to the periphery.
B. Disinfect the site by using a circular motion from periphery to center
C. Cleanse the site by using a circular motion from center to periphery
D. Sterilize the site by using a circular motion from periphery to center

A

Cleanse the site by using a circular motion from center to periphery

76
Q

When performing a skin puncture on an infant what is the preferred site?

A. The anteromedial aspect of the heel
B. The plantar surface of the heel
C. The lateral surface of the heel
D. The plantar curvature of the heel

A

The plantar surface of the heel

77
Q

Which of the following actions should the medical assistant take to make a vein more prominent when attempting to select a venipuncture site?

A. Firmly tap the arm several times and palpate with a non-gloved finger.
B. Apply a warm compress to the area for 5 minutes.
C. Leave the tourniquet in place and ask the patient to dangle the arm for one minute.
D. Apply firm pressure to the arm from the shoulder to the elbow.

A

Apply a warm compress to the area for 5 minutes.

78
Q

When performing a CBC on a six year old, the parent insists upon using an anesthetic at the venipuncture site. Which would be correct?

A. lidocaine Jelly
B. xylocaine jelly
C. EMLA
D. TAC

A

EMLA

MED ASSISTANT NCCT INTERACTIVE REVIEW (9 decks)

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