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Phlebotomy Flashcards

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USMLE® Step 1 flashcards
1
Q

When might a puncture site need extra pressure to stop bleeding?

A. If the patient is on aspirin
B. If the patient has low blood pressure
C. If the patient is taking high blood pressure medications
D. If the patient has diabetes

A

A. If the patient is on aspirin

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2
Q

What should the blood pressure cuff be inflated to during a bleed time test?

A. 200mm Hg
B. 40mm Hg
C. 20mm Hg
D. 80mm Hg

A

B. 40mm Hg

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3
Q

Which of the following items is a must for specimen labeling?

A. Patient’s complete name, ID number, date, time of collection, physician
B. Patient’s complete name, ID number, date, time of collection, and collector’s names
C. Patient’s complete name and ID number
D. Patient’s complete name, date, time of collection

A

B. Patient’s complete name, ID number, date, time of collection, and collector’s names

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4
Q

What is the significance of the patient’s identifications number on the specimen tube labels?

A. To be used for as an accession number in processing
B. To be used for insurance ID and payment purpose
C. To avoid confusion of multiple specimens
D. To avoid confusion specimens from patients with the same name

A

D. To avoid confusion specimens from patients with the same name

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5
Q

A hospital’s lab is overburden and one patient’s specimen testing is delayed for more than an hour after collection. What exactly does the phlebotomy technician do?

A. Still send to the lab
B. Leave out at room temperatures, until the lab is clear
C. Transfer into tubes that contain preservative
D. Tell the patient they will have to come back to repeat the test.

A

D. Tell the patient they will have to come back to repeat the test.

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6
Q

Which of the following specimens would be examined in the field of anatomical pathology?

A. Synovial Fluid
B. Cerebrospinal Fluid
C. Biopsy tissue
D. Urine sediment

A

C. Biopsy tissue

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7
Q

Which department would perform a CBC?

A. Hematology
B. Blood bank
C. Chemistry
D. Immunology

A

A. Hematology

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8
Q

Which of the following department would receive a sample for fibrin degradation product testing?

A. Coagulation
B. Blood bank
C. Chemistry
D. Microbiology

A

A. Coagulation

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9
Q

What is required for a adult patient’s implied/ express consent for venipuncture?

A. Patient signature
B. Patient extending an arm
C. Presence of a witness
D. Vicarious liability

A

B. Patient extending an arm

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10
Q

A patient begins to complain of a sharp, painful sensation radiating down their arm during a venipuncture. The phlebotomy technician believes a nerve has been damaged. When should this incident be reported to management?

A. Immediately
B. After the patient leaves
C. By the end of the shift
D. At the beginning of the next shift.

A

A. Immediately

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11
Q

Which PPE should be used when performing a venipuncture on an HIV patient?

A. Googles
B. N95 respirator
C. Face Shield
D. Gloves

A

D. Gloves

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12
Q

which of the following precautions are currently recommended by the CDC for infection control?

A. Standard
B. Reverse
C. Waived
D. Isolation

A

A. Standard

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13
Q

A phlebotomy tech slipped on a spill and fell in a patient’s room. What agency would be involved in the investigation of this incident?

A. JCAHO
B. CDC
C. OSHA
D. CLSI

A

C. OO[- ;……………………………………

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14
Q

For fasting glucose test, hoe may hours should a patient fast from all food and liquids except water before testing?

A. 7
B. 8
C. 10
D. 16

A

B. 8

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15
Q

Venipuncture is usually done in the antecubital region. Which vein is usually the most suitable for drawing from?

A. Cephalic
B. Basilic
C. Median Cubital
D. Median

A

C. Median Cubital

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16
Q

Which of the following is the best site for capillary puncture on an adult?

A. Middle finger
B. Thumb
C. Heel
D. Index finger

A
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17
Q

What area should be used for a dermal puncture on an infant under 12 months of age?

A. Great toe
B. Index finger
C. Earlobe
D. Heel

A

D. Heel

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18
Q

How many inches above a venipuncture site should a tourniquet be applied?

A. 1 - 2
B. 2-3
C. 3-4
D. 4-5

A

C. 3-4

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19
Q

What is the additive in a green top tube?

A. Potassium oxalate
B. Sodium citrate
C. Ethylendiaminetertraacetic acid
D. Sodium heparin

A

D. Sodium heparin

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20
Q

What substance is inside serum separator tube?

A. Triplasmic gel
B. Thixotropic gel
C. Sodium citrate
D. Tricyclic gel

A

B. Thixotropic gel

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21
Q

A doctor prescribe a pregnancy test. What color tube top would a phlebotomy technician used to obtain a blood sample?

A. Lavender
B. Light Blue
C. Red
D. Dark green

A

C. Red - Contains no anticoagulant or preservative

Red is Chemistry

HCG is a hormone secreted in pregnancy and detectable beginning a week to two weeks (or more) after conception, depending on the test

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22
Q

What color tube top is used for a thyroid panel test?

A. Lavender
B. Light green
C. Red
D. Tiger

A

A. Lavender

Hematology ( Contains EDTA)

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23
Q

Which of the following tubes will contain serum?

A. Green top
B. Red top
C. Light blue top
D. Lavender

A

B. Red top

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24
Q

Most coagulation tests require a blood specimen to be collected in what color tube?

A. Light blue top tube
B. Gray top tube
C. Lavender top tube
D. Plasma Separator tube

A

A. Light blue top tube

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25
Q

Which test should be collected in a royal blue top tube?

A. Calcitonin
B. Lipoprotein
C. Aluminum
D. Magnesium

A

C. Aluminum

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26
Q

Which of the following gauge sizes would be appropriate to use when drawing a hand with a winged infusion?

A. 16
B. 23
C. 17
D. 20

A

B. 23

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27
Q

A specimen must be collected on a 6-year old child by a phlebotomy tech. The child is apprehensive. What is the tech to do?

A. Explain to the child in simple terms what will be done
B. Restrain the child and draw the specimen
C. Promise to give a treat to the child if the child does not cry
D. Ask the child to relax and not to worry

A

A. Explain to the child in simple terms what will be done

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28
Q

A doctor has ordered blood work that requires lavender, red and grey tube tops. What is the correct order of draw?

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

A

A. Red, Lavender, Gray

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29
Q

What is an appropriate angle for needle insertion when performing a venipuncture procedure?

A. 0-10 degree
B. 15-30 degree
C. 45-60 degree
D. 65-80 degree

A

B. 15-30 degree

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30
Q

During an venipuncture, when should a needle safety device be activated?

A. Before the needle is put into the sharps
B. In the beginning of the procedure
C. After the specimen is labeled
D. After the needle is withdrawn from the vein

A

D. After the needle is withdrawn from the vein

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31
Q

The patient begins to sweat, becomes pale and complains of a vision after a venipuncture procedure. What do these symptoms means?

A. Hypoglycemia
B. Vasovagal syncope
C. Hypotension
D. Panic Attack

A

A. Hypoglycemia

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32
Q

What does the term hematoma mean?

A. Blood capillaries under the skin
B. Blood under the skin
C. Blood clot traveling in the blood vessel
D. Blood loss due to a disorder

A

B. Blood under the skin

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33
Q

What of the following coagulation tests can a POC instrument be used to monitor on a patient?

A. BNP and HCT
B. BUN and UA
C. HCO3 and TNI
D. PTT and INR

A

D. PTT and INR

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34
Q

When are blood collection tubes labeled?

A. When the phlebotomy tech receives a requisition
B. Before the specimen is collected
C. After the specimen is collected
D. During transport to the laboratory

A

C. After the specimen is collected

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35
Q

How long should blood clot in a standard serum separator tube before centrifugation?

A. 1-5 min
B. 10-15 min
C. 30-45 min
D. 60-90 min

A

C. 30-45 min

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36
Q

Which of the following tests should be protected from light?

A. Vitamin D 25 hydroxy
B. Bilirubin
C. Varicella zoster
D. Vitamin B12

A

B. Bilirubin

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37
Q

Which of the following specimens should be transported in ice?

A. Ammonia
B. Bilirubin
C. Folate
D. Vit B12

A

A. Ammonia

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38
Q

Where does a phlebotomy tech record poor techniques that affects sample quality?

A. Quality Improvement Report
B. Incident report
C. Procedure manual
D. Laboratory requisitions

A

A. Quality Improvement Report

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39
Q

Which infection-control strategy requires that all blood and bodily fluids be treated as if they are infectious?

A. Infection Control Precaution
B. Needle Stick Safety Precaution
C. Transmission-based precautions
D. Standard precaution

A

D. Standard precaution

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40
Q

Which of the following scenarios could lead to legal actions against a phlebotomy tech?

A. Mislabeled specimen
B. Needle stick injury to an employee
C. Hemolysis of the specimen
D. Inadequate specimen quantity

A

A. Mislabeled specimen

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41
Q

Which medical office document contains information on chemical products as well as relevant emergency and first aid procedure?

A. Universal Precautions
B. Consent form
C. CLSI guidelines
D. Safety data sheet

A

D. Safety data sheet

42
Q

An instruction to take blood from a patient has been given to a phlebotomy tech. What should they do after that?

A. Select the vein
B. Collect the supplies
C. Identify the patient
D. Wipe a collection site with an alcohol pad

A

C. Identify the patient

43
Q

On a patient who has a left mastectomy, where should a multi-sample blood collection be done?

A. Left antecubital
B. Right antecubital
C. Left hand
D. Third finger of either hand

A

B. Right antecubital

44
Q

What can happen if the tourniquet is left on too long before drawing blood?

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

A

A. Hemoconcentration

Hemoconcentration can cause falsely elevated results for glucose, potassium, and protein-based analytes such as cholesterol.

45
Q

Which of the following additives is found in a yellow topped tube?

A. Ethylenediaminetraacetic acid
B. Sodium Citrate
C. Serum separator tube
D. Sodium polyanethol sulfonate

A

D. Sodium polyanethol sulfonate

46
Q

What is the antiglycolytic agent in a gray topped tube?

A. Sodium citrate
B. Potassium sodium
C. Sodium fluoride
D. Potassium coagulates

A

C. Sodium fluoride

47
Q

What additive is found in a dark green top tube?

A. Sodium citrate
B. Sodium heparin
C. Potassium oxalate
D. EDTA

A

B. Sodium heparin

48
Q

Which tube is used to check coagulation factors?

A. Green top
B. Yellow Top
C. Blue Top
D. Grey Top

A

C. Blue Top

49
Q

If the laboratory test requires serum, which vacutainer tube is the tube of choice?

A. Lavender topped
B. Red Topped
C. Yellow Topped
D. Black Topped

A

B. Red Topped

50
Q

The gray topped is usually drawn for which test?

A. Glucose
B. PTT
C. Enzyme
D. Hematology

A

A. Glucose

51
Q

What is an example of quality control measure in phlebotomy?

A. Checking the expiration date of evacuated tubes
B. Documenting every missed venipuncture
C. Logging hours on your time sheet daily
D. Recording Quality Assurance indicator daily

A

A. Checking the expiration date of evacuated tubes

52
Q

Which of the following will reduce the stress a patient feels when having a venipuncture?

A. Count to three before inserting a needle
B. Contract the Supervisor
C. Use a calm voice to explain the process from start to finish
D. Review the patient’s medical record

A

C. Use a calm voice to explain the process from start to finish

53
Q

Which of the following test may requires a special chain of custody?

A. Blood culture
B. Blood donor
C. Therapeutic drug monitoring
D. Drug Screen

A

D. Drug Screen

54
Q

What should be done as soon as possible during a venipuncture if the patient passes out before the blood is completely collected?

A. Apply pressure to the site
B. Remove the tourniquet and needle
C. Notify staff member for assistance
D. Lay patient flat on the floor

A

B. Remove the tourniquet and needle

55
Q

Which kind of test must be completed at a physician’s office laboratory (POL) to guarantee the accuracy of the tests conducted on a patient?

A. Laboratory test
B. Point of Care
C. Clinical trail test
D. Control test

A

D. Control test

56
Q

WHat is sputum define as ?

A. Fluid around the heart
B. Mucus from the lungs
C. Wound fluid
D. Cultivation of micro-organisms

A

B. Mucus from the lungs

57
Q

Which BP is outside of the normal range for a health adult?

A. 106/70
B. 112/72
C. 112/80
D. 136/94

A

D. 136/94

Normal 120/80

58
Q

What is the procedure for removing the plasma or serum from a blood tube and transferring it to a different container known as ?

A. Centrifugation
B. Aliquoting
C. Processing
D. Exemplification

A

B. Aliquoting

59
Q

Which of the following pre-analytical steps should be taken when collecting a blood specimen for an ammonia test?

A. Warm the tube prior to collection
B. Vigorously shake the tube immediately after collection
C. Protect the tube from light
D. Place the tube on ice immediately after collection.

A

C. Protect the tube from light

60
Q

A Plasma specimen has been aliquoted and will be tested later. What is the longest specimen can be left at room temperature before being refrigerated?

A. 3
B. 5
C. 8
D. 10

A

C. 8

61
Q

WHat is the blood vessel that only carries blood away from the heart?

A. Vein
B. Vena Cava
C. Capillary
D. Artery

A

Artery

62
Q

After selecting a vien, what is the next step in preparing for phlebotomy?

A. Remove the tourniquet
B. Wipe the area with an alcohol pad
C. Collect the needle
D. Collect the tube

A

D. Collect the tube

63
Q

What antiseptic agent is not appropriate for cleansing a collection site for a blood alcohol test?

A. Soap and water
B. 70% isopropyl methanol
C. Benzalkonium chloride
D. Povidone iodine

A

B. 70% isopropyl methanol

64
Q

What is the maximum length of time that tourniquet can stay on the arm before a flow of blood is obtained?

A. 1 min
B. 3 Min
C. 6 min
D. 10 min

A

A. 1 min

65
Q

A blood test that requires the use of multiple tubes was ordered for a patient. When should the tourniquet be released?

A. When the first tube has been filled as desired
B. When the final tube is filled as desired
C. Once the blood flow as been established in the first tube
D. After the final tube as been removed

A

C. Once the blood flow as been established in the first tube

66
Q

Which of the following would be filled last?

A. Light blue top
B. Red top
C. Anaerobic culture bottle
D. Lavender

A

D. Lavender

67
Q

Which of the following is true for the bevel of the needle?

A. It attaches to the syringes or the holder
B. It should be held at a 50 degree angle to the skin
C. It should always be facing up when inserted into the skin
D. It should always be facing down when inserted into the skin

A

C. It should always be facing up when inserted into the skin

68
Q

How should a butterfly needle be held?

A. By the tubing
B. By the wings
C. By the base of the needle
D. By the safety shield

A

B. By the wings

69
Q

What is the procedure, in accordance with OSHA Guidelines, would help a phlebotomy technician avoid unintentional needle sticks?

A. Anchor the needle
B. Recap the needle
C. Activate a safety device on the needle
D. Reinsert the needle

A

C. Activate a safety device on the needle

70
Q

Blood was taken too rapidly from the patient’s arm. What resulted from that?

A. The arm bruised
B. The vein collapsed
C. The vein disappeared
D. The vein rolled

A

B. The vein collapsed

71
Q

When a patient has undergone a right-side mastectomy and lymph node removal, where would blood be drawn?

A. Left antecubital fossa
B. Left hand
C. Right antecubital fossa
D. Right Hand

A

A. Left antecubital fossa

72
Q

A patient with IVs in both arm must have a protime specimen taken by the phlebotomist. What is the ideal location to gather the specimen?

A. Below one of the IV
B. From an ankle vein
C. From one of the IV
D. From above the IV

A

A. Below one of the IV

73
Q

Which test requires a whole blood specimen?

A. CMV
B. CPR
C. CBC
D. EBV

A

C. CBC

74
Q

How many tubes are drawn for a three-hour glucose tolerance test?

A. 3
B. 4
C. 5
D. 6

A

B. 4

75
Q

Which of the following is not the part of the CBC?

A. APPT
B. Hemoglobin
C. Differential
D. HCT

A

A. APPT

76
Q

What is the recommended sample for urine pregnancy testing?

A. Random
B. First Morning
C. Midstream clean-catch
D. Times

A

B. First Morning

77
Q

What is involved in TB testing administration?

A. Injecting an antigen just under the skin
B. Apply pressure right after an injection
C. Applying the correct bandage after an injection
D. Cleaning the site

A

A. Injecting an antigen just under the skin

78
Q

Which of the following is a reason for a sample to be rejected by QNS?

A. Red/SST half full
B. Green PST half full
C. Light blue with 7:1 ratio
D. Royal blue with 7:1 ration

A

C. Light blue with 7:1 ratio

Light blue should have 9:1 ratio

Venous blood specimens for coagulation assays should be collected into a tube containing 3.2% buffered sodium citrate tube (blue top tube), yielding a whole blood sample with a 9:1 blood to anticoagulant ratio. Inadequate filling of the collection tube will decrease this ratio, and may affect test results.

79
Q

What method is used to collect DNA from cells on the inside of a person’s check?

A. Intradermal swab
B. Buccal Swab
C. Throat Swab
D. Rectal swab

A

B. Buccal Swab

80
Q

When drawing blood from a patient who is taking blood thinners, what will be done with the blood after the draw is finished?

A. A Band-Aid
B. Coband wrap
C. Paper tape
D. Gauze

A

B. Coband wrap

81
Q

When should a phlebotomy technician obtain consent from their patient during the blood collection process?

A. Postanalytical
B. Preanalytical
C. Preanalytical
D. Analytical

A

C. Preanalytical

82
Q

Which of following procedures require informed consent?

A. Invasive surgery
B. a POCT
C. Venipuncture
D. CPR on an unconscious

A

A. Invasive surgery

83
Q

If a procedure is a performed on a patient who refused consent, what can the phlebotomist be charged with?

A. Assault
B. Battery
C. Negligence
D. Defamation

A

B. Battery

84
Q

After after blood drawn, a patient complains that it hurts and that the site swells. What exactly does a phlebotomy tech do?

A. Put a bandage on the site and re-examine the patient
B. Apply pressure with qauze and re-examine the patient.
C. Place a tourniquet on the arm to sloe the bleeding and re-examine the patient
D. Tell the patient the pain and swelling will go away and give them a patient care card

A

B. Apply pressure with qauze and re-examine the patient.

85
Q

According to the Patient’s Bill of Rights, which of the following represents the right of a patient?

A. To share their medical information with family
B. To seek consultation with the physician of their choice as long as it is within the Health Maintenance Organization ( HMO)
C. To be treated confidentially, with access to their records limited to those involved in their care or designated by the patient
D. To receive partial disclosure of their insurance plan

A

C. To be treated confidentially, with access to their records limited to those involved in their care or designated by the patient

86
Q

What document states a patient’s right to refuse a medical procedure and to be informed of all the consequences of doing so?

A. Patient’s Bill of Rights
B. Standard of Care
C. HIPAA
D. Standard Procedure

A

A. Patient’s Bill of Rights

87
Q

A coworker requests that a phlebotomy tech cover for her when she arrives late from lunch. What is the phlebotomy tech. supposed to do.

A. Tell the staff that the co-worker was in the restroom
B. Tell the co-worker that she will be able to cover for her
C. Say nothing with a blank face
D. Tell the co-worker that she has to return the favor

A

B. Tell the co-worker that she will be able to cover for her

88
Q

Which legislation established national standards for electronic health care transactions?

A. HITECH
B. HCQIA
C. HIPAA
D. ACA

A

C. HIPAA

89
Q

A phlebotomy tech mentioned to a co-worker that the patient she had just drawn blood for HIV. What does this violation?

A. HITECH
B. OSHA
C. HIPAA
D. CLIA

A

C. HIPAA

90
Q

How many unsuccessful venipuncture attempts can be made a patient before calling in another phlebotomy tech, according to CLSI guidelines?

A. 2
B. 3
C. 4
D. 5

A

A. 2

91
Q

What do OSHA standards require in order to prevent cross-contamination of micro-organisms from one patient to another?

A. Proper hand washing techniques
B. Disinfection
C. Barrier protection
D. Exposure control plan

A

A. Proper hand washing techniques

92
Q

Which of the following is required by OSHA?

A. Written bloodborne pathogen exposure control plan
B. Verbal bloodborne pathogen exposure control plan
C. HIV vaccine
D. HBV vaccines

A

A. Written bloodborne pathogen exposure control plan

93
Q

When a phlebotomy tech observes or suspects child abuse or neglect, which of the following should be the next step to take?

A. Notify the police
B. Wait for further confirmation
C. Notify the health department
D. Advise your supervisor privately

A

D. Advise your supervisor privately

94
Q

For a accidental needle stick, whiih of the following should be preformed first?

A. Report the incident to a supervisor
B. Seek medical treatment
C. Wash the affected area with soap and water
C. Rinse the affected area with water continuously

A

C. Rinse the affected area with water continuously

95
Q

A patient needs to give a specimen from home. Which of the following should be performed first?

A. Clean the site
B. Handwashing
C. Wearing gloves
D. Voiding

A

B. Handwashing

96
Q

In order to prevent possible needle stick injuries, the sharps container should be changed when it is how full?

A. 1/4
B. 1/3
C. 2/5
D. 2/3

A

D. 2/3

97
Q

What technique uses heat, steam and chemicals to prevent infectious diseases?

A. Clean tech
B. Surgical asepsis
C. Sterilization
D. Medical asepsis

A

C. Sterilization

98
Q

Plain soap us used in a routine hand wash procedure to remove soil and transient bacteria. Which of the following is a hand antiseptic?

A. Gel-based creams after the routine hand wash
B. Scrub brushes
C. Antimicrobial soap
D. Medicated towels for drying clean hands

A

C. Antimicrobial soap

99
Q

Which of the following precautions require special handling and ventilation?

A. Standard
B. Contact
C. Antimicrobial soap
D. Airborne

A

D. Airborne

100
Q

What item is donned first when wearing full PPE?

A. Mask and google
B. Face protection over the nose and mouth
C. Gown tied at neck and waist
D. Gloves to eliminate cross contamination.

A

C. Gown tied at neck and waist

Medical Assistant (8 decks)

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