Specimen Collection Flashcards

1
Q
A term that means "syringe" is:
A. evacuated blood collection system
B. nonevacuated blood collection system
C. Microtainer
D. Unopette
A

B. nonevacuated blood collection system

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2
Q
Specimens for which of the following tests must be collected by syringe?
A. ABG
B. BUN
C. CBC
D. ESR
A

A. ABG

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3
Q
On which of the following patients would a phlebotomist most likely choose a syringe to perform a venipuncture?
A. a 14-year old high school freshman
B. a 46-year old high school teacher
C. a 53-year old construction worker
D. an 85- year old grandmother
A

D. an 85-year old grandmother

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4
Q

On which of the following patients would a phlebotomist most likely use a syringe to collect a blood specimen?
A. a woman who had a mastectomy
B. a man with a heparin lock
C. a woman who just suffered a miscarriage
D. a man who just underwent angioplasty surgery

A

B. a man with a heparin lock

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5
Q
The closed system that is composed of a needle, a holder, and a tube containing a premeasured amount of vacuum is the:
A. evacuated blood collection system
B. nonevacuated blood ollection system
C. Microtainer system
D. Unopette system
A

A. evacuated blood collection system

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6
Q
Which of the following needle lengths is most commonly used for adult venipuncture?
A. 1/2 and 1 inch needles
B. 1 and 1-1/2 inch needles
C. 1-1/2 and 2 inch needles
D. 2 and 2-1/2 inch needles
A

B. 1 and 1-1/2 inch needles

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7
Q
What criterion does a phlebotomist use when selecting needle guage prior to a venipuncture procedure?
A. if the specimen is arterial or venous
B. direction of the patient's vein
C. the lumen size of the patient's vein
D. the physician's order
A

C. the lumen size of the patient’s vein

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8
Q
Evacuated tubes are manufactured in a range of sizes.  Which of the range of volumes listed below most accurately reflects available sizes of evacuated tubes?
A. 1 to 15 mL
B. 1 to 25 mL
C. 2 to 20 mL
D. 2 to 30 mL
A

C. 2 to 20 mL

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9
Q
An evacuated tube contains clot activator and serum separator gel.  What color is the Hemogard closure?
A. gold
B. green
C. light green
D. royal blue
A

A. gold

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10
Q
An evacuated tube contains thrombin.  What color is the Hemogard closure?
A. gold
B. green
C. orange
D. royal blue
A

C. orange

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11
Q
If an evacuated tube contains heparin and plasma separator gel, what color is the Hemogard closure?
A. gold
B. light green
C. orange
D. royal blue
A

B. light green

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12
Q
Which of the following blood collection devices is manufactured with a rubber sheath?
A. single sample needle
B. multisample needle
C. evacuated tube
D. nonevacuated tube
A

B. multisample needle

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13
Q
Which of the following additives is found in a red stoppered evacuated tube?
A. EDTA
B. SPS
C. none
D. sodium heparin
A

C. none

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14
Q
Which of the following additives is found in an evacuted tube with a green conventional stopper?
A. EDTA
B. SPS
C. none
D. sodium heparin
A

D. sodium heparin

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15
Q
Which of the following additives is found in an evacuated tube with a gray conventional stopper?
A. EDTA
B. SPS
C. sodium citrate
D. sodium fluoride
A

D. sodium fluoride

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16
Q
Which of the following additives is found in an evacuated tube with a yellow conventional stopper?
A. EDTA
B. SPS
C. sodium citrate
D. sodium fluoride
A

B. SPS

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17
Q
Which of the following additives in evacuated tubes binds calcium?
A. sodium heparin
B. potassium oxalate
C. sodium citrate
D. thrombin
A

C. sodium citrate

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18
Q
Which of the following additives in evacuated tubes neutralizes thrombin?
A. ACD
B. EDTA
C. sodium heparin
D. sodium citrate
A

C. sodium heparin

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19
Q
Which of the following evacuated tube stoppers is manufactured with the lowest verified levels of trace elements available?
A. lavender
B. light blue
C. royal blue
D. yellow
A

C. royal blue

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20
Q
Which of the following evacuated tube stoppers is manufactured with very low levels of lead?
A. tan
B. lavender
C. red
D. red SST
A

A, tan

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21
Q
Which of the following additives is found in lavender stoppered evacuated tubes?
A. ACD
B. CPDA
C. EDTA
D. SPS
A

C. EDTA

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22
Q
Which of the following additives is found in an evacuated tube with a yellow conventional stopper?
A. ACD
B. EDTA
C. lithium heparin
D. sodium citrate
A

A, ACD

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23
Q
Which of the following additives is found in an evacuated tube with a light blue conventional stopper?
A. ACD
B. EDTA
C. lithium heparin
D. sodium citrate
A

D. sodium citrate

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24
Q
Which of the following additives in evacuated tubes binds calcium?
A. EDTA
B. potassium oxalate
C. sodium heparin
D. thrombin
A

A. EDTA

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25
Q
Which of the following additives in evacuated tubes promotes clotting?
A. ACD
B. EDTA
C. heparin
D. thrombin
A

D. thrombin

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26
Q
The standard for measuring the diameter of the lumen of a needle is the needle:
A. bore
B. brand
C. guage
D. length
A

C. guage

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27
Q
The internal space of a needle is the needle's:
A. bevel
B. brand
C. guage
D. lumen
A

D. lumen

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28
Q
Which of the following needles has the largest interior diamenter?
A. 18
B. 19
C. 20
D. 21
A

D. 18

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29
Q
Which of the following needles has the smallest interior diameter?
A. 20
B. 21
C. 22
D. 23
A

D. 23

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30
Q
Listed below are conventional stopper colors of evacuated tubes.  Which stopper color should be used when collecting specimens for analyses that require BOTH a patients cells and serum?
A. green
B. green PST
C. red
D. red SST
A

C. red

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31
Q
Listed below are conventional stopper colors of evacuated tubes.  Which stopper color indicates the tube contains silica particles to facilitate blood clotting?
A. red
B. red SST
C. green
D. green PST
A

B. red SST

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32
Q
Which of the following needle gauges is used most often to perform routine venipuncture?
A. 20 and 21
B. 21 and 22
C. 22 and 23
D. 23 and 24
A

B. 21 and 22

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33
Q
Which of the following additives in evacuated tubes acts a glycolytic inhibitor?
A. lithium heparin
B. potassium oxalate
C. sodium citrate
D. sodium fluoride
A

D. sodium fluoride

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34
Q
Which of the following additives in evacuated tubes prevents platelets from clumping?
A. EDTA
B. SPS
C. potassium oxalate
D. sodium citrate
A

A. EDTA

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35
Q
Which of the following additives in evacuated tubes preserves labile coagulation factors?
A. EDTA
B. SPS
C. sodium citrate
D. sodium heparin
A

C. sodium citrate

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36
Q
Which of the following additives in evacuated tubes produces artifact residue on blood smears stained with Wright's stain?
A. EDTA
B. fibrin
C. sodium heparin
D. thrombin
A

C. sodium heparin

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37
Q
A phlebotomist transfixes a vein during a venipuncture.  Which of the following specimen characteristics may result?
A. clotting in plasma tubes
B. hemolyzed specimen
C. hemoconcentration of specimen
D. short draw
A

D. short draw

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38
Q
A phlebotomist obtains a specimen from a patient, following a traumatized venipuncture.  Which of the following specimen characteristics may result?
A. hemoconcentration
B. hemolysis
C. glycolysis
D. lipemia
A

B. hemolysis

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39
Q

A lavender stoppered evacuated tube must be redrawn because of clots in the tube. What collection error causes this?
A. traumatized specimen
B. transfixed vein
C. improper patient preparation
D. insufficient mixing of additive with specimen

A

D. insufficient mixing of additive with specimen

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40
Q
Which of the following equipment would a phlebotomist carry on his or her tray for a skin puncture procedure?
A. holder, needle, evacuated tube
B. syringe, heparin, ice
C. Simplate, filter paper, stopwatch
D. lancet, Microtainer, guaze
A

D. lancet, Microtainer, guaze

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41
Q
A potential complication of accidentally puncturing the calcaneus bone during skin puncture, characterized by inflammation of the bone and bone marrow is called:
A. osteocarcinoma
B. osteochondritis
C. osteomyelitis
D. osteoporosis
A

C. osteomyelitis

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42
Q
A potential complication of accidentally puncturing the calcaneus bone during skin puncture, characterized by inflammation of the bone and cartilage, is called:
A. osteocarcinoma
B. osteochondritis
C. osteomyelitis
D. osteoporosis
A

B. osteochondritis

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43
Q
A potential complication of accidentally puncturing the calcaneus bone during skin puncture, characterized by the presence of pathogenic microorganisms or their toxins in the blood or other tissues, is called:
A. osteochondritis
B. osteomylitis
C. sepsis
D. stasis
A

C. sepsis

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44
Q
An inherited condition that is caused by the body's inability to metabolize phenylalanine is:
A. PCV
B. PID
C. PKU
D. PPLO
A

C. PKU

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45
Q
Which of the following values are higher in newborns than in adults?
A. electrolyte levels
B. red cell counts
C. heterophile titer levels
D. varicella zoster virus
A

B. red cell counts

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46
Q
Which of the following blood constituents will increase as the oxygen content of the air decreases?
A. red blood cell counts
B. write blood cell counts
C. CK levels
D. LDH levels
A

A. red cell counts

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47
Q
Which of the following values are higher in the morning?
A. cortisol levels
B. eosinophil counts
C. iron levels
D. WBC counts
A

A. cortisol levels

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48
Q
Eating which of the following foods can cause lipemic serum in a patient's blood specimen?
A. apple
B. butter
C. carrot
D. hard candy
A

B. butter

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49
Q
Which of the following can affect cortisol levels?
A. caffeine
B. glucose
C. lipids
D. saccharin
A

A. caffeine

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50
Q
Which of the following levels will remain elevated for at least 24 hours following exercise?
A. ABG
B. BUN
C. CBC
D. CK
A

D. CK

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51
Q
A patient is being treated with a thiazide diuretic.  Which health care professional is responsible for recognizing potential drug interferences with test results.
A. medical technologist
B. nurse
C. phlebotomist
D. physician
A

D. physician

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52
Q

Changing a patient’s position from supine to standing will cause which physiologic change?
A. no change will occur
B. plasma glucose will increase
C. water will filter from the plasma to the tissues
D. water will filter from the tissues to the plasma

A

C. water will filter from the plasma to the tissues

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53
Q
During pregnancy, the increase of body fluids may cause a patient's RBC count to:
A. decrease
B. increase
C. remain unchanged
D. show no difference due to gender
A

A. decrease

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54
Q
Which of the following patient conditions may cause a transient elevation in WBC count results?
A. altitude change
B. gender
C. pregnancy
D. stress
A

D. stress

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55
Q
A new field of medicine that deals with the study of interaction between the brain, endocrine system, and the immune system is called:
A. psychiatry
B. psychoneuroimmunology
C. psychoanaleptic
D. psychodometry
A

B. psychoneurommunology

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56
Q
What method of blood collection is preferred for infants?
A. accessing indwelling lines
B. arterial puncture
C. skin puncture
D. venipuncture
A

C. skin puncture

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57
Q
Specimens for home glucose monitoring are routinely collected by:
A. accessing indwelling lines
B. arterial puncture
C. skin puncture
D. venipuncture
A

C. skin puncture

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58
Q

Specimens for which of the following patients should be drawn by skin puncture?
A. a new admint, for a chemistry profile
B. a 6 month old baby for a blood culture
C. a 25 year old woman for type and crossmatch
D. an oncology patient, for a WBC count and platelet count

A

D. an oncology patient, for a WBC count and platelet count

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59
Q
Why is skin puncture preferred over venipuncture for infants for the collection of blood specimens?
A. continuous quality indicator
B. increased accuracy of test results
C. prevent anemia
D. prevent infection
A

C. prevent anemia

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60
Q
Which of the following tests is most commonly performed on skin puncture samples?
A. PCV
B. pH
C. PKU
D. PTT
A

C. PKU

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61
Q
Which of the following collection procedures will yield a specimen composed of arterial, venous, and capillary blood?
A. arterial puncture
B. drawing from an indwelling line
C. skin puncture
D. venipuncture
A

C. skin puncture

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62
Q
If a skin puncture site is warmed prior to blood collection, the specimen is said to be:
A. arterialized
B. concentrated
C. hemolyzed
D. ischemic
A

A. arterialized

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63
Q
Which of the following test procedures cannot be performed on specimens collected by skin puncture?
A. bilirubin
B. blood cultures
C. calcium
D. T3, T4
A

B. blood cultures

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64
Q
Which of the following test procedures cannot be performed on specimens collected by skin puncture?
A. bilirubin
B. calcium
C. ESR
D. T3, T4
A

C. ESR

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65
Q
Which of the following test procedures cannot be performed on specimens collected by skin puncture?
A. APTT
B. bilirubin
C. calcium
D. T3, T4
A

A. APTT

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66
Q

Which of the following information should not be provided to the patient by the phlebotomist?
A. if the phlebotomist is a student
B. the department the phlebotomist works in
C. the phlebotomist’s name
D. what the test is for

A

D. what the test is for

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67
Q
Which of the following laboratory professionals has the greatest public relations responsibility for the laboratory?
A. pathologist
B. phlebotomist
C. medical laboratory technician
D. medical technologist
A

B. phlebotomist

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68
Q

A phlebotomist enters a patient’s room at 5:30 AM, but the patient is asleep. The phlebotomist should:
A. ask the nurse to wake the patient
B. gently wake the patient and proceed
C. mark the slip can’t get and return to the lab
D. return to the patient’s room later

A

B. gently wake the patient and proceed

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69
Q

A phlebotomist is about to collect a blood specimen from a patient in ICU, but the patient is unconscious. The phlebotomist should:
A. call a code
B. call a nurse
C. proceed as though the patient were conscious
D. return when the patient awakens

A

C. proceed as though the patient were conscious

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70
Q
Which of the following personnel has priority with the patient?
A. phlebotomist with a stat request
B. physician talking to a patient
C. nurse giving the patient a bed bath
D. respiratory therapist
A

B. physician talking to a patient

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71
Q
Which of the following has priority with the patient?
A. clergyman administering Communion
B. nurse giving a bed bath
C. phlebotomist to collect a CBC
D. respiratory therapist
A

A. clergyman administering Communion

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72
Q
If a patient is not in his or her room, how should the phlebotomist locate the patient?
A. ask at the nurse's station
B. page the patient
C. refer to the patient's chart
D. search the laboratory's computer
A

A. ask at the nurse’s station

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73
Q

If a patient’s family is in the patient’s room when the phlebotomist enters, the phlebotomist should:
A. ask the family to restrain the patient
B. ask the family to step outside the room
C. explain the test’s clinical significance
D. ignore the family

A

B. ask the family to step outside the room

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74
Q
How many steps are involved in proper patient identification?
A. 1
B. 2
C. 3
D. 4
A

B. 2

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75
Q

What is the first step in proper patient identification?
A. the phlebotomist asks, “Are you Mrs. Smith?”
B. the nurse identifies the patient by room number
C. the patient is asked to state his or her name
D. the phlebotomist reads the card above the bed

A

C. the patient is asked to state his or her name

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76
Q

What is the most important step in patient identification?
A. asking “are you Mrs. Smith?”
B. verifying identification with the nurse
C. verifying identification with a visitor
D. comparing the medical record number on the requisition with the patient’s wristband

A

D. comparing the medical record number on the requisition with the patient’s wristband

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77
Q
Which of the following information should NEVER be the same on any two patients?
A. date of birth
B. first names
C. last names
D. medical record number
A

D. medical record number

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78
Q
If a patient's wristband matches the requisition entirely except for the medical record number, the phlebotomist should:
A. change the number on the requisition
B. change the number on the wristband
C. contact the nurse's station
D. draw the patient
A

C. contact the nurse’s station

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79
Q

If a patient’s identification bracelet is on his or her nightstand and it matches the requisition exactly, the phlebotomist should:
A. ask a nurse to affix the wristband on the patient
B. discard the requisition
C. discard the wristband
D. draw the patient

A

A. ask a nurse to affix the wristband on the patient

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80
Q

What infection control equipment should the phlebotomist use when performing a skin puncture procedure?
A. alcohol, sterile gauze
B. heel warmer, Unopette, Simplate
C. lancet, capillary tubes, heel warmer, alcohol pad
D. sharps, biohazard bag, gown, gloves

A

D. sharps, biohazard bag, gown, gloves

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81
Q

What equipment does the phlebotomist need for site preparation prior to skin puncture?
A. heel warmer, alcohol, sterile gauze
B. heel warmer, povidone iodine, sterile gauze
C. lancet, Unopette, sharps, gloves
D. gown, gloves, sharps, biohazard bag

A

A. heel warmer, alcohol, sterile gauze

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82
Q
Heel warmers should heat within which of the following temperature ranges?
A. 35 - 39
B. 36 - 40
C. 37 - 41
D. 39 - 42
A

D. 39-42

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83
Q
What is the maximum length lancet that may be safely used for skin puncture on an infant's foot?
A. 2.4 mm
B. 3.0 mm
C. 2.4 cm
D. 3.0 cm
A

A 2.4mm

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84
Q

Which of the following describes the best site to select for skin puncture on an infant’s foot?
A. arch area of the foot
B. lateral portion of the palmar surface of the heel
C. lateral portion of the plantar surface of the heel
D. posterior curvature of the heel

A

C. lateral portion of the plantar surface of the heel

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85
Q

Which of the following sites is acceptable to use for skin puncture on an infant’s foot?
A. arch of the foot
B. lateral portion of the palmar surface of the heel
C. posterior curvature of the heel
D. the great toe

A

D. the great toe

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86
Q
Which of the following describes the best site to select for skin puncture, using a patient's finger?
A. distal phalanx of the index finger
B. distal phalanx of the little finger
C. distal phalanx of the middle finger
D. distal phalanx of the thumb
A

C. distal phalanx of the middle finger

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87
Q
Which of the following sites is the best site to select for skin puncture, using a patient's finger?
A. distal phalanx of the index finger
B. distal phalanx of the little finger
C. distal phalanx of the ring finger
D. distal phalanx of the thumb
A

C. distal phalanx of the ring finger

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88
Q

Which of the following sites is the best site to select for skin puncture, using a patient’s finger?
A. distal phalanx of the thumb, palmar surface
B. index finger, palmar surface
C. little finger, palmar surface
D. middle finger, palmar surface

A

D. middle finger, palmar surface

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89
Q

Skin punctures performed on patients’ fingers should be made:
A. at the crease between the first and second phalanx
B. on the very tip of the finger
C. parallel to the fingerprints
D. perpendicular to the fingerprints

A

D. perpendicular to the fingerprints

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90
Q

If a heel warmer is applied to a skin puncture site, this will:
A. decrease blood flow to the site
B. increase blood flow to the site
C. prevent hemoconcentration of the specimen
D. prevent hemolysis of the specimen

A

B. increase blood flow to the site

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91
Q
By how much blood flow to a skin puncture site be increased if a warmer is applied prior to skin puncture?
A. 4 times
B. 5 times
C. 6 times
D. 7 times
A

D. 7 times

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92
Q
What portion of the capillary circulation is increased when a warmer is applied to a skin puncture site?
A. arterial
B. capillary
C. interstitial fluid
D. venous
A

A. arterial

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93
Q
At least how long should a warmer be applied to a skin puncture site prior to making a skin puncture?
A. 3 minutes
B. 4 minutes
C. 5 minutes
D. 6 minutes
A

A 3 minutes

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94
Q
Which of the following tests requires that the site be warmed prior to skin puncture?
A. bilirubin
B. calcium
C. capillary blood gases
D. reticulocyte count
A

C. capillary blood gases

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95
Q

Which of the following actions may result in a QNS skin puncture specimen?
A. alcohol contamination
B. anemic condition of the patient
C. failure to wipe away the first drop of blood
D. insufficient puncture

A

D. insufficient puncture

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96
Q
What is the rationale for the order of draw for the collection of multiple specimens following skin puncture?
A. minimize contamination
B. minimize hemoconcentration
C. minimize hemolysis
D. minimize platelet clumping
A

D. minimize platelet clumping

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97
Q
The following tests were to be collected from a patient following skin puncture: platelet count, bilirubin, T3.  In what order should these tests be collected?
A. bilirubin, platelet count, T3
B. bilirubin, T3, platelet count
C. platelet count, bilirubin, T3
D. T3, bilirubin, platelet count
A

C. platelet count, bilirubin, T3

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98
Q
The following Microtainers were to be collected following skin puncture: lavender, pink, red SST.  In what order should the microtainers be collected?
A. lavender, pink, red SST
B. pink, red SST, lavender
C. pink, lavender, red SST
D. red SST, lavender, pink
A

A. lavender, pink, red SST

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99
Q
What is the maximum number of times an infant's heel may be punctured to collect a blood specimen?
A. 1
B. 2
C. 3
D. 4
A

B. 2

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100
Q

Which of the following could cause hemolysis of a specimen obtained by skin puncture?
A. collecting specimens in an incorrect order
B. residual alcohol left on the site
C. using povidone iodine to clean the site
D. warming the site

A

B. residual alcohol left on the site

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101
Q

Which of the following could cause hemolysis of a specimen collected by skin puncture?
A. excessive squeezing of the puncture site to secure the specimen
B. incorrect order of draw
C. using povidone iodine to prepare the site
D. warming the site

A

A. excessive squeezing of the puncture site to secure the specimen

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102
Q
Bleeding time procedures are usually ordered:
A. as timed tests
B. in a series
C. presurgically
D. stat
A

C. presurgically

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103
Q
Bleeding times are used to assess which of the following?
A. coumarin dosage
B. fibrinogen levels
C. heparin dosage
D. platelet function
A

D. platelet function

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104
Q
Bleeding times are used to assess which of the following?
A. blood vessel integrity
B. pancreatic function
C. risk of diabetes
D. risk of heart disease
A

A. blood vessel integrity

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105
Q
Which of the following can influence the results of a bleeding time test?
A. cholesterol level
B. circulating von Willebrand's factor
C. glucose level
D. potassium level
A

B. circulating von Willebrand’s factor

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106
Q
Which of the following medications will interfere with the bleeding time test result?
A. acetaminophen
B. aspirin
C. insulin
d. furosemide
A

B. aspirin

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107
Q
Which of the following medications will interfere with the results of the bleeding time test?
A. acetaminophen
B. insulin
C. furosemide
D. salicylic acid
A

D. salicylic acid

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108
Q

Before starting a bleeding time test, the phlebotomist should:
A. ask the patient to sign a consent form
B. ask the patient if he or she has eaten
C. ask the patient if he or she has taken any medications
D. take the patient’s blood pressure

A

C. ask the patient if he or she has taken any medications

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109
Q
Which of the following procedures is routinely performed on a patient's earlobe?
A. Duke bleeding time
B. glucose tolerance test
C. lactose tolerance test
D. modified Ivy bleeding test
A

A. Duke bleeding time

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110
Q
Which of the following is used to collect blood following the puncture in a Duke bleeding time procedure?
A. filter paper
B. microhematocrit tube
C. Microtainer tube
D. Unopette
A

A. filter paper

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111
Q
Which of the following compounds is used to prepare the site prior to the puncture in a Duke bleeding time procedure?
A. alcohol
B. heel warmer
C. ice
D. iodine
A

A. alcohol

112
Q
During a Duke bleeding time procedure, a phlebotomist touches the wound with a collection device.  The bleeding time results will be:
A. falsely decreased
B. falsely prolonged
C. impossible to interpret
D. unchanged
A

B. falsely prolonged

113
Q
If a patient has taken aspirin, how long will it affect the patient's platelet function?
A. 1 to 2 hours
B. 7 to 10 minutes
C. 1 to 2 days
D. 7 to 10 days
A

D. 7 to 10 days

114
Q
If a test procedure can be performed the same way, on the same patient, and generate almost identical results, the test is said to be:
A. reliable
B. reproducible
C. sensitive
D. specific
A

B. reproducible

115
Q
A test that will detect borderline abnormalities in a patient is said to be:
A. reproducible
B. reliable
C. sensitive
D. specific
A

C. sensitive

116
Q
If a physician wishes to assess a patient's platelet function, which of the following tests will provide the physician with the most reliable results?
A. capillary bleeding time
B. Duke bleeding time
C. modified Ivy bleeding time
D. tourniquet test
A

C. modified Ivy bleeding time

117
Q
If a physician would like to screen platelet function in a patient, which of the following tests will provide the physician with the most sensitive results?
A. capillary bleeding time
B. Duke bleeding time
C. modified Ivy bleeding time
D. tourniquet test
A

C. modified Ivy bleeding time

118
Q
Why is the Duke bleeding time procedure not routinely performed in modern medical practice?
A. dangerous collection container
B. lack of standardized puncture
C. too many patient complaints
D. too messy
A

B. lack of standardized puncture

119
Q
The use of a template and surgical incision as part of a bleeding time procedure was introduced by:
A. Duke
B . Ivy
C. Landsteiner
D. Mielke
A

D. Mielke

120
Q
What equipment should a phlebotomist carry on his or her try for the Ivy bleeding time procedure?
A. bleeding time device, alcohol
B. bleeding time device, iodine
C. steel blade lancet, alcohol
D. steel blade lancet, iodine
A

A. bleeding time device, alcohol

121
Q

What equipment should a phlebotomist carry on his or her tray for an Ivy bleeding time procedure?
A. bleeding time device, blood pressure cuff
B. blood pressure cuff, iodine
C. filter paper, steel blade lancet
D. iodine, filter paper

A

A. bleeding time device, blood pressure cuff

122
Q

What equipment should a phlebotomist carry on his or her tray for an Ivy bleeding time procedure?
A. bleeding time device, iodine
B. filter paper, steel blade lancet
C. butterfly bandage, blood pressure cuff
D. butterfly bandage, iodine

A

C. butterfly bandage, blood pressure cuff

123
Q
The Ivy bleeding time procedure is routinely performed on the patient's:
A. earlobe
B. foot
C. forearm
D. wrist
A

C. forearm

124
Q

The Ivy bleeding time procedure is routinely performed on the patient’s:
A. distal phalanx of the ring finger, palmar surface
B. lateral area of the plantar surface of the foot
C. lateral aspect, volar surface of the forearm
D. medial area of the plantar surface of the foot

A

C. lateral aspect, volar surface of the forearm

125
Q
During an Ivy bleeding time procedure, the blood pressure cuff should be positioned:
A. above the antecubital crease
B. below the antecubital creast
C. around the patient's calf
D. around the patient's wrist
A

A. above the antecubital crease

126
Q
During an Ivy bleeding time procedure, the blood pressure cuff should be inflated to:
A. 35 mm Hg
B. 40 mm Hg
C. 45 mm Hg
D. 50 mm Hg
A

B. 40 mm Hg

127
Q
During an Ivy bleeding time procedure, the maximum length of time that may elapse between inflation of the blood pressure cuff and making the incision is:
A. 10 seconds
B. 60 seconds
C. 90 seconds
D. 120 seconds
A

B. 60 seconds

128
Q
The dimensions of the most commonly used bleeding time devices are:
A. 1 mm deep x 3 mm wide
B. 1 mm deep x 5 mm wide
C. 3 mm deep x 5 mm wide
D. 5 mm deep x 1 mm wide
A

B. 1 mm deep x 5 mm wide

129
Q

During an Ivy bleeding time procedure, the phlebotomist should start the stopwatch:
A. after applying the tourniquet
B. after blotting the first drop of blood
C. simultaneously with the incision
D. when the blood pressure cuff is applied

A

C. simultaneously with the incision

130
Q
A potential patient complication of the Ivy bleeding time test is:
A. hematoma
B. scarring
C. poor reproducibility
D. poor sensitivity
A

B. scarring

131
Q

Two examples of bleeding time devices are:
A. safety flow lancet, steel blade lancet
B. Simplate, Surgicutt
C. Microtainer and Unopette
D. Unopette and Tenderfoot

A

B. Simplate, Surgicutt

132
Q
Cleaning the bleeding time puncture site too vigorously may cause:
A. hemoconcentration
B. hemolysis
C. hyperemia
D. hyperchromia
A

C. hyperemia

133
Q
What effect will increasing blood flow to the bleeding time site have on the results of the procedure?
A. falsely decreased
B. falsely elevated
C. impossible to predict
D. no effect
A

B. falsely elevated

134
Q
What effect will dislodging the platelet plug have on the bleeding time results?
A. falsely decreased
B. falsely elevated
C. impossible to predict
D. no effect
A

B. falsely elevated

135
Q

During an Ivy bleeding time procedure, which position of the bleeding time device offers a cosmetic advantage to the patient?
A. parallel to the antecubital crease
B. perpendicular to the antecubital crease
C. tilted to the left of the phlebotomist
D. tilted to the right of the phlebotomist

A

A. parallel to the antecubital

136
Q

During an Ivy bleeding time procedure, which position of the bleeding time device is more sensitive to borderline abnormalities?
A. parallel to the antecubital crease
B. perpendicular to the antecubital crease
C. tilted to the left of the phlebotomist
D. tilted to the right of the phlebotomist

A

A. parallel to the antecubital

137
Q

Prior to making a puncture during a blood collection procedure, antiseptic solution should be applied to the site selected:
A. in concentric circles, beginning at the puncture site
B. in concentric circles, beginning away from the puncture site
C. parallel to the antecubital crease
D. perpendicular to the antecubital crease

A

A. in concentric circles, beginning at the puncture site

138
Q
To examine by touch or feel is to:
A. palate
B. palpitate
C. palpate
D. patency
A

C. palpate

139
Q
A return flow of blood from an evacuated tube into a patient's arm during a venipuncture procedure is called:
A. reflex
B. reflux
C. reagent
D. refractile
A

B. reflux

140
Q
Small, nonraised bruises the size of a pinpoint are called:
A. patella
B. pedicel
C. petechiae
D. pellicle
A

C. petechiae

141
Q
The condition in which the fluid portion of the blood filters into the tissues, decreasing the fluid portion of the blood in the blood vessels, is called:
A. hemochromoprotein
B. hemoclastic
C. hemoconcentration
D. hemocuprein
A

C. hemoconcentration

142
Q
The liberation of hemoglobin into the plasma following destruction of red blood cells is called:
A. hemoagglutination
B. hemoconcentration
C. hemolysis
D. hemostasis
A

C. hemolysis

143
Q
What is the medical term for the following symptoms: dizziness, pallor, sweating, clammy skin, unconsciousness?
A. emesis
B. hematoma
C. syncope
D. tetany
A

C. syncope

144
Q
The accumulation of fluid in the tissues is called:
A. edema
B. emesis
C. syncope
D. tetany
A

A. edema

145
Q

Under universal precautions, what PPE must the phlebotomist use for every blood collection procedure?
A. gloves
B. gown
C. gown, gloves, sharps, and biohazard bag
D. sharps and biohazard bag

A

A. gloves

146
Q
To prepare a puncture site prior to routine venipuncture, the phlebotomist would use:
A. 50% isopropyl alcohol
B. 70% isopropyl alcohol
C. betadine
D. providone iodine
A

B. 70% isopropyl alcohol

147
Q
Which of the following equipment is used for a routine venipuncture?
A. heel warmer, lancet, Microtainer
B. heel warmer, needle, Microtainer
C. needle, evacuated tube, holder
D. syringe, evacuated tube
A

C. needle, evacuated tube, holder

148
Q
Which of the following equipment is used for site selection and preparation during routine skin puncture?
A. betadine
B. povidone iodine
C. heel warmer
D. tourniquet
A

C. heel warmer

149
Q

What is the correct sequence of the following steps in a routine venipuncture procedure?
A. apply alcohol, palpate site, apply tourniquet
B. apply tourniquet, palpate site, release tourniquet
C. palpate site, apply alcohol, apply tourniquet
D. palpate site, apply tourniquet, apply alcohol

A

B. apply tourniquet, palpate site, release tourniquet

150
Q

What is the correct sequence of the following steps in a routine venipuncture procedure?
A. anchor the vein, insert the needle, uncap the needle
B. anchor the vein, uncap the needle, insert the needle
C. uncap the needle, anchor the vein, insert the needle
D. uncap the needle, insert the needle, anchor the vein

A

C. uncap the needle, anchor the vein, insert the needle

151
Q
During routine venipuncture, the needle should be inserted:
A. bevel down
B. bevel up
C. bevel turned toward the left
D. bevel turned toward the right
A

B. bevel up

152
Q
During routine venipuncture, needles should be inserted at which of the following angles, relative to the patient's arm?
A. 0 to 10 degrees
B. 5 to 10 degrees
C. 15 to 30 degrees
D. 30 to 45 degrees
A

C. 15 to 30 degrees

153
Q
During routine venipuncture, how should the needle be positioned, relative to the vein selected?
A. perpendicular
B. parallel, 1 inch below
C. parallel, 1 inch below
D. same direction
A

D. same direction

154
Q

During routine venipuncture, how deep should the needle be inserted?
A. 1 inch
B. 1-1/2 inch
C. until the phlebotomist feels a slight decrease in resistance
D. until the phlebotomist feels a slight increase in resistance

A

C. until the phlebotomist feels a slight decrease in resistance

155
Q

What is the correct sequence of the following steps in a routine venipuncture procedure?
A. release tourniquet, engage tube, release vein
B. release tourniquet, release the vein, engage the tube
C. release vein, engage tube, release tourniquet
D. release vein, release tourniquet, engage tube

A

C. release vein, engage tube, release tourniquet

156
Q
During venipuncture, the tourniquet should be left on a patient's arm no longer than:
A. 1 to 2 minutes
B. 2 to 3 minutes
C. 3 to 4 minutes
D. 4 to 5 minutes
A

A. 1 to 2 minutes

157
Q
A patient has undergone a left radical mastectomy.  Which site cannot be used for venipuncture until the patient's physician is consulted?
A. cephalic hand vein
B. dorsal hand vein
C. left arm
D. right arm
A

C. left arm

158
Q
What condition sometimes occurs following mastectomy that becomes a factor in venipuncture site selection?
A. hemostasis
B. homeostasis
C. lymphostasis
D. venous stasis
A

C. lymphostasis

159
Q
The phlebotomist inspects the antecubital fossa of a patient and notes that the area surrounding the puncture site is purple, accompanied by swelling of the puncture site.  What is the name of this condition?
A. hematoma
B. hemangioma
C. lipoma
D. lymphoma
A

A. hematoma

160
Q
If a phlebotomist notes a purple swelling around the site selected for venipuncture, he or she should:
A. notify the nurse
B. proceed, using the site selected
C. select another site
D. write "can't get" on the requisition
A

C. select another site

161
Q
What condition, caused by a hematoma surrounding a venipuncture site, may lead to erroneous results?
A. hemostasis
B. homeostasis
C. lymphostasis
D. venous stasis
A

A. hemostasis

162
Q
Swelling caused by an abnormal accumulation of fluid is called:
A. edema
B. emesis
C. hemostasis
D. hematoma
A

A. edema

163
Q
If a phlebotomist notes that the arm selected for venipuncture is edamatous, he or she should:
A. perform the venipuncture
B. notify the patient's nurse
C. select another site
D.. write "can't get" on the requisition
A

C. select another site

164
Q
Which of the following conditions occuring in edematous tissues may alter the results?
A. destruction of platelets
B. destruction of red blood cells
C. dislodging of the platelet plug
D. injury of fragile tissue
A

D. injury of fragile tissue

165
Q
Which of the following veins is often the most accessible in obese patients?
A. basilic vein
B. cephalic vein
C. median cubital vein
D. median vein of the forearm
A

B. cephalic vein

166
Q
Veins that are hardened are:
A. elastic
B. resilient
C. sclerosed
D. spongy
A

C. sclerosed

167
Q
If a phlebotomist palpates a vein and determines that it is sclerosed, the phlebotomist should:
A. draw above the sclerosed area
B. draw below the sclerosed area
C. notify the patient's physician
D. turn off the IV and perform the draw
A

B. draw below the sclerosed

168
Q
Which of the following is a cause of sclerosed veins?
A. numerous venipunctures
B. radical mastectomy
C. residual alcohol
D. residual iodine
A

A. numerous venipunctures

169
Q
If a phlebotomist must collect a blood specimen from a patient's arm that has an IV, the phlebotomist should draw from:
A. above the IV
B. below the IV
C. the IV line directly
D. the patient's CVC
A

B. below the IV

170
Q
During routine venipuncture, after the phlebotomist engages the evacuated tube, no blood appears in the tube.  The phlebotomist determines that the venipuncture attempt was unsuccessful.  What should the phlebotomist do FIRST to end the procedure?
A. call the nurse
B. tighten the tourniquet
C. untie the tourniquet
D. withdraw the needle
A

C. untie the tourniquet

171
Q

During venipuncture, the phlebotomist inserts the needle next to the patient’s vein, on the left side of the patient’s vein. No blood appears in the evacuated tube. The phlebotomist should:
A. completely withdraw the needle
B. insert the needle deeper
C. pull back and reinsert the needle to the left
D. pull back and reinsert the needle to the right

A

D. pull back and reinsert the needle to the right

172
Q
The following colored tubes with conventional stoppers are to be collected during routine venipuncture: red SST, yellow (SPS), sky blue, green. According to NCCLS guidelines, in what sequence should the tubes be collected, following venipuncture?
A. red SST, yellow, sky blue, green
B. red SST, sky blue, green, yellow
C. yellow, red SST, sky blue, green
D. yellow, red SST, green, sky blue
A

C. yellow, red SST, sky blue, green

173
Q
The following colored tubes with conventional stoppers are to be collected during routine venipuncture: gray, red, blue, lavender.  According to NCCLS guidelines, in what sequence should the tubes be collected, following venipuncture?
A. blue, gray, lavender, red
B. gray, blue, lavender, red
C. red, blue, lavender, gray
D. red, gray, blue, lavender
A

C. red, blue, lavender, gray

174
Q
The following colored tubes with conventional stoppers are to be collected during routine venipuncture: red SST, lavender, gray, sky blue.  According to NCCLS guidelines, in what sequence should the tubes be collected first, following venipuncture?
A. gray
B. lavender
C. red SST
D. sky blue
A

C. red SST

175
Q
The following colored tubes with conventional stoppers are to be collected during routine venipuncture: green, gray, lavender, black.  According to NCCLS guidelines, in what sequence should the tubes be collected first, following venipuncture?
A. black
B. green
C. gray
D. lavender
A

D. lavender

176
Q
The following colored tubes with conventional stoppers are to be collected during routine venipuncture: lavender, red SST, sky blue, yellow (containing SPS).  According to NCCLS guidelines, in what sequence should the tubes be collected first, following venipuncture?
A. lavender
B. red SST
C. sky blue
D. yellow
A

D. yellow

177
Q
The following colored tubes with conventional stoppers are to be collected during routine venipuncture: lavender, red SST, sky blue, yellow (SPS). According to NCCLS guidelines, which tube should be collected last?
A. lavender
B. red SST
C. sky blue
D. yellow
A

A. lavender

178
Q
The following colored tubes with conventional stoppers are to be collected during routine venipuncture: green, gray, red SST, sky blue. According to NCCLS guidelines, which tube should be collected last?
A. green
B. gray
C. red SST
D. sky blue
A

B. gray

179
Q
A phlebotomist is to collect a specimen for an APTT and prothrombin time from a patient.  According to NCCLS guidelines, what tube stopper color should the phlebotomist collect first?
A. green
B. gray
C. red
D. sky blue
A

C. red

180
Q
The following colored tubes with Hemogard stoppers are to be collected during routine venipuncture: gold, green, gray, lavender.  According to NCCLS guidelines, which tube should be collected first?
A. gold
B. green
C. gray
D. lavender
A

A. gold

181
Q
The rationale for the sequence of multiple specimen collection following venipuncture is to prevent:
A. contamination
B. glycolysis
C. hemolysis
D. platelet clumping
A

A. contamination

182
Q
The condition characterized by deep and rapid respiration preceding the onset of muscular twitching and contractions is called:
A. hematoma
B. hemolysis
C. syncope
D. tetany
A

D. tetany

183
Q
The condition characterized by dizzines, weakness, pallor, clammy skin, and unconsciousness is called:
A. hematoma
B. hemolysis
C. syncope
D. tetany
A

C. syncope

184
Q
The condition characterized by a purple area surrounding a venipuncture site, accompanied by swelling, is called:
A. hematoma
B. hemolysis
C. syncope
D. tetany
A

A. hematoma

185
Q
The condition characterized by small reddish-purple spots on a patient's skin is called:
A. hematoma
B. hemolysis
C. petechiae
D. syncope
A

C. petechiae

186
Q
The term that describes the backward flow of blood into a patient's veins during venipuncture is:
A. hematoma
B. hemolysis
C. reflux
D. rouleaux
A

C. reflux

187
Q
What response may some patients have at the sight of their blood being drawn?
A. hematoma
B. hemolysis
C. syncope
D. synergy
A

C. syncope

188
Q
Which of the following conditions may be caused by a needle penetrating all the way through the vein during venipuncture?
A. hematoma
B. hemolysis
C. syncope
D. synergy
A

A. hematoma

189
Q
Which o the following may cause petechiae on a patient's skin?
A. allergy to the iodine
B. blood leaking into the tissues
C. patient platelet defects
D. the sight of blood
A

C. patient platelet defects

190
Q
During venipuncture, a phelbotomist moves the tube gently up and down in the holder, moving the contents back and forth.  What may this cause?
A. hematoma
B. hemolysis
C. petechiae
D. reflux
A

D. reflux

191
Q
The condition in which the plasma portion of the blood filters into the tissues is called:
A. hematoma
B. hemoconcentration
C. hemolysis
D. hemostasis
A

B. hemoconcentration

192
Q
Hemoconcentration of the specimen may be caused by:
A. drawing from a hematoma
B. prolonged tourniquet application
C. residual alcohol on the site
D. shaking an additive tube
A

B. prolonged tourniquet application

193
Q
Hemoconcentration of the specimen may be caused by:
A. drawing from a hematoma
B. residual alcohol on the site
C. shaking additive tubes
D. vigorous hand pumping
A

D. vigorous hand pumping

194
Q
Using a needle that is too small to accommodate the force of the vacuum of an evacuated tube may cause which of the following in a patient's specimen?
A. hemoconcentration
B. hemolysis
C. hemostasis
D. hematoma
A

B. hemolysis

195
Q
Shaking an evacuated tube containing an additive too forcefully to mix the contents may cause which of the following in a patient's specimen?
A. hemoconcentration
B. hemolysis
C. hemostasis
D. hematoma
A

B. hemolysis

196
Q
Drawing blood through a hematoma may cause which of the following in a patient's specimen?
A. hemoconcentration
B. hemolysis
C. hemostasis
D. hematoma
A

B. hemolysis

197
Q
Obtaining a specimen as a result of a traumatic venipuncture can cause which of the following in a patient's specimen?
A. hemoconcentration
B. hemolysis
C. hemostasis
D. hematoma
A

B. hemolysis

198
Q
A patient suffers a transfusion reaction.  What may this condition cause in the patient's specimen?
A. hemoconcentration
B. hemolysis
C. hemostasis
D. hematoma
A

B. hemolysis

199
Q
If a specimen is hemolyzed, what color is the serum?
A. green
B. pink
C. white
D. yellow
A

B. pink

200
Q
Which of the following analyses requires an arterial specimen?
A. blood alcohol levels
B. blood culture
C. blood gas analysis
D. blood urea nitrogen
A

C. blood gas analysis

201
Q
Which of the following departments in the health care setting relies most heavily on ABG results?
A. occupational therapy
B. physical therapy
C. radiation therapy
D. respiratory therapy
A

D.. respiratory therapy

202
Q
Involuntary contraction of an artery is called:
A. agglutination
B. arrhythmia
C. arteriosclerosis
D. arteriospasm
A

D. arteriospasm

203
Q
A process where blood is provided to a part of the body by more than one blood vessel is called:
A. Allen test
B. iontophoresis
C. collapsed vein
D. collateral circulation
A

D. collateral circulation

204
Q
Which of the following structures is located on the lateral aspect of the wrist?
A. radial artery
B. ulnar artery
C. deep palmar arch
D. superficial palmar arch
A

A. radial artery

205
Q
Which of the following structures is located on the medial aspect of the wrist?
A. brachial artery
B. femoral artery
C. radial artery
D. ulnar artery
A

D. ulnar artery

206
Q
Which of the following structures is located in the leg?
A. brachial artery
B. femoral artery
C. radial artery
D. ulnar artery
A

B. femoral artery

207
Q
Which of the following structures is located in the medial anterior aspect of the antecubital fossa?
A. brachial artery
B. femoral artery
C. radial artery
D. ulnar artery
A

A. brachial artery

208
Q
Which of the following tests is performed to assess collateral circulation of a patient's hand prior to arterial puncture?
A. Allen test
B. mucin clot test
C. Ropes test
D. sweat chloride test
A

A. Allen test

209
Q
Listed below are several sites commonly used for arterial puncture.  Which site offers the advantage of collateral circulation?
A. brachial artery
B. femoral artery
C. radial artery
D. ulnar artery
A

C. radial artery

210
Q
Listed below are several sites commonly used for arterial puncture.  Which is the second choice for arterial puncture?
A. brachial artery
B. femoral artery
C. radial artery
D. ulnar artery
A

A. brachial artery

211
Q
Listed below are several sites commonly used for arterial puncture.  Which site offers the advantage of largest size?
A. brachial artery
B. femoral artery
C. radial artery
D. ulnar artery
A

B. femoral artery

212
Q
Listed below are several sites commonly used for arterial puncture.  Which site offers the advantage of being close to the basilic vein?
A. brachial artery
B. femoral artery
C. radial artery
D. ulnar artery
A

A. brachial artery

213
Q
Listed below are several sites commonly used for arterial puncture.  Which site offers the disadvantage of increased risk of infection?
A. brachial artery
B. femoral artery
C. radial artery
D. ulnar artery
A

B. femoral artery

214
Q
During the Allen test, which two arteries are compressed by the phlebotomist?
A. brachial and femoral
B. brachial and radial
C. femoral and radial
D. radial and ulnar
A

D. radial and ulnar

215
Q
During the Allen test, which artery is released FIRST?
A. brachial 
B. femoral
C. radial
D. ulnar
A

D. ulnar

216
Q
During the Allen test, two arteries are compressed.  One artery is subsequently released.  If normal circulation is present, the patient's hand should turn pink within how many seconds?
A. 5
B. 7
C. 9
D. 10
A

A. 5

217
Q

During an Allen test, a patient’s hand returns to pink 10 seconds after one of the arteries is released. What should the phlebotomist do next?
A. call a code
B. perform Allen test on another site
C. select the brachial artery for arterial puncture
D. select the artery tested for arterial puncture

A

B. perform Allen test on another site

218
Q
Which of the following supplies would a phlebotomist carry on his or her tray to collect samples for ABG analysis?
A. alcohol, tourniquet, syringe
B. alcohol, syringe, rubber stopper
C. iodine, syringe, aluminum foil
D. alcohol, iodine, tourniquet
A

B. alcohol, syringe, rubber stopper

219
Q
Which of the following blood vessel characteristics is helpful to a phlebotomist, when palpating for a suitable site for arterial puncture?
A. pulse
B. elastic structure
C. ropelike structure
D. spongy texture
A

A. pulse

220
Q
Which of the following equipment is used routinely for venipuncture, but not arterial puncture?
A. alcohol
B. iodine
C. warmer
D. tourniquet
A

D. tourniquet

221
Q
Which of the following anticoagulants is used for the collection of specimens for ABG analysis?
A. EDTA
B. SPS
C. heparin
D. oxalate
A

C. heparin

222
Q
The phlebotomist should inform a patient that the ABG procedure is:
A. less painful, compared venipuncture
B. more painful, compared venipuncture
C. as painful as venipuncture
D. a painless procedure
A

B. more painful, compared venipuncture

223
Q
Which o the following equipment is used to collect specimens for ABG analysis?
A. evacuated tube
B. Microtainer
C. syringe
D. Unopette
A

C. syringe

224
Q
At what angle should the needle be inserted during an arterial puncture procedure?
A. 15 degrees
B. 30 degrees
C. 45 degrees
D. 60 degrees
A

C. 45 degrees

225
Q
Which of the following tests requires that the puncture site be warmed prior to collection?
A. capillary blood gas analysis
B. PKU analysis
C. sickle cell screen
D. T3, T4 analysis
A

A. capillary blood gas analysis

226
Q
Which of the following is used to mix the specimen with the collection tube additive during capillary blood gas specimen collection?
A. agitator
B. clay
C. metal flea
D. rotator
A

C. metal flea

227
Q
Following collection, how should specimens collected for ABGs be transported?
A. at 37 degrees
B. on ice
C. routinely
D. shielded from light
A

B. on ice

228
Q
A phlebotomist collected a specimen for ABG analysis.  What should the phlebotomist do with the needle, after withdrawing it from the patient's arm?
A. insert it into a cork stopper
B. insert it into a rubber stopper
C. place it in a biohazard bag
D. place it in a sharps container
A

B. insert it into a rubber stopper

229
Q
Which of the following complications may occur following arterial puncture, but not venipuncture?
A. arteriospasm
B. hematoma
C. infection
D. thrombus formation
A

A. arteriospasm

230
Q
A sudden, transient constriction of an artery in response to pain or other stimuli is called:
A. arteriospasm
B. hematoma
C. reflux
D. thrombus
A

A. arteriospasm

231
Q
Pressure is applied to an arterial puncture site for at least 5 minutes following a procedure to prevent:
A. arteriospasm
B. hematoma
C. reflux
D. thrombus formation
A

B. hematoma

232
Q
A physician would most likely order a blood culture on a patient who has:
A. AGL
B. CAB
C. FUO
D. UCHD
A

C. FUO

233
Q

Which of the following concerns is important when collecting specimens for blood culture analysis?
A. preventing air bubbles in the specimen
B. using heparin
C. using sterile technique to prepare the site
D. transporting the specimen on ice

A

C. using sterile technique to prepare the site

234
Q
The presence of bacteria and their toxins in the bloodstream is called:
A. bacteremia
B. basophilia
C. hyperemia
D. septicemia
A

A. bacteremia

235
Q
The term that means "without air" is:
A. aerobic
B. anaerobic
C. afebrile
D. antimicrobial
A

B. anaerobic

236
Q
A phlebotomist must collect a specimen for a blood culture analysis.  The phlebotomist should prepare the venipuncture site using:
A. alcohol only
B. iodine only
C. alcohol and iodine
D. tincture of green soap
A

C. alcohol and iodine

237
Q
Contamination rates of blood culture specimens should not exceed:
A. 0%
B. 3%
C. 6%
D. 10%
A

B. 3%

238
Q

Which of the following actions may result in a false positive blood culture result?
A. collecting blood in an SPS evacuated tube
B. introducing iodine into the collection container
C. leaving the tourniquet on too long
D. repalpating the site

A

D. repalpating the site

239
Q
Which of the following tests may require an extra step in patient identification?
A. blood cultures
B. cold agglutinin titers
C. glucose tolerance testing
D. type and crossmatch
A

D. type and crossmatch

240
Q
Which of the following blood collection techniques requires sterile technique to prepare a venipuncture site?
A. blood cultures
B. cold agglutinin titers
C. glucose tolerance testing
D. type and crossmatch
A

A. blood cultures

241
Q
Which of the following specimens requires warming a collection tube to 37 degrees?
A. blood cultures
B. cold agglutinin titers
C. glucose tolerance testing
D. type and crossmatch
A

B. cold agglutinin titers

242
Q
Which of the following procedures requires a patient to refrain from strenuous exercise for 12 hours prior to the test?
A. blood cultures
B. cold agglutinin titers
C. glucose tolerance testing
D. type and crossmatch
A

C. glucose tolerance test

243
Q
Which of the following tests requires that a patient fast prior to collection of the blood specimen?
A. blood cultures
B. cold agglutinin titers
C. glucose tolerance testing
D. type and crossmatch
A

C. glucose tolerance test

244
Q
Introducing bacteria from a patient's skin into a specimen for blood culture analysis may result in:
A. false negative results
B. false positive results
C. hemoconcentration
D. hemolysis
A

B. false positive results

245
Q
Introducing iodine into a specimen for blood culture analysis can result in:
A. false negative results
B. false positive results
C. hemoconcentration
D. hemolysis
A

A. false negative results

246
Q
Repalpating a site prior to venipuncture for blood culture analysis, may result in:
A. false negative results
B. false positive results
C. hemoconcentration
D. hemolysis
A

B. false positive results

247
Q
Introducing air into an anaerobic blood culture collection container may result in:
A. false negative results
B. false positive results
C. hemoconcentration
D. hemolysis
A

A. false negative results

248
Q
Which of the following conventional stopper colors corresponds to the evacuated tube suitable for blood culture specimen collection?
A. lavender
B. royal blue
C. sky blue
D. yellow
A

D. yellow

249
Q
Which of the following evacuated tube additives inhibits complement?
A. sodium citrate
B. sodium heparin
C. EDTA
D. SPS
A

D. SPS

250
Q
Which of the following tests would most be affected by lack of proper patient preparation?
A. blood cultures
B. fibrin degradation products
C. glucose tolerance testing
D. type and crossmatch
A

D. type and crossmatch

251
Q

Which of the following blood culture specimen collection containers incorporates an aerobic bottle and an anaerobic bottle?
A. Bactec system
B. gas impermeable syringe
C. SPS evacuated tube/conventional stopper
D. SPS evacuated tube/Hemogard closure

A

A. Bactec system

252
Q
While performing a venipuncture with a syringe, a phlebotomist notices blood frothing between the hub of the needle and a syringe.  As a result, the specimen may be:
A. activated
B. contaminated
C. hemolyzed
D. iontophoresced
A

C. hemolyzed

253
Q

A specimen collected by syringe is hemolyzed. What may have caused this?
A. aliquoting specimens in the wrong order
B. forcefully drawing back the plunger
C. gently drawing back the plunger
D. gently inverting the specimen tubes

A

B. forcefully drawing back the plunger

254
Q
Following venipuncture by syringe, blood must be aliquoted into the following evacuated tubes: red, sky blue, green.  In what order should the evacuated tubes be filled?
A. green, red, sky blue
B. red, green, sky blue
C. red, sky blue, green
D. sky blue, green, red
A

D. sky blue, green, red

255
Q
The rationale for the order of draw for syringes is to minimize:
A. cross contamination of specimens
B. clotting in anticoagulant tubes
C. hemolysis of the specimen
D. platelet clumping
A

B. clotting in anticoagulant tubes

256
Q
Which of the following is increased, compared with the antecubital fossa, on the skin surface of the hand/
A. bacteria
B. endothelial casts
C. number of arteries
D. number of veins
A

A. bacteria

257
Q
Which step in the venipuncture procedure must the phlebotomist exercise extra care in performing when collecting blood by venipuncture from a hand vein?
A. anchoring the vein
B. labeling the specimen
C. needle insertion
D. tourniquet application
A

A. anchoring the vein

258
Q

Why is the fifth finger of a patient’s hand routinely eliminated as a potential site for skin puncture?
A. it has a pulse
B. it has an increased number of nerve endings
C. the tissue is thinner than other fingers
D. it is usually calloused

A

C. the tissue is thinner than other fingers

259
Q

Why is the index finger of a patient’s hand routinely eliminated as a potential site for skin puncture?
A. it has a pulse
B. it has an increased number of nerve endings
C. the tissue is thinner than other fingers
D. it is usually calloused

A

B. it has an increased number of nerve endings

260
Q
Which of the following blood constituents may be falsely elevated if the skin puncture site is prepared with povidone iodine?
A. hemoglobin
B. hepatitis B surface antigen
C. platelet count
D. potassium
A

D. potassium

261
Q
Which of the following constituents is present in higher concentrations in blood collected by skin puncture than in blood collected by venipuncture?
A. calcium
B. glucose
C. potassium
D. total protein
A

B. glucose

262
Q

Which of the following skin puncture specimens is most likely to be adversely affected by excessive squeezing of the site?
A. bedside glucose test from a 75 year old woman
B. bilirubin test from a 12 hour neonate
C. microhematocrit determination from a 30 year old donor
D. WBC and platelet count from 65 year old oncology patient

A

B. bilirubin test from a 12 hour neonate

263
Q
Positioning a patient's arm downward prior to venipuncture will help prevent:
A. hemoconcentration
B. hemolysis
C. reflux
D. syncope
A

C. reflux

264
Q

A phlebotomist attempts a venipuncture on a patient’s basilic vein. If the blood that appears in the evacuated tube is dark purple-red, the phlebotomist should:
A. allow the tube to fill, following standard precautions
B. immediately release the tourniquet and withdraw the needle
C. insert the needle deeper
D. withdraw the needle, and apply pressure for 5 minutes

A

A. allow the tube to fill, following standard precautions

265
Q

A phlebotomist selects a 4.5 mL sodium citrate tube to collect a patient’s specimen. The patient was a difficult draw, but the phlebotomist successfully collected approximately 3.0 mL of specimen into the sodium citrate tube. The phlebotomist should next
A. gently invert the specimen 5 to 10 times
B. label the specimen
C. recollect the specimen
D. shield the specimen from light

A

C. recollect the specimen

266
Q
If a patient's arms and hands are swollen due to excessive fluid retention, this patient's condition is called:
A. edema
B. hemolysis
C. petechiae
D. syncope
A

A. edema

267
Q

A specimen for ABG analysis would be rejected if the specimen:
A. contained air bubbles
B. included the needle attached to the syringe
C. was collected in heparin
D. was transported on ice

A

A. contained air bubbles

268
Q
Clinically significant changes will occur in a specimen collected for ABG analysis if the specimen is left at room temperature for more than:
A. 5-10 minutes
B. 10-15 minutes
C. 15-20 minutes
D. 20-25 minutes
A

A. 5-10 minutes

269
Q
A phlebotomist attempts an arterial puncture of the brachial artery.  If the blood appearing in the syringe is bright orange-red, the phlebotomist should:
A. apply an ice pack
B. call a code
C. continue the procedure
D. discontinue the procedure
A

C. continue the procedure

270
Q
Which of the following situations will be caused if too much heparin is in the syringe used to collect a specimen for ABG analysis?
A. acidosis of the specimen
B. alkalosis of the specimen
C. excessive bleeding
D. hematoma formation
A

A. acidosis of the specimen

271
Q
A syringe used for collection of ABG samples should be:
A. blue
B. green
C. gas impermeable
D. gas permeable
A

C. gas impermeable

272
Q
What is the maximum number of venipuncture attempts a phlebotomist should make to secure a specimen?
A. 1
B. 2
C. 3
D. 4
A

B. 2

273
Q
What is the maximum length of time that a tourniquet may be left on a patient's arm without adversely affecting test results?
A. 1 minute
B. 3 minutes
C. 5 minutes
D. 7 minutes
A

A. 1 minute

274
Q
Which of the following evacuated tubes must always be preceded by a discard tube?
A. green
B. lavender
C. red SST
D. sky blue
A

D. sky blue

275
Q
What is the maximum number of times a phlebotomist should perform skin puncture on an infant's foot to secure a specimen?
A. 1
B. 2
C. 3
D. 4
A

B. 2