Week 2

Question 1

What is the correct order of draw?

Answer 1

Question 2

The following are the proper steps of patient
identification EXCEPT:
a) Ask the patient for his/her/their first, middle,
and last name, and date of birth

b) Use the labels on the patient’s door as
identification

c) Check the patient’s wristband to confirm
his/her/their full name

d) Check that the patient’s requisition matches
with the wristband

Answer 2

b) Use the labels on the patient’s door as
identification

Question 3

In the case of a discrepancy between the
patient’s statement and the wristband, you
should do all of the following EXCEPT:
a) Document all action taken

b) Solve the problem before you proceed

c) Accept what the patient told you and
proceed

d) Ask the nurse for assistance in correcting
the discrepancy

Answer 3

c) Accept what the patient told you and
proceed

Question 4

What should you do if you have specimens
drawn from 2 different patients but have the
same name on the labels?

a) Ask your supervisor to decide what to do

b) Go back to the patient and see if
he/she/they can identify the blood

c) Send it to the lab so they can fix it there

d) Discard both specimens and redraw each
patient

Answer 4

d) Discard both specimens and redraw each
patient

Question 5

What should you do if your inpatient has no
wristband?
a) The wristband is not important as long as you
have the patient’s testimony and the requisition
that matches

b) Have the nurse put a wristband on the patient,
proceed with the draw, and then document

c) Use the wristband that is attached to the
patient’s bedrail

d) Use the signs on the door to identify the patient

Answer 5

b) Have the nurse put a wristband on the patient,
proceed with the draw, and then document

Question 6

What is the order of preference in choosing
a vein for a venipuncture?
a) Basilic, cephalic, median cubital
b) Median cubital, cephalic, basilic
c) Cephalic, median cubital, basilic
d) Basilic, cephalic, jugular

Answer 6

What is the order of preference in choosing
a vein for a venipuncture?
a) Basilic, cephalic, median cubital
b) Median cubital, cephalic, basilic
c) Cephalic, median cubital, basilic
d) Basilic, cephalic, jugular

Question 7

How many inches above the antecubital
fossa should the tourniquet be applied?
a) 3-4 inches
b) 1-2 inches
c) 5-6 inches
d) 2-3 inches

Answer 7

How many inches above the antecubital
fossa should the tourniquet be applied?
a) 3-4 inches
b) 1-2 inches
c) 5-6 inches
d) 2-3 inches

Question 8

When cleansing the site for a routine
venipuncture, you should do all of the
following EXCEPT:
a) Insert the needle before the alcohol dries so
it is sterile
b) Use 70% isopropyl alcohol for a routine
draw
c) Use a back-and-forth motion
d) Allow the alcohol to dry completely before
inserting the needle

Answer 8

When cleansing the site for a routine
venipuncture, you should do all of the
following EXCEPT:
a) Insert the needle before the alcohol dries so
it is sterile
b) Use 70% isopropyl alcohol for a routine
draw
c) Use a back-and-forth motion
d) Allow the alcohol to dry completely before
inserting the needle

Question 9

When performing a venipuncture, you
should insert the needle at a:
a) 15-30 degree angle with bevel up
b) 15-30 degree angle with bevel down
c) 30-40 degree angle with bevel up
d) 90 degree angle with bevel up

Answer 9

When performing a venipuncture, you
should insert the needle at a:
a) 15-30 degree angle with bevel up
b) 15-30 degree angle with bevel down
c) 30-40 degree angle with bevel up
d) 90 degree angle with bevel up

Question 10

According to CLSI, the order of draw is:
a) Red top, green top, light blue top, gray top,
lavender top, blood culture
b) Blood culture, lavender top, gray top, green
top (light and dark), red top, light blue top
c) Blood culture, light blue top, red/tiger/gold
top, green top (light and dark), lavender
top, gray top
d) Blood culture, red/tiger/gold top, light blue
top, lavender top, green top (light and dark)

Answer 10

According to CLSI, the order of draw is:
a) Red top, green top, light blue top, gray top,
lavender top, blood culture
b) Blood culture, lavender top, gray top, green
top (light and dark), red top, light blue top
c) Blood culture, light blue top, red/tiger/gold
top, green top (light and dark), lavender
top, gray top
d) Blood culture, red/tiger/gold top, light blue
top, lavender top, green top (light and dark)

Question 11

All of the following is true about tubes with
additives EXCEPT:
a) They must be mixed thoroughly by shaking
the vial vigorously for proper mixing
b) They must be mixed promptly to prevent
platelet clumping
c) They must be mixed gently 8 to 10 times to
avoid hemolysis
d) They must be drawn in a particular order to
minimize the effects of carryover

Answer 11

All of the following is true about tubes with
additives EXCEPT:
a) They must be mixed thoroughly by shaking
the vial vigorously for proper mixing
b) They must be mixed promptly to prevent
platelet clumping
c) They must be mixed gently 8 to 10 times to
avoid hemolysis
d) They must be drawn in a particular order to
minimize the effects of carryover

Question 12

Define Hemolysis?

Answer 12

Damage or destruction of RBC’s and release of hemoglobin into the fluid portion of a specimen, causing the serum color to range from pink (slight hemolysis) to red (gross hemolysis)

Question 13

When should you label the specimen tubes?
a) In the middle of the draw
b) After the blood is drawn, at the patient’s
bedside
c) In the lab before going to the patient’s
room
d) After the specimen reaches the lab

Answer 13

When should you label the specimen tubes?
a) In the middle of the draw
b) After the blood is drawn, at the patient’s
bedside
c) In the lab before going to the patient’s
room
d) After the specimen reaches the lab

Question 14

Palpating the vein serves what purpose?
a) Helps determine the size of the vein and
what angle to insert the needle
b) Distracts the patient from discomfort
c) Increases the amount of blood in the vein
d) Helps to anchor the vein for the draw

Answer 14

Palpating the vein serves what purpose?
a) Helps determine the size of the vein and
what angle to insert the needle
b) Distracts the patient from discomfort
c) Increases the amount of blood in the vein
d) Helps to anchor the vein for the draw

Question 15

What is the most common site for
venipunctures?
a) The dorsal side of the wrist
b) The middle part of the forearm
c) The antecubital fossa of the arm
d) The anterior side of the wrist

Answer 15

What is the most common site for
venipunctures?
a) The dorsal side of the wrist
b) The middle part of the forearm
c) The antecubital fossa of the arm
d) The anterior side of the wrist

Question 16

What effect does warming the site have on
the venipuncture?
a) Prevents the vein from rolling
b) Makes artery stand out
c) Increases localized blood flow
d) Anchors the vein

Answer 16

What effect does warming the site have on
the venipuncture?
a) Prevents the vein from rolling
b) Makes artery stand out
c) Increases localized blood flow
d) Anchors the vein

Question 17

How long should the tourniquet be left on
the patient’s arm?
a) Approximately 4 minutes
b) Until after the needle is removed
c) Approximately 3 minutes
d) No more than one minute

Answer 17

How long should the tourniquet be left on
the patient’s arm?
a) Approximately 4 minutes
b) Until after the needle is removed
c) Approximately 3 minutes
d) No more than one minute

Question 18

If a patient is receiving IV solution in both
arms, the selected side should be?
a) Above the IV line
b) On the IV line
c) Below the IV line
d) Adjacent to the IV line

Answer 18

If a patient is receiving IV solution in both
arms, the selected side should be?
a) Above the IV line
b) On the IV line
c) Below the IV line
d) Adjacent to the IV line

Question 19

What is the main purpose of applying a
tourniquet?
a) To help locate a vein
b) To help the patient hold his/her/their
hand still
c) To help obtain a concentrated specimen
d) To prevent the vein from rolling

Answer 19

What is the main purpose of applying a
tourniquet?
a) To help locate a vein
b) To help the patient hold his/her/their
hand still
c) To help obtain a concentrated specimen
d) To prevent the vein from rolling

Question 20

Match the following tubes with their
anticoagulants?
Question 18
___ Lavender Top A. Sodium citrate
___ Gray Top B. Heparin (Na, Li, NH3)
___ Light Blue top C. None
___ Green top D. EDTA
___ Red top E. Potassium oxalate/
Sodium fluoride

Answer 20

Match the following tubes with their
anticoagulants?
Question 18
D Lavender Top A. Sodium citrate
E Gray Top B. Heparin (Na, Li, NH3)
A Light Blue top C. None
B Green top D. EDTA
C Red top E. Potassium oxalate/
Sodium fluoride

Question 21

Match the following tubes with the
laboratory tests:
___ Lavender Top A. PT, PTT
___ Gray Top B. CBC
___ Light Blue top C. Glucose, EtOH
___ Green top D. Chemistries
___ Red top E. Chemistries, Serologies,
Immunology

Answer 21

Match the following tubes with the
laboratory tests:
B Lavender Top A. PT, PTT
C Gray Top B. CBC
A Light Blue top C. Glucose, EtOH
D Green top D. Chemistries
E Red top E. Chemistries, Serologies,
Immunology

Question 22

Match the following:
___ To avoid A. Keep specimens in dark
agglutination due B. Keep specimens cold
to cold agglutinins C. Patient fasting for 10-12 hours
___ To avoid D. Keep specimen warm
degradation of
bilirubin
___ To handle arterial
blood gases
___ To avoid lipemia

Answer 22

Match the following:
D To avoid A. Keep specimens in dark
agglutination due B. Keep specimens cold
to cold agglutinins C. Patient fasting for 10-12 hours
A To avoid D. Keep specimen warm
degradation of
bilirubin
B To handle arterial
blood gases
C To avoid lipemia

Question 23

Capillary blood is composed of:
a) Arterial, venous, capillary, interstitial, and
intracellular blood
b) Venous, cardiac, and peripheral blood
c) Arterial, cerebrospinal, pulmonary blood
d) None of the above

Answer 23

Capillary blood is composed of:
a) Arterial, venous, capillary, interstitial, and
intracellular blood
b) Venous, cardiac, and peripheral blood
c) Arterial, cerebrospinal, pulmonary blood
d) None of the above

Question 24

The following are reasons for performing a
dermal puncture:
a) Patients with burns or scarring in
venous blood collection sites
b) Patients receiving IV therapy in both
arms and hands
c) Point-of-care testing where only a few
drops of blood are needed
d) All of the above

Answer 24

The following are reasons for performing a
dermal puncture:
a) Patients with burns or scarring in
venous blood collection sites
b) Patients receiving IV therapy in both
arms and hands
c) Point-of-care testing where only a few
drops of blood are needed
d) All of the above

Question 25

Name the 2 types of lancing devices used for collection of capillary blood: a) Syringe and butterfly devices b) Butterfly devices and evacuated tube devices c) Puncture devices and lancet devices d) Puncture devices and the winged infusion set

Answer 25

Name the 2 types of lancing devices used for collection of capillary blood: a) Syringe and butterfly devices b) Butterfly devices and evacuated tube devices **c) Puncture devices and lancet devices** d) Puncture devices and the winged infusion set

Question 26

The most common size of a puncture device for a normal-sized infant is: a) 1.2 mm b) 2.0 mm c) 3.6 mm d) 4.0 mm

Answer 26

The most common size of a puncture device for a normal-sized infant is: a) 1.2 mm **b) 2.0 mm** c) 3.6 mm d) 4.0 mm

Question 27

The depth of the incision MUST be controlled to avoid a complication named: a) Osteomyelitis b) Hematopoiesis c) Osteomalacia d) Phlebitis

Answer 27

The depth of the incision MUST be controlled to avoid a complication named: **a) Osteomyelitis** b) Hematopoiesis c) Osteomalacia d) Phlebitis

Question 28

The dermal incision site should be: a) Free of scars, bruises, rashes, swellings, blisters b) Warm and pink c) Free of bruises and swelling d) All of the above

Answer 28

The dermal incision site should be: a) Free of scars, bruises, rashes, swellings, blisters b) Warm and pink c) Free of bruises and swelling **d) All of the above**

Question 29

For finger sticks, the two frequently used fingers are: a) The index finger and the little finger (the pinky) b) The thumb and the index finger c) The 3rd and the 4th finger d) All of the above

Answer 29

For finger sticks, the two frequently used fingers are: a) The index finger and the little finger (the pinky) b) The thumb and the index finger **c) The 3rd and the 4th finger** d) All of the above

Question 30

The proper site of a finger stick is the: a) Tip of the finger where blood is more readily available b) Fleshy pad at the end of the finger, slightly off center c) Bottom of the finger where there is more blood available d) All of the above

Answer 30

The proper site of a finger stick is the: a) Tip of the finger where blood is more readily available **b) Fleshy pad at the end of the finger, slightly off center** c) Bottom of the finger where there is more blood available d) All of the above

Question 31

What is the reason for wiping off the first drop of blood after creating a dermal incision? a) To avoid picking up alcohol residue, contaminants, and interstitial tissue fluid b) The second drop is usually larger and fuller c) To give you time to grab the microtainer for collection of sample d) To reduce the pain at the incision site

Answer 31

What is the reason for wiping off the first drop of blood after creating a dermal incision? **a) To avoid picking up alcohol residue, contaminants, and interstitial tissue fluid** b) The second drop is usually larger and fuller c) To give you time to grab the microtainer for collection of sample d) To reduce the pain at the incision site

Question 32

The medial plantar surface of the heel is located: a) At the very back portion of the heel b) In the middle of the bottom of the heel c) On the big-toe side of the bottom of the heel d) On the little-toe side of the bottom of the heel

Answer 32

The medial plantar surface of the heel is located: a) At the very back portion of the heel b) In the middle of the bottom of the heel **c) On the big-toe side of the bottom of the heel** d) On the little-toe side of the bottom of the heel

Question 33

The primary purpose of warming a capillary puncture site is to: a) Delay clotting b) Increase the blood flow c) Minimize contamination d) Reduce hemoconcentration

Answer 33

The primary purpose of warming a capillary puncture site is to: a) Delay clotting **b) Increase the blood flow** c) Minimize contamination d) Reduce hemoconcentration

Question 34

Why do we need to draw blood? a) Blood test results can help doctors evaluate how well organs are working b) A great deal of information can be learned regarding the patients’ health status and risk factors c) Blood test results diagnose diseases d) All of the above

Answer 34

Why do we need to draw blood? a) Blood test results can help doctors evaluate how well organs are working b) A great deal of information can be learned regarding the patients’ health status and risk factors c) Blood test results diagnose diseases **d) All of the above**

Question 35

What must the process of blood collection always begin with? a) Greeting the patient b) Explaining the procedure to the patient c) Lab requisition from the physician d) None of the above

Answer 35

What must the process of blood collection always begin with? a) Greeting the patient b) Explaining the procedure to the patient **c) Lab requisition from the physician** d) None of the above

Question 36

Requisitions vary from facility to facility and they can be: a) Hand-written b) Preprinted or computer-generated (electronic) c) Verbal orders from the ER physician d) All of the above

Answer 36

Requisitions vary from facility to facility and they can be: a) Hand-written b) Preprinted or computer-generated (electronic) c) Verbal orders from the ER physician **d) All of the above**

Question 37

The single most important task a phlebotomist performs in blood collection is: a) Washing hands with antibacterial soap before handling the patient b) Wearing gloves while drawing blood c) Accurately identifying the patient d) Patient education

Answer 37

The single most important task a phlebotomist performs in blood collection is: a) Washing hands with antibacterial soap before handling the patient b) Wearing gloves while drawing blood **c) Accurately identifying the patient** d) Patient education

Question 38

What would you do if the patient is not wearing an ID band? a) Go ahead and draw blood as long as the patient tells you who they are and grants you permission b) Go ahead and draw blood if the nurse tells you that you have the right patient c) Ask the nurse to place an ID band on the patient; then proceed with the proper procedure and document all action d) None of the above

Answer 38

What would you do if the patient is not wearing an ID band? a) Go ahead and draw blood as long as the patient tells you who they are and grants you permission b) Go ahead and draw blood if the nurse tells you that you have the right patient **c) Ask the nurse to place an ID band on the patient; then proceed with the proper procedure and document all action** d) None of the above

Question 39

What could go wrong if a patient is misidentified? a) The patient will get the wrong diagnosis based on another patient’s result b) The patient will get improper course of treatment c) In case of blood transfusion, the patient might have a transfusion reaction which could be fatal d) All of the above

Answer 39

What could go wrong if a patient is misidentified? a) The patient will get the wrong diagnosis based on another patient’s result b) The patient will get improper course of treatment c) In case of blood transfusion, the patient might have a transfusion reaction which could be fatal **d) All of the above**

Question 40

If ever in doubt as to the identification of a specimen during any time in the process of blood collection, specimen transport, or specimen processing: a) Continue to use the specimen but notify your supervisor and document b) Continue with the testing of the specimen and also redraw the specimen for comparison c) Discard the specimen immediately and draw a new sample d) All of the above

Answer 40

If ever in doubt as to the identification of a specimen during any time in the process of blood collection, specimen transport, or specimen processing: a) Continue to use the specimen but notify your supervisor and document b) Continue with the testing of the specimen and also redraw the specimen for comparison **c) Discard the specimen immediately and draw a new sample** d) All of the above

Question 41

Proper procedure for phlebotomists to follow in labeling patient sample tubes is: a) Pre-label tubes in order to save time b) Label tubes immediately after drawing at the patient’s bedside c) Label tubes after returning to the lab d) Never label your sample tubes

Answer 41

Proper procedure for phlebotomists to follow in labeling patient sample tubes is: a) Pre-label tubes in order to save time **b) Label tubes immediately after drawing at the patient’s bedside** c) Label tubes after returning to the lab d) Never label your sample tubes

Question 42

If a patient is wearing an ID band that does not match the requisition or the patient’s testimony: a) Go ahead and draw as long as the name given by the patient matches the requisition b) Stop. Get the nurse to solve the discrepancy by re-banding the patient ensure that the patient’s testimony, the armband, and the requisition all match. Document! c) Go ahead and draw as long as the nurse approves it, then document d) None of the above

Answer 42

If a patient is wearing an ID band that does not match the requisition or the patient’s testimony: a) Go ahead and draw as long as the name given by the patient matches the requisition **b) Stop. Get the nurse to solve the discrepancy by re-banding the patient ensure that the patient’s testimony, the armband, and the requisition all match. Document!** c) Go ahead and draw as long as the nurse approves it, then document d) None of the above

Question 43

In an effort to prepare the patient for a draw, what steps must be taken? a) Introduce yourself, then explain (educate) the patient in simple terms b) High-five the patient to gain his/her confidence c) Take a cookie from the lab to show empathy towards the patient d) All of the above

Answer 43

In an effort to prepare the patient for a draw, what steps must be taken? **a) Introduce yourself, then explain (educate) the patient in simple terms** b) High-five the patient to gain his/her confidence c) Take a cookie from the lab to show empathy towards the patient d) All of the above

Question 44

When you go into a room and find the patient sleeping: a) This is your chance. Whistle a lullaby and quietly draw the sample without awakening the patient b) Find the nurse for instructions c) Gently awaken the patient before beginning the procedure d) None of the above

Answer 44

When you go into a room and find the patient sleeping: a) This is your chance. Whistle a lullaby and quietly draw the sample without awakening the patient b) Find the nurse for instructions **c) Gently awaken the patient before beginning the procedure** d) None of the above

Question 45

If the patient is out of their room: a) You may return later as long as it is not a timed draw or a STAT draw b) If it is a routine draw, come back later when the patient is back in the room c) If it is a timed draw or a STAT draw, ask the nurse to locate the patient. Document all activities. d) All of the above.

Answer 45

If the patient is out of their room: a) You may return later as long as it is not a timed draw or a STAT draw b) If it is a routine draw, come back later when the patient is back in the room c) If it is a timed draw or a STAT draw, ask the nurse to locate the patient. Document all activities. **d) All of the above.**

Question 46

If a patient refuses to have a venipuncture performed, the phlebotomist should: a) Never force the patient to undergo venipuncture b) Try to determine why and attempt to alleviate their fears if possible c) Report refusal to the nurse and your supervisor and document d) All of the above

Answer 46

If a patient refuses to have a venipuncture performed, the phlebotomist should: a) Never force the patient to undergo venipuncture b) Try to determine why and attempt to alleviate their fears if possible c) Report refusal to the nurse and your supervisor and document **d) All of the above**

Question 47

Bandages, gloves and gauze that are contaminated with potentially infectious material must be placed in a: a) Container that has the special “Biohazard Symbol” b) Container with a ”Caution, Contaminated Items” sign c) Sharps container d) Recycling bin

Answer 47

Bandages, gloves and gauze that are contaminated with potentially infectious material must be placed in a: **a) Container that has the special “Biohazard Symbol”** b) Container with a ”Caution, Contaminated Items” sign c) Sharps container d) Recycling bin

Question 48

All sharps (needles, lancets, slides, etc.) must be disposed in: a) A red bag with the Biohazard symbol b) A brown bag with the Biohazard symbol c) In a container with double red bags with the Biohazard symbol d) A sharps container with the biohazard symbol

Answer 48

All sharps (needles, lancets, slides, etc.) must be disposed in: a) A red bag with the Biohazard symbol b) A brown bag with the Biohazard symbol c) In a container with double red bags with the Biohazard symbol **d) A sharps container with the biohazard symbol**

Question 49

Sharps container must be: a) Leak-proof and puncture-resistant b) Sealed and replaced when 2/3 full c) Used for only sharp objects d) All of the above

Answer 49

Sharps container must be: a) Leak-proof and puncture-resistant b) Sealed and replaced when 2/3 full c) Used for only sharp objects **d) All of the above**

Question 50

Infectious waste is: a) Waste that is produced by infectious individuals b) Waste material that must only be handled by the Infectious Committee c) Any material (wound dressing, bandages, blood or body fluid-soaked paper towels, etc) that can carry disease d) None of the above

Answer 50

Infectious waste is: a) Waste that is produced by infectious individuals b) Waste material that must only be handled by the Infectious Committee **c) Any material (wound dressing, bandages, blood or body fluid-soaked paper towels, etc) that can carry disease** d) None of the above

Question 51

When collecting blood cultures which antiseptic should you use?

Answer 51

Chloraprep

Question 52

What is the order of draw mnemonic?

Answer 52

be, lighthearted, respectful, gentle, loving and gracious

Question 53

What is a sclerosed vein?

Answer 53

Sclerosed veins * Hardened veins * Difficult to push needle through

Question 54

What are the 3 types of sclerosed vein?

Answer 54

Tortuous veins * Twisted veins * Easy to push needle through wall Thrombotic veins * Blood clot in the vein * Feels hard, inflexible, and tender Phlebitic veins * Inflammation of blood vessels * Tender and warm to touch – appear red

Question 55

Which of the following equipment is required when collecting blood with the syringe method? Multisample needle Transfer device Tube holder Lancet

Answer 55

Transfer device

Question 56

A light blue topped tube is most often associated with tests in which department? Chemistry Hematology Coagulation Serology

Answer 56

Coagulation

Question 57

What type of is **1st** in your order of draw?

Answer 57

Blood culture (sterile tube)

Question 58

What is the tube top color for a **blood culture**?

Answer 58

Can vary depending on brand and manufacturer but it is noted as "Blue and Red bottle, yellow SPS"

Question 59

What additives will be found in a yellow topped **Blood culture (sterile tube)**?

Answer 59

Sodium Polyanethol Sulfonate (SPS) *not used very often anymore*

Question 60

When drawing a blood culture which bottle should be drawn first and why does it matter?

Answer 60

Depends on method **BUT** if you are using a method where there is air introduced **BEFORE** the bottle then you must use the aerobic bottle first. Introducing oxygen into the oxygen poor environment of the Anaerobic bottle can ruin test results.

Question 61

What is a **Blood Culture** test used for and by which department?

Answer 61

Microbiology uses the blood culture to determine the presence or absence of infection

Question 62

When drawing a **Blood culture** you don't need to wait 30 seconds after applying povidone-iodine/chloraprep before venipuncture, only with isopropyl alcohol. **T/F**

Answer 62

**FALSE** You must wait 30 seconds before venipuncture when drawing a blood culture, use the time to wipe the bottle tops

Question 63

What is the **2nd** tube type drawn in the proper order of draw?

Answer 63

Coagulation Tube

Question 64

What is the top color for a **Coagulation** tube?

Answer 64

Light blue

Question 65

What additive would you find in a **Light Blue** tube?

Answer 65

Sodium Citrate

Question 66

What tube would you find **Sodium Citrate** in and what does it do?

Answer 66

Sodium Citrate is found in a **Light Blue** Coagulation tube and it prevents coagulation by binding to **Calcium**

Question 67

What is blood collected in a **Light Blue** tube used for?

Answer 67

Coagulation Studies Most commonly: * PT = prothrombin time * aPTT = activated partial thromboplastin time

Question 68

You receive a requisition form for a **PT and PTT** test, which bottle top color will you grab?

Answer 68

Light Blue

Question 69

**Plasma** comes from tubes that contain an anti-coagulant and **Serum** is the liquid part of blood *after* coagulation. **T/F?**

Answer 69

**TRUE** Plasma: cell-free liquid part of blood that has been treated with an anticoagulant Serum: liquid part of blood AFTER coagulation, therefore devoid of clotting factors, like fibrinogen

Question 70

What is the ratio of blood-to-anticoagulant necessary in **Coagulation Tube**?

Answer 70

Light Blue 9:1 ratio of blood-to-anticoagulant

Question 71

If a butterfly needle is used, and the light blue is the only or first tube, a discard tube must be drawn first?

Answer 71

For collections with butterfly blood collection sets, a discard tube should be collected prior to collection of the blue top to ensure sufficient sample volume. Drawing a discard tube will displace the air from the blood collection set tubing to ensure proper blood draw volume.

Question 72

How many times does a **Coagulation Tube** need to be mixed?

Answer 72

3-4 gentle turns You can actually destroy the sample by over mixing or being too aggressive

Question 73

What is the **3rd** type of tube in the proper order of draw?

Answer 73

Non-Additive tube

Question 74

What color top would you find on a **Non-Additive** tube?

Answer 74

Red

Question 75

If you are draw requires a discard tube which tube should you grab and why?

Answer 75

A red top, Non-Additive tube. Specifically because there are no chemicals to worry about cross contamination

Question 76

What additives would you find in a **Red Top** tube?

Answer 76

None, it is a Non-Additive tube

Question 77

Which department(s) would likely use a **Red Top** tube and what might they use it for?

Answer 77

Serology - the scientific study or diagnostic examination of blood serum, especially with regard to the response of the immune system to pathogens or introduced substances. Serum chemistry tests so tests on blood serum without clotting factors

Question 78

A requisition form asks you to draw blood for a Uric Acid, PSA or Lipid Panel. Which tube should you grab?

Answer 78

Red Top

Question 79

What are the common tests that require collection via a **Non-Additive** tube?

Answer 79

Red top Uric Acid, PSA, Lipid Panel

Question 80

If you need a **Serum Separator Tube (SST)** which color tube top will you grab?

Answer 80

Gold / Tiger Top SST = Serum Separator Tube Contains gel at the bottom to separate serum from RBCs

Question 81

What is an **SST** tube?

Answer 81

Serum Separator Tube (SST) That includes Red, Gold / Tiger top tubes

Question 82

What is the mode of action for a **Red, Gold or Tiger Top** tube?

Answer 82

Blood is allowed to clot. You have to wait **30 minutes** for the blood to clot before testing

Question 83

If they are all SSTs, what is the difference between a **Red top** tube and a **Gold / Tiger Top** tube?

Answer 83

Red tops have no chemical additive Gold/Tiget Tops include a clot activator or gel seperator

Question 84

Which departments use **Serum Separator Tubes**?

Answer 84

Serology - the scientific study or diagnostic examination of blood serum, especially with regard to the response of the immune system to pathogens or introduced substances. Serum chemistry tests so tests on blood serum without clotting factors

Question 85

If your requisition form lists a **Hepatic Panel, BMP or CMP** which type of tube/color would you prepare?

Answer 85

Serum-Seperator Tube (SST) Gold / Tiger Top

Question 86

Because they do not contain anticoagulants ______, _______ and _______ tubes are used for serum testing.

Answer 86

Red, Gold and Tiger

Question 87

When asked for a **Heparin** tube, which color should you grab?

Answer 87

Light green (Lithium Heparin) or Dark Green (Sodium Heparin), depending on the additive needed Used for Chemistries - For lithium level, use sodium heparin - For sodium level, use lithium heparin - For ammonia level, use either

Question 88

What is the **4th** type of tube used in the order of draw?

Answer 88

Heparin Tube (PST)

Question 89

What is the difference between a **Light Green** and **Dark Green** top?

Answer 89

Light green contains lithium heparin and dark green contains Sodium Heparin

Question 90

What is the mode of action for a **Green top** tube?

Answer 90

Heparin prevents coagulation by inhibiting the action of thrombin

Question 91

If coagulation is prevented because thrombin is inhibit the chemical anticoagulant is...?

Answer 91

Heparin

Question 92

What kind of test requires collection in a **Green top** tube?

Answer 92

Plasma Chemistry Tests

Question 93

You receive a requisition form that is asking for **Electrolytes (Lytes) or Ammonia** test, which bottle(s) do you grab?

Answer 93

Heparin Tube (PST) Light/Dark Green

Question 94

What is the **5th** tube we collect in the proper order of draw?

Answer 94

Lavender EDTA tube

Question 95

What color is an **EDTA** tube?

Answer 95

Lavendar

Question 96

What additives would you find in a **Lavender** tube?

Answer 96

Potassium EDTA or Sodium EDTA

Question 97

What is EDTA and what does it do?

Answer 97

Anticoagulant that prevents coagulation by binding to calcium - Forms calcium salts to remove calcium - Prevents platelet aggregation - Preserves the shape of the cell **NOTES** -Primarily used for whole blood testing -Cannot be used for coagulation studies -NEVER draw before heparin

Question 98

Which tube prevents platelet aggregation?

Answer 98

Lavender EDTA tube

Question 99

Which department is most likely to request a draw with an EDTA tube?

Answer 99

Hematology studies

Question 100

When asked to draw a **CBC** which tube will you grab?

Answer 100

Lavendar EDTA tube

Question 101

What is a CBC and which tube do you collect blood with for that test?

Answer 101

CBC = complete blood count Lavender EDTA tube

Question 102

Which tube is primarily used for whole blood specimens?

Answer 102

Lavendar EDTA Tube

Question 103

What color is a **Glycolitic Inhibitor Tube**?

Answer 103

Gray top

Question 104

What is the **6th** tube in the correct order of draw?

Answer 104

Gray top Glycolitic Inhibitor Tube

Question 105

Which tube contains **Potassium Oxalate/Sodium Fluoride**?

Answer 105

Gray top Glycolitic Inhibitor Tube

Question 106

What additives would you find in a **Gray** top tube?

Answer 106

Potassium Oxalate/Sodium Fluoride Antiglycolytic agent preserves glucose for up to 5 days

Question 107

What is the mode of action in a **Grey top Glycolitic Inhibitor** tube?

Answer 107

- Potassium oxalate = prevents coagulation by binding Ca2+ - Sodium fluoride = inhibits glycolytic activity

Question 108

What department(s) my request test requiring a **Grey** top tube?

Answer 108

Chemistry and Toxicology Common tests: Blood EtOH, Glucose, Lactic Acid

Question 109

You are requested to draw blood for a **Blood EtOH, Glucose or Lactic Acid** test, which tube to you grab?

Answer 109

Gray top Glycolitic Inhibitor Tube

Question 110

Your requisition form requests: Blood EtOH, Uric Acid, BMP and PT. What tube tops are you getting and what is the proper order of draw?

Answer 110

Light blue (PT) > Red Non-Additive (Uric Acid) > Gold/TIger Serum Separator (BMP) > Gray Glycolitic Inhibitor (Blood EtOH)

Question 111

Your requisition form requests: Electrolytes, CBC, Lipid Panel and Blood Cultures. What tube tops are you getting and what is the proper order of draw?

Answer 111

Blood culture bottle Aerobic first (Blood Cultures) > Red Non-Additive(Lipid Panel) > Light green / Dark green Heparin Tube (Electrolytes) > Lavender EDTA (CBC)

Question 112

Your requisition form requests: CMP, CBC, PTT and Glucose What tube tops are you getting and what is the proper order of draw?

Answer 112

Light blue coagulation tube (PTT), Gold/Tiger Serum Seperator Tube (CMP) > Lavendar EDTA Tube (CBC) > Gray Glycolitic Inhibito Tube (Glucose)

Question 113

What information **MUST** appear on a requisition form?

Answer 113

Patient info - First and Last name, Middle name or initial ID Number or medical record number Date of Birth Location (in patient only) Ordering Physicians' name Name(s) of test(s) ordered Date and time of specimen collection Phlebotomists' ID number or initials (or student phlebotomist)

Question 114

What should you do if you have doubts while collecting a specimen?

Answer 114

- Report to supervisor IMMEDIATELY - Seek help from nurse in charge - Redraw specimen if necessary

Question 115

What is the most important task the phlebotomist performs?

Answer 115

Identification of the patient

Question 116

Per the Joint Commision a patient must be identified by atleast ___ number of steps.

Answer 116

2; Step 1: Ask patient for full name and DOB Step 2: Match patient information on requisition to patient's ID band

Question 117

If presented with a **Pink** top tube, what is it and where does it belong in your order of draw?

Answer 117

sPink top contains EDTA so it follow the **Lavendar EDTA** It is used in blood banks for type and screen

Question 118

If presented with a **Yellow** top tube, what is it and where does it belong in your order of draw?

Answer 118

Yellow top contains Acid citrate dextrose (ACD) which preserves WBCs and it follows the **Gray** tube HLA typing and other tests that require isolation of DNA

Question 119

If presented with a **Black** top tube, what is it and where does it belong in your order of draw?

Answer 119

Black top contains Sodium citrate and would follow **Light Blue** tube Coagulation - Westergren sedimentation rate Special filling requirement 4:1 ratio of blood to anticoagulant

Question 120

If presented with a **Brown** top tube, what is it and where does it belong in your order of draw?

Answer 120

Brown top contains Heparin and would follow **light/dark green** tubes Lead testing

Question 121

If presented with a **Dark Blue** top tube, what is it and where does it belong in your order of draw?

Answer 121

Dark blue can actually contain different additives: No additive Sodium heparin EDTA This means they can be drawn, depending on the additive, in different places within the order of draw. They are used in toxicology for trace metal assays

Question 122

What are the special handling instructions associated with **blood gases**?

Answer 122

Keep cold

Question 123

What are the special handling instructions associated with **ACE**

Answer 123

Keep cold

Question 123

What are the special handling instructions associated with **ACTH**

Answer 123

Keep cold

Question 124

What are the special handling instructions associated with **Glucagon**

Answer 124

Keep cold

Question 125

What are the special handling instructions associated with **Catecholamines**

Answer 125

Keep cold

Question 126

What are the special handling instructions associated with **Ammonia**

Answer 126

Keep Cold

Question 127

What are the special handling instructions associated with **Gastrin**

Answer 127

Keep cold

Question 128

What are the special handling instructions associated with **Renin**

Answer 128

Keep cold

Question 129

What are the special handling instructions associated with **Cold agglutinins**?

Answer 129

Keep Warm

Question 130

What are the special handling instructions associated with **Bilirubin**

Answer 130

Keep in the dark

Question 131

What are the special handling instructions associated with **Carotene**

Answer 131

Keep in the dark

Question 132

What are the special handling instructions associated with **Vitamin B12**

Answer 132

Keep in the dark

Question 133

What are the special handling instructions associated with **Folic Acid**

Answer 133

Keep in the dark

Question 134

When do we make blood smear slides?