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Phlebotomy Boards > Wrong Practice Test Answers > Flashcards

Wrong Practice Test Answers Flashcards

1
Q

For which of the following is collection of timed samples indicated?

A

Therapeutic drug monitoring

Timed samples must be drawn at specified intervals due to medication or biological rhythms. Therapeutic drug monitoring is one example of a timed specimen.

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2
Q

What is the indication for making a blood smear?

A

To look for Malaria

Blood smears are needed for microscopic examination of the blood and are commonly used for a CBC differential, Malarial smear, and special hematology procedures.

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3
Q

When is a phlebotomist allowed to use ankle veins to draw blood?

A

With a physician’s order

The medical assistant will likely never draw from the foot or ankle unless all other attempts have failed and they have a physician’s order to draw from the foot or the ankle.

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4
Q

Which of the following situations would most likely trigger hematoma formation?
a. Applying too much pressure on a puncture site.
b. Filling the evacuated tube only half full.
c. Removing the needle while the tourniquet is still on the arm.
d. Removing the tourniquet before removing the needle.

A

Removing the needle while the tourniquet is still on the arm

Hematoma formation is the most common complication of venipuncture. It is caused by blood leaking into the tissues during or following venipuncture, situations that can trigger hematoma formation are excessive probing, arterial puncture, needle went through the vein, pressure is not adequately applied following venipuncture, or the needle is removed while the tourniquet is still on.

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5
Q

A blood sample is needed from a dialysis patient. Which of the following is an acceptable procedure?
a.
Draw from a hand vein.
b.
Draw from the vein with a cannula.
c.
Draw from the vein with a fistula.
d.
Have the nurse collect the blood.

A

Draw from a hand vein.

Blood should not be drawn from a cannula or fistula. Draw the blood from a hand vein. If the patient has a fistula, samples should be drawn from the opposite arm.

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6
Q

When blood is inoculated into blood culture bottles using a butterfly apparatus the
a.
aerobic bottle is inoculated first.
b.
anaerobic bottle is inoculated first.
c.
safety device is activated first.
d.
volume of blood inoculated is increased.

A

aerobic bottle is inoculated first.

The aerobic bottle should be filled first because there will be some residual air in the tubing of the butterfly apparatus.

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7
Q

The phlebotomist places the blood specimen in circles on special filter paper, for what test?

A

PKU

Phenylketonuria (PKU) us a deficiency in the enzyme phenylalanine hydroxylase which is responsible for converting phenylamine into tyrosine. The test is done after the newborn has ingested protein. 3 or 4 drops of blood are collected on a special card with special filter paper.

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8
Q

A postprandial specimen is collected:
a.
directly before a meal is consumed.
b.
immediately after a meal is consumed.
c.
two hours after a meal is consumed.
d.
while the patient is fasting.

A

Two hours after a meal is consumed.

Instead of starting with a glucose tolerance test (GTT), the physician may order a postprandial blood glucose drawn 2 hours after a meal. This is used as a screening test after a patient has shown elevated levels of a fasting blood glucose.

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9
Q

By bracing the hand while holding the needle assembly against the patient’s arm you
a.
Allows tubes to be filled quicker
b.
Decreases patient discomfort
c.
Decreases the possibility of hemolysis
d.
Prevent excess needle movement

A

Prevent excess needle movement

The bracing of the hand that is holding the needle assembly against the patient’s arm will prevent excess needle movement.

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10
Q

What would be would be the very first step in performing a routine venipuncture on a patient?

A

Identify yourself

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11
Q

A falsely decreased blood alcohol level may be obtained if?

A

the tube is only partially filled

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12
Q

After the last tube is filled, what is done next?

A

filled tube is removed from holder

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13
Q

Why should alcohol should be allowed to dry completely prior to skin puncture?

A

prevent hemolysis of red blood cells.

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14
Q

What is the coagulation process that causes formation of a blood clot followed by lysing of the blood clot when the injury is repaired?

A

Hemostasis

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15
Q

Petechiae are tiny, non-raised red spots on a patient’s skin when the tourniquet is applied. This indicates that?

A

site may bleed excessively

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16
Q

What is the most critical step in collecting a blood culture?

A

Proper cleansing of the venipuncture site.

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17
Q

The most critical part of a blood culture collection is?

A

skin antisepsis of the collection site

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18
Q

The phlebotomist would collect a blood sample in a tube containing the anticoagulant sodium citrate, which inhibits glycolysis, for which type of laboratory test?

A

coagulation studies

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19
Q

How long should a tourniquet be placed around a patient’s arm?

A

no more than one minute

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20
Q

What color evacuated tube would be commonly used for coagulation testing?

A

light blue

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21
Q

The heel is the recommended site for collection of capillary puncture specimens on infants. The phlebotomist is going to stick in the posterior curvature of the heel. Is this correct?

A

No, the medial plantar surface of the heel is the best site to prevent possible bone damage

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22
Q

Which of the following tubes is normally used to collect a serum sample?
Blue, green, purple, or red

A

red

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23
Q

If an EDTA evacuated tube is collected before a heparinized tube, what test would potentially be affected?

A

Potassium level

24
Q

When performing a heel puncture on an infant, proper technique includes

A

Placing the lancet flat against the skin on the medial or lateral plantar surface of the heel

Ensure the lacet device maintains contact with the skin without applying pressure.

25
Q

Which of the following best describes the proper collection of a sputum specimen?
a.
Coughing into a microbiology culture plate

b.
Mucus is coughed up from deep in the lung and expectorated into a sterile cup

c.
Saliva is spit out of the mouth into a sterile cup

d.
The mouth is rinsed with water and followed by spitting into a sterile cup

A

Mucus is coughed up from deep in the lung and expectorated into a sterile cup

Sputum is the mucus and phlegm that a person will cough out from the lungs, bronchi, or trachea. The sample is produced through coughing by the patient and expectorated into a sterile container.

26
Q

What type of infection occurs 48 hours or more after admission or within 30 days of a hospital or healthcare facility?

A

Nosocomial infection

Nosocomial infections, also known as healthcare-associated infections, develop in a patient 48 hours or more after admission to a hospital or health facility.

27
Q

A pregnant patient who tells you that she is having pain during urination or in the kidney area may be experiencing

A

A urinary infection or kidney stones.

If a pregnant patient stated that she has pain during urination or in the kidney area, she may have a urinary infection or she has kidney stones.

28
Q

When testing is delayed for more than one hour after urine collection, how should the urine be stored?

A

At room temperature

Deterioration of chemical and cellular elements in the urine or multiplication of bacteria may occur in urine where testing is delayed and not appropriately preserved. Refrigeration will preserve the urine for routine analysis, grey top tubes preserve urine for cultures, and yellow or tiger top tubes preserve urine for other testing.

29
Q

What method of urine specimen collection may be indicated for pediatric patients?

A

Urine collection bag.

Younger children do not have control of their bladder function, therefore a pediatric urine collection bag is indicated to collect the urine. The bag adheres to the child and urine is collected into the bag when they urinate.

30
Q

A specimen that requires chilling for transport to the lab should be immediately placed in?

A

A container of crushed ice and water

31
Q

The preferred urine specimen used for urine pregnancy testing should be collected?

A

first thing in the morning

32
Q

Exposure to light decreases concentrates in certain specimens. These specimens must be protected from light to prevent analytical errors. Which of the following needs to be protected from light?
a.
Ammonia
b.
Cryoglobulins
c.
Potassium
d.
Vitamins C, E, and K

A

Vitamins C, E, and K

Tests for bilirubin and vitamins C, E, and K require protection from light to preserve concentrates. Ammonia is transported in an ice bath.

33
Q

When blood is collected from a patient, the serum should be separated from the blood cells as quickly as possible to avoid
a.
glycolysis
b.
hemoconcentration
c.
hemolysis
d.
Hemostasis

A

hemolysis

Hemolysis results when red blood cells are damaged or destroyed and the hemoglobin they contain escapes into the fluid portion of the specimen. Procedural errors in specimen collection or handling can damage the red blood cells and lead to hemolysis.

34
Q

Which of the following is the nation’s largest network of institutional health-care providers?
a.
American College of Physicians
b.
American Hospital Association
c.
American Medical Association
d.
American Pharmaceutical Association

A

American Hospital Association

35
Q

Which of the following timed urine tests would require the most attention when scheduling specimen collection assignments?
a.
24-hour urine specimens
b.
Random urine specimens
c.
Tolerance test specimens
d.
Urine culture and sensitivity specimen

A

tolerance test specimens

Tolerance tests typically require collection of urine at specific times. The traditional standard glucose tolerance test (GTT) requires individual urine specimens collected serially at specific times that correspond with the timing of blood collection.

36
Q

Bilirubin concentration decreases by what amount following one hour of exposure to light?

A

50%

37
Q

The physician orders peak and trough blood specimens for therapeutic drug monitoring of a drug taken orally. You collect the peak specimen at the appropriate time once the first dose has taken effect. You should then instruct the patient to return for the trough specimen?

A

just before the patient takes their next dose

Since you do not know the duration of the effect of the drug then 2 hours may not be sufficient for a trough because the drug is still in the bloodstream. It takes 2 hours for a drug taken orally to peak. Taking blood right after dosing is incorrect. At the same time the next day does not indicate if the next dose was already taken for that day. It could be once, twice, or thrice per day. The best time to take the trough is just before they take the next dose.

38
Q

The most effective way to determine whether you are communicating negatively is to

A

ask for feedback

39
Q

Manufacturers affix expiration dates to tubes. An expiration date of 12.05.11

A

Manufacturers affix expiration dates to tubes. An expiration date of 12.05.11

40
Q

Identifiers must match the requisition form. If there is any difference (even by one letter) you must

A

notify the patient’s nurse and wait for information to be corrected.

If there is any difference you must notify the patient’s nurse and wait for the information to be corrected. The information must match the requisition in order to proceed with the procedure.

41
Q

Which document is required by OSHA, which provides guidelines regarding the handling and storage of chemicals?

A

SDS

A Safety Data Sheet (SDS) is a document that contains information on the potential hazards (health, fire, reactivity, and environmental) and how to work safely with the chemical product. It is a starting point for the development of a complete health and safety program. It also contains information on the use, storage, handling and emergency procedures all related to the hazards of the material. Safety Data Sheets (SDS) were previously referred to as Material Safety Data Sheets (MSDS).

42
Q

Which of the following statements is true regarding bloodborne pathogens?
a.
CDC does not mandate that gloves be worn at all times when collecting blood specimens.
b.
HBV has been found to be stable in dried blood and blood products for up to 7 days.
c.
HCV is primarily found in fecal material.
d.
HIV has been detected and can survive up to 2 weeks outside the body.

A

HBV has been found to be stable in dried blood and blood products for up to 7 days.

The Hepatitis B virus (HBV) has been found to be stable in dried blood and blood products for up to 7 days.

43
Q

A voluntary, nongovernmental agency charged with establishing standards for the operation of hospitals is

A

The Joint Commission

44
Q

Where is the most appropriate place in a clinical setting to find information on a substance’s hazards and recommended safety precautions?

A

The SDS

While some of this information may be found in the other choices, the SDS is the best answer since it is the most comprehensive and comes directly from the manufacturer. Employers are required to obtain the SDS of every hazardous chemical present in the workplace and to make all SDSs readily available to employees.

45
Q

In an effort to reduce needlestick injuries, NIOSH has specific recommendations for employers and employees. Which recommendation is the responsibility of the employer?
a.
Do not recap needles after venipuncture

b.
Dispose of used needles promptly and appropriately

c.
Make safety awareness in the workplace a priority

d.
Participate in all bloodborne pathogen training

A

Make safety awareness in the workplace a priority

Employers are responsible for making safety awareness in the workplace a priority. It is the responsibility of the phlebotomist to attend required safety training, dispose of used needles in the appropriate sharps container provided, and not to recap needles.

46
Q

In the Diamond Identification System used by the National Fire Protection Association (NFPA), the color red denotes

A

flammability

47
Q

What is the code of ethics?

A

Guideline for medical assistants facing complex ethical and moral issues in the course of their work.

48
Q

To go forward with a civil suit, what must the plaintiff be able to prove.

A

The elements of negligence are:
1. Duty. Duty of care
2. Derelict. Breach of the duty of care
3. Direct cause. A legal recognizable injury occurs as a result of the breach of care
4. Damage. Wrongful activity must have caused the injury or harm that occurred

49
Q

What type of consent exists when an emergency procedure such as CPR is provided?

A

Implied Consent

50
Q

In a court trial involving a phlebotomy-related nerve injury, a phlebotomy supervisor is asked to testify regarding the proper angle of needle insertion for venipuncture. What is the correct angle of draw?

A

15 to 30 degrees

51
Q

If a patient feels threatened by the phlebotomist, he or she may bring suit under civil law for

A

assault

52
Q

Which of the following body systems provides support and allows the body to move?

A

skeletal

53
Q

Which of the following is a digestive enzyme commonly tested for in the laboratory?

A

Lipase

54
Q

A sputum culture is helpful in detecting infections in which system?

A

respiratory system

55
Q

The CDC implemented two levels of precautions to prevent healthcare-acquired infections. The first precaution level is:

A

standard

Phlebotomy Boards (3 decks)

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