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phlebotomy week 3
phlebotomy week 3
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1
Which of the following laboratory test results are affected most if the patient is not fasting?
triglycerides and glucose
cortisol and testosterone
CBC and PT
AST and CPK
2
Which of the following steps should stop the phlebotomist from collecting blood from a patient's arm vein?
high blood pressure
stroke that occurred the previous morning
cardiac bypass surgery
mastectomy
3
In most cases, when should blood be collected to determine blood levels of medications?
one hour after medication is administered
at noon
just prior to the next dose of the medication
at 7:00 AM
4
If a phlebotomist is accidently stuck with a contaminated needle, what is the first thing s/he should do?
call a supervisor
test the patient for HIV and HBV
immediately wash the area with soap and water
proceed with routine tasks and report it during the next break
5
When hemoglobin is released and serum becomes tinged pink or red, this condition is referred to as:
hemophilia
lymphocytosis
hemoconcentration
hemolysis
6
Which of the following has been shown to erroneously affect lab results?
sneezing
smiling
violent crying
syncope
7
What effects do prolonged fasting or severe diets have on patients?
no effects occur to the blood analytes
electrolyte disturbances and cardiac disrhythmias may result
only glucose tolerance levels are affected
only WBC and RBC counts are affected
8
Another term for fainting is:
thrombus
lymphostatis
transient blood
syncope
9
The color coding for needles indicates the:
length
manufacturer
gauge size
anticoagulant
10
How long after a venipuncture procedure should pressure be applied to the puncture site?
90 seconds
60 seconds
30 seconds
until the bleeding has stopped
11
What effect does excessive probing with a needle in the patient's arm have on a venipuncture specimen?
no effect at all and the specimen should be acceptable
can rupture RBCs and release tissue clotting factor
often necessary and alters only the leukocyte count
no effect, but a physician should be notified of the circumstances
12
When using a butterfly needle to collect a coagulation test, which of the following is an essential step?
withdraw a dummy tube after the specimen is collected
make a notation on the label about the method of collection
draw a discard tube first
split the blood between two tubes
13
Which of the following analytes increases with age?
cholesterol and triglycerides
estrogen
bilirubin
growth hormone
14
If you are drawing a patient that tells you they just arrived home from China, what analyte may be affected?
bilirubin
chloride
creatine kinase
cortisol
15
When describing phlebotomy procedures, the term "STAT" refers to:
using the early morning specimens for laboratory testing
immediate and urgent specimen collection
abstaining from food over a period of time
using timed blood collections for specific specimens
16
Specimens for which of the following tests must be collected in gray topped tubes?
trace elements
molecular testing
PT
glucose
17
What is the ideal time for specimens to be collected?
16 hours after the last ingestion of food
at noon if food ingestion occurred after 8 AM
10 hours after the last ingestion of food
5 hours afters the last ingestion of food
18
Which of the following anticoagulants is used frequently in coagulation blood studies?
sodium citrate
potassium oxalate
CPD
ACD
19
The most common sites for venipuncture are in which of the following areas?
the dorsal side of the wrist
the middle finger
the antecubital area of the arm
the middle forearm
20
Which of the following blood analytes is sensitive to light?
lead
calcium
glucose
bilirubin
21
If the blood specimen appears lipemic, it indicates that:
triglycerides are elevated in the specimen
RBCs has ruptured in the specimen
patient is in a basal state
phlebotomist has performed excesssive probing with the needle
22
Which of the following analytes is significantly increased in the blood with changes in position?
tetosterone
cortisol
glucose
iron
23
The recommended way to locate a vein for a routine venipuncture is which of the following?
slight elevation of the patient's arm
to see the vein close to the skin surface
asking the doctor for a preferred site
palpating the entire antecubital area to feel the vein
24
Effects of exercise have shown on blood laboratory tests an increase in:
carbon dioxide
total protein
sodium
chloride
25
Which of the following blood collection tube tops has sodium fluoride as an additive?
gray
light blue
royal blue
red
26
Which of the listed needle gauges has the smallest diameter?
21
19
23
20
27
Containers for the disposal of needles and syringes should have which of the following features?
antiseptic solution
label with a red and white cross
yellow and black markings
puncture resistant
28
If a patient is taking high does of Tylenol, which of the following analyte result is most likely to be affected?
creatine kinase
blood glucose
serum bilirubin
blood cholesterol
29
What does the term "edema" mean?
infection of the skin
obesity
buildup of fluid
renal failure
30
If you are drawing a patient in a supine position, this means the patient was:
laying down with his or her legs elevated
lying on his or her back
standing near a counter
sitting in a chair
31
Blood for lead levels needs to be collected in a:
light blue topped tube
green topped tube
purple topped tube
tan topped tube
32
From the listed needle gauges, which one has the smallest diameter?
20
19
21
23
33
Emotional stress, such as anxiety and fear, can lead to a decrease of which of the following analytes?
serum iron
WBCs
CPK
RBCs
34
What type of hand sanitizer is usually acceptable for decontamination of hands prior to a venipuncture procedure?
lotion-based
saline-based
alcohol-based
rubs that are slightly acidic
35
Which of the following would be a concern if you were drawing a patient on aspirin therapy?
there is no cause for concern
patient may bleed excessively
BUN will be erroneous
creatinine result will be altered
36
Which of the following anticoagulants is found in a green topped collection vacuum container?
ammonium oxalate
sodium heparin
EDTA
sodium citrate
37
Which of the following contains an antiglycolytic agent?
light blue topped tube
purple topped tube
gray topped tube
green topped tube
38
Which of the following anticoagulants is found in a green topped blood collection vacuum tube?
sodium citrate
sodium heparin
EDTA
postassium oxalate
39
What effect does warming the site have on venipuncture?
makes blood flow more quickly
prevents veins from rolling
causes hemoconcentration
increases localized blood flow
40
During the venipucture, what is the best angle for inserting the needle into the skin?
60 to 80 degrees
45 to 60 degress
30 degrees or less
90 degrees
41
A basal state exists:
after the evening meal
early morning, 12 hours after last meal
before lunch
afternoon, 3 hours after eating lunch
42
which of the following is best for collection of trace elements, toxicology, and nutritional studies?
purple topped tube
yellow topped tube
royal blue topped tube
gold topped tube
43
The yellow topped vacuum collection tube has which of the following additives?
trisodium citrate
lithium heparin
sodium polyanetholesulfonate (SPS)
EDTA
44
The color coding for needles indicates the
gauge
length
manufacturer
anticoagulant
45
Using a butterfly needle is beneficial for
heel punctures
helps the health care worker determine the age of the patient
geriatric patients
routine venipuncture in healthy adults
46
Which of the following would be a likely cause for specimen rejection?
specimen arrives to the lab with several other specimens that are STAT
specimen appears hemolyzed
specimen is transported immediately to the lab in a biohazard bag
specimen has a handwritten label
47
If you are drawing a patient on IV heparin therapy why would you be concerned?
BUN will be erroneous
patient may bleed excessively
H and H will be altered
there is no cause for concern
48
Which of the following is a solid mass derived from blood constituents that can occlude a vein?
hemolyzed WBC
hemolyzed RBC
triglyceride
thrombus
49
What is the importance of hand-hygiene techniques?
significantly reduces number of outbreaks of infections
helps with vein selection
prevents HBV infection after a needlestick
eliminates the use of gloves
50
Palpating the venipuncture site serve which purpose?
pushes arteries out of the way prior to venipuncture
helps the health care worker determine the age of the patient
distracts the patient from the discomfort of the procudure
provides an indication of the size and depth of the vein
51
Hand lotions can be used in phlebotomy for which of the following purposes?
to maximize antiseptic action
to minimize the occurence of dermatitis
to finish the process of hand antiseptics
to provide lubrication prior to wearing gloves
52
Specimens for which of the following tests must be collected in light blue topped tubes?
APTT
RPR test
selenium
VDRL
53
What should a phlebotomist do if his or her hands are visibly dirty with dust and dirt?
wash hands with soap and water
wear sterile gloves
use antimicrobial wipes
use an alcohol-based hand rub and wipe it off with paper towels
54
The glycolytic inhibitor is found in the:
purple topped tube
light blue topped tube
gray topped tube
green topped tube
55
A blood cell count requires whole blood collected in a:
green topped tube
light blue topped tube
lavender topped tube
gray topped tube
56
Information on an inpatient's identification armband always includes the:
patient's name and identification number
physician's name and laboratory tests usually ordered
patient's bed assignment
nearest relative and emergency phone number
57
A hospitalized patient may NOT be identified by which of the following means?
patient's armband
patient's chart
verbal confirmation from the patient
nurse
58
How long should the tourniquet be placed around the patient's arm?
until the entire venipuncture is completed
until the needle is removed
no more than 1 minute
approximately 4 minutes
59
A physiological abnormality that can cause hemolyis is
performing blood collection before the alcohol has dried
needle readjustment
shaking blood collection tube vigorously after collection
sickle cell disease
60
Which of the following tests usually requires blood collected in a tan topped tube?
cortisol level
lead level
CBC
lactate dehydrogenase
61
If the tourniquet is applied longer than 3 minutes, which of the following analytes will most likely be falsely elevated
potassium
bilirubin
parathyroid hormone
GGT
62
The anticoagulant lithium heparin is most appropriate for blood collection to perform:
measurement of lithium levels
measurement of folate levels
measurement of potassium levels
blood smear preparation
63
Which of the following is the primary cause of vein collapse during venipuncture?
tourniquet is too tight
blood is withdrawn too quickly or forcefully
tube has no vacuum in it
tourniquet is not tight enough
64
Which anticoagulant is preferred for collection of STAT clinical chemistry specimens?
EDTA
sodium citrate
heparin
sodium oxalate
65
What does the term "preanalytical" refer to in phlebotomy practice?
variables that affect the specimen prior to laboratory analysis
when a test result is reported prior to verification of quality control
an episode of syncope
equipment malfunction prior to analytical testing
66
Which of the following anticoagulants allows preparation of blood films with minimal distortion of WBCs?
sodium citrate
EDTA
lithium heparin
sodium heparin
67
What is the best angle for needle insertion during venipuncture?
30 degrees or less
80 degrees
45 degrees or more
5 degrees
68
After withdrawing a needle from a patient's arm, what step should be performed immediately?
labeling the specimen
disposing of the needle
applying adhesive bandage to the site
activating the safety device on the needle
69
Which of the following would most likely NOT be an explanation for turbid serum?
bacterial contamination
elevated glucose level
elevated cholesterol results
elevated triglyceride results
70
During a venipuncture procedure, the needle should always be inserted with the:
bevel pointed away from the insertion site
bevel perpendicular to the skin
bevel side down
bevel side up
71
Which of the following analytes is affected by diurnal rhythm?
ACTH
CK
creatinine
cholesterol
72
How should the anticoagulant be mixed with a blood specimen in an evacuated tube?
gentle inversion of the specimen
centrifugation for 15 minutes
mixing that occurs naturally as the specimen is transported
shaking the tube for 30 seconds
73
Which of the following anticoagulants is found in a lavender topped collection vacuum tube?
sodium oxalate
sodium heparin
ammonium heparin
EDTA
74
What is the effect on a patient if a phlebotomist punctures a nerve with the phlebotomy needle?
it should not have an effect on the patient
specimen may be contaminated with interstitial fluid
patient will feel a sharp radiating pain and the procedure discontinued
may tingle slightly but should not interfere with the rest of the procedure
75
For capillary collection from a newborn, a lancet of which length should be used to avoid penetrating bone?
1.75 mm
3.00 mm
2.75 mm
2.0 mm
76
Identification procedures for a comatose patient may involve which of the following?
positive identification by a family member
name tag on the bed
positive identification by a hospital volunteer
medical record/chart on the bedside table
77
Which of the following causes pooling of blood in veins?
evacuated tube method
capillary tube
syringe method
tourniquet
78
When blood is collected, it should be centrifuged as quickly as possible to avoid:
hemostasis
glycolysis
hemoconcentration
hemolysis
79
If a patient becomes anxious and hyperventilates during blood collection, which lab result below will be altered?
triglyceride level
blood pH level
RBC count
protein level
80
To avoid microclotting, it is extremely important to invert blood collected in a lavender tube a minimum of:
5 times
8 times
0 times
12 times
