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Final part 1
Final part 1
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1
The following can help when a hand vein must be used for venipuncture:
Do not use pediatric collection tubes.
Hold the vein 1 to 2 inches below the insertion site.
Use a large bore needle.
Keep the patient’s hand in an upward position.
2
Coagulation studies may require:
being warmed upon collection.
protection from light.
being placed in an ice-water mixture.
a discard tube.
3
When a venipuncture is completed and a bandage is applied, the patient should be asked:
to keep his/her arm straight.
not to apply pressure.
to lift his/her arm up.
to bend his/her elbow.
4
Isopropyl alcohol is a bacteriostatic antiseptic. What does bacteriostatic antiseptic mean?
Inhibits the growth of viruses
Sterilizes bacteria on the skin
Kills any pathogen living on the skin
Inhibits the growth of bacteria
5
Osteomyelitis is:
a buildup of fluids.
the bottom surface, or sole, of the foot.
the heel bone.
an infection of the bone and marrow.
6
You notice that the date on the needle's sterility label has passed. How should you proceed?
Discard the needle because its sterility is in question.
Needle integrity is irrelevant to the blood draw.
Use the needle because all of your needles display the same date.
Use the needle because it has not yet been unsheathed.
7
Which is least likely an example of a quality indicator?
adherence to test guidelines
timeliness of service
customer satisfaction
accuracy of results
8
What color Becton-Dickinson cap was designed for difficult blood draws?
Translucent cap
Speckled
Solid color
Multicolor
9
Which hormone stimulates ovulation and estrogen production in females and stimulates testosterone production in males?
Luteinizing hormone
Adrenocorticotropic hormone
Growth hormone
Prolactin
10
A physician can order bloodwork a few different ways. Which is typically the preferred method of ordering bloodwork?
Form faxed to the lab
Prescription pad
Order given to the patient
EHR
11
What type of blood vessel is shown in image “A”?
Vein
Artery
Capillary
Inferior vena cava
12
How are thrombocytes involved during blood vessel injury?
Protein clot formation
Spasm of the blood vessel
Platelet plug formation
Fibrinolysis of the clot
13
To dispose of the phlebotomy equipment after the procedure you:
activate safety device and dispose the unit into a sharps container
Place the entire unit into the sharps container immediately.
Activate safety device on the needle & out it in the sharps container.
Remove the used needle and keep the rest of the equipment.
14
To check for levels of antibodies to specific antigens, what test would be ordered?
Antibody titers
Wet prep
Culture and sensitivity
Immune antibody
15
The phlebotomist is the “face of the laboratory.” This phrase is reflected in the definition of:
quality cost management (QCM).
total quality management (TQM).
quality assessment and process improvement (QAPI).
quality control (QC).
16
If a heelstick is performed with the cut applied as pictured in this image, what may result?
No adverse situations. This is an appropriate area for a heelstick.
Blood will clot before it can be collected.
Blood will not form drops, but rather run along the back of the heel.
The calcaneus may be punctured.
17
A patient needs a CBC, HIV, lipid panel, CMP, random glucose, & TSH. Which of these are collected as a fasting specimen?
Random glucose
HIV, TSH, random glucose
Lipid panel
CBC, CMP
18
Iatrogenic anemia is:
caused by drawing more than the maximum amount of blood on an infant.
caused by performing venipunctures on infants.
hereditary anemia.
not possible on outpatient collections.
19
What is the maximum number of times blood collection should be attempted on a patient with difficult veins?
Two times
One time
Unlimited
Three times
20
Blood cells formed by the myeloid compartment include all of these EXCEPT:
erythrocytes.
lymphocytes.
monocytes.
platelets.
21
If you were questioning the amount of blood withdrawn from an infant, where would you look for that information?
The information is on the patient’s wristband.
The information is not documented.
The information is in the laboratory’s information system.
The information is in the patient’s health record.
22
The process of documenting a phlebotomist’s ability to perform assigned tasks is:
corrective action.
training.
competency assessment.
preventive action.
23
The term HAZMATS is used to identify
chemical absorbent materials.
hazardous materials and chemicals.
chemicals that can neutralize volatile chemicals.
chemicals that have low to no risk.
24
Which of the tubes shown here should be drawn first in the order of draw?
Either tube may be drawn first.
Lavender tube
Light-blue tube
A red-topped tube must be drawn before either tube.
25
When should a “STAT” sticker be affixed to a specimen?
When collecting specimens for timed tests
When test results are needed immediately
When specimens are collected from critically ill patients
When test results are needed as soon as possible
26
When did the phlebotomy profession become established as a result of technology & an expansion of laboratory functions?
1930s and 1940s
1980s and 1990s
1890s
1960s
27
What venipuncture situation is represented by this image?
Needle inserted against the vein wall
Needle inserted too close to a valve
Proper needle insertion
Needle inserted too shallow
28
A patient seated in a phlebotomy chair will have her/his arm:
supported and extended downward in a straight line.
supported and slightly bent at the elbow.
raised above her/his head.
dangling toward the floor.
29
The anticoagulant in a gray-stoppered blood collection tube is:
potassium heparin.
lithium heparin.
sodium fluoride.
potassium oxalate.
30
Which of the following is NOT a bone in the arm?
Ulna
Radius
Humerus
Tibia
31
Which of the following statements is TRUE?
Needles should be recapped prior to disposal.
Safety devices are part of the venipuncture needle or holder.
Double-ended needles are used with syringes.
Higher needle gauges correspond to larger needle bore size.
32
Which error in quality control results occurs when an outdated control material is used?
Systematic error
Quality assurance error
Random error
Delta check error
33
What is an inanimate object capable of carrying a disease?
Helicobacter pylori
Giardia lamblia
Pseudomonas aeruginosa
Fomite
34
During patient care activities that are likely to generate splashes of blood, a phlebotomist should wear (a):
gloves.
all of these.
gown.
goggles.
35
A concern to laboratory personnel when tube stoppers are removed or with uncovered centrifuge tubes is the prevention of
aerosols.
hemolysis.
contamination.
clotting.
36
Which of the following must be present for an action to be considered negligence?
The patient is owed a duty of care.
There is a breach in the duty of care.
There is a recognizable injury to the patient.
All of these
37
Depending on the requirements of the facility, the phlebotomist may document specimen collection information by
barcoding information into an LIS.
handwriting information onto a log sheet.
verbally informing the healthcare provider.
typing the information into an HIS.
38
Which of these images represents the proper handling of specimens for cold agglutinins?
Image B
Image A
Image C
Image D
39
Which vessel carries blood from the lungs and returns it to the heart?
Pulmonary artery
Inferior vena cava
Pulmonary vein
Pulmonary valve
40
You are preparing to draw blood on a hospitalized patient for a CBC. When should you label the specimen?
Have your supervisor label it after you complete the draw
Immediately after the blood draw
Immediately before the blood draw
Have your coworker label it while you're completing the blood draw
41
Which color stopped would be used to check a patients' glucose levels?
Gray
Lavender
Gold
Light green
42
The site(s) to consider for dermal punctures on the plantar surface of the heel in infants is/are:
the distal region.
the medial region.
the proximal region.
the lateral region.
43
Set of rules, procedures, or guidelines that examine values, actions, & choices to help determine right from wrong is:
HIPAA.
a code of ethics.
a duty to act.
compliance.
44
A bloody mass under the skin as a result of blood seeping beneath the skin during venipuncture is:
hemoconcentration.
ecchymosis.
a hematoma.
the collapse of a vein.
45
Greiner Bio-One has specific indicators on its tubes. What does the white ring around the cap represent?
Tube contains a clot activator
Pediatric or difficult draws
Used for drug screening
Adult blood draws
46
The assessment and treatment of hormone disorders is the function of which medical specialty?
Nephrology
Geriatrics
Gynecology
Endocrinology
47
Before you begin to aliquot a specimen, you should:
compare the label to the specimen tube.
create all new labels at one time.
mix the specimen and aliquot as needed.
deliver to the laboratory.
48
To help and anxious patient explain that movement can cause problems with the procedure and:
tell the patient that you may strap his/her arms.
engage the patient in conversation to distract him/her.
explain about needles tearing veins.
remind the patient he/she has the right to refuse.
49
A rule of conduct or action prescribed or formally recognized as binding or enforced by a controlling authority is:
bedside manner.
a code of ethics.
a law.
a duty.
50
Which of the following is a place where organisms grow and multiply?
Site
Reservoir
Transmission
Host
51
To prevent venous reflux (evacuated tube contents flowing back into the vein) you should release the tourniquet
after the needle is in the vein but before the first tube is engaged.
while the last tube is filling.
while the first tube is filling.
after the needle is removed from the vein.
52
Gloves are worn during phlebotomy procedures to
appear professional for the patient.
keep your fingerprints off the equipment.
maintain a professional appearance.
prevent the spread of contamination.
53
Which agency can provide you with current information on standard precautions?CDC
FDA
NAACLS
CDC
OSHA
54
A delta check is:
used to confirm the validity of patient results.
the degree of calibration needed for an instrument.
the act of checking and rechecking results prior to reporting.
a shift or a trend in control values.
55
Which order would you draw a type and screen, electrolytes, and coagulation tests.
Coagulation tests, blood type and screen, electrolytes
Blood type and screen, coagulation tests, electrolytes
Coagulation tests, electrolytes, blood type and screen
Electrolytes, blood type and screen, coagulation tests
56
Upon entering a patient room, you encounter a fire in the waste container. The FIRST thing you should do is:
rescue those who need immediate help.
activate the fire alarm or phone in the alarm.
extinguish if possible.
contain the fire as much as possible.
57
When friction cleaning the blood culture site, the site is allowed to air dry. Why?
To allow for the circular cleaning
To eliminate the need for another cleansing
So the antiseptic has time to kill the germs
To be able to retouch the site
58
Which of these events occurs LAST after a blood vessel is injured?
Platelet plug formation
Fibrinolysis of the clot
Clot formation in the blood vessel
Spasm of the blood vessel
59
The term
phlebotomy
means:
cut into a vein.
drain blood.
draw blood.
dermal cut.
60
A patient needs peak-level therapeutic drug monitoring. What circumstances must be followed for a correct blood draw?
The specimen should be collected shortly after the medication is given.
The specimen should be collected at its lowest serum concentration.
The specimen should be collected just before the next dose is given.
The specimen should be collected at its highest serum concentration.
61
Just before insertion of a needle into a vein for blood collection, you should
Engage the safety device.
Remove the cap from the needle and inspect the needle for defects.
Hold the assembly so the needle will enter at a 60 to 75 degree angle.
Hold the assembly so the bevel of the needle faces downward.
62
Which part of the needle in the image is used to puncture the cap on evacuated tubes?
Part B
Part D
Part C
Part A
63
For forensic testing, the phlebotomist should:
wear a lab coat at all times.
wear gloves at all times.
wear goggles at all times.
wear a surgical gown and surgical gloves.
64
Discard tubes contain
an anticoagulant.
a clot activator.
a separation barrier.
nothing.
65
If a microcontainer is underfilled, it may have too much anticoagulant for the amount of blood collected. Outcomes?
It will not have enough anticoagulant and will cause microclot formation.
The entire specimen may clot.
Nothing will happen.
It will alter the anticoagulant-to-blood ratio and affect test results.
66
Your next patient states that you need to wear latex-free gloves. What type of precaution is this addressing?
Allergen exposure
Chemical exposure
Ergonomics
Standard precautions
67
55yr old male patient. The diagnosis code says, "pancreatic disorders." What 2 tests might you see ordered?
CMP, TSH
Amylase, lipase
Magnesium, phosphate
Ceruloplasmin, ammonia
68
Testing samples with a known amount of analyte is an activity of:
quality control.
post-examination testing.
quality assurance.
competency assessment.
69
The four basic elements in the communication loop are:
sender, message, receiver, and feedback.
receiver, message, listener, and feedback.
speaker, listener, sender, and message.
message, feedback, listener, and white noise.
70
Fibrinolysis is the stage of hemostasis in which
the blood vessel goes into spasm.
clotting proteins form a cell-trapping mesh
established clots are broken down.
platelets adhere to blood vessel walls.
71
Larger arteries branch off into smaller arteries. What are these smaller arteries called?
Venules
Capillaries
Veins
Arterioles
72
Which of the following may a patient have during a glucose tolerance test?
chewing gum
alcohol
food
water
73
Metabolic wastes in the blood are filtered through the:
bladder.
liver.
heart.
kidneys.
74
Blood has 3 types of formed elements: erythrocytes, leukocytes, & thrombocytes. What other term is used for thrombocytes
White blood cells
Platelets
Plasma cells
Red blood cells
75
You are required to draw blood for plasma chemistry tests. Which tube would you select for this blood draw?
Image B
Image C
Image A
Image D
76
If a heelstick is performed with the cut applied as pictured in this image, what may result?
Blood will not form drops, but rather run along the back of the heel.
The calcaneus may be punctured.
No adverse situations. This is the appropriate area for a heelstick.
Blood will clot before it can be collected.
77
Inpatient facilities where phlebotomists can work include all of the following EXCEPT:
physician office laboratories (POL).
rehabilitation centers.
nursing homes.
hospitals.
78
While the phlebotomist is collecting blood using the venipuncture method, the holder falls away from the needle. Why?
An artery was punctured instead of a vein.
The needle and holder were not made by the same manufacturer.
There was not enough vacuum in the tube.
The patient's blood pressure was very high.
79
The most commonly used vein for venipuncture in the antecubital area is the:
basilic vein.
brachial artery.
cephalic vein.
median cubital vein.
80
If an infant has several old puncture sites, you should:
use an area near the calcaneus.
attempt to find an unused area.
attempt a finger puncture.
use the most recently punctured area.
81
A sudden jump in control value results, though still in range, that continues for several days is a:
random error.
shift.
quality control error.
trend.
82
When a tube containing a thixotropic separator gel and blood is centrifuged, the gel moves to the
top and middle.
top.
bottom.
middle.
83
When collecting a dermal specimen into a microcollection container, why would you tap the container on a hard surface?
It will allow the specimen to clot.
It will cause the heavier cells to drop to the bottom.
It will distract the patient and cause less pain.
It will allow the blood to mix with the anticoagulant, if present.
84
Place the blood collection containers, represented by the stoppers in this image, in their proper order of draw.
2, 4, 1, 3
4, 3, 2, 1
1, 2, 3, 4
3, 2, 1, 4
85
Which of the following bacteria have become resistant to antibiotics? (Choose all that apply)
Clostridium difficile
Staphylococcus aureus
Enterococci
Pseudomonas aeruginosa
86
Which of the following actions is against OSHA policies because it may result in a needlestick injury?
Keeping fingers out of the path of needle insertion
Placing an uncapped needle down on the table
Engaging the engineering control upon withdrawal of the needle from the arm
Jamming a used needle down into a full sharps container
87
This image represents test values that are:
accurate but not precise.
precise but not accurate.
both accurate and precise.
neither accurate nor precise.
88
If legal documents for a blood alcohol specimen haven't been completed before the blood draw, the phlebotomist can:
called to testify in court.
sued for assault and battery.
sued for assault.
sued for battery.
89
Which part of the heart pumps oxygenated blood to the entire body?
Septum
Left ventricle
Left atrium
Right ventricle
90
The white box represents additional hazards. What does the “W" mean?
No chemicals needed
Reactive with water
No waste
No water used
91
What is the purpose of the part of this needle assembly marked “E”?
It keeps the needle sterile before the blood draw.
It covers the needle after the blood draw.
It holds the needle assembly together.
It keeps the needle sharp before the blood draw.
92
If all types of tubes are used for a blood collection, the potassium oxalate tube would be which number in the order
7th
6th
9th
2nd
93
Where does gas exchange in the tissues occur during blood circulation?
Capillaries
Heart
Veins
Arteries
94
The antiglycolytic agent in a gray-stoppered blood collection tube is:
heparin.
sodium fluoride.
EDTA.
potassium oxalate.
95
Which layer or layers of the skin contain blood vessels? (Choose all that apply)
Epidermis
Cutaneous
Dermis
Subcutaneous
96
Which of the dermal punctures in this image is performed correctly?
Neither of these
Image A
Image B
Both of these
97
The appearance of this blood smear is caused by using:
a slide with fingerprints on it.
unequal pressure on the spreader slide.
a chipped slide for the spreader slide.
a start-and-stop motion
98
When switching specimen from the collection container the phlebotomist splashes a specimen in their eye. What do you do?
Hand Sanitizer
Wash hands
eye wash station
Shower
99
A hematoma may form if the tourniquet:
is released before removing the evacuated tubes from the holder.
is tied upside down.
is not released before the needle is removed from the vein.
is tied too tightly.
