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WVUP NHA Phlebotomy Exam 2021-2022 Flashcards | StudBud
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WVUP NHA Phlebotomy Exam 2021-2022
WVUP NHA Phlebotomy Exam 2021-2022
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1
Which of these do not require a chain of custody
Blood alcohol level test
Paternity testing
HIV screening
Toxicology screening
2
What is a critical lab value
A physiological value that is used to assess a patient’s response to drugs
A value that is critical to the therapeutic management of a patient
An abnormal value that possesses immediate risk to the patient’s health
A value that is used to assess analytic errors in hematology samples
3
The dark green top tube is suitable for all these tests except
Serum calcium
Arterial blood gases
Parasite speciation
Serum sodium
4
Which is false about room temperature
Ranges from 15-30 degrees C
Samples for CBC cannot be kept at room temperature more than 24 hours
Same as the temperature in the laboratory
Specimens kept at room temperature are expected to be promptly processed
5
Mistakes and identification can cause which of these errors
Post analytic errors
Analytic errors
All of the above
Pre-analytic errors
6
Concerning lipemic samples which is correct
It is caused by the presence of bile acids in the blood samples
It can be corrected by centrifuging the samples
They are sources of analytic errors in the laboratory tests
It can be avoided by an overnight fast or at least 10 hours
7
Which of these guidelines is not useful in chain of custody
Use at least two patient identifiers for sample collected
Have a minimum of 10 people handling the specimen
Obtain signatures on the transfer of the specimen
Store samples in the appropriate containers and bags
8
Which is not an allergen for a patient during phlebotomy
Chlorhexidine gluconate
Steel needles
Latex gloves
Povidone iodine
9
Which is incorrect concerning a phlebotomy procedures
Apply a tourniquet about 2 to 4 inches about above the site
Swab the skin with 70% isopropyl alcohol in CHG for over 30 seconds
Place a finger over the vein to guide the shaft of the needle
Inspect the ante-cubital fossa of the arms or the veins in the forearm
10
Which is a critical value of a 50 year old man who just did a fasting plasma glucose with a glucometer
5.5mmol/L
4mmol/L
7.5mmol/L
2.5mmol/L
11
Which of these tubes is useful for serum electrolyte, urea, and creatinine
Lavender top tube
Purple top tube
Light green top tube
Red top tube
12
Which reduces the incidence of sharp’s injury
Discarding uncapped needles into sharps container
Prophylactic administration of hepatitis B vaccines
Activate safety device before use
Emptying sharps container when 1/3 full
13
Which is correct concerning a closed blood sample system
It is not routinely used in phlebotomy procedures
It involves the use of vacuum extraction tubes
Not suitable for arterial blood sampling
can’t be used for collecting multiple samples from a single venipuncture
14
Which is not a requirement of informed consent
Voluntariness
Competence
Disclosure of information
Level of education
15
Which of these conditions cannot be managed by albumin infusion
Cirrhosis
Anemia
Nephritic syndrome
Severe burns
16
Which is not required for routine venipuncture
Isopropyl alcohol
Iodine
Tourniquet
Vacuum tubes
17
Which is the most preferred venipuncture site
Antecubital fossa
Dorsum of the hand
Forearm
Dorsum of the foot
18
Which is not a use of a peripheral blood film
To assess clotting factors
To evaluate malaria parasites
To assess the cause of hepatosplenomegaly
To assess neutrophilia
19
Which of these is true concerning inborn errors of metabolism
An example is phenylketonuria a disorder of amino acid metabolism
Autosomal recessive disorders that affect metabolic processes
Autosomal dominant disorders that affect metabolic processes
An example is glycogen’s disease which causes a defect in red blood cells
20
A patient with hemophilia will most benefit from which of these blood components
Albumin
Cryoprecipitate
Platelets
Red blood cell
21
Which can increase the potassium content of the blood sample
Isopropyl alcohol
Povidone
Tincture of iodine
Clorhexedine gluconate
22
Concerning red blood cells which of these is false
Red blood cells have a lifespan of 60 days
It is the oxygen carrying component of the blood
Red blood cells make up about 43% of the blood volume
A single drop of blood contains 5 million red blood cells
23
Which is the correct method of peripheral blood film
Easiest and most common way of making blood films
Requires a level of dexterity and coordination
It forms star-shaped smears
Uses one glass slide and 1 capillary pipette
24
Which of these is not a usual complication of Vena puncture on the upper limb
Hematoma
Deep vein thrombosis
Phlebitis
Petechiae
25
Which is not correct about the principles of workplace safety?
Promotes the avoidance of potential hazards at work
Important for optimizing work-place conditions
The employee is responsible for promoting health & safety at work
Created by OSHA & NIOSH
26
Which of these is a critical PT/INR Ratio for a 50-year-old woman on warfarin therapy
2.5
2.0
3.5
3.0
27
Which best describes the impact of stress on phlebotomy procedures
Increased risk of blood clots
Increased risk of Hemolysis
Increased serum cholesterol
Increased risk of bleeding
28
Which best describes the inversion process after blood collection
Turning the bottle around 360° to the starting position
Turning the vacuum extraction tube around 360° to the starting position
Turning the blood bottle around 180° to the starting position
Turning the vacuum extraction tube around 180° to the starting position
29
Which of these is not a component of needlestick safety and prevention act
Regularly updating the exposure control plan
Providing needles with engineering controls
Protecting patience from blood-borne pathogens
Educating employees on the use of medical equipment
30
Define a physiological state with steady equilibrium of internal functions is maintained
Homostasis
Homeostasis
Basal state
Steady state kinesis
31
Which is incorrect
Thin films used to view blood cells;thick film are not
Thin film smeared using wedge technique;whole thick film not smeared
Thin film used for parasite speciation;thick for parasite quantification
Thin films not fixed in methanol;whole thick films fixed in methanol
32
Which of these is not a characteristic a point of care testing
Laboratory test that is done with automated systems
Glucometer
A laboratory test that has a minimal risk of error
A laboratory test that is done close to the patient’s point of care
33
Which of these is a type of CLIA-waved tests
Partial thromboplastin time
Erythrocyte sedimentation rate
Blood culture
CBC
34
The correct coverslip technique of peripheral blood film
Popular way of making peripheral blood films
Requires the use of a capillary pipette
Requires use of 2 coverslips & 1 glass slide
Requires the use of Pasteur pipette
35
Which of these best describes the difference between serum and plasma
Serum does not contain fibrinogen while plasma does
Serum does not contain albumin while plasma does
Serum contains fibrinogen while plasma does not
Serum contains albumin while plasma does not
36
Which is an antiseptic that is not used for 1- month old routine venipuncture
Tincture of iodine
Povidone-iodine
Isopropyl alcohol
Chlorhexidine gluconate
37
First stage of patient preparation for Venipuncture
Introduce yourself to the pt
Explain the procedure to the pt & get expressed consent
Confirm the indication for the procedure
Confirm the Pt identifiers
38
In preparing to collect a fasting plasma glucose which information is necessary
Chronic use of marijuana
Overnight fasting for 14 hours
Allergies to latex
BMI of 23kg/m2
39
Concerning the blood order of draw which is incorrect
The sodium citrate tube is filled before lithium heparin
The gold top tube is also called the serum separator tube
The blood culture bottle is the first bottle in the order of the draw
The oxalate bottle is the last tube in the order of the draw
40
Which is not an example of a good blood smear
Evenly spread to cover the entire slide
Shaped like a tongue
Gradual transition from thick to thin areas
Has no lines and holes
41
Which can increase the risk of clotting of blood samples
Using a small hypodermic needle
Overfilling blood collection tube
Inverting the test tube vigorously
Collecting an inadequate blood sample
42
Which of these best describes blood group systems
They are used to classify white blood cell antigens
They are used to classify red blood cell antibodies
They are used to classify plasma antigens
They are used to classify red blood cell antigens
43
Which does not cause a false-negative blood culture
Collecting sample after administering IV antibiotic
Collecting samples from a central line
Collecting insufficient blood sample
Collecting samples contaminated with chlorhexidine
44
Which is incorrect in preparation of whole blood samples
Centrifuge the specimen for 5-10 minutes
Gently invert 5-8 times
Collect blood samples in an EDTA bottle
Store the blood specimen in room temperature
45
Which of these is the role of the phlebotomist in patient care
Two-hourly turning of a bedridden patient
Primary health education and prevention of streptococcus infection
Commencement of chest physiotherapy for orthostatic pneumonia
Therapeutic communication techniques in obtaining informed consent
46
The light blue top tube is suitable for all tests except
Platlet count
Partial thromboplastin time
Erythrocyte sedimentation rate
Prothrombin time
47
When applying antiseptic agent to venipuncture site
1-step use 70% isopropyl alcohol in tincture of iodine
1-step use Povidone-iodine
2-step use 70% isopropyl alcohol for 30sec then Povidone for 30sec
2-step use 70% isopropyl alcohol for 30sec then CHG for 30sec
48
Which is incorrect regarding freezing blood specimens
Blood samples for freezing must be centrifuged and shared in aliquots
They are usually transported in biohazard bags that are colored red
Blood samples should be frozen in plastic tubes
Specimens for CBC should not be frozen
49
Which record is not mandated by OSHA as part of the bloodborne pathogen standard
Training records
Drug use history
Incident records
Sharps records
50
The purple top tube is suitable for all these except which
Peripheral blood film
Arterial blood gases
Erythrocyte sedimentation rate
CBC
51
Which step is false in preparation of serum samples
Do not keep tourniquet on for more than 1 minute
Avoid lipemic samples by collecting samples in the basal state
Centrifuge samples within 2 hours of venipuncture
Collect blood samples in light blue top tubes
52
Which of these is not a use for platelets
Aplastic anemia
DIC
Chronic anemia
Bone marrow transplant
53
Which sample requires storage in a dark aliquot bottle
Cerebrospinal fluid
Plasma
Whole blood
Urine
54
Which is not a technique of making peripheral blood smears
Glass slide technique
Wedge technique
Automated slide making
Coverslip technique
55
Pediatric blood sample which is true regarding blood volume
Specialized pediatric culture bottles keep blood to broth ratio
The recommended volume of blood is 10-15ml
At least 1ml of blood be be collected for all pediatric patients
The amount of blood required depends on patient’s clinical status
56
Which of these tubes is appropriate for a two hour postprandial test
Light blue top tube
Purple top tube
Gray top tube
Dark green top tube
57
Which is a quality control measure for pre-analytic errors
Equipment maintenance documentation
Centrifuging and aliquoting of blood specimens
Installation of error alerts on laboratory equipment
Use of laboratory information systems
58
Which of these is a critical value for a patient with end stage renal failure
Hemoglobin-6g/L
Creatinine-150mmol/L
Potassium-5.5mmol/L
Sodium-125mmol/L
59
Which best describes a hematoma
Benign swelling of the blood vessels
Accumulation of blood in tissue spaces
Inflammation of the basement membrane of a vein
Bleeding under the skin caused by broken capillaries
60
A 41-year-old is scheduled to do a fasting plasma glucose how long are they expected to fast
24 hours
12 hours
Four hours
Six hours
61
Which is not a standard operating procedure in phlebotomy
Pt identification and communication
Use of single-use sterile gloves
Prep of skin with 70% is isopropyl alcohol
Use of single-use needles, sharps,lancets
62
Which is correct concerning the tube for coagulation
It is used for cross matching in blood banks
It must have a blood to additive ratio of 9:1
It has a dark green top
It is known as the EDTA tube
63
Which guideline is useful to prevent physical hazards in the lab
Provision of safety-engineered needles and sharps
Provision of hand gloves for human tissues
Prompt replacement of fraying electric cords
Provision of ear buds for loud noise
64
Which of these is not useful in reducing the risk of sample Hemolysis
Using a 23 gauge needle for routine collections
Not collecting a blood specimen from a hematoma
Not removing the needle from the vein if its vacuum tube is engaged
Not Centrifuging A blood sample for more than 10 minutes
65
Which of these is correct about plasma
About 50% of plasma is made up of water
Plasma does not contain factor VII
It does not contain fibrin molecules
It makes up about 55% of the blood
66
Which of these is correct about the bevel up technique
It punctures a vein at a 45° angle
Punctures the vein at a 60° angle
Punctures the vein at a 30° angle
It punctures the vein at a 15° angle
67
Concerning transfusions are red blood cells which of these is false
Red blood cells are indicated for patients with severe hemorrhage
Red blood cells are stored in acid citrate dextrose
Red blood cells do not contain clotting factors
A unit of red blood cells increases the hematocrit by 10%
68
A source of contaminate during a venipuncture for a blood culture
Guiding the needle with the index finger and thumb
Cleaning the tops of the blood culture covers with isopropyl alcohol
Swab skin with isopropyl alcohol & iodine
Use thumb & index finger to control the flow of blood into the bottles
69
Regarding blood cultures which is false
Adult pt. each culture bottle inoculated with 5-10ml of blood
Vascular access devices are susceptible to colonization by flora on skin
Rate of isolation of pathogens proportional to quantity of blood sample
False-negative results can arise from IV administration of antibiotics
70
Which is not useful when forming a good introduction to a pt
Addressing pt with medical records number
Finding a common ground to form a connection
Understanding pt hierarchy
Making eye contact
71
Which of these best describes laboratory information system
A system that gives information on pre-analytic errors
A system that records, manages, and stores data for clinical laboratories
System that stores information on the maintenance of laboratory equipment
An automated system that stores a patient’s medical records
72
Which of these is true concerning white blood cells
They are the smallest blood cells
A healthy individual has more white blood cells then red blood cells
There are about 15,000 white blood cells per cubic milliliter of blood
They make up the Buffy layer of a centrifuge blood sample
73
Which requires recording of custody, transfer, analysis, disposition of physical and electronic evidence
Incident report
Chain of custody
Exposure control plan
Confidentiality act
74
Which of these is not a function of a phlebotomist
Collecting blood and non-blood specimens
Point of care testing at prisons
Preparing laboratory specimens for testing
Commencing therapeutic management
75
Which of these principles is false in Phlebotomy
The tourniquet is applied 2 to 4 inches above the selected vein
The phlebotomist has a maximum of three attempts at venipuncture
76
Which is matched incorrectly
Safety hazards-loose electric cord on the floor
Chemical hazard- regent spills on work surfaces
Biological hazard- needle prick injuries
Psychological hazard-difficult blood draw on a restless patient
77
Which is not a roll of phlebotomist in quality control of blood samples
Use of a dipstick urinalysis for serum potassium
Preparation of peripheral blood smears using the wedge technique
Transportation of semen samples at room temperature
Collection of blood samples for coagulation studies in the lavender bottle
78
Which is not done in the hematology lab
Complete blood count
HbA1c
Peripheral blood count
Hemoglobin
79
With venipuncture on the Dorsum of the hand which is not helpful
Do not select a vein that is branching out
Choose straight vein
Anchor the vein by placing thumb above puncture site
Choose bouncy vein
80
Which is not useful in identifying patients
Using automated systems to minimize error
Using two identifiers include a name age medical record number
Using nonverbal communication techniques for confused patients
Encouraging active participation from the patient and their caregivers
81
Venipuncture for bacteremia which is correct
Collect sample before and 24 hours after starting antibiotics
Collect when patient has chills and rigor
Collect sample when patient has a spike in temperature
Collect 4 samples 12 hours apart before giving antibiotics
82
Which is incorrect which is incorrect
Blood smear Samples are stored in EDTA tubes
Blood smears should be made within 8 hours of collection
Each sample should have 2-3 blood smears
Blood smears are made from centrifuged blood
83
All these are useful tips in filling a requisition form except
The physician must provide their complete information and NPI
Fill up all the patient’s information
Use a requisition form for each laboratory test
84
You collected an insufficient blood for a pediatric blood culture best choice
Inoculate the aerobic bottle first
Discard the blood sample & start again
Inform the ordering physician
Inoculate the anaerobic bottle first
85
Which of these is correct about platelets
They contain clotting factors
They are smaller than both the red blood cells and white blood cells
They are responsible for maintaining homeostasis
They make up the Buffy layer with red blood cells
86
Records mandated by OSHA
Kept by employer for at least 8 years after employee’ departure
Should only contain sharp injury,brand of sharps,location,time
Are protected by HIPPA guidelines of protected information
Are available to employer without the employee’s knowledge
87
The correct order of draw for serology, blood culture, and coagulation is
Blood culture, serology, coagulation
Coagulation, serology, blood culture
Serology, blood culture, coagulation
Blood culture, coagulation, serology
88
What is the full meaning of a ACD
Acid citrate dextran
Acid citrate dextrose
Acetyl citrate dextrose
89
Which is not useful in applying & removing a tourniquet
The tourniquet should be placed 2-4 inches above the site
The needle should be removed before the tourniquet
The vein should be visible before the tourniquet is applied
The tourniquet should be applied before swabbing the skin
90
Which is incorrect regarding blood cultures
2 sets of culture bottles filled with blood from 2 different sites
Winged collection aerobic bottle first
Needle/syringe anaerobic culture bottle first
The standard blood to broth ratio is 1:3
91
Which of these best describes a Guthrie test
It is best done with blood collected via a femoral tap
It is also known as the heel prick test
About to drops of blood are sufficient
It is done to screen neonate for insulin-dependent diabetes
92
Which is not normal finding in a peripheral blood film
Mast cells
Erythrocytes
Basophils
Neutrophils
93
Which is an example of negligence
Clotting of blood samples due to inadequate blood volume collection
Assessing a patient’s medical records without their consent
Forgetting to remove the tourniquet after phlebotomy
Using physical restraints for Venipuncture on a non-compliant patient
94
Which is incorrect regarding maintenance of laboratory equipment
Troubleshooting of malfunctioning equipment
Use of error alerts on laboratory equipment
Regular phlebotomist training on maintenance and repair of equipment
Developing standard operating procedures for laboratory equipment
95
Which is not a complication of prolonged tourniquet application
Hemodilution
Hemoconcentration
Nerve injury
Ischemia
96
Which is not a clinical feature of septicemia
Hemorrhage
Fever
Hypotension
Chills
97
Which of these best describes cryoprecipitate
A substrate of fresh frozen plasma that does not contain fibrinogen
It contains an anti-hemophilic factor
It is preferred plasma expander
It is made by thawing fresh frozen plasma at 10°C
98
Which of these steps in Phlebotomy is incorrect
Hand hygiene before starting procedure
Applying a tourniquet at least 3 to 4 inches above the selected vein
Discard uncapped needles into sharps container immediately after use
Swabbing the skin before selecting a vein
99
All of these are examples of OPIMs except
Urine
Semen
Cerebrospinal fluid
Vaginal secretions
100
Which of these is not a white blood cell
Megakaryocyte
Basophils
Mast cells
Eosinophils
