If a patient is having blood drawn for a prothromin time test, you might expect:

the patient to bleed for a long time

Which of these situations can result in hemoconcentration during venipuncture?

leaving the tourniquet on over 1 minute

After applying a tourniquet, small red spots appear on the patients arm. These spots are a sign that:

the site may be bleeding excessively

Which of these would be the best choice of equipment for drawing blood from a small hand vein?

a 23 gauge needle and ETS holder

Which of these would be most likely to allow reflix to occur during venipuncture?

filling the tube stopped end-first

Which of these represents the proper capillary specimen collection technique?

touch the scoop to the blood drop, not the skin surface

You have made 2 unsuccessful attempts trying to draw blood, what do you do next?

ask another phlebotomist to collect it

Why would an infant bilirubin specimen be obtained in an amber-coloured tube?

to protect the specimen from light

The purpose of royal blue top tubes is to:

minimize contamination of trace elements

You have drawn blood into a blue topped tube but the tube is only half full. You should:

repeat the procedure with a new blue topped tube

Patient is very anxious about having her blood drawn, afraid of needles. You dont have much experience. What do you do?

ask an experienced phlebotomist to perform the draw for you

You are asked to collect a blood specimen from an inpatient but the patient is not wearing an ID band. What do you do?

ask the patients nurse to put an id tag on before you draw the specimen

If no blood enters the tube during a venipuncture, you should:

feel for the vein, then try to locate it with the needle

The corredct way to transfer blood from a syringe into a ETS tube is to:

safely remove the needle and attach a transfer device to fill the tube

You receive a specimen that is supposed to come with a chain of custody form. The form is missing, what should you do?

ask for a new specimen to be collected

What is the best approach to use on an 8 year old who needs to have blood drawn?

explain the draw in simple terms and ask for the childs cooperation

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MLPAO Specimen Procurement, Processing and Data Collection

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Answers

1
Serum speciments can be collected in _____ top tubes.
green
light blue
pst
red
2
If a patient is having blood drawn for a prothromin time test, you might expect:
the serum to be very lipemic
to have difficulty filling the tube
the patient to bleed for a long time
the patient to be fasting
3
PKU tests are routinely performed on:
HIV patients
cancer patients
elderly patients
newborn infants
4
What is the reference range for glucose in CSF?
2.8-4.4 mmol/L
4.4-5.8 mmol/L
5.8-7.4 mmol/L
7.4-8.8 mmol/L
5
Why is it important to control the depth of the lancet insertion during heel puncture?
to avoid puncturing an artery
to avoid bacterial contamination
to prevent bone injury
to avoid puncturing a vein
6
Which of these situations can result in hemoconcentration during venipuncture?
mixing the specimen too vigorously
leaving the tourniquet on over 1 minute
partially filling a normal draw tube
drawing a large tube with a small needle
7
After applying a tourniquet, small red spots appear on the patients arm. These spots are a sign that:
that patient is taking an anticoagulant
the tourniquet is too tight
the site may be bleeding excessively
the tourniquet is in the wrong place
8
Which of these should a patient avoid eating before a fecal occult blood test?
popcorn
red meat
fish
whole wheat bread
9
What additive do dark green top tubes contain?
heparin
sodium citrate
potassium oxalate
EDTA
10
Which of these is an appropriate site for venipuncture?
the aorta
the median cubital vein
the radial vein
the internal carotid
11
Bright red blood that spurts into a vacutainer indicates:
a high hematocrit
low hemoglobin
a low blood pH
an arterial puncture
12
You have mixed up two specimens. What should you do?
retake both specimens
continue regardless
ask the nurse to identify the specimen
ask the patient which one is theirs
13
You have to draw blood from a nervous patient. What should you do?
be friendly and confident
tell the patient to calm down
rush through the procedure to get it over with
cancel the requistion and send them home
14
Which of these would be the best choice of equipment for drawing blood from a small hand vein?
a 21 gauge needle and syringe
a 25 gauge butterfly and syringe
a 23 gauge needle and ETS holder
a 22 gauge needle and ETS holder
15
Which is the best anticoagulant for a bone marrow aspirate to be sent for a cytogenetic study?
sodium fluoride
3.2% tri-sodium citrate
EDTA
sodium heparin
16
Which of these can be used instead of a tourniquet?
nicotine patch
fentanyl patch
cotton wool
blood pressure cuff
17
Clean catch urine specimens are necessary when testing uring for:
bacteria
bilirubin
occult blood
glucose
18
Which of these would be most likely to allow reflix to occur during venipuncture?
lateral redirection of the needle
filling the tube stopped end-first
using the wrong order of draw
tourniquet release on blood flow
19
Which of these needles has the largest diameter?
20
21
18
19
20
Throat swabs are often taken to diagnose:
hepatitis
herpes zoster
streptococcus
bleeding ulcers
21
Which of these specimens would lead you to suspect that the patient was not fasting when the specimen was collected?
pale-yellow plasma
yellowish-brown serum
cloudy white serum
pink to redish plasma
22
Which of these represents the proper capillary specimen collection technique?
squeeze the finger hard to get the very best blood flow
puncture the skin parallel to the whirls of the finger print
touch the scoop to the blood drop, not the skin surface
clean the site with alcohol and wipe ot dry so it will not sting
23
You have made 2 unsuccessful attempts trying to draw blood, what do you do next?
ask another phlebotomist to collect it
try to draw it one more time
ask the patients nurse to do the draw
collect it by arterial puncture
24
Lavendar top collection tubes are used for:
ummunology tests
hematology tests
glucose determinations
microbiology tests
25
Pipetting of biological specimens by mouth is:
hazardous and unacceptable
more accurate
necessary when collecting capillary samples
permissible if one is careful
26
Urine samples for culture should be collected in:
containers containing an anticoagulant
sterile containers
containers cleaned with disinfectant
narrow mouthed containers
27
For which of these tubes is the blood to additive ration most critical?
red top
lavendar top
green top
light blue top
28
A vacutainer tube with a dark blue stopper would most likely be used for:
prothrombin time
blood banking
trace elements
chlosterol
29
Plasma for stat chemistry specimens is collected in ______ top tubes.
green
red
black
light blue
30
Which of these tubes contain and anticoagulant that works by binging calcium?
green top
pst
red top
light blue top
31
Which of these tests is collected first during a single capillary puncture?
cbc
electrolytes
phosphorus
glucose
32
Why would an infant bilirubin specimen be obtained in an amber-coloured tube?
to identify it as a bilirubin specimen
to slow the rate of glycosis
to protect the specimen from light
to flag it as a capillary specimen
33
What colour tube is used for blood bank test?
pink
dark blue
red
pink
34
The main reason a capillary puncture site is warmed beforehand is to:
delay clotting
reduce hemoconcentration
minimize contamination
increase blood flow
35
A patient has a mastectomy on the left side, IV midway down right arm. Where is the best place to do venipuncture?
on one of the patients legs
above the IV on the right arm
in the left hand or wrist
below the IV on the right arm
36
You are taking an arterial puncture. What is the first area of the patients body you should examine for a suitable site?
the thumb side of the wrist
the brachial artery
the femoral artery
the antecubital area of both arms
37
The time is 3:50 pm. You have received these test requests on different patients. Which should you collect first?
cortisol ordered for 4:00pm
post hemoglobin
fasting glucose
CBC ordered STAT
38
The purpose of royal blue top tubes is to:
minimize contamination of trace elements
encourage blood to clot
prevent blood from clotting
prevent glucose from breaking down
39
What is the maximum lancet size for heel punctures on babies?
2.4 mm
3.4 mm
1.4 mm
4.4 mm
40
You have drawn blood into a blue topped tube but the tube is only half full. You should:
pour a little from a red tube into a blue one
repeat the procedure with a new blue topped tube
mark the tube QNS
fill another blue topped tube partly full and mix the two tubes
41
Patient is very anxious about having her blood drawn, afraid of needles. You dont have much experience. What do you do?
use an ice pack to numb the area before drawing the specimen
ask an experienced phlebotomist to perform the draw for you
tell her that its not a big deal and that she shouldnt be afraid
explain to her that you will use a small needle that barely hurts
42
You are asked to collect a blood specimen from an inpatient but the patient is not wearing an ID band. What do you do?
ask the patients nurse to put an id tag on before you draw the specimen
ask the patients name and collect the specimen if it matches the requistion
identify the patient by the name card on the door
refuse to draw the specimen and cancel the request
43
If no blood enters the tube during a venipuncture, you should:
immediately call for help
feel for the vein, then try to locate it with the needle
change to pedictric tubes
probe around
44
The corredct way to transfer blood from a syringe into a ETS tube is to:
hold the tube carefully and insert the needle through the tube stopper
discard needle, open tube, slowly eject blood into it
safely remove the needle and attach a transfer device to fill the tube
place the tube in a race and inser the needle through the stopper
45
You receive a specimen that is supposed to come with a chain of custody form. The form is missing, what should you do?
go ahead with the test anyway
use a chain of custody form from a specimen of a different patient
ask for a new specimen to be collected
fill out a new chain of custody form yourself
46
Which of these tests requires arterial blood?
Glucose
ABG
Bilirubin
Electrolytes
47
Which tubes should be filled last?
green top
blood culture bottles
light blue top
purple top
48
To perform an arterial draw, you need a heparin solution, sterile gauze, betadine wipes, a sterile needle & syringe & ..
sugar solution
ice water
alcohol wipes
a butterfly needle
49
Stool specimens for O&P should be collected in a jar containing:
a buffer
agar
sodium hypochlorite
SAF fixative
50
What is the best approach to use on an 8 year old who needs to have blood drawn?
have someone restrain the child and collect the specimen
tell the child it wont hurt and will only take a few seconds
explain the draw in simple terms and ask for the childs cooperation
offer the child a treat or toy if she does not cry
51
Which vacutainer tube is used to collect and seperate serum?
sst
lavendar
light blue
green
52
Which of these tubes contains EDTA?
grey
sst
lavendar
light blue
53
The best way to judge the patency of a vein is to:
press and release it several times to determine resilience
feel it to determine the strength of the pulse
ask the patient how their vein feels
palpate above and below where you first feel it
54
Which of these is a normal blood creatinine level for an adult male?
3.0 mg/dL
4.0 mg/dL
1.0 mg/dL
2.0 mg/dL
55
A patients arm is in anatomical position. There appears to be a loop, buzzing between the wrist and elbow. What is it?
PICC
sclerosed vein
AV graft
implanted port
56
A patient has a mastectomy on the right side. What special precaution is needed when drawing blood?
make sure the patient is lying down
make sure the patient is sitting
dont draw blood from the right arm
dont draw blood from the left arm
57
Which of these tests would most be affected if the patient is not fasting?
glucose
cbc
blood culture
cardiac enzymes
58
Which of these vacutainer tubes does not contain an anticoagulant?
green
yellow
light blue
red
59
Venipuncture needles are colour-coded according to their:
gauge
manufacturer
length
expiration date
60
You need to draw blood into a grey, gold and lavendar top tube. What is the correct order of draw?
gold lavendar grey
grey gold lavendar
lavendar gold grey
gold grey lavendar
61
Urine, breath, and which other sample is used for ketone testing?
blood
sputum
sperm
stool
62
Which of these specimens would most likely be rejected for testing?
a hemolyzed potassium specimen
an icteric bilirubin specimen
an underfilled serum tube
a non fasting glucose specimen
63
Why must you clean the skin before a venipuncture?
to provide a wet surface for the needle to stick to
to remove microorganisms from the puncture site
to cause the veins to be more pronounced
to allow blood flow to the area
64
When performing venipuncture with a syringe, what could happen if you pull the plunger too quickly when drawing?
adulteration of the specimen
a needle stick injury
hemolysis of the specimen
bacterial contamination
65
What might happen if an angle of 8 degrees is used when performing venipuncture?
the needle may go completely through the vein
the needle may enter above the vein
a deep hematoma might form
the needle may go through the posterior wall of the vein
66
Underfilling which tube will most likely result in a hemolyzed specimen?
light blue top
sst
grey top
edta tube
67
When preparing blood smears, at what degree should the spreader slide be?
90 degrees
30 degrees
15 degrees
45 degrees
68
There are several short lengths of IV type tubing protruding from a patients chest. This is most likely a:
arterial line
CVC
PICC
implanted port
69
A "stat" glucose should be performed:
immediately
2 hours after the last meal
only on fasting specimens
within 1 hour
70
When performing a heel puncture, care must be taken not to hit the ________ with the lancet.
thigh bone
metatarsal
shin bone
heel bone
71
Which of these is a classic sign that a patient is scared and nervous?
steady breathing
a pulse of 70 bpm
sweating
making small talk
72
Which of these is the safest area of an infant's foot for a capillary puncture?
the lateral plantar heel surface
the posterior curvature of the heel
the medial area of the arch
the central area of the heel
73
Glucose tests use _______ top collection tubes.
grey
lavendar
green
light blue
74
A technician draws blood from a patient and then wraps the tube in aluminum foil. What analyte is being tested?
urobilinogen
bilirubin
PTT
albumin
75
A grey top vacutainer can be used to collect a specimen for:
ptt
glucose
bilirubin
TSH
76
You are doing venipuncture ona difficult vein using a butterfly. You have an SST and a light blue to collect. Order?
collect and mix the sst before filling and mixing the light blue top
collect and mix the light blue top before filling and mixing the sst
draw half of the sst, then fill and mix the light blue, then finish the sst
draw a clear tube, fill and mix the light blue, then fill and mix the sst
77
Which of these is a recommended site for finger puncture for adults?
the proximal segment of the ring finger
the end segment of the little finger
the distal segement of the middle finger
the plantar surface of the index finger
78
24 gauge needles are used for:
diabetics
infants
obese patients
patients with AIDS
79
You insert a needle, engage tube and no blood flows, you make subtle adjustments and nothing. What is the next step?
try a new tube in case its a vacuum problem
keep redirecting the needle until you hit a vein
discontinue the draw and try somewhere else
lift the needle to create a steeper angle
80
Grey vacutainers contain:
thrombin
flouride and edta
flouride and oxalate
sodium heparin and edta
81
There are 2 patients in a room, one has a latex allergy, you need to collect blood from the other patient.
do not take anything that contains latex into the room
ask the patient with the allergy to wear a mask until you leave
proceed as usual
pull the curtain between the beds and proceed as usual
82
What sample is needed for the hemoccult test?
stool
sputum
sweat
blood
83
You have to draw a glucose analysis from a patient who has a IV on his left wrist and a cast on his right... where?
an earlobe
the left median cubital
a vein in the left hand
the right median cubital
84
Which of these vacutainer additives provides a physical barrier to prevent glycolysis?
silica
edta
thixotropic gel
sodium flouride
85
You are frawing blood from a patient you think is named John Smith but are not sure, what is the best way to confirm?
"Can you confirm that you are John Smith please?"
"Is your name the same as it is written here on this form?"
"What is your name?"
"Are you John Smith"
86
You have a spcimen that must be kept at room temp. What is room temp?
20-25 degrees celcius
10-15 degrees celcius
40-45 degrees celcius
30-35 degrees celcius
87
The most frequently collected lab specimens are:
blood, urine and swabs for culture
feces, CSF and semen
blood, urine and feces
swabs for culture, tissue samples and amniotic fluid
88
Identify the false statement regarding 24 hour urine collection.
testing is done in clinical chemistry
the last time specimen is included
collections during the night are discarded
a preservative may be used for some tests
89
What is the outer diameter of a 21 gauge needle?
0.2mm
0.8mm
0.4mm
0.6mm

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