You discovered your GTT patient vomited in waiting room not more than 20min. after ingesting glucose solution. Proceed?

Call physician to see whether test should be continued or rescheduled

The following should be perf. to prev. moving of needle in patient’s arm as Phleb. Puts tube on&takes it off needle exc:

Anchor hand on patient’s arm while pulling tube straight out holder

Which of the following statements is true regarding collection of blood from children:

Newborns may need larger vol. blood drawn for adequate serum/plasma levels

Question is in the image above

Use the blood from the morning draw

Proper identification procedures for adults may differ from children and infants. Which methods are correct for infants?

Identify based on identification number of the baby

Squeezing or milking capillary puncture sites during collection process:

Contaminates specimen with tissue fluid and hemolyzed cells

You just removed needle fr.patient’s arm for routine admissions testing. Nurse asks you to leave. You should:

Tell the nurse you will leave as soon as the tubes are labeled

Draw an appropriate discard tube first, the collect the PT, PTT

Go to the nursing station and ask for the patient to be re-banded

Phleb. selects winged infusion setw/ syringe to draw fr. infant. After,Phleb. begins to transfer bloodto approp. tube by

Removing syringe fr. hub adapter&attaching a blood transfer device

Proper technique for filling a hematocrit is by:

Touching the drop and letting it fill by capillary action

When testing a 2-hr postprandial sample glucose, the patient who is diabetic would have a glucose level:

Higher than normal reference range

After cleansing puncture site, the phleb.should wait 30-60 sec. before inserting needle for following reasons except to:

Prevent hemoconcentration of the specimen

Proper collection of micro collection tubes include all of the following except:

Squeezing as you scrape upward to capture drop

Bright red blood is spurting into the tube causing you to suspect that you may have punctured an artery. How to proceed?

Complete the draw and level the specimen “arterial”

Blood collection procedures begins with?

Requisition or order for blood test

Proper procedure for collection on a newborn screening test is to:

Fill circle completely with 1 large drop of blood

The first drop of blood must be wiped away after the puncture to:

Prevent tissue fluid contamination

A new phlebotomist drew blood in AC, patient had IV in the hand of same arm. How would this affect test results?

Test result would be inaccurate. Blood would be diluted w/IV fluid

Verbal orders for lab tests must be followed up with a:

Written order in hard copy or electronic format

Question is in the image above

Distal to the hematomas and oozing puncture sites

Question in image above

Call down to lab for STAT delivery of heel warmer to nursery

When performing dermal puncture on the finger, puncture should be made:

Perpendicular to fingerprint ridges

Which of the following would be a reason for specimen rejection

Improper specimen handling after collection

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Phlebotomy Final (chapters 8-14)

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Questions 100

Answers

1
You discovered your GTT patient vomited in waiting room not more than 20min. after ingesting glucose solution. Proceed?
Call physician to see whether test should be continued or rescheduled
Stop the test, document and send patient home
Give patient another dose of glucose solution and continue
Continue, but document time when patient vomited
2
The following should be perf. to prev. moving of needle in patient’s arm as Phleb. Puts tube on&takes it off needle exc:
Apply forward pressure on adapter when removing the tube
Anchor hand on patient’s arm while pulling tube straight out holder
Use flanges on adapter to stabilize needle
Apply backward pressure on adapter when inserting the tube
3
Which of the following statements is true regarding collection of blood from children:
Pernicious anemia may result from repeated draws
VP is the recommended collection procedure
Removal of 5% blood volume may result in renal failure
Newborns may need larger vol. blood drawn for adequate serum/plasma levels
4
Which of the following test(s) are required to be performed by law on newborns in the U.S.
Glucose
PKU
Ammonia
Hepatitis B virus (HBV)
5
Question is in the image above
Document the patient’s refusal on the request
Notify the healthcare provider of the refusal
Use the blood from the morning draw
Explain that the procedure is necessary for treatment
6
Which of the following departments requires special identification bands for patients?
Hematology
Blood bank
Chemistry
Microbiology
7
Which of the following devices is not typically used for blood draw, because of collapsing tubes upon aspiration?
Implanted port
Hickman
PICC
CVC
8
Proper identification procedures for adults may differ from children and infants. Which methods are correct for infants?
Identify based on identification number of mother
Identify based on identification number of the baby
Identify based on social security number
Identify based on sex and last name (baby girl, Smith)
9
The phlebotomist must check fasting status of patient before performing VP. What is not prohibited during fasting?
Caffeine
Water
Nicotine
Glucose
10
Squeezing or milking capillary puncture sites during collection process:
Contaminates specimen with tissue fluid and hemolyzed cells
Increases efficiency of collection process
Helps form round drop of blood
Increases blood flow to site
11
Best area for site selection in geriatric patients:
Wrist
Forearm
Antecubital space
Hand
12
You just removed needle fr.patient’s arm for routine admissions testing. Nurse asks you to leave. You should:
Exit the room to finish up in the hallway
Leave and retuned to the lab to finish up
Tell the nurse you will leave as soon as the tubes are labeled
Call the lab and inquire how to handle the situation
13
Which of the following tests can be performed on blood that is collected by dermal puncture
Erythrocyte sedimentation rate
Blood culture
Thrombin time
BUN
14
Which of the following represents a safe % of blood volume that can be removed from an infant in a 24hr period ?
2%
5%
7%
10%
15
Extra tubes within arm’s reach in case tube needs to be replaced w/needle in patient’s arm, tray should be:
Windowsill
Floor
Patient’s bed
Night stand
16
Which of the following specimen collections does not require the collection of samples in pre-warmer tubes?
Cryoglobulin
Sedimentation rate
Cryofibrinogen
Cold agglutinins
17
Question is in image
Draw an appropriate discard tube first, the collect the PT, PTT
Redraw the patient for PT & PTT tests
Put the PT/PTT tube back on to see whether it will completely fill
Finish collecting last tube, then pop on another citrate tube
18
Question is in image
Continue with identification process since patient is now banded
Ask for extra identification verifiers before performing venipuncture
Call down to lab, explain what happened, ask how to proceed
Go to the nursing station and ask for the patient to be re-banded
19
Which of the following tubes require(s) a full draw?
Blue&gray tubes
Green tubes
Blue tubes
Purple tubes
20
The phlebotomist receives lab requisition and proceeds to use it for all of the following purposes except
Ensuring that necessary equipment is in the tray
Verifying patient identification
Assessing patient diagnosis
Determining specimens to be collected
21
Phleb. selects winged infusion setw/ syringe to draw fr. infant. After,Phleb. begins to transfer bloodto approp. tube by
Popping tops off the tubes&dispensing requiredtube volumes
Carefully inserting needle tip of butterfly into tube
Attaching needle on syringe&inserting it on handheld tube
Removing syringe fr. hub adapter&attaching a blood transfer device
22
The type of specimen used for STAT chemistry testing in the laboratory is:
Serum
Clotted blood
Plasma
Whole blood
23
Proper technique for filling a hematocrit is by:
Placing pipette directly on skin as the drop forms
Touching the drop and letting it fill by capillary action
Angling tube downward to let blood drip into it
Removing any air bubbles by flicking the tube
24
When testing a 2-hr postprandial sample glucose, the patient who is diabetic would have a glucose level:
Identical to baseline sample value
Higher than normal reference range
Identical to normal reference range
Lower than normal reference range
25
After cleansing puncture site, the phleb.should wait 30-60 sec. before inserting needle for following reasons except to:
Allow for maximum bacteriostatic action
Prevent hemoconcentration of the specimen
Prevent stinging at the point of needle entry
Avoid hemolysis
26
Most commonly used antiseptic used during blood collection procedures is:
Betadine
Alcohol
EMLA
Iodine
27
Proper collection of micro collection tubes include all of the following except:
Allowing blood to run freely into tube
Tapping lightly to move blood into tube
Squeezing as you scrape upward to capture drop
Touching scoop to drop of blood
28
Equipment for a dermal puncture to collect a sample for bilirubin testing on a newborn includes all but:
Lancet
Amber-colored microtainer tube
Providone-iodine
Warming device
29
Bright red blood is spurting into the tube causing you to suspect that you may have punctured an artery. How to proceed?
Immediately stop procedure and apply pressure
Redraw the specimen from a vein
All of the above
Complete the draw and level the specimen “arterial”
30
Blood collection procedures begins with?
Patient’s consent
Greeting patient
Requisition or order for blood test
Knock on the door
31
Which of the following is not a type of central venous catheter (CVC)?
PICC
Groshong
Broviac
Triple lumen
32
Level of drug that is drawn 30 min. before administration of next dose is:
Trough level
Therapeutic level
None of the above
Peak level
33
How long must a patient fast before beginning an oral glucose tolerance test?
6 hrs
12 hrs
10 hrs
2 hrs
34
Number of core newborn screening tests required by U.S. Secretary of Health & Human Services is:
35
22
29
15
35
Proper procedure for collection on a newborn screening test is to:
Fill circle completely with 1 large drop of blood
Apply 1 large drop of blood to both sides of filter paper
Suspend card vertically to air-dry
Touch the heel to filter paper several times to fill circle
36
Question is in the image above
Chain of custody
Specimen volume
Temperature of specimen
Specimen transportation
37
The first drop of blood must be wiped away after the puncture to:
Allow for round drop formation
Remove the platelet plug
Prevent tissue fluid contamination
Remove loose epithelial cells
38
When inserting a needle into hand vein using winged infusion set, correct angle is:
30-35 degrees
10-15 degrees
20-25 degrees
45 degrees
39
Phlebotomist should knock on patient’s door before entering:
When the door is closed
Every time
During visiting hours
When the physician is present
40
Patients who suffer from latex allergies may exhibit all of the following symptoms if a latex tourniquet is used. Except
Hives
Wheezing
Petechiae
Rash
41
A new phlebotomist drew blood in AC, patient had IV in the hand of same arm. How would this affect test results?
No effect.it was far enough away fr. IV site to negate effect
Only coag.results would be affected, w/longer or shorter clotting times
Hematology test result would be elevated bec. Concent. blood analytes w/ IV
Test result would be inaccurate. Blood would be diluted w/IV fluid
42
The use of anticoagulants will yield which type of blood specimen?
Plasma only
Plasma and serum
Whole blood and plasma
Whole blood and serum
43
Selection of type of skin puncture device is determined by the:
Supplies available
Size of micro collection tube
Phlebotomist’s preference
Age of patient
44
Question is in the image
Firing of the phlebotomist
Unnecessary treatment
Firing of the nurse
Incorrect diagnosis
45
Verbal orders for lab tests must be followed up with a:
Copy of the results faxed to physician’s office
Phone call verifying the request
Written order in hard copy or electronic format
Verbal confirmation by physician
46
Question is in the image above
Above the hematomas and oozing puncture sites
Off to the side of hematomas and oozing puncture sites
To go through the hematomas and oozing puncture sites
Distal to the hematomas and oozing puncture sites
47
Question in image above
Call down to lab for STAT delivery of heel warmer to nursery
Proceed w/out heel-warmer, but double stick heel for greater blood flow
Wet small towel or wash cloth, place in microwave to heat it
Fill latex or vinyl glove with hot water, place it on baby’s heel
48
When performing dermal puncture on the finger, puncture should be made:
Perpendicular to fingerprint ridges
Horizontal to whorls on fleshy pad
Parallel to edge of distal segment
Parallel with phalanges of finger
49
Which of the following would be a reason for specimen rejection
Specimen delivered via pneumatic tube system
Tube labeled using a black marker pen
Tube wrapped in aluminum foil
Improper specimen handling after collection
50
Normal daily fluctuations in body chem.related to hormonal cycles, sleep-wake cycles,& other reg. Patterns of change are
Diurnal variation
Therapeutic drug monitoring
Hyperglycemia
Septicemia
51
Collection of specimens for blood alcohol should be obtained using any of the following antiseptics, except:
Iodine
Cyclohexadine
Soap and sterile water
Alcohol
52
Life threatening blood infection by a multiplying pathogenic microorganism is known as:
Septicemia
Septic shock
Fever of unknown origin
Bacteremia
53
The needle gauge describes the diameter of the needle’s:
Shaft
Hub
Lumen
Bevel
54
Which of the following sample collections does not require transportation to the lab in chilled environment?
Gastrin
Ammonia
Vitamin A
Parathyroid hormone
55
The composition of capillary blood includes:
Venous and capillary
Venous and arterial
Capillary and tissue fluid
Arterial and capillary
56
The most commonly used antiseptic in routine venipuncture is:
70% isopropyl alcohol
Providone-iodine
Benzalkonium chloride
Chlorhexidine gluconate
57
All of the following are characteristic of a good dermal site , except:
Good, venous flow
Easily accessible
Warm, healthy skin
Clearance above underlying bone
58
Phlebotomist enters the patient’s room and proceeds to verify identity of the patient by:
Comparing requisition to patient’s armband
Asking patient to state name and compare lab requisition to armband
Showing patient printer label and asking whether it is correct
Stating patient’s name and asking social security number
59
Which of the following organizations regulates and safeguards the collection procedures for blood donor collections:
Occupational Health and Safety Administration
U.S. Food and Drug Administration
Drug Enforcement Agency
Centers for Disease Control and Prevention
60
Medical term for “fainting” is:
Petechiae
Emesis
Syncope
Vertigo
61
When the palpated vein is deep within the tissue and not visible, how can the phleb. determine where to insert needle?
Use a pen to mark the area where the vein was felt
Landmark the vein via freckle, skin crease etc
Stick in the general area and gently probe until located
Clean a gloved finger and touch to locate it before insertion
62
Steps involved in performing dorsal hand vein draw on infants involve all but:
Inserting 23-gauge needle into dorsal hand vein
Using infant ID band to identify patient
Cleansing area with isopropyl alcohol
Applying tourniquet 2 to 3 inches above hand
63
The patient is sleeping when you enter to draw blood a timed specimen. How should you proceed?
Turn the light on; make a lot of noise while calling out the patient’s name
Ask the nurse to page your when the patient is awake
Proceed with collection quietly so patient is not disturbed
Gently wake the patient before proceeding with the collection
64
Question is in image
Hemoconcentration
Hematoma
Petechiae
Hemolysis
65
Question is in image
Verify physician’s name to confirm identity and continue the procedure
Assume patient’s in too much pain to remember and continue procedure
Assume that there is a clerical error and proceed with venipuncture
Go to triage desk to verify patient’s identity and resolve discrepancy
66
Phleb. uses winged infusion set&small-vol.tubes on accident victim. Draws-Chem7&CBC (in this order)Probl.W/coagulation.
Order of draw was incorrect, contaminating tubes w/ anticoagulant
Internal bleeding causes hemoconcentration of coagulation factors
The tube was not completely full due to air space in length of tubing
Butterflies should not be used for coagulation tests bec. of possible hemol
67
A timer blood draw that needs to be performed 30 min. before next dose of medication is referred to as:
Peak level
Basal level
Trough level
Postprandial level
68
A patient who requires blood alcohol levels has wristband confirming allergy to iodine. Use what cleansing agent?
Alcohol
Betadine
Betadine or Chlorhexidine gluconate
Chlorhexidine gluconate
69
Why must a phlebotomist discard the first sample drawn from a heparin or saline lock?
Potential dilution of specimen
Risk of sample clotting in line
Presence of antibodies in tubing
Reduce risk of infection in catheter
70
You enter a patient’s room and observe that the patient has a VAD. How should you proceed?
Call lab to send another phlebotomist to assist you with collection
Call the doctor and request permission to draw blood through VAD
Get the nurse to draw blood specimens for you
Proceed with caution,internal AV shunt& easy to stick
71
On return to the lab after drawing an in-house patient, the phleb. discovers she has used an exp. lavender top. Action?
Put the blood into an unexpired tube and mix thoroughly
Not worry about it-the tube was a full draw
Discard the tube and redraw patient using an unexpired tube
Redraw patient if the test results are abnormal
72
Reflux/the flow of blood from the collection tube back into the needle&into the patients vein can be prevented. Except:
Keeping the patient’s arm in a downward position
Prevent contact of the needle with blood in the tube
Filling tubes from the bottom upward
Removing tourniquet after tube is removed
73
The acronym BURP represents a collection of tests that:
Cannot be performed on capillary blood
Means collect bullets: red, purple, pink
Cannot be performed using providone-iodine
Are performed using Unopette
74
Phleb. has a orders for CBC,ABO,Rh,antibody screen,hepatitis panel,kidneypanel,RPR,CRP,RA,thyroidpanel,&PT. Best course?
Follow correct order of draw and collect all tubes
Enter into comp. the locations of tubes for dept. that share samples
Draw one of each tube and prepare aliquots for each department
Draw one of each tube first, then go back and collect the remaining tubes
75
Phlebotomist needs to draw blood from patient who has an IV line in both arms. Correct procedure includes all but:
First 5mL of blood discarded
Site of the VP distal to the IV
IV turned off for at least 2 min. before draw
Order of draw reversed to avoid dilution
76
During glucose tolerance testing, patient must be instructed to drink standardized glucose solution within__minutes.
10
5
20
15
77
You are preparing to draw blood from an elderly patient who is “crotchety” and extremely rude to you. You proceed to:
Go to the nurses’ station to report patient
Ignore patient and draw the blood as quickly as possible
Remain professional in speech, mannerisms, and procedure
Chastise the patient for his rude behavior
78
Why would a phlebotomist want to avoid using the basilic vein whenever possible?
There is increased risk of damaging a nerve or hitting the brachial artery
Only a small-gauge needle can be used to access this vein
Using this site may increase risk of infection
Specimens drawn from this vein are often hemolyzed
79
Phlebotomist collected a specimen that needs protected from light during transpo. What specimen did the phleb collect?
Alkaline phosphates
Beta-carotene
Triglycerides
Lactate dehydrogenase
80
Question is in the image above
Yes, because the max blood withdrawal allowed for this baby is 7.68mL
Yes, because the max blood withdrawal for this baby is 9.6mL
No, because max blood withdrawal for this baby is exceeded at 0.096mL
No, because the max blood withdrawal for this baby is already 2.4mL
81
Phlebotomist will inoculate which bottle first when performing a syringe draw for a blood culture?
Anaerobic
Order doesn’t matter in a syringe draw
Microaerophilic
Aerobic
82
Blood cultures are drawn at times intervals from multiple sites for all of the following reasons, except:
Increase likelihood of retrieving pathogens
Decrease number of false positive tests
Retrieve different organisms colonizing various vessels
Verify presence of known contaminant at two different sites
83
The medical term for nausea and vomiting is:
Vertigo
Syncope
Emesis
Petechiae
84
A tourniquet is used in performing venipuncture to:
Prevent venous blood flow out of the arm to enlarge veins
Make the skin taut for easier palpability & access to vein
Force hemoconcentration of analytes for more accurate assays
Maximize pooling of arterial blood for enhanced visibility of veins
85
Which of the following statements about bilirubin is not true?
Bilirubin is produced by kidneys
Bilirubin in excess can cause jaundice
Bilirubin in excess can lead to brain damage
Bilirubin is a breakdown product of RBC’s
86
What is the appropriate needle gauge to use when routinely performing VP for collection of a large blood vol. on infant?
18 gauge
21 gauge
25 gauge
23 gauge
87
Question is in image above
After medication to reduce fever
In the evening, when temperature is elevated
In the morning, when temperature is normal
Just before temperature spike
88
Question in image
Tech wanted to rerun specimen again to recheck first two results
Specimen spilled when aspirating needle displaced extra blood
Extra time to fill microtainer resulted in hemolysis of specimen
Microclots had formed as a result of overfilling microtainer tube
89
When collecting blood cultures, phlebotomist uses butterfly-winged infusion device. Which sample is drawn first:
Anticoagulated tube
Aerobic bottle
SST tube
Anaerobic bottle
90
By definition, the basal state of the body is the body’s state after abstention from exercise and fasting for____hours.
12
24
6
20
91
Which of the following statements is true regarding bilirubin?
Bilirubin causes hemolysis when in excess
Bilirubin must be protected from light
Bilirubin is removed from the body via pancreas
Bilirubin is collected in a tan color stopper tube
92
Inherited disorder of hemoglobin molecule may be screened for in newborns from high risk ethnic groups is what?
Sickle cell anemia
Polycythemia
Galactose
PKU
93
Phlebotomist just collected specimens of cold agglutinins. What special coll/or transport must be taken before or after
Specimen must be protected from light
Specimen must be transported on ice
Specimen must be collected in heparinized syringe
Specimen must be collected in pre-warmed tubes
94
Which of the following devices is an artificial connection between an artery and a vein?
PICC
Arterial line
Arteriovenous shunt
Saline lock
95
You have a patient with polycythemia Vera. Removal of blood fr. patient’s system to aid in treatment of disorders is:
Autologous donation
None of the above
Directed donation
Therapeutic phlebotomy
96
You must draw blood for CBC, ordered daily for a 2yr old with leukemia. What is commonly used for pediatric patients?
Dermal puncture
Vacutainer collection
Winged infusion set
Syringe collection
97
Advantages to using a syringe include all of the following except:
No need for evacuated tubes
Vein less likely to collapse
Controlled vacuum
Blood appears in the hub on entry into the vein
98
Question is in the image above
Look around the room to see whether the ID band can be located
Ask a nurse to attach a new ID band to the patient
Ask the patient for his or her name to confirm
Ask a family member to confirm the patient’s ID
99
The phlebotomist, preparing to draw blood on elderly patient w/small fragile veins, selects what needle gauge?
21
20
23
16
100
Chain of custody procedures includes all of the following, except:
Specimen sealing so that tampering can be detected
Patient signature of consent form
Specimen transport in properly labeled and sealed biohazard bag
Patient presentation of picture ID

Phlebotomy Final (chapters 8-14) Flashcards | StudBud