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Phlebotomy Final Exam Practice

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created 2 years ago by Bwinters45
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1

Phlebotomists are an important part of the health care team because they

Represent the laboratory and the institution, are in direct contact with the patient, and perform tasks that are critical to the patient's diagnosis

2

Phlebotomists often have many duties and tasks. Which is the primary duty?

Collecting venous blood samples

3

Which laboratory employee has the most education and is usually a consultant to other physicians?

Pathologist

4

When a patient refuses to have blood drawn, the phlebotomist should do all of the following EXCEPT

Try to convince the patient to have blood drawn

5

The most common source of laboratory error is:

Administrative

6

What laboratory department tests a type and cross-match?

Immunohematology

7

A geriatric patient is:

An elderly patient

8

Perhaps the single most important step in phlebotomy, and often where an error occurs, is:

Patient identification

9

Therapeutic phlebotomy is performed as a treatment for patients with:

Polycythemia Vera

10

What laboratory department does the Pap test?

Cytology

11

The hematocrit test is performed in what department of the laboratory?

Hematology

12

What hospital department cares for newborn infants?

Neonatal

13

What hospital department cares for patients with cancer?

Nephrology

14

Where in a hospital would you find a patient in labor for childbirth?

Obstetrics

15

Where in a hospital would you find a patient with broken bones?

Orthopedics

16

Which is the organization that does quality checks of the laboratory through surveys and samples?

College of American Pathologists (CAP)

17

Which is a quality assurance plan that not only aims to meet minimum standards, but also seeks to constantly improve performance?

Continuous quality improvement

18

What is the type of phlebotomy where the phlebotomist is part of the laboratory team and is dispatched to the nursing units from the laboratory?

Centralized phlebotomy

19

An unexpected occurrence in a health care facility that involves death or serious psychological injury is

Sentinel Event

20

What should you do if you accidentally stick yourself with a contaminated needle?

Wash your hands and clean and bandage the puncture site. Record the patient's name and ID number, report the incident to your supervisor, and fill out an incident report

21

Handwashing:

Is the best way to prevent the spread of infection

22

Which disease requires the use of respiratory (airborne) precautions?

Tuberculosis

23

The primary purpose of infection control is:

Prevent the spread of communicable disease within health care facilities

24

What disease is NOT a vaccine-preventable disease?

AIDS

25

Gloves should be worn:

During ALL venipunctures and capillary punctures

26

The single most important way to prevent the spread of infection in a hospital or other health care facility is:

Handwashing

27

The name given to an infection that a patient acquires 48 hours or more after admission to a hospital is:

Hospital Acquired (Nosocomial)

28

Which of the following is NOT classified as a personal protective equipment (PPE).

HBV Vaccine

29

A potential source of infectious material from a patient in protective isolation includes:

None (The phlebotomist is considered a potential source of infection to the patient)

30

Aerosols call be produced by:

Centrifuging open serum tubes, popping the top off blood tubes, and pouring off a serum samples

31

Standard Precautions state that if there is a possibility of coming into contact with a patient's blood, or any other body fluid, you must wear?

Gloves

32

According to Standard Precautions, blood and body fluids from which group are considered bio hazardous?

ALL blood and body fluids

33

According to Standard Precautions, all used needles are to be disposed of in the following manner:

Discarded intact

34

A person who has a buildup of fluids in their entire body is known to be:

Edematous

35

Anatomy is the study of the:

Shape and structure of the body

36

The study of the function of each body part and how the functions coordinate is called?

Physiology

37

The part of the cell that controls the activities of the cell (brain of the cell) is the:

Nucleus

38

The system responsible for body movement is?

Muscle

39

Skeletal muscle is also known as?

Voluntary

40

Lymph fluid is also called?

Interstitial

41

When the body systems work together to form a steady state, it is referred to as?

Homeostasis

42

The process of using simple substances to build more complex substances is called?

Anabolism

43

The process of producing energy by breaking down complex compounds is?

Catabolism

44

The process of making substances or breaking down substances so that the body can functions is?

Metabolism

45

The channel for transporting material in and out of the nucleus is the?

Endoplasmic Reticulum

46

The cell structure that digests enzymes and breaks down cellular components is the?

Lysosomes

47

The tissue that protects the body by covering internal and external surfaces is?

Epithelial tissue

48

What supports and connects organs and tissues?

Connective tissue

49

Which type of muscle makes up the muscles of the body?

Cardiac, skeletal, and smooth

50

The layer of the integumentary system that contains the blood system is the?

Dermis

51

The process in which oxygen-rich blood diffuses into tissue cells is?

Internal Respiration

52

The most common disorder of the endocrine system is

Diabetes

53

The axial skeleton is responsible or located in

Protection to parts of the body

54

The function of the leukocytes is to

Fight infection

55

What is the difference between plasma and serum?

Plasma contains fibrinogen, serum does not

56

The life span of the red blood cell is approximately?

120 days

57

The function of the erythrocyte (Red Blood Cell) is to

Carry oxygen

58

The buffy coat consists of

Leukocytes and thrombocytes

59

What is the substance in erythrocytes that carries oxygen?

Hemoglobin

60

Which cell contributes most to blood clotting?

Platelets

61

Where does the electrical impulse start in the heart?

Sinoatrial node

62

Which blood vessels generally carry blood that is high in oxygen?

Arteries

63

Blood flows from the right atrium into the right ventricle. From this point, it is pumped through the?

Pulmonary artery to the lungs

64

The tricuspid and bicuspid valves are associated with the?

Heart

65

When a patient has had a mastectomy, venipuncture should be avoided on the affected side because?

Patient is more susceptible to infection

66

Why does the left ventricle of the heart have such a thick muscular wall?

To pump blood to all parts of the body

67

The main function of the circulatory system is to provide

Transportation

68

The ventricles of the heart are principally responsible to

Pumping blood

69

Unoxygenated blood from the head and neck region returns to the heart via?

Superior vena cava

70

What does NOT carry oxygenated blood

Pulmonary artery

71

Which is referred to as the pacemaker of the heart?

Sinoatrial node

72

What is the function of the coronary arteries?

They supply oxygenated blood to the heart muscles

73

What happens when a coronary artery becomes occluded?

Myocardial infarction

74

The fluid portion of anticoagulated whole blood that contains fibrinogen is called the?

Plasma

75

The formed elements of blood found inside a tube drawn with an anticoagulant are

Plasma, buffy coat, and erythrocytes

76

The formed elements make up about_____ percent of the whole blood volume

45%

77

Five components that are found in a CBC with diff. are?

WBC, RBC, Hemoglobin, Hematocrit, Differential

78

Which bore (diameter) of the needle is the smallest?

23-gauge needle

79

The common needle gauges used for drawing blood with an evacuated system are?

20, 21, or 22 gauge

80

Through which size needle will blood flow the fastest?

20

81

The unit of liquid volume in the metric system is the?

Liter

82

The gauge of the needle indicates the following relationship: the larger the gauge number, the:

Smaller the diameter of the bore

83

In general, a syringe is used when drawing specimens and/or patients EXCEPT for?

Requests for multiple testing, requiring different anticoagulants and multiple tubes

84

Which anticoagulant prevents coagulation of blood by removing calcium through the formation of insoluble calcium salt?

EDTA, Oxalate, and Lithium heparin

85

You are preparing to draw blood for multiple tests in several tubes. The best and most cost-efficient technique would be?

Evacuated tube system

86

The anticoagulant heparin is used for blood gases and other chemistry tests. It works by?

Preventing the conversion of prothrombin to thrombin

87

10mL is the same as?

10cc

88

Blood is needed for routine bleeding and coagulation studies (PT, PTT). Which color tube top is to be used

Light blue

89

When serum is needed for testing which tube listed should be used?

Red

90

The anticoagulant preferred for hematology testing is?

EDTA

91

An arterial puncture is more likely to result in a hematoma than a venipuncture is because of?

Higher pressure in the arteries

92

Which arteries are least suitable for drawing blood gases?

Femoral

93

Which statement is true about arterial punctures?

Collateral circulation should be checked before drawing, Heparin is the anticoagulant of choice, and the site must be held at least 5 minutes after completing the puncture

94

A patient has a negative Allen test. What should you do?

Perform the Allen test on the other arm

95

The artery that lies on the thumb side of the wrist is the?

Radial

96

If the blood is drawn too quickly from a vein, the vein will have a tendency to?

Collapse

97

The bevel of the needle

Should always be facing up when inserted into the skin

98

Under which of the following conditions would you avoid a site for a venipuncture?

Edematous arm, arm with IV, and a hematoma

99

When drawing blood samples, which of the following should be performed first?

Identify the patient

100

What is the primary source of information when labeling a patient sample in the hospital?

Wristband and patient verification of name

101

An arterial puncture site is more likely to bleed because?

Arteries have higher pressure than veins

102

Venipuncture is usually performed in the antecubital area. Which vein is usually the best to draw from?

Medial cubital

103

The doctor orders a CBC, serum drug level, PT and a set of blood cultures. What is the order of draw?

Blood culture, light blue, red, lavender

104

What can happen if the tourniquet is left on to long before drawing blood?

Hemoconcentration

105

Which two arteries are occluded when the Allen test is performed?

Radial and Ulnar

106

Once an arterial blood sample is obtained, the puncture site should have pressure held for at least?

5 minutes

107

As a general rule, you should not stick a person more than ____ in an attempt to obtain blood?

Twice

108

Serum is described is icteric in the presence of increased?

Bilirubin, causing jaundice

109

Serum is described as lipemic in the presence of increased?

Lipids in a nonfasting sample

110

Serum is described as hemolyzed in the presence of increased?

Hemoglobin from ruptured RBCs

111

Why is the first tube discarded when you are drawing from an indwelling line?

To remove heparin or saline contamination

112

The purpose of the Allen test is to?

Check for collateral circulation through the ulnary artery before sampling the radial artery

113

The following items are minimum requirements for sample labeling?

The patients complete name, the identification number, date, time of collection, and collectors initials

114

A patient sitting in a chair has fainted. Possible acceptable actions by the phlebotomist include?

Placing a cold compress on the back of the patients neck, putting the patients head between his/her knees, or call for assistance

115

Which is generally the most common complication from phlebotomy?

Hematoma

116

A phlebotomist is requested to draw an unconscious patient. The patient's name and identification number on the armband agree with the information on the request form and computer labels. What else should be done to ensure patient identification?

Nothing else is necessary

117

A conscious patient does not have an identification armband. The name on the water jug and room number on the door agree with the information on the request. What should the phlebotomist do?

Do not draw the patient until an armband has been applied

118

An unconscious, unidentified man is admitted to an emergency trauma center. What would be the system of choice to ensure patient identification?

Use a three-part identification system that utilizes a temporary armband and labels for specimens and blood to be transfused.

119

To fill an evacuated tube with blood from a syringe, the phlebotomist should:

Use a transfer device by removing the syringe needle after the safety shield has been engage and then attaching the syringe to the transfer device for filling the evacuated tubes.

120

In what order should a serum (SST) tube, a green tube, light blue tube and a lavender tube be filled from a syringe?

Light blue, serum, green and lavender

121

A patient comes to have a monthly Prothrombin time (PT) collected. You must use a butterfly system because of the patient's small veins. This is the only test you need to draw. What must you remember to do first?

Ask another phlebotomist to try

122

In performing an arterial puncture, you should puncture the artery using a:

45-degree angle of insertion with the bevel of the needle facing the elbow

123

Which of the following is true about microcapillary collection?

The first drop of blood should be wiped away.

124

Which of the following neonatal tests is required by law?

Neonatal screening

125

The safe area of heel puncture on an infant is:

The most medial and lateral portion of the plantar surface

126

The depth of cut made by a puncture device for a heel stick on a full-term infant should be no more than:

2.0mm

127

What can happen if you squeeze the patient's finger too vigorously during a capillary puncture?

The sample will be diluted with tissue fluid, and hemolysis can occur

128

Why must the first drop of blood from a capillary puncture be wiped away?

To remove tissue fluid

129

You are to collect by fingerstick a green top, a lavender top, and a red top microcollection container. What microcontainer do you collect first?

Lavender top

130

When doing venipuncture on a child, whom should you talk to and explain the procedure to?

Child and the parent

131

In a skin puncture procedure, hemolysis can occur from:

Squeezing the heel or finger too hard

132

Warming the skin puncture site:

Increases the blood flow through the arterioles and capillaries sevenfold

133

Skin puncture blood is more likely to be contaminated by:

Hemolysis

134

A CBC is collected by fingerstick from a patient. The results of the CBC show a lower WBC and platelet count than blood collected the previous day. What caused this change?

The blood was collected too slowly and partially clotted in the collection container.

135

Children understand illness in different ways. What age group would have the greatest stress because of separations from caregivers and a change in the home routine?

The first 2 years

136

Children understand illness in different ways. What age group might think that an illness is a punishment for being "bad"?

Ages 2 to 6

137

At what age does a child start to understand the mechanics of health and how procedures help lead to a cure?

Ages 6 to 9

138

Children understand illness in different ways. At what age would a child start to understand illness and why he or she does not feel well?

Ages 10 and above

139

The idea of moving the child's attention from the procedure to something else is called:

Distraction

140

What is the best way to restrain a child?

Parent or caregiver holds the child

141

What is the best technique the phlebotomist can use for a safe and successful venipuncture?

Patience and understanding

142

Dorsal vein blood collection uses a vein in the patient's:

Hand

143

Glycolysis occurring in a tube of unseparated blood will cause:

A decrease in serum glucose concentration

144

What does NPO mean?

Nothing by mouth

145

The glucose tolerance test?

Is performed to aid in the diagnosis of diabetes mellitus

146

You receive an order to draw a STAT CBC. Your responsibility is to?

Draw blood in a lavender tube and send it to the lab promptly

147

What is the major drawback of a 24-hour urine collection?

Patient cooperation is essential and is often hard to get.

148

A test performed after a meal is called:

Postprandial

149

The process for prepping the puncture site for this procedure is similar to that for an arterial puncture. What is the procedure?

Blood culture collection

150

Which test is NOT usually done to detect clotting problems?

Glucose

151

The gray top tube is usually drawn for which test(s)?

Glucose

152

Which of the following statements concerning bleeding time testing is true?

You should touch the drop of blood with the filter paper, a stopwatch should be started at the same time as the puncture is made, and it is used to assess platelet functions

153

The glucose tolerance test includes:

Administration of glucose and multiple timed blood draws

154

What is the purpose of the bleeding time test?

To assess platelet function

155

Hypoglycemia is a condition of:

Low blood sugar

156

What is the best sample for urine collection?

A clean-catch midstream urine sample

157

The patient's fasting glucose can be elevated if:

The patient ate before having blood drawn

158

Disturbing the platelet plug on a patient while performing a bleeding time will cause the results to be:

Falsely elevated

159

A properly collected 24-hour urine sample:

May contain a chemical preservative

160

The most common cause of blood culture contamination is:

Improper skin preparation

161

In which test should alcohol NEVER be used to cleanse the venipuncture site?

Blood alcohol level

162

Glucose tolerance tests and therapeutic drug monitoring tests have which of the following collection requirements in common?

Timed sample

163

When blood is drawn to monitor the therapy of a specific antibiotic, the peak level is drawn 1 hour after administering the antibiotic. The term used to refer to the antibiotic level drawn right before the antibiotic is given is called the:

Trough level

164

The results of a test can change because of:

Exercise, stress and posture

165

Citrate tubes must be within _____ percent of full to give accurate results.

10

166

Circadian changes are best described as:

Cyclical changes throughout the day

167

Protecting a sample from light is best done by:

Placing the sample in an amber-colored tube, or wrapping aluminum foil around the sample

168

Samples may be rejected for testing if?

The sample was drawn above a running IV, the sample was not labeled with the patients complete name and an anticoagulated sample had a clot

169

Which occurrence is NOT a cause of sample rejection?

Clot in a red, black, or gold top tube

170

The most critical step in phlebotomy is:

Patient identification

171

Which statement best summarizes the quality of blood samples?

Samples of low quality can produce inaccurate and potentially dangerous results

172

If the tourniquet is applied for longer than 1 minute, which of the following analytes will be elevated and will continue to increase the longer the tourniquet is applied?

Potassium

173

Preexamination errors are variables that occur to a sample before the sample is tested. The type of error caused by a patient would be:

The patient eating a candy bar when the test is supposed to be fasting

174

Preexamination errors are variable that occur to a sample before the sample is tested. The type of error caused by a phlebotomist would be:

The phlebotomist putting the incorrect name on the tube of blood

175

Preexamination errors are variables that occur to a sample before the sample is tested. A transportation error would be:

The tube breaking in transport

176

To achieve quality customer service, the phlebotomist must meet what customer needs?

Know what the customer wants, determine the level of service received, and take action to satisfy the customer

177

When two people are communicating, they understand each other when they have a common understanding. This common ground is based on three frames of reference:

Background, education, experience

178

The phlebotomist who tends to smooth over a conflict is known as a(n):

Accommodator

179

Unconscious postures, gestures, and facial expressions are known as:

Kinesics

180

Which is a barrier to communication?

The patient has a hearing impairment, the patient is unconscious or the patient is unable to speak English

181

Which would NOT be part of patient satisfaction?

Problems phlebotomist has at home

182

The average person can listen at the rate of approximately _____words per minute and can speak at the rate of____words per minute.

500-600;100-200

183

Eye contact is a method of ___________communication

Nonverbal communication

184

The OIG is the?

Office of Inspector General

185

Of the three situations listed, which one is compliant with the Antikickback Law?

Furnishing the physician with the blood collection tubes that are returned to the furnishing laboratory for testing

186

A patient is having blood collected and asks the phlebotomist to have a copy of the results sent to a physician who was not listed on the requisition. What should the phlebotomist do?

Call the ordering physician to see if this is permissible

187

A patient's information that is connected to their medical information is:

Personal health information (PHI)

188

An associate is hired as a phlebotomist and completes the initial training and competency certification. When will the next competency certification be needed?

6 months

189

To demonstrate competency, a phlebotomist must verify the ability to collect blood samples from what age group?

All age groups

190

The competency assessment check-off form must include what information?

All the steps involved in completing the procedure

191

In most health care facilities, a phlebotomist would NOT be authorized to:

Start an IV

192

A competency program should verify the competency of a phlebotomist in the area(s) of:

Customer service, safety, and computer use

193

Phlebotomists certified with ASCP after January 2004 must maintain their certification through the:

Certification maintenance program

194

For a phlebotomist to be fully competent the phlebotomist must be competent in:

Obese patients, different age patients and psychiatric patients

195

Which of the following POC laboratory tests is within the CLIA defined scope of practice for a phlebotomist?

Strep test and urine dip

196

The phlebotomist is performing a venipuncture on an apprehensive school age child. Which of the following approaches should the phlebotomist use to calm the child?

Explain the procedure and reassure the child that the parent can stay with her

197

Which task should a phlebotomist complete prior to daily use of a POC instrument?

Perform QC on the instrument

198

A patient brings in written lab tests results, including a mix of POC and higher complexity tests, and asks the phlebotomists for help with interpretation. Which of the following should the phlebotomist do?

Refer the patient to the physician for interpretation of all results

199

Which of the following is outside the scope of practice for a phlebotomist?

Performing CLIA moderate complexity tests

200

Which if the following specimens require the phlebotomist to follow chain-of-custody documentation procedures?

Blood alcohol and Drug testing

201

Which of the following QC measures are within the phlebotomists scope of practice?

Checking the expiration dates of venipuncture supplies, Monitoring temperatures of specimen refrigerators, and routine cleaning of surfaces where specimens are processed.

202

At which of the following times should a test tube be labeled with the patients identifications?

While in the patients room, after drawing the blood.

203

Instead of obtaining consent from a patient who is mentally competent, the phlebotomist obtains consent from a family member. This is a violation of?

The Patient's Bill of Rights

204

The phlebotomist is asked to draw blood on a non-responsive patient in an emergency department. This draw would be conducted under?

Implied consent

205

A patient presents to have a diagnostic HIV test drawn. Which of the following forms of consent must the phlebotomist obtain prior to venipuncture?

Informed consent

206

A 19-year-old patient offers her arm to the phlebotomist when she comes in with a venipuncture tray. This is an example of?

Implied consent

207

Which of the following is a CLIA waived test that can be performed by the phlebotomist?

Chemical urinalysis

208

Commitment to privacy, continuity of care, advance directives, and the authority to refuse treatment are granted according to which of the following?

The Patient's Bill of Rights

209

While giving a patient an injection, the patient jumped, causing the phlebotomist to get stuck on the hand with a contaminated needle. After performing thorough hand washing, which of the following should the phlebotomist do first?

Report the incident to the supervisor

210

A phlebotomist has active symptoms of the common cold. Under which of the following conditions may he perform venipuncture?

The phlebotomist may perform venipuncture provided he is wearing a mask and afebrile

211

Which of the following statements by a new phlebotomist indicates the need for further education on standard precaution?

"I will wear a gown, gloves, and mask for inpatient collections."

212

An immunization is currently available for prevention of which of the following bloodborne diseases?

Hepatitis B

213

Which of the following is the minimum PPE requirement when drawing lab work on a patient with suspected HIV?

Gloves only

214

Which of the following best describes the proper way to clean up a broken glass tube?

Use a broom and dust pan to sweep up the glass and fragments and place in a sharps container

215

The phlebotomist arrives at an inpatient room to collect a blood sample. There is an isolation chart located outside the room. The phlebotomist washes her hands and puts on the following personal protective equipment: gown, gloves, and mask. Which of the following types of precaution is being used for this patient?

Droplet

216

The phlebotomist is preparing to remove her gloves after a venipuncture and notices blood on the gloves. Where should the phlebotomist dispose of her gloves.

A biohazard waste container

217

If a phlebotomist has questions about disposing of outdated hazardous chemicals, where should she look to find this information?

MSDS

218

Keeping contaminated equipment and supplies away from the phlebotomists clothing to prevent pathogen transmission to the next patient is an example of which of the following?

Medical asepsis

219

Which of the following is a requirement for a healthcare facility to be in compliance with OSHA?

Annual employee safety training

220

Which of the following tube and additive combinations should be used for a PT/INR test?

Light blue, sodium citrate

221

For which of the following tubes must the phlebotomist prep the site with povidone iodine or chlorhexidine?

A yellow tube with SPS

222

The phlebotomist is drawing plain red, purple, and blue top tubes. Upon completion of the blood draw the phlebotomist noticed that he missed an order requiring an SST. The phlebotomist should share the?

Red tube

223

A phlebotomist has received a requisition to collect specimen for a Bilirubin from a premature newborn patient. Which of the following is the best device for this collection?

1.00mm lancet

224

Using the guidelines for any method of venipuncture, after confirming patient identity which of the following actions should the phlebotomist perform first?

Review the requirements for collecting and handling the blood specimen as ordered by the physician

225

The phlebotomist is instructed to preform a capillary stick for newborn screening. Which of the following collection devices should the phlebotomist use?

Heel stick lancet

226

The physician has ordered a prothrombin time (PT) and complete blood count (CBC) for an adult patient with a diagnosis of thrombophlebitis. The phlebotomist should collect the evacuated tubes in which of the following orders?

Blue, Lavender

227

The phlebotomist applies pressure to the venipuncture site using gauze. After two minutes he observes that the bleeding has not stopped. The next appropriate action would be to?

Elevate the arm while applying pressure

228

A patient on coumdin therapy is at the lab for their weekly coagulation test. Which of the following tubes should the phlebotomist collect for this test?

Light blue top

229

A physician has orders a STAT blood work for a patient. The physician ordered hematology tests and chemistry and coagulation panels. Which of the following tubes are needed for this procedure?

Light blue, Red, and Lavender

230

A CMP is ordered for an older adult patient whose veins continue to collapse despite drinking water. Which of the following is the best collection method for this patient?

Butterfly needle

231

When inspecting a patient's arm before performing a venipuncture, the most desirable site appears to be the back of the hand. Which of the following venipuncture methods is most appropriate in this situation?

Butterfly needle

232

Which of the following actions should the phlebotomist take to make a vein more prominent when attempting to select a venipuncture site?

Apply a warm compress to the area for 5 minutes

233

Which of the following actions should the phlebotomist take to decrease the potential for hemolysis of a blood specimen in an EDTA tube?

Gently invert the tube after collecting the specimen

234

For which of the following patients is the use of an adhesive bandage contraindicated?

Newborn with hyperbillirubinemia

235

Grey-topped sodium fluoride tubes should not be used to collect alanine aminotransferase (ATL) or aspartate aminotransferase (AST) because the anticoagulant

Destroys many enzymes

236

A 2-week-old infant has been brought in the lab for a repeat PKU/neonatal screening. Which of the following collection procedures is appropriate to collect the specimens?

Capillary using heel puncture lancet

237

A phlebotomist working in a hospital is collecting blood from a patient with very small, difficult veins. Three tubes of blood need to be collected. The blue and green tubes fill easily and completely, but the lavender tube fills incompletely. Changing the lavender tube using the same draw also results in an incomplete specimen. Which of the following should the phlebotomist do next?

Re-position the needle and recollect the lavender tube

238

The phlebotomist is collecting a capillary sample from an infant. Following the collection, the phlebotomist holds firm pressure on the site until bleeding has stopped. How should the phlebotomist proceed?

Do not bandage

239

During palpation of a large vessel in the forearm, the phlebotomist detects a vibration sensation. The phlebotomist should then

Choose a different collection site

240

The phlebotomist notes the patients arm is scarred in the lateral aspect of the antecubital fossa, and the other arm is not available. The phlebotomist decides to use a more medial site in the fossa over the basilica vein. Which of the following make this a poor choice?

Increased risk of nerve damage, and increased risk of arterial involvement

241

After a phlebotomy draw, the phlebotomist realizes that the tourniquet was on for an extensive length of time. Which of the following is the more likely resulting complication?

Hemoconcentration

242

Which of the following sites should the phlebotomist use for newborn screening blood collection?

Plantar surface of the heel

243

A patient with an order for a blood draw presents with burns covering both arms. Which of the following is the phlebotomist's best option for collecting the largest amount of blood for this patient?

Microcollection container

244

When performing venipuncture on a patient with a left mastectomy, which of the following sites should the phlebotomist use?

Right antecubital fossa

245

Which of the following steps is completed first in performing venipuncture?

Identify the patient

246

The phlebotomist is educating the patient on fasting diet requirements prior to a glucose tolerance test. Which of the following is the minimum time frame the patient must remain fasting before the start of the test?

8-12 Hours

247

Which of the following information is contraindicated for patient identification at the time of draw?

Insurance number

248

Which of the following veins would generally be acceptable for routine blood collection by the phlebotomist?

Cephalic

249

When performing a capillary puncture on an infant, which of the following is the preferred site?

Plantar surface of the heel

250

Which of the following is a site preparation solution required for collecting blood cultures and blood alcohol levels?

Povidone Iodine

251

Which of the following statements represents correct patient identification for a phlebotomist is an outpatient setting?

"May I have your name please?"

252

Which of the following is an appropriate draw site for an adult patient with a central line?

Dorsal side of the hand

253

The phlebotomist received a requisition for a blood test on a 70-year-old female patient with diabetes and a mastectomy of the left breast. Upon entering the room the phlebotomist notices a PICC line in the patient's right arm. For this specimen collection, the phlebotomist should?

Refer the draw to the nurse

254

The patient on hemodialysis with a left AV shunt has undergone a right sided mastectomy and has an order for a STAT glucose. After consulting with the physician the phlebotomist is told to perform a capillary draw. Which of the following sites should the phlebotomist use?

Left ring finger

255

Capillary blood specimens are most likely to be successfully collected from patients that

are extremely obese

256

The phlebotomist applies the tourniquet, but than has trouble relocating the vein after several minutes of palpation. Which of the following is an expected outcome in these test results?

Falsely elevated K levels from tissue damage

257

The phlebotomist has a requisition for chemistry and coagulation testing. Which of the following is the correct tube selection and order of draw?

Light blue, and SST

258

On the initial attempt the phlebotomist went through the vein, but was able to pull back on the needle and successfully collect the specimen. Which of the following should the phlebotomist do next?

Explain to the patient that a bruise may be likely, but it should be gone within a few days.

259

The phlebotomist has collected an ammonia level. Which of the following should be done regarding transport of the specimen?

Immerse the specimen in an ice and water slurry

260

The phlebotomist needs to draw a blood culture, sedimentation rate, PTT, and a glucose test. Which of the following is the correct order of draw?

Yellow, light blue, lavender, and grey

261

A phlebotomist has completed a draw on a patient. After the blood is drawn the patient informed the phlebotomist that he tends to bleed longer. Which of the following is the next course of action the phlebotomist should take?

Confirm hemolysis and apply gauze with paper tape

262

Which of the following should the phlebotomist do when collecting blood via finger stick?

Position the lancet across the fingerprint lines

263

The phlebotomist is asked to draw blood from a patient with an IV in the right arm whose left arm is inaccessible. The phlebotomist may draw blood without a physician's approval from the

Right arm distal to the IV site

264

A phlebotomist is asked to collect a CBC, PT, electrolytes, and a BUN. The correct order of draw for this collection is?

Light blue, green, lavender

265

A phlebotomist has received a requisition to draw a bilirubin on an infant with jaundice. The phlebotomist should?

Protect the specimen from light

266

A phlebotomist receives an order to collect a cold agglutinin specimen. The phlebotomist should?

Maintain the specimen at 37 degrees Celsius

267

An older adult patient arrives to have blood drawn. While assessing the arms for venipuncture, the phlebotomist notices scar tissue in the antecubital areas and is unable to palpate a vein. Which of the following is an appropriate alternative course of action?

Draw blood from the hand using a winged infusion set

268

While performing a venipuncture, immediately before removing the needle, the phlebotomist should?

Release the tourniquet

269

The phlebotomist has an order to collect a complete blood count with differential, partial thromboplastin time, basic metabolic panel, and blood cultures. Place the tubes in the correct order of draw.

Blood culture bottles, light blue, red, lavender

270

An infant is brought to the clinic for a CBC. After performing a heelstick, not enough blood is collected to perform the test. Which of the following actions should the phlebotomist take?

Apply a warm compress

271

When inserting a needle during venipuncture, the bevel should be in which of the following positions in relation to the vein?

Up

272

Forceful shaking of blood in an evacuated collection tube will cause which of the following complication?

Hemolysis

273

The physician orders the following blood work to evaluate a patient for sepsis: CBC, Blood culture, and a BMP. When using the evacuated tube method for venipuncture, in which of the following orders should the tubes be drawn?

Blood culture, Red top, Lavender top

274

A patient shares with the phlebotomist the last time he was in the clinic to have his blood drawn, he "became very dizzy and felt like the room was spinning." Which of the following actions should the phlebotomist take?

Encourage the patient to lie down during the venipuncture

275

When performing a capillary puncture on an infant, which of the following is the reason for using the lateral heel instead of a finger?

The small amount of tissue between the skin and bone in the finger makes an injury to the bone likely.

276

When a complete metabolic serum profile (CMP) and complete blood count (CBC) are ordered at the same time, why would the CMP be drawn first?

Tubes without additives should be drawn before tubes with additives

277

Which of the following statements best describes the reason antecubital veins are most desirable to use when performing venipuncture?

The tissue surrounding these veins is less sensitive, making the procedure less painful

278

Which of the following evacuated tubes should the phlebotomist draw first?

Light blue top

279

Capillary blood specimen collection is contraindicated in patients that

Have edema of the hands and feet

280

Which of the following is the reason blood cultures are typically drawn first?

They can easily be contaminated

281

After performing a venipuncture on a patient the phlebotomist notices the patient is bending his elbow to hold the gauze in place. This action is contraindicated because bending the elbow is likely to?

Create a hematoma

282

While performing a capillary stick on a six-month-old infant's heel, the lancet should be no longer than?

2.0mm

283

Which of the following is the maximum time the phlebotomist should leave a tourniquet secured in place on a patient's arm when performing a venipuncture?

One minute

284

Which of the following is the reason for wiping off the first drop of blood from the patient's finger with gauze when performing a capillary puncture?

The first drop of blood may contain traces of tissue fluids

285

Venipuncture should be avoided on an arm with

An elbow splint

286

Which of the following must be included on a specimen label once it has been filled with blood?

Collector's identification

287

Which of the following techniques should the phlebotomist use when collecting a blood specimen from a geriatric patient?

Pulling the skin taunt and firmly anchor the vein

288

Which of the following should the phlebotomist do after drawing blood from a patient on anticoagulant therapy?

1.) Hold pressure and elevate the patient's arm, 2.) Wait for bleeding to stop, 3.) Apply a pressure dressing over the site

289

In the middle of a blood draw the patient experiences a seizure. Which of the following should the phlebotomist do after removing the tourniquet and withdrawing the needle?

1.) Call for help and 2.) Protect the patient's head and lower her to the floor

290

During a blood draw, a patient begins complaining of discomfort and tingling, at which time the phlebotomist notices bruising and discoloration at the site. How should the phlebotomist proceed?

Release the tourniquet, withdraw the needle, and apply pressure

291

During the transport of blood specimens the blood begins to freeze. How will this affect the test results?

Decreased cell counts

292

While performing a venipuncture, the phlebotomist removes the filled tubes, but forgets to remove the tourniquets prior to needle withdrawal. Which of the following is the most likely result?

Hematoma

293

The patient reports feeling faint, and slumps forward during a venipuncture. After calling for assistance, which of the following actions should the phlebotomist take next?

Remove the tourniquet

294

When performing a venipuncture, sudden swelling is observed at the insertion site. Which of the following actions should the phlebotomist take?

Release the tourniquet, remove the needle, and immediately apply pressure at the site

295

Which of the following is an appropriate alternative to using a rubber tourniquet when attempting a venipuncture on a known patient who is difficult to obtain a sample from?

Blood pressure cuff

296

While performing a venipuncture in the antecubital space, the patient verbalizes an extreme amount of pain and the blood in the collection tube is noted to be bright red. Which of the following sites is most likely to have been inadvertently punctured?

Brachial artery

297

After centrifuging a blood specimen, the phlebotomist notes the serum has a reddish appearance. Which of the following has occurred?

The specimen is hemolyzed

298

While obtaining blood during a venipuncture, the patient faints. Which of the following actions should the phlebotomist take initially?

Discontinue the venipuncture and call for help

299

Which of the following actions is an example of compliance with Quality Control (QC) guidelines for phlebotomy?

Check controls on urinalysis dipsticks daily

300

Which of the following forms is the phlebotomist responsible for having the patient sign when a specimen is being collected for substance abuse screening for employment?

Chain-of-custody

301

Which of the following regulations set the minimum standards for medical laboratory practice and quality?

CLIA

302

Which of the following actions should the phlebotomist take when disposing of a needle following a venipuncture?

Place the needle with safety device activated immediately in a sharps container

303

What does the color of an evacuated collection tube represent?

The type or absence of an additive

304

The phlebotomist is drawing blood on an 88-year-old patient that has multiple skin tears. Which of the following should be used to secure the 2X2 gauze sponge?

Rolled gauze

305

The rubber sleeve at the end of a venipuncture needle allows for

Multiple use

306

Which of the following should be included on a patient's laboratory requisition?

Test priority

307

After selecting the appropriate location to collect a blood sample, how many inches above that location should the phlebotomist tie the tourniquet?

3 to 4 inches

308

After the phlebotomist has introduced herself and identified the patient, she should next?

Explain the procedure

309

The phlebotomist preps the median cubital vein for a venipuncture procedure. How should the phlebotomist prep the patient's skin?

Use a circular motion, from the inside out

310

To help prevent a hematoma at the site after drawing blood, which of the following actions should the phlebotomist take?

Apply direct pressure with cotton gauze

311

The physician orders a hemoglobin level to be checked on a 2-month-old patient. Which of the following sites should the phlebotomist use to obtain the specimen?

Hell of the foot

312

A finger stick capillary puncture should be performed at which of the following sites to prevent injury?

Slightly to the side of the center of the fingertip

313

Most laboratory testing errors occur during the

Patient prep to lab arrival pre-analytical phase

314

While performing a venipuncture using an evacuated tube, a small amount of blood enters the tube and then stops. Which of the following conditions is most likely to have caused this?

Collapsing vein

315

Which of the following conditions may occur if a tourniquet is left in place on a patient's extremity for longer than 60 seconds?

Venous stasis

316

A centrifuge functions is which of the following ways?

Rotates to separate components of a patients blood

317

Which of the following is the correct order of PPE removal prior to leaving the exam room of a patient who is in contact-droplet isolation?

Gown, Gloves, Mask

318

Which of the following needle gauges is most commonly used for venipuncture?

21-23

319

Negligence by health care professional is considered which of the following?

Malpractice

320

According to the American Hospital Association, if a Spanish-speaking patient is not provided a translator although one was requested? This would be considered a violation of?

Patient's Bill of Rights

321

Which of the following organizations makes on-site visits to inspect phlebotomy laboratories?

CLIA

322

It is appropriate for the phlebotomist to use an alcohol-based hand rub as the only method of hand hygiene after which of the following activates?

Before putting on gloves prior to veinpuncture

323

Which of the following precautions should be used for a patient with pulmonary TB?

Airborne and standard

324

Which of the following would be considered a hospital acquired infection?

A patient who contracts MRSA infection from a venipuncture

325

A sharp may be disposed of following a venipuncture once the needle is

Sheathed

326

Which of the following standards are being violated when a phlebotomist fails to use proper hand washing technique?

CLIA

327

Which of the following actions by the phlebotomist is the first line of defense in preventing the spread of microorganisms?

Perform regular hand hygiene

328

Which of the following is included in an exposure control plan?

Contaminated needlestick injury evaluation process

329

The Needlestick Safety & Prevention Act exists to protect healthcare workers from accidental exposure to?

Blood borne pathogens

330

A phlebotomist must follow transmission based precautions for which of the following patients?

Patient with meningitis

331

A physician orders a CBC and glucose tolerance test. Which of the following is the correct tube selection and order of draw?

Lavender, grey

332

Which of the following is the appropriate blood collection device for obtaining a PKU on an infant?

Lancet

333

Which of the following is the CLSI recommended micro-collection order of draw for a BMP, CBC, and bilirubin?

Lavender, green, red

334

The patient was sent to the lab to have lavender, light blue, green, and gray. Place the evacuated tubes in the correct order of draw.

Light blue, green, lavender, and grey

335

Which of the following is the most common light sensitive analyte specimen?

Bilirubin

336

Following an uncomplicated venipuncture, the patient is still bleeding after three minutes of continuous pressure by the phlebotomist. The phlebotomist asks the patient if she is on anticoagulants. The patient indicates that she is, and states that this is normal for her. How should the phlebotomist proceed?

Hold direct pressure until the bleeding stops, apply a bandage, and notify the nurse

337

A phlebotomist has received a requisition for a blood draw on a patient with a coagulation disorder. The phlebotomist should be sure to

Hold pressure on the draw site until bleeding has stopped

338

If a patient has measles, which of the following is a required additional precaution?

N95 Respirator

339

When a phlebotomist enters a patient's room to collect a STAT blood sample, a sign above the bed states that all collections should be from the patients central port. Which of the following should the phlebotomist do next?

Communicate the test order to the nursing staff and wait for one of them to collect the sample

340

Which of the following actions is a HIPAA violation?

Disposing of extra patient tube labels in a regular trash can

341

Which of the following is an example of negative nonverbal communication?

Folding the arms across the chest


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