NCCT Official Review for National Certified Phlebotomy Technician

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The forearm vein most commonly used for venipuncture is the -

median cubital

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The smallest veins in the human body are known as -

venules

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The aorta branches into smaller divisions called arteries, which in turn branch into even smaller divisions called -

arterioles

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Characteristics of capillaries include -

having thin walls, forming microscopic pathways, and connecting arterioles with venules

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Within capillaries, blood cell functions include -

releasing oxygen, binding carbon dioxide, and eliminating waste

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The heart, lymphatic organs, and blood vessels are in the - - system.

cardiovascular

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The suffix -URIA at the end of a medical term refers to what body location?

Urine

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The study of blood is known as -

hematology

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The liver, stomach, mouth, and pancreas are in the - - system.

digestive

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The most important step to insure accuracy in sample collection is -

identifying the patient properly.

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The bladder, urethra, kidneys, and ureters are in the - - system.

urinary

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The trachea, nose, lungs, and pharynx are in the - - system.

respiratory

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The sebaceous glands, skin, hair, and nails are in the - - system.

integumentary

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The body system that is a primary regulator of hormones is the - - system.

endocrine

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Neutrophils, eosinophils, basophils, lymphocytes, and monocytes are types of -

white blood cells.

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The common name for the thrombocyte is the -

platelet.

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The liquid portion of an anticoagulated blood sample is known as -

plasma.

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The instrument that measures blood pressure is called a -

sphygmomanometer.

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An artery can be distinguished from a vein because an artery will be -

pulsating.

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Lancets are used to collect blood samples by -

capillary or skin puncture.

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The abbreviation VAD is commonly used in hospitals to refer to -

venous access devices.

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To determine the size of a needle, remember that the higher the gauge, the -

smaller the needle bore.

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Adult capillary punctures most often involve the use of the - - finger(s).

third and fourth (middle and ring)

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A centrifuge is used in a clinical laboratory setting to -

separate liquid from cells in blood.

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The oral glucose tolerance test is used for the detection of -

diabetes.

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Use a - -topped evacuated tube for collection of blood for a CBC test.

lavender

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Use a - -topped evacuated tube for collection of blood for electrolyte testing.

red (or green for STAT orders)

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Use a - -topped evacuated tube for collection of blood for cholesterol testing.

red

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Sodium citrate is an anticoagulant of choice for coagulation studies because it protects -

clotting factors.

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When preparing a blood smear directly from a skin puncture, it is best to -

wipe away the first drop of blood.

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The purpose of doing blood cultures is to detect -

septicemia.

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Anticoagulants are used to -

prevent blood from clotting.

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White blood cells help the body by -

defending against foreign invaders.

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Platelets help circulation by -

participating in hemostasis.

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When blood seeps into the surrounding tissue during venipuncture, a - - may form.

hematoma

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In a patient with a clotting disorder, pressure should be applied to the puncture site for at least - - minutes after venipuncture to insure blood stoppage.

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Skin punctures may be indicated for use when -

1)the patient is an infant, toddler, or preschooler, 2) only a small amount of blood is needed, or 3) patient veins need to be preserved for IV therapy.

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All specimens should be labeled with -

1) Patient's name, D.O.B., and numeric ID) 2) Date and time collected 3) Collector's initials

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One test often used to assess hemostasis before surgery is -

bleeding time.

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One possible cause of unexpected clotting in an anticoagulated blood tube might be -

insufficient mixing.

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When performing a venipuncture, position the bevel of the needle -

facing up (you should be able to see the opening).

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If blood does not appear in an evacuated tube upon venipuncture, the phlebotomist's first course of action should be to -

slightly reposition or turn the needle.

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Redirecting a needle during venipuncture is sometimes necessary when -

1) the vein was not properly anchored, 2) the patient moves unexpectedly, 3) blood flow starts, then stops.

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A vein might be prone to collapse if the -

vacuum tube is too large for the vein, or the syringe plunger was pulled back too quickly.

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Hemolysis would cause rejection of a sample collected for - - testing.

potassium

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If a patient is prone to syncope during venipuncture, the phlebotomist should -

watch in case of fainting.

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A tube of blood that arrives in the laboratory without a label must be -

rejected automatically.

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If a blood sample must be collected 2 hours post-prandial, the phlebotomist should collect the sample -

2 hours after a meal.

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Knowing when to collect peak and trough levels is important when drawing -

therapeutic drugs.

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A pre-warming technique may be used to -

increase a patient's tendency to bleed.

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The role of all anticoagulants is ultimately to prevent formation of -

Fibrin.

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The anticoagulant EDTA works by -

binding calcium.

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If the tourniquet is not released before the needle is withdrawn from the arm during venipuncture, this will most likely result in -

bleeding from the site.

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The bilirubin test is - - sensitive.

light

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The - - must be followed exactly whenever drawing patient test samples that may be used in a legal proceeding.

Chain of Custody

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The anticoagulant SPS (sodium polyanetholesulfonate) is recommended for use in blood cultures because it -

does not inhibit bacterial growth.

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Before entering an inpatient room if the door is closed, phlebotomists should always -

Check for isolation signage, knock, and ask for permission to enter.

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Before entering designated isolation rooms, phlebotomists should always -

check requirements on signs.

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The single most important means of prevent the spread of infection in a hospital is by -

hand washing.

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The most prevalent type of nosocomial infections are -

urinary tract infections.

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Phlebotomists have a statistically greater chance of contracting - - in a work-related accident than they do of contracting AIDS.

hepatitis

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AIDS is caused by -

the HIV virus.

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When performing heelsticks on infants in a hospital nursery, it is important to never -

share supplies from one infant to another.

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When delivering blood samples to a laboratory, they should always be transported inside -

sealed plastic bags.

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If a biohazard spills in the laboratory, a phlebotomist should first try to -

contain the spill safely.

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According to OSHA, a contaminated needle may be safely discarded into a -

sharps container.

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In most hospitals, a phlebotomist with a cough may draw from a patient provided the -

1) Patient is not in reverse isolation 2) The phlebotomist does not have a fever 3) The phlebotomist wears a mask

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When drawing blood from pediatric inpatients, a phlebotomist can increase the safety for the patients by -

1) Using a smaller bore needle and smaller collection tubes 2) Getting help to hold the patient securely during the draw 3) Making sure the bed-rails are left raised if found that way

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To eliminate bacteria from the skin of a bacterial culture venipuncture site, - - is sometimes used in addition to alcohol in the skin cleansing process.

iodine

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The term that refers to right and wrong conduct is -

ethics.

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An unlawful threat or attempt to do bodily injury is -

assault.

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Law protects the health worker if it can be determined that he or she acted reasonably as compared with fellow workers; this is called -

reasonable care.

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Negligence by a professional person is called -

malpractice.

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Information given by a patient to medical personnel that can not be disclosed without consent constitutes -

privileged communication.

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Permission granted by a person voluntarily (and in his right mind) is -

consent.

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A phlebotomist who attempts to draw blood without sufficient training could be accused of - - if the procedure is performed incorrectly, causing harm to the patient.

incompetence

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Forcing venipuncture on a patient who has refused it would be considered -

battery.

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The branch of study of moral issues, questions, and problems arising in the practice of medicine and biomedical research is called -

bioethics.

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Conduct, courtesy, and manners, customary in the medical profession, is called -

medical etiquette.

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Each and every patient is entitled to - - as part of his or her patient rights.

respect and complete care

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Some suggested methods of controlling on the job stress during phlebotomy might include -

taking deep breaths if anxious.

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Appropriate means of communicating with a patient that is profoundly hearing impaired might include -

using written communication.

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In performing phlebotomy on children, it is best to -

1) talk softly and gently 2) enlist the help of parents 3) tell the truth if asked

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A patient who is making a fist and frowning is exhibiting - - body language.

uncooperative

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A 24-hour urine specimen must be kept -

refrigerated.

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A chronic disease in which the pancreas fails to secrete enough insulin is called -

diabetes mellitus.

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The purpose of the bleeding time test is to assess -

platelet plug formation in the capillaries.

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Diurnal rhythms refer to variations in the body's functions or fluids that occur during -

every 24 hours.

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EMLA is an emulsion of lidocaine and prilocaine that can be used to -

topically anesthetize a draw site.

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Another name for red blood cells is -

erythrocytes.

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The artery located in the groin, lateral to the femur bone, which is used as an alternative site for arterial blood gas collections is the -

femoral.

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The federal law that was expanded in 2000 to protect the confidentiality of electronically stored health information is abbreviated as -

HIPPA.

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The study of all aspects of disease in the body is known as -

pathology.

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The phase of laboratory testing that refers to test orders, test collection, and test sample preparation are all part of the - - phase.

pre-analytical

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A patient in reverse isolation has been so placed because he or she -

needs protection from others carrying infection.

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Contaminated objects that can penetrate skin, such as needles, scalpels, broken class, and broken capillary tubes are called -

contaminated sharps.

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To use a physical-chemical procedure to destroy all microbial life including highly resistant bacterial endospores is to -

sterilize.

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The single most important source of HIV and HBV in the workplace is -

blood.

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After they are used, disposable syringes, scalpel blades, and other sharp items should be placed in - - containers for disposal.

puncture resistant

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Contaminated laundry should be - - where it was soiled.

bagged or containerized at the location

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The suffix - - means blood.

-emia

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The literal meaning of the word hemolysis is -

blood breaking down.

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PT is the lab abbreviation for the - - test.

Prothrombin time

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When a patient's arm is swollen with excess fluids, this is called -

edema.

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A nosocomial infection is an infection acquired -

in the healthcare facility.

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Choose the item that is NOT a single use only item: needles, tourniquets, tube holders, winged infusion sets.

Tourniquets

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The name of the equipment used to separate plasma or serum from red blood cells is -

centrifuge.

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The tube holder and needle are to be disposed of - - into a sharps container.

together, as a unit

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Needles are color-coded to indicate their -

gauge.

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According the the CLSI, the maximum recommended depth for heel punctures is -

2.0 mm

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The - - color stopper indicates the blood collection tube contains sodium heparin.

green

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When a lipid panel is ordered, the patient should be fasting for -

at least 12 hours with water allowed.

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The key principle of Universal Precautions is that -

the blood and body fluids of all individuals are considered potentially infectious.

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A patient having a glucose tolerance test does not have the restriction of -

drinking water.

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In the healthcare setting, HBV, HCV, and HIV can be transmitted by -

1) sharps injuries, 2) splash of blood or body fluids to the mucous membranes, 3) touching non-intact skin without gloves

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Needlestick injuries can be prevented by -

using safe needle devices and following instructions for proper use.

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Sharps containers should be closed, sealed, and made ready for disposal when it is -

3\4ths full.

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If you should recieve a needlestick injury, you should report it -

immediately.

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Antisepsis is a technique used on -

skin.

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The transmission based isolation category Airborne Precautions is used when a patient is known or suspected to have -

tuberculosis.

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The bloodborne disease most likely to be transmitted by a needlestick in the US is -

Hepatitis C.

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A patient experiences shooting pains in his arm when you are drawing from the antecubital area, which means you may have -

punctured or nicked the basilic nerve.

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The most likely reason a CBC specimen would clot is -

the blood and the anticoagulant in the tube were not mixed sufficiently.

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A patient had a mastectomy on the right side five years ago. The side you will draw from is -

the left side, as blood is never drawn from the side with a mastectomy.

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You are drawing blood from an outpatient when they begin to feel faint. The recommended course of action is to -

remove the needle, and lower the patient's head between their legs.

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Hemoconcentration may be cause by -

prolonged application of the tourniquet.

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The primary cause of a collapsed vein during venipuncture is -

blood is withdrawn too quickly or forcefully.

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Mixing the blood with the anticoagulant or additive by shaking may result in -

a hemolyzed specimen.

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If you find blood on the outside of the tube you have just filled, you should -

wipe the outside of the tube with a disinfectant.

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Name three things that could result in a lawsuit being filed against a phlebotomist.

1) Inserting the needle at an incorrect angle. 2) Excessive probing after missing a vein. 3) Mislabeling blood tubes.

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Considering patient safety, the most dangerous phlebotomy practice is -

labeling the empty collection tubes before the collection.

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Per CLSI, the maximum number of venipuncture attempts by an individual phlebotomist is -

no more than two.

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According to standards of good practice, specimen collection tube labeling should always occur -

before the phlebotomist leaves the patient's side.

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The first drop of blood that forms following a skin puncture should be -

wiped away.

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When identifying a patient, you must ask them to state -

their name and date of birth.

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The - - vein is recommended for use when drawing 5 mL of blood on an 18 month old.

dorsal hand

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Cleansing the skin with Betadine for a skin puncture may interfere with the analysis of -

bilirubin.

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When performing a microcollection procedure, the best way to increase blood flow is to -

pre-warm the site.

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A patient's wristband matches your requisition form except for the birth date. It shows the same month and day, but the year is 1947 instead of 1945. In order to draw blood -

all identification discrepancies must be resolved FIRST!

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Drugs used to kill or destroy bacteria that cause disease are called -

antibiotics.

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CSF is the abbreviation for -

cerebrospinal fluid.

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Red and white blood cell counts are examples of - - tests.

hematology

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The blood cells most numerous in the circulating blood are the -

red blood cells.

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The medical term for fainting is -

syncope.

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Serum or plasma that has a milky white appearance is called -

lipemic.

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The lab test "T & C" is the abbreviation for -

Type and Crossmatch.

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The rubber sleeve (at the end opposite of the beveled needle tip) on an evacuated tube needle makes it possible for use with -

multiple tubes.

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Capillary blood sampling may be used if the laboratory tests require -

very little blood.

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A tube adapter visibly contaminated with blood should be -

disposed in a biohazard waste container.

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The evacuated tube containing sodium citrate has a - - colored stopper.

blue or light blue

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A fasting test is ordered to -

eliminate the effects of diet on the test results.

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A - - topped tube should be used for a lab test requiring serum.

red

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Hepatitis - - is not a blood borne pathogen.

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The LAST choice for blood collection in the antecubital area is the -

brachial veins.

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The venipuncture site should be cleaned in a circular motion from the center to the -

periphery.

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A patient on which you have been ordered a draw has no armband. You should -

tell the patient's nurse that the patient does not have an armband, and you can not collect until it is placed on the patient.

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Therapeutic phlebotomy is performed as a treatment for patients with -

polycythemia vera.

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The formed elements make up about - - percent of the whole blood volume.

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The buffy coat consists of -

leukocytes and thrombocytes.

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The two components of blood found in a tube without anticoagulant are -

serum and clot.

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

plasma.

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The fluid portion of blood after clotting has taken place is called -

serum.

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The difference between plasma and serum is -

plasma contains fibrinogen; serum does not.

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Blood returns to the heart from the lungs into the -

left atrium.

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The pulmonary - - does NOT carry oxygenated blood.

artery

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A blood collection on dialysis patient with a fistula or graft should be drawn from -

the opposite arm. Never draw on the arm with a fistula or graft.

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The order of which veins should be used for draw in the antecubital area is -

1) Median Cubital 2) Cephalic 3) Basilic 4) Median

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The most common phlebotomy complication is -

hematoma formation.

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The test with cleaning techniques similar to those for blood culture tests is -

Arterial Blood Gases.

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The Allen test checks the patient for -

collateral arterial circulation.

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The two arteries are occluded during the Allen Test are -

The radial and the ulnar.

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The artery on the thumb side of the wrist is the -

radial.

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The safe area for heel punctures in an infant is -

the most lateral portion of the plantar surface (the side of the pinkie toe).

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Skin puncture blood is more likely to be contaminated by -

hemolysis.

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An estimate on how much time do you have for ASAP and STAT orders is -

2-4 hours for ASAP orders, and 1 hour for a STAT order.

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The amount of blood needed for blood culture draws for adults and for children are -

8-10 mL for Adults, 1-5 mL for children.

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When using a butterfly needle for a blood culture test with two bottles, the - - bottle goes first.

Aerobic

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Examples of tests that must be chilled immediately after collection are -

Ammonia, Catecholamines, Lactic acid, and PH\blood gasses.

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Examples of tests that must be kept warm after collection are -

Cold agglutinins, Cryoglobulin.

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Examples of tests that must be kept from the light are -

Bilirubin, and vitamins C, E, and K.

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The two bottles used in blood culture collections are -

Aerobic and Anaerobic.

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

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A phlebotomist certified by the American Society of Clinical Pathologists (ASCP) is required to maintain certification by completing and documenting continuing education. This is known as the -

Certification Maintenance Program (CMP)

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NPO means -

'Non per os' or 'nothing by mouth'.

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The lifespan of a red blood cell is -

100 - 120 days.

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