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MCC Phlebotomy exam
MCC Phlebotomy exam 1-70
| Question | Answer |
|---|---|
| Which of the following tests is performed in the clinical microbiology lab | Blood culture |
| The Patient's Bill of Rights describes which of the following | A patient's rights in any health care facility |
| In which laboratory section are immunohemtology procedures performed | Blood bank |
| The laboratory director is the | Pathologist |
| Which of following is an example of proxemics | Zone of comfort |
| Which of the following would not be considered a preanalytical error | Misreporting patient results |
| Which of the following tests cannot be performed on hemolyzed specimen | Magnesium, most enzyme tests, Potassium |
| Which of the following specimens needs to be chilled | Ammonia |
| Which of the following conditions would cause a specimen to be rejected for testing | Potassium specimen on ice |
| Which statement describes proper centrifuge operation | Place tubes of equal size and volume opposite one another |
| Which type of specimens may take longer to clot | Chilled specimens, specimens from patients taking heparin, specimens from patients with high WBC counts |
| Which specimens can be centrifuged immediately upon arrival in specimen prosessing | Calcium a green top |
| Which of the following does not represent proper aliquot preparation | Carefully pour the contents into the aliquot tube |
| A first morning specimen is preferrred for HCG testing because it is | Usually more concentreated |
| Drugs of abuse can be detected in | Hair, saliva, urine, |
| Which type of specimen must be protected from light | Amniotic fluid |
| Sputum samples are typically collected to diagnose | Tuberculosis (TB) |
| This type of urine specimen is aspirated directly through the wall of the bladder using a sterile needle and syringe | Suprapubic |
| Which of the following patients would be considered to be in a "steady state" for ABG collection. A patient who has | Been asleep for 30 minutes while breathing room air |
| Which of the following is proper needle insertion angle for radial artery puncture | 45 derees |
| a proper cleaning solution for preparing an arterial puncture site is | Providone iodine |
| Which of the following tests may require special "chain of custody" documentationn when collected | Drug screen |
| Identify the condition in which a unti of blood is withdrawn from a patient as treatment | Hemochromatosis, Polycytemia |
| Which of the following tubes can be used to collect blood for a type and crossmatch | Nonadditive red top |
| An autologous blood transfusion is a transfuion of blood | Donated by a patient for his or her own use |
| The most critical aspect of blood culture collection is | Skin antisepsis |
| This test requires a specimen with a 9:1 ratio of blood to anticoagulant | Prothrombin time (PT) |
| The hormone detected in positive urine pregnancy tests is | HCG |
| Tests that can be perfromed using special POCT instruments or test kits include | Arterial blood gases, glucose, occult blood |
| TDM is used by physicians to | Determine a beneficial drug dosage for a patient |
| A phlebotomist arrives to colloect a 2 hour postprandial (PP) glucose specimen on an inpatient and discovers that 2 hours have not elapsed since the patient's last meal. What should the phlebotomist do | Consult with the patient's nurse to verify the correct time to draw the specimen |
| If blood is drawn too quickly from a small vein, the vein will have a tendency to | Collapse |
| A fistula is a | permanent fusion of an artery and a vein |
| When a test requires a fasting specimen, but the serum is _______, it is a clue that the patient was not fasting | Lipemic |
| Testing influenced by dirunal variation are often ordered as ______ test, and it is important to collect them as close as possible to the time ordered | Timed |
| Skin puncture blood reference values (normal) are higher for | Glucose |
| Which microcollection container would be used to collect a CBC | Lavendar |
| What is PKU | A hereditary inability to metabolize phenylalanine |
| It is necessare to control depth of lancet insertion during skin puncture to avoid | Bone injury |
| What is the purpose of warming the site before skin puncture | It increase blood flow up to 7 times |
| What would be the system of choice to identify laborataory specimens from an unconscious, unidentifed woman in the emergency room | Use a three part identification band and labels |
| Test are classified as routine if they are ordered | In the course of establishing a diagnosis |
| You arrive to draw a specimen on an inpatient. The patient's door is closed. What do you do | Knock softly and open the door slowly, checking to see if it is all right to enter |
| It is important to mix anticoagulant tubes immediataely after filling them in order to | Prevent microclot formation |
| You must collect a specimen on a 6 year old. The child is a little fearful. What do you do | Explain what you are going to do in simple terms and ask the child for cooperation |
| The patient asks if the test you are about to draw is for diabetes. How do you answer | Tell the patient that it's best to disuss the test with his or her physician |
| An unconscious patient does not have an ID band. The name and room number on the door agree with the requistion. What should you do | Do not draw the patient until the nurse has applied an ID bracelet |
| Which of the following is part of informed consent | Letting the patient know that your are a student phelbotomist |
| What is the purpose of waiting 30 seconds for the alcohol to dry before needle insertion | To allow the evaporation process to help destroy microbes,Tto avoid a stinging sensation, To prevent hemolysis of the specimen |
| Hemostasis | The coagulation process |
| Lymph fluid originates from | Excess tissue fluid |
| Which of the following veins is not an antecubital vein | Femoral |
| Which test must be performed on whole blood | CBC |
| A major difference between arteries and veins is that veins | Have valves |
| When you are facing someone in the normal anatomic position, at which body plane are you looking | Frontal |
| The layer (s) of the skin containing blood vessels is (are) | Dermis and Subcutaneous |
| The avascular layer of the skin is the | Epidermis |
| Which one of the following basic tissue type covers and lines organs,vessels and cavities | Epithelial |
| The addreviation "ESR" means | Erythrocyte sedimentation rate |
| What word means "condition of clotting" | Thrombosis |
| Which of the following terms means pain | Myalgia |
| What word means "hardening of the artery" | Arteriosclerosis |
| The main principles involved in radiation exposure are | Exposure time, distance and shielding |
| Which of the following is an example of a nosocomial infection. When a | Catheter site of a patient in the ICU becomes infected |
| Which of the following is not an exapmle of possible "parenteral" means of transmission | Drinking contaminated water |
| In what instance might a patient be placed in protective isolation. The patient has | Severe burns |
| Which of the following is an example of work practice control that reduces risk of exposure to blood borne pathogens | Handwashing following glove removal |
| Which type of contact infection transmission involves transfer of an infective microbe to the mucous membranes of a susceptibel individual by means of a cough or sneeze | Droplet |
| You are the only phlebotomist in an outpatient drawing center. A physician orders a test with which you are not familiar. What is the most appropriate action to take | Refer to the user manual for instructions |
| Some tests require immediate cooling on ice and water slurry in order to: | Slow metabolic process |
| What is the purpose of an Arterial puncture (ABS) | This test is used to evaulate patients who have respiratory probems - very painful |
| What is the first thing you do when locating a site for ABG | The site has to be pre-warmed before the procedure |
| What is the first choice(site)for Arterial Blood Gas procedure | Radial Artery - which lies close to the surface which is an advantage but it is small and hard to fine - disadvatage |
| What is Collerated Circulation | An area supplied with blood from more than one artery so that circulcation can be maintained if one vessel is obstructed - |
| The biggest advantage of using the Radial Artery | Is the presence of good collateral circulation, both the radial(thumb)artery and the ulnar(pinky) artery supply the hand with blood |
| What is the second choice (site) for Arterial Blood Gas procedure | Brachial Artery located in the line of the ring finger - Advantage is that it is a Large Artery but very deep and close to the cephalic vein and median nerve |
| What is the third choice (site) for Arterial Blood Gas procedure | Femora Artery - Done by physician/trained specialist only - Femoral Artery is in the groin area. Used for poor Cardiac output |
| What is an disadvantage for using the Femoral Artery for ABG | This artery does not have Collerated Circulation and the site is the most cause of infection (dirty area) |
| What is another way a ABG can be colltected | From an In-Dwelling line - the nurse will do this procedure |
| What is the antiseptic used to clean the site for ABG | Povidone iodine |
| What is the Local anesthetic to numb the ABG site | 1% lidocaine without epinephrine is recommended under the skin (wheal) to lessen the pain. |
| What size needle is used for ABS | 22 gauge, 1 inch needle is used for radial and brachial puncture and a 22 gauge, 1 1/2 needle for femoral puncture |
| What type of syringe is used for ABS | A plastice self filling syringe prefilled (blood will pump into the syringe make usre the plunger is pulled back) - 1 /12 or 2mL with the appropriate amount and type of lyophilized heparin salt |
| What do you do to the Luer-tip | Cap the luer tip needle and clean with alcohol |
| How do you label the ABG specimen | The specimen is labeled and laced in an ice slurry (completely submerge the syringe barrel) to slow the medabolism of white blood cells |
| What state does the patient have to be in before proceding with the ABG test | Steady state - Stable condition requred before obtaining blood gas specimen; that is, a condition in which there has been no exercise, suctioning, or respirator change for at least 20 to 30 minutes |
| Pumonary function test | A bronchi diaulator oxygen exchange ABG test is performed |
| Allen test (modified Allen Test) | There must be circulation on both sides - Radial and ulnar - have the patient pump their fist then grasp w/thumbs puch down hard on both sides of the wirst release Ulnar side first |
| Positive Allen test | The hand should flush and resume its normal pinkish coloration |
| Negative Allen test | If the hand does not resume its normal coloration the ABG can not be performed on that arm and the patient's physician/nurse should be notified of the problem |
| After cleaning the site for the ABG the phlebotomist also cleans: | Their finger/hand with the Povidone iodine |
| From what direction to you perform the ABG | Away from the hand at a 45 degree angle |
| Is a tournquet needed for an ABG | No |
| How do you prevent air bubbles in the syringe (ABS) | Make sure the needle is put on tight to the syringe |
| After the ABG is performed what does the phlebotomist do: | Applies 3-5 minutes of pressure until bleeding stops and checks for the pulse at the site - if not pulse is found notify the physician - patient may have a clot (thrombus) and damage to the artery wall |
| Arteriospasm - disadvantages for ABG | Pain caused by the needle, muscle contracts and blood flows stops caused by patient pain/anxiety, assure the patient so they stay calm |
| Repeat ABG | Can cause damage to the artery resulting in swelling weakness in the wall of the artery, can cause an aneurysm |
| After effects of a ABG | Bruising (hematoma) blood can leak into the surrounding skin, arteries have alot of elasticity to snap back be sure to apply pressure, Numbness may occur, notifly the physician/nurse asap there may be damage to the artery |
| Thrombus | Clot formation |
| Embolism | Traveling blood clot |
| How to prevent infection ABS | Clean the site well |
| Vasovagal syncope | Sudden faintness or loss of consciousness due to a nervous system response to abrupt pain, stress, or trauma - this may happen during an ABG |
| After the ABG is performed the phelbotomis does one more test | Do another Allen test just to make the sure the circulation returns |
| Hemostasis | Coagulation process - process by which the body stops the leakage of blood from the vascular system after injury |
| Homeostasis | State of equilibrium or balance of the interal environment of the body |
| Hemolyzed | The condition of serum or plasma that contains hemoglobin from broken RBC |
| Hemolysis | Damaged or destruction of RBC and release of hemoglobin into the fluid portion of a specimen, causing the serum color to range from pink to ted |
| Hemoconcentration | A decrease in the lfuid content of blood with a subsequent increase in non filterable large molecules |
| Hemopoiesis | Production and development of blood cells and other formed elements, normally in the bone marrow |
| Polycythemia | A disorder involving over production of red blood cells |
| Reticulocytes | Immature RBCs in the blood stream that contain remnants of material from the nuclear phase |
| Erythrocytes | Red blood cells - anuclear disk shaped blood cells whose main fuction is to carry oxygen form the lungs to the tissue cells and to transport carbon dioxide awsy from the cells to the lungs |
| Leukocytes | White blood cells - Nucleus containing blood cells whose main function is to combat infection and remove disintergrated tissue - they can also move through blood vessel walls |
| Basophils | The least numerous White Blood Cells - they release histamine and heparin which enhance the infloammatory reponse |
| Eosinophils | WBC that ingest and detocify foreign protein, helping to turn off immune reactions, they increase with allergies and pinworm infestation |
| Neutrophils | Nomrally the most numerous WBC in adults avergaing 65% of the total WBC count, aka: poys PMNs or segs |
| Thrombocytes | Medical term for platelets - cellular elements that play a arole int he coagulation process and are the smallest of the formed elements |
| Pituitary gland | Aka - The master gland |
| Whole blood | Blood that is in the same form as when it circulated in the blood stream |
| Frontal plane | Divides the body vertically into front and back protions |
| Respondent superior | Let the master respond - employer must answer for damages their employees cause withing the scope of their practice |
| Posterior/Dosal | Term referring to the back - Cranial cavity |
| Proxemics | The study of an individuals concept and use of space |
| Proximal | Nearest to the center of the body or point of attachment |
| Serum | Normally a clear pale yellow fluid that can be seperated from a clotted blood specimen and has tha same compostion as plasma except that it does not contain fibrinogen |
| Plasma | The top layer of clear liquid used for testing also the fluid portion of the blood in the living body |
| Exsanguination | Blood loss to a point where life cannot be sustained |
| Exsanguinate | To remove all the bodies blood |
| Epithelium | The avascular layer of cells that forms the epidermis and the surface layer of the mucous and serous membranes |
| Human Chronic Gonadotropin (HCG) | The hormone that appears in both urine and serum beginning approximately 10 days after conception |
| Percutaneous | Through the skin |
| Permoucosal | Through the mucous membranes |
| Quantitaive | Determines how much of a substance is actually present in the specimen |
| Qualitative | Yes or No answer - pregancy test results the strip will reveal the presence of an positive or negative result |
| Sodium citrate | Blue top - An anticoagulant that prevents clotting by binging calcium and is used for coagulation test because it does the best job of preserving the coagulation factors |
| Sodium floride | Gray top - An additive that preserves glucose and inhibits the growth fo bacteria |
| SSTs | Serum seperator tube |
| EDTA | Ethytenediamenetebraacetic Acid - an anticoagulation that prevents coagulation by binging or chelating calcium it is used for hematology studies because it preserves cell morphology inhibits platelet clumping |
| Heparin | Anticoagulant that preents clotting by inhibiting thrombin formation |
| Medical cubital vein | The preferred (first choice)vein for venipuncture located in the middle of the antecubital fossa |
| Cephalic vein | The second choice antecubital vein for venipuncture located in the lateral aspect of the antecubital fossa |
| Basilic vein | Large vein on the inner side of the antecubital area that is the last choice vein for venipuncture |
| Where does the blood enter the heart | Blood enters the heart from the upper and lower Vena Cava |
| The receiving chambers of the heart are: | Right arterium (first) and left arterium (second) |
| The delivering chambers of the heart are: | Right and left venticles delivers blood to the body |
| Left ventricle delivers | oxygneated blood to the Aorta |
| The main types of blood vessels are: | Arteries, Arterioles, Capillaries, Venules, Veins |
| Arterioles | The smallest branches of arteries, which join the capillaries |
| Capillaries | Microscopic one-cell thick vessels that connect the arterioles and venulse, forming a bridge between the arterial and veneous circulation |
| Venules | The smalles veins at the junction of the capillaries |
| Serum tubes/Plain red tubes - reasons why sometimes it takes longer for blood to clot | Low oxygen, blood thinners, hight WBC count, ice slurry/chilled specimen |
| Aliquot | A portion of a specimen used for testing |
| What is the most common tube used for hematology | CBC - Complete Blood Count - lavendar |
| ID bands | Blood bank/laboratory will have specific ID bands they use |
| Autologous donation | Blood that is donated for one's own use |
| POCT - Point of care tests | Arterial blood gase, Glucose, Occult blood |
| Reason why a blood sample may have become hemoloyzed | Blood drawn w/too small of a needle, Drawn too fast, Collapse veins |
| Skin puncture - Order of draw for microcontainers | Capillary, Lavendar (EDTA most important), Any other tube, Last plain red/serum tube |
| Calcanius | Medical term for heel bone |
| Heel pressure | No milking - just pressure |
| Delta Check | Comparison of current results of a laboratory test iwth previous results for the same test on the same patient |
| Material Safety Data Sheet - MSDS | A document containing general information as weel as precautionary and emergency information for and product with a hazardoud warnig o0n the label |
| Airborn transmission | Transmission of diseasae by dispersal of evaporated droplet neclei containing an infectious agent |
| Contact transmission | Transfer of an infectious agent to susceptibe host through direct or indirect contact |
| Vector transmission | Transmission of an infectious agent by an insect, arthropod or animal |
| Vehicle transmission | Transmission of an infectious agent through contamianted food, water, drugs or the transfusion of blood |
| Ingestion | Taking substance through the mouth into the gestrointestine track such as through eating/drinking |
| Parenteral administration | Administration by nay route other than the digestive tract |
| RACE | Rescue, Alarm, Contain, Extingish |
| PASS | Pull, Aim, Squeeze, Sweep |
| Class A fire | Ordinary household item,wood,papercloth, |
| Class B fire | Flammable liquids |
| Class C fire | Electrical equipment |
| Class D fire | Combustible metals |
| Class K fire | Cooking oils, grease, fat |
| Distal | Fartherest grom the center of the body orgin or point of attachment |
| Anabolism | A construction process by which the body coverts simple compounds into complex substances needed ot carry out the cellular activities of the body |
| Catabolism | The process by which complex substances are broken down into simple ones,including the digestion of food |
| Lateral | Toward the side of the body |
| Superior | Higher, above, or toward the head, cranial |
| Supine | Lying of the back with the face up |
| Prone | Lying face down |
| Sagittal plane | This plane divides the body vertically into right and left portions |
| Midsagittal | This plane divides the body into equal vertically right and left portions |
| Transverse | This plane divides the body in upper and lower portions |
| Ventrial | Front of the body |
| Dorsal | Back of the body |
| EKG - Electrocardiogram | The electrical current corresponding to each event in the heart muscle contraction |
| Anatomic postion | The position of standing erect, arms, at the side with eyes and palms facing forward |
| Epicardium | The thin outer layer of the heart |
| Myocardium | The middle muscle layer of the heart |
| Endocardium | The thin inner layer of the heart |
| Specific types of Anemia | Low Iron, Iatrogenic, Vitamin deficiency, Internal bleeding |
| Non blood fluid must be: | Labeled correctly including the source and site very important |
| Ammonia | Must be kept chilled |
| Bilirubin and Amniotic fluid | Must be protected from light |
| Cold Agglutinin | Must be kept warm/heated |
| Sodium and Potassium | Room temperature |
| Where is Spinal fluid collected from | Between the 2nd and 3rd lumbar vertebrae |
| Gastric analysis | Physician only - a test that examines stomach contents for abnomal substances and measures gastric acid concentration to evaluate stomach acid production |
| Cerebrospainal fluid | Must be kept at Room temperature - this is a STAT test - it is clear, colorless liquid that circulates within the cavities surrounding the brain and spinal cord |
| Nasopharyngeal (NP) | A term referring to the nasal cavity and pharynx |
| NP swab checks for: | Influenza, MRSA, Pertussin(whooping cough), Pneumonia |
| Sperm collection | When checking a man's sperm, the specimen MUST be kept at body temperature also the specimen must be annlysis with 30 minutes |
| Pheural fluid | Lungs |
| Peritoneal fluid | Abdominal |
| Pericardial fluid | Heart |
| Sputum test | Test checks for TB and cultures are done |
| Sweat test | Tests for Cystic Fibrous |
| Synovial fluid | Joint fluid |
| Buccal swab | Swab of material collected from the inside of the cheek, test for DNA |
| Bone Marrow | Physician test the bone marrow when they are looking for cancer |
| Breath test | Checks to see if you have Helicobacterpylori (H.pylori) |
| Stool testing check for | Ova and parasites, C-Dificile, Cultures, Facal fat |
| Hair tests check for | Drug abuse, Metals |
| Tissue specimens are stored what solution | Formulin |
| Order of draw | Blood culture, coagulation (blue), serum (red, gold SST), heparin (green), EDTA (lavendar), glycolytic inhibitor (gray) |
| Standards precaution | They apply to blood, all body fluids (including all secretions and excretion except sweat, whether or not the contain visible blood) nonintact skin and mucous membranes |
| Syncope | Medical term for fainting |
| Bleed test | A cut is made in the under site of the forearm and the blood is measured every 30 seconds using a special paper marked with documentation of time between wipes - Activated Clotting Test (ACT) |
| Largest Portion of the laboratory | Chemistry |
| Biopsy are examined by the: | Pathoologist |
| Pap smears are examine by the: | Cytologist |
| CLIA88 - Clinical Laboratory Improvement Amendments of 1988 | Federal regulation establich quality standards that apply to all facilities including clinics and physicians office, laboratories that test human specimens for the purpose fo providing or treat disease and asses health status |
| 3rd part payer | Insurance companies, HMO, PPO |
| ASCP | American Society for Cinical Pathology |
| Torturary care | Extended stay care facility |
| What is example a specimen would be rejected by the laboratory | QNS -Quantiy not sufficient, clots, wrong tube, labeled incorrectly, transport incorrectly, miss-handled |
| Hepatitis B Virus vaccine | 1 month, 1 month and 5 months |
| What is the major cause of respriatory distress in infants | Respiratory Syncytial Virus (RSV) |
| What hormone is produced by the heart to show how well the heart is working | BNP - Brain Natriuretic Peptide |
| Skeleton muscle | Voluntary |
| Cardiac muscle | Involuntary |
| Smooth muscle (organ) | Involuntary |
| First layer of skin | Epidermis - avascular - no blood vessels |
| Second layer of skin | Dermis aka: Corium - blood vessels |
| Third layer of skin | Subcutaneous - blood vessels |
| Thoracic cavity | Heart |
| Abdominal and Pelvic cavity | Intestines, stomach, reproductive organs |
| Reason why you wait 30 second for antiseptic to dry | Destroys microbes, Less painful(string), interferes w/blood sample |
| Why is it not a good idea to draw blood from a screaming child | The White Blood Cell cound will be elevated |
| ACT | Activated Clotting Test |
| Puttin on PPE | Gown, Mask, Gloves |
| Takin off PPE | Gloves, Gown, Mask |
| Vicarious liability | This is a legal doctrine that assigns libility for an injury to a person who did not cause the injury but who has a legal relationship to the person who did act negligently |
Created by:
mmfleischer