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Phlebotomy Exam

Phlebotomy mock CPT exam

QuestionAnswer
Blood leaving the left ventricle of the heart flows through what vessel? Aorta
Which substance is present in plasma but is absent in serum? Fibrinogen
What medical term means red blood cell? Erythrocyte
The smallest blood vessels are called what? Capillaries
Formed elements makes up approximately what portion of the blood in a healthy adult? 45%
All of the following specimens arrive in the laboratory at the same time. Which one would you deliver immediately to the lab section that performs the test requested?---Throat swab for culture, Spinal fluid for cell count, Gray-top/glucose, Lav.-top/CBC Spinal fluid for cell count
For which test is a first-morning urine specimen preferred? Urine pregnancy test
What type of fecal testing is used to detect Salmonella? Culture
What is the proper way to collect a 24-hour urine specimen beginning at 8 AM on Monday? At 8 AM Monday collect a urine sample and discard it; collect all the urine for the next 24 hours including the one collected at 8 AM Tuesday.
What special instructions should be given to a patient who is going to collect a fecal sample for occult blood? Abstain from eating meat and taking aspirin or vitamin C for 3 days prior to the collection
Amniotic fluid should be sent to the laboratory in what type of container? Sterile amber tube
A routine urine culture and sensitivity (C&S) is ordered. What type of specimen is needed? Clean-catch, mid-stream
The activated clotting time (ACT) performed at the patient’s bedside monitors what type of therapy? Heparin
What bedside test is used to monitor diabetes? Glucose
Bedside hemoglobin testing is one way to monitor which of the following? Anemia
What is the acceptable state for a urine sample for routine testing? Well mixed at room temperature
A phlebotomist who does home visits needs to follow what procedural step that is not necessary when drawing samples from hospitalized patients? Carry a cell phone in order to call for help in an emergency
Rapid strep testing requires what type of specimen? Throat swab
Which item of personal protective equipment (PPE) should be removed first? Gloves
What is the term used to describe a person who is not sick but carries a pathogen that can be transmitted to others? Reservoir
What is the most important action a phlebotomist can do to prevent the spread of infection? Hand washing
Proper hand-washing procedures include rubbing the hands together vigorously for a minimum of how long? 15 seconds
Where in the laboratory would you find written information about a specific chemical being used and its hazards? Material Safety Data Sheet
What is the appropriate action for a phlebotomist to take first after being stuck with a contaminated needle? Clean the wound with soap and water or antiseptic immediately
A phlebotomist sees flames in a laboratory area but sees no people in the area. What is the first action that should be taken? Pull the nearest fire alarm
What is the minimum frequency that temperatures must be recorded for refrigerators and freezers used for reagents or specimens in the laboratory? Daily
Over what type of error does the phlebotomist have the most control? Pre-analytical
What is the term used to describe the quantitative methods used to monitor the quality of procedures and patient results in the laboratory? Quality Control (QC)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides rules concerning what subject of interest to the phlebotomist? Privacy of health information
During early morning rounds, a phlebotomist discovers that all of the lav-top tubes on her tray expired last week. If she goes back to the laboratory to get new ones, her collections will be delayed. Which is an UNACCEPTABLE course of action? Use the tubes just for the STAT or timed collections and then return to the lab to replace the tubes before drawing the routine patients.
How often must centrifuges used in specimen processing be calibrated? Every 3 months
A centrifuge has 12 numbered slots, labeled in a single circle, in consecutive order. There are three tubes of equal amounts of blood that need to be centrifuged. What slots could the tubes be placed in so that the centrifuge is balanced? 1,5,9
A physician’s office calls wishing to add a calcium level to the order of a patient whose blood has already been collected. Two tubes were collected—a lav-top for a CBC and a lt.blue-top for a (APTT). What do you tell the physician’s office? A new sample will have to be drawn and sent to the lab because the anticoagulants in both the lav- and blue-topped tubes bind calcium so it can’t be measured on a sample collected in them
Which specimen needs special handling in the lab due to the possibility of blood-borne pathogens? All blood and body fluid specimens should be treated as if they are infectious
Which specimen should be delivered to the laboratory section that performs the test immediately upon the arrival of the sample in specimen processing? ABG
Which tests need to be protected from exposure to UV light? Bilirubin
Which urine sample typically has a temperature sensor on the specimen container? Drug screen
What is the most critical document if testing results have the potential for being used in a court of law or other formal venue? Chain of custody
What is the term used to describe a unique number assigned to specimens upon receipt in a processing area of some laboratories? Accession number
What is the typical method of collection for state-required neonatal testing? Heel puncture absorbed onto filter paper
What is an appropriate way to collect semen sample for fertility studies? Collected at home into a sterile container and transported to the lab immediately
Many therapeutic drugs have to be collected in paired samples to check for both the lowest and highest levels of the drug. When should the trough specimen be collected? Immediately before the next dose of the drug
According to the Clinical Laboratory Standards Institute (CLSI), what is the maximum amount of time that can elapse between collection and separation of cells from plasma or serum? 2 hours
What is the major risk when removing a stopper from a blood collection tube? Aerosol formation
A phleb. enters a hospital room to draw a Pt. sample & the Pt. does not have an armband on. It's lying on the bedside table. The info. on the band matches the requisition. What is the appropriate course of action? Contact the patient’s nurse and have a new armband put on before drawing the blood
Which piece of information is optional for a test requisition on an inpatient? Which of the following pieces of information is optional for a test requisition on an inpatient?
The following tests are ordered on four different patients on the same floor: 1) Routine CBC 2) Peak gentamicin 3) STAT electrolytes 4) ASAP BUN and creatinine What would be the most appropriate order of draw? 3, 2, 4, 1
In routine venipuncture, at what angle should the needle be inserted? 15 to 30 degrees
What is the single most important step in venipuncture? Positive identification of the patient
What is the proper placement of the tourniquet for routine venipuncture? 3 to 4 inches above the venipuncture site
What is the maximum amount of time that a tourniquet can be left on an arm? 1 minute
Which vein is normally considered to be the first choice for a venipuncture? Median cubita
What is the most common antiseptic used for cleansing a venipuncture site? 70% isopropyl alcohol
When palpating a vein, how should it feel? Bouncy, spongy, and firm
How long should the venipuncture site be allowed to dry after cleansing with antiseptic? 30 to 60 seconds
Hemoconcentration of the sample can occur as a result of which of the following? Leaving the tourniquet on too long
Which alternate choice vein lies on the same side of the arm as the smallest finger and is located near the brachial artery? Basilic
When should the tourniquet normally be removed? As soon as the blood flow into the tube is established
When should tubes be labeled? At the patient’s bedside after the blood has been drawn
Which would be the last step in collecting a patient sample? Wash hands
When using a syringe, a small flash of blood appears in the hub when the vein is entered but no more blood enters the tube. What is the next step? Gently pull back on the plunger to fill the syringe
How should blood from a syringe be transferred to evacuated tubes? Remove the needle from the syringe after activating the needle safety device. Attach a blood transfer device to the syringe and use the device according to instructions
What is the best place to sit the phlebotomy tray while performing the venipuncture? On a night stand close to the bed
What is the term for agents such as alcohol that are used to clean the skin prior to venipuncture or dermal puncture? Antiseptic
What is the term for the diameter of the internal hollow tube of a needle? Gauge
How is the needle adapter (tube holder) disinfected between uses? The needle holder is not reused; discard it
A test requires plasma. Which of the following tubes is the only one that provides serum rather than plasma? Green, Lav, Blue, Red Red
A patient for a bleeding time test (BTT) should be instructed to avoid ingesting what over-the-counter drug for at least 10 days before the test? Asprin
Which of the anticoagulants inhibits clotting by directly preventing the conversion of prothrombin to thrombin? Heparin
Which anticoagulant is routinely used for coagulation studies? Sodium citrate
What anticoagulant is typically used for blood cultures? SPS
What is an appropriate order of draw of the following tubes: 1) lavender-top, 2) light blue-top, 3) blood culture, 4) plastic red-top? 3, 2, 4, 1
What is the proper procedure for disposing the used venipuncture needle? Dispose of needle and adapter in a sharps container after activating the needle safety device
Although many different tests may be collected by dermal culture, which of the following tests must be collected by venipuncture only? Blood cultures
Which substance is present in higher levels in venous blood than in capillary blood? Calcium
Which substance is present in higher levels in capillary blood than in venous blood? Glucose
A laser lancing device that uses a laser to pierce the skin for dermal puncture is only approved for use on patients over what age? 5 years
What type of tubes are used primarily for collection of capillary blood gases? Micropipets
A warming device is sometimes used on a dermal puncture site before collection. What is the maximum temperature of the warming device? 42°F
A dermal puncture performed too close to underlying bone may puncture the bone and ultimately lead to what serious, sometimes fatal, bone infection? Osteomyelitis
For a heel puncture on a newborn, what is the maximum depth of the puncture due to the location of the calcaneus bone? 2 mm
What is the preferred site of dermal puncture on a 5-year-old? Distal end of the middle finger
For a dermal puncture on an adult patient, what is the proper puncture technique? Lateral border of the ring finger, perpendicular to the ridges of the fingerprint
Which of the following tests may be collected by dermal puncture using povidoneiodine as an antiseptic? Glucose
Which action is acceptable during collection of phosphorus by dermal puncture? Wipe away the first drop of blood
During dermal puncture, which of the following tests should be collected first? CBC, glucose, blood smears, BUN Blood smears
Due to a potential choking hazard, band aids should not be used on a finger-stick in children younger than what age? 2 years
The Pt. for a venipuncture is located in ICU. Upon entering the room, the phleb. checks the armband and determines the patient identity as required. After addressing the patient verbally, no response is received. What is the best course of action? Verify with the ICU staff that the patient is unconscious; if so, explain the procedure to the patient just as if the patient can hear and then perform the venipuncture
After explaining the venipuncture procedure to an inpatient, the patient refuses to let you perform the procedure. What is the appropriate course of action? Gently try to convince the patient to have the blood drawn; if he still refuses, document this on the request and notify his health care provider
A needle going through a vein can cause which of the following? Hematoma
Which of the following tests can be collected when 70% isopropyl alcohol is the only antiseptic used to cleanse the puncture site? Blood bank tests
Too much vacuum on a small vein from using a large evacuated tube is likely to cause what? Collapsed vein
Which of the following tests is significantly affected by hemolysis of a blood specimen? CK, glucose, potassium, Uric acid Potassium
Which of the following actions should be avoided during venipuncture in order to prevent reflux from the collection tube? Maintain the tube at an angle above the venipuncture site
A large amount of bleeding into the tissue surrounding a venipuncture site in a patient with a bleeding disorder may result in what condition? Compartment syndrome
For infants and children, what is the preferred maximum amount of blood volume that should be removed in a 24-hour period? 3%
Which of the following is an inappropriate action when performing a blood draw on a child? Tell the child that it will not hurt
A newborn in the nursery is being kept under special UV lights as a treatment. These lights should be turned off during collection of what test? Bilirubin
Created by: CharleeDilley