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Phlebotomy Certif!
| Question | Answer |
|---|---|
| The appropriate anticoagulant used to coat a syringe for collecting an arterial blood gas is: | Heparin |
| A patient in the ICU had indwelling lines for fluid and medication. A chemistry panel was ordered. The correct procedure for collecting blood from an indwelling line is: | To discard the first 5 mL |
| A sample was collected 24 hours ago in a red-topped tube and sent to the Chemistry Laboratory for testing. This morning the physician requested that a manganese test be added. This trace metal: | Is stable at room temperature of 7 days |
| A specimen that was difficult to collect was sent to the lab for an active partial thromboplastin time (APTT) and the results were prolonged. The patient was not on any medication. A repeat sample was collected and the results were normal. A possible expl | Under-collected, causing excess anticoagulant. |
| A patient is the ICU is infected with methicillin-resistant Staphylococcus aureua (MSRA). The proper PPE to be worn when collecting blood from the patient is: | Gown and gloves |
| A patient scheduled for a 2-hour glucose tolerance test drinks the glucose beverage and complains of feeling nauseated. The patient vomits 75 minutes into the test. The phlebotomist should: | Stop the test, it is complete |
| A patient is being monitored for diabetes. While hypoglycemia is diagnosed with a fasting blood specimen, diabetes is monitored with a: | 2-hour postprandial blood test |
| A patient needs to submit a urine test for a routine drug screen but is unable to provide a urine sample. The patient is instructed to drink up to 24 Fl. Oz. Of water in 2 hours. Another sample is obtained but it is insufficient in quantity. The Lab shoul | Discard the Irvine sample and cancel the test. |
| To best preserve the urinary sediment in a 24-hr urine specimen, the preservatives of choice are: | Boric acid and thymol |
| For a 24-Hr urine specimen to be handled appropriately it should include: | The total volume of urine collected |
| A sample collected by a syringe for coagulation testing should not be placed into a vacutainer tube by piercing the cap because of: | Hemolysis of red blood cells |
| When collecting blood from adolescents the phlebotomist should: | Answer all questions the adolescent might ask |
| Contaminated sharps must be placed in a puncture resistant container that displays: | A biohazard symbol |
| A patient comes to the outpatient phlebotomy area to have blood collected. The patient is on AZT, and the test ordered is a CD4. The phlebotomist assumes the patient is HIV infected and should; | Practice standard procedures routinely used for collecting blood |
| Which of the following could be an application of bar code utilization in the post-analytical phase? | Maintaining frozen specimen storage records |
| The patients results were abnormal for the following tests: potassium, calcium, uric acid, billirubin. It was noted that the sample was collected by fingerstick. A possible source of error is: | Using Betadine to clean the site |
| NCCLS Recommends when performing a heelstick on a newborn, the site be warmed for: | 42C for 3 minutes |
| The best vein for venipuncture is the: | Median cubital |
| The trough valve of a drug is collected: | Prior to the patient receiving the drug |
| A sample that was difficult to collect had a CBC with an abnormally high RBC and hemoglobin values. Upon recollection the results were normal. This could be a result of: | Prolonged tourniquet application |
| Failure of a phlebotomist to provide standard of care is; | Malpractice |
| The loosened skin seen on geriatric patients is due to: | The loss of supportive connective tissue |
| Post exposure prophylaxis (PEP) for exposure to HIV is most effective when started: | 1-2 hours after exposure |
| According to NCCLS, an IV bleeding time should be stopped after: | 15 minutes |
| Blood cultures containing ARD/resin would be collected: | On patients receiving antibiotics |
| If the patient has fragile names that appear likely to collapse during phlebotomy, the best system to use for blood collection is a: | Syringe |
| A patient who is recumbent is: | Supine |
| When performing a venipuncture on a 65-year-old patient with good veins, the phlebotomist should choose which gauge needle for the venipuncture? | 21 |
| A patient in the emergency department must have a blood alcohol level collected to be used in court in relation to drunk driving charges. The site should be cleaned with: | Betadine |
| If a patient is receiving tissue plasminogen activator (tPA), blood may be collected: | Only with the physician's approval |
| The inner lining of the heart is known as the: | Endocardium |
| Which of the following should be collected as a whole blood specimen? | HLA typing |
| A patient's blood glucose was tested at the point-of-care (POC). The results exceeded the establishment range of the POCT equipment. The first course of action would be to: | Repeat the sample |
| If a glucose level is ordered "postprandial" the sample should be collected after: | Eating |
| The best way for a phlebotomist to verify a patient's name is to: | Check their wristband |
| The main function of the circulatory system is to provide: | Transportation |
| Which of the following statements best describes a vein? | It contains structures called valves |
| When handling body fluids, universal precautions should be used: | At all times |
| A blood sample is to be collected from a patient. The patient has an IV in the right arm, and a full cast on the left arm. In order to collect the sample: | Ask a nurse to turn off the IV and collect the sample from below the IV site |
| A nurse agrees to collect a blood sample from a patient's indwelling line. The nurse submits the very first syringe of blood collected from the line. The phlebotomist would: | Ask the nurse to collect a second syringe of blood from the patients line and use this sample to fill your collection tube. |
| The safe areas for a heel puncture on an infant is/are: | The most medial or lateral portion of the plantar surface |
| Which of the following arteries in the leg is recommended for collecting blood for ABG? | Femoral artery |
| Which of the following conditions would create an adverse effect on the quality of a fingerstick blood specimen? | Swollen fingers |
| Which of the following analytes would be affected if the sample were exposed to light? | Bilirubin |
| A full bottle Mrs. collecting blood samples from six patients. The requisition for the first patient requires a blood sample be collected for a blood gas. When collecting blood from the remainder of the patients, the best way to store/transport this sampl | In icewater |
| When collecting a blood sample from an elderly, real patient sometimes the best method is to collect from the back of the patient's hand. The best collection device to use for this situation is: | A syringe |
| Upon entering in emergency department a position has just completed collecting a blood sample. The physician recaps the needle using the one hand it scoop method and discard the needle into a regular trashcan container lined with plastic. The physician la | The collection needle should never be disposed of in a regular trash container |
| A method that is in accurate but precise would be represented on a bull's-eye target as: | Tight scatter around the bully's-eye. |
| Because she's hospital patient, is not wearing in identification armband. The name and the room number on the door agree with the information on the laboratory requisition. The next step is to: | Not collect the patient's blood until an armband is placed on the patients are |
| What is carried away from the heart to the rest of the body via: | Arteries |
| A blood sample is required on a patient suffering from TB. Which of the following items should the phlebotomist remove from the patient's room after completing the venipuncture? | the blood sample collected during the venipuncture |
| a blood specimen is requested from a patient suspected of having septicemia. Which of the following substances should the phlebotomist use to clean the venipuncture site? | Alcohol and Iodine |
| CSF is manufactured in the: | meninges of the brain |
| To prevent blood clotting in an indwelling line, which of the following substances may be flushed through the line? | Saline or Heparin |
| The surgery unit collects blood specimen for routine chemistry testing and immediately places the specimen on ice. A phlebotomist who just happens to be in the unit is asked to take the sample to the lab. The phlebotomist accepts the sample and takes it t | request a repeat sample submitted at room temperature. |
| A blood specimen is collected from a patient who is unable to speak. An upset family member is present at the time of the collection and abruptly asks the phlebotomist to explain the reason for the phlebotomy. the phlebotomist should: | answer the question in a diplomatic manner |
| A fingerstick is preformed and blood flow is minimal. To increase the flow of blood from the site, the phlebotomist should: | Milk the finger |
| A phlebotomist collected a blood sample in the appropriate tube for an activated coagulation time (ACT) test, but did not mix the tube after collecting the sample. if the sample were used for bedside testing ACT, the results obtained will likely be: | increased |
| Which of the following is required to preform quality control procedures on a centrifuge? | a tachometer |
| the best course of action to assist a patient who becomes nauseated following a venipuncture is to: | apply a cold wet washcloth to the patient's forehead |
| Which of the following is the best option to collect a venipuncture sample from the hand of a patient with veins that are difficult to palpate? | syringe |
| Capillary blood is acceptable for hemoglobin testing because it contains: | oxygen-carrying red blood cells |
| A specimen for a legal blood alcohol was collected. Before delivering the blood to the lab for testing, the phlebotomist must complete which of the following forms? | Chain-of-custody requisition |
| The appropriate PPE for collecting blood from a patient under droplet precaution is: | Mask and gloves |
| In the systemic circulatory system, deoxygenated blood leaves the heart and is brought to the lungs by which vessel? | Pulmonary artery |
| A blood specimen for a CBC is collected in an EDTA tube and is mistakenly left on the accessioning counter overnight. Which of the following parameters, if any, would be affected by the processing delay of the specimen? | WBC DIff |
| A 45-yr-old, 260-lb truck driver in an outpatient clinic is waiting to have his blood collected while the phlebotomist assembles the equipment. he states that he is feeling faint. What should be done next? | Have the patient lie down if there is a cot, or floor is necessary and have him raise his feet and breathe deeply |
| What is the function of a "lancet"? | it pierces the skin to obtain blood via skin puncture |
| Which of the following are used for a bleeding time test? | sphygmomanometer, filter paper, simplate, stopwatch |
| Which of the following statements is true concerning phlebotomy of newborns and infants? | The same safety precautions are used for a skin puncture as for a venipuncture |
| What is the effects on a blood gas specimen if it is exposed to air? | the blood gas results will be in error |
| Where are blood gas specimen usually collected from an adult? | Radial artery near the thumb |
| A phlebotomist is given the following categories of orders for the patients to be collected: STAT, Fasting, Routine, Timed, Pre-op. In what order should the patients be collected? | STAT, Fasting, Routine, Timed, Pre-op |
| What specimen is used to test for the disease "cystic fibrosis" in children? | Sweat |
| Which of the following should be collected in an anticoagulant tube, placed in ice water, and brought to the lab ASAP? | Lactate Levels |
| Four patients are waiting to have blood collected as follows: P#1: chem 20 screen; P#2 CBC and Diff; P#3: cryoglobulin level; P#4: type and screen. Which patient should be last one collected before returning to the lab? | Patient #3 |
| A specimen for a blood ammonia test was collected at 9:30 am, but did not reach the lab until 12:30 pm. The ammonia result was 250 ug/dL (Ref. range 15-50 ug/dL). A repeat sample collected at 1:00 pm and analyzed at 1:15 pm was 25 ug/dL. Which of the foll | The first result could have been elevated due to processing delay |
| Which of the following tests must patients closely follow instructions concerning diets before coming to the lab, and record of the time for each specimen collected is of utmost importance? | glucose tolerance test (GTT) |
| What is recommended minimum time period for allowing blood to clot in a SST before centrifuging? | 30 minutes |
| A patient is scheduled for peak and trough vancomycin levels. When the phlebotomist arrives to collect the peak levels at 10 am, he notices that the vancomycin IV bag still contains fluid and the IV site is swollen. After informing the nurse about the IV | reschedule the peak and trough levels with the next dose |
| AABB standards state that labels for the crossmatch specimens must include patient name, patient I.D. number, and: | date of collection |
| A specimen for urine cytology requires a: | random urine |
| Which of the following terms refers to surgical removal of breast tissue? | mastectomy |
| "Blood Doping" refers to: | increasing the oxygen carrying capacity of blood through the use of erythopoietin |
| The preferred specimen in sports drug testing is: | urine |
| if a patient had a mastectomy on the right side, which site would be the best choice for collection of a blood specimen? | Left arm |
| A specimen for blood acetone should be kept tightly sealed during transportation and processing to prevent: | evaporation |
| Pericardial fluid is collected from the: | heart cavity |
| A dark blue tube is required for the collection of a specimen to be tested for: | maganese |
| What kind of fluid is collected during a lumbar puncture? | Spinal |
| At what angle should the needle used for venipuncture enter the skin? | 15 degrees |
| Acid washed syringes are used to collect specimens for analysis of: | trace elements |
| A child who is crying may have a falsely elevated: | WBC count |
| The primary purpose of Standard Precautions is to: | prevent disease transmission |
| After preparing a puncture site with alcohol, it must be allowed to dry completely to prevent: | specimen hemolysis |
| Which profile requires a patient to fast? | Lipid |
| The Maximum depth for a heel puncture is: | 2.4 mm |
| The most significant advantage of an automatic lancet device is that the: | puncture depth is standardized |
| The gel in a SST aids in: | glycolysis prevention |
| Specimens for capillary blood gases can be stored in an ice slurry for a maximum of: | 2 hours |
| Arterial blood leaves the heart through the: | aorta |
| The liquid portion of the blood within the body is | plasma |
| the lab receives a STAT request for a blood glucose level on a patient in the emergency department. It is appropriate to: | treat the request as a medical emergency: collecting and processing the blood immediately |
| The best location to perform a dermal puncture for a point-of-care glucose test on an adult is the tip of the palmer surface of the: | third and fourth finger |
| Low and high controls are required for a glucose meter. these are run: | exactly the same as patient samples are run |
| A patient has recently had a radical mastectomy of the right breast. the best site for venipuncture in this patient is the: | left arm |
| Urine begins forming in the *** where the blood is ***. | Kidneys; filtered |
| The length and width of lancet blades are important for assuring an adequate flow of blood and to: | prevent injury to the bone |
| Blood culture collection sites are prepared by swabbing the venipuncture site with iodine, which is left on for at least: | 20 seconds |
| A tourniquet is applied to the arm above the venipuncture site to: | Slow the flow of venous blood to the heart |
| Arterial walls have thick layers of *** to withstand increased blood pressure during the contraction of the heart and to maintain blood flow during its resting phase. | Muscle |
| Which of the following is a normal finding in plasma specimen? | Light yellow color |
| A blood specimen for a 2-hour postprandial glucose test is collected: | after the patient eats a meal |
| Which of the following describes the appropriate response by the phlebotomist? | A patient on withhold for 8 hours reports drinking water. A blood glucose level was collected, and no report was added to the requisition |
| A patient's Lab requisition requests the specimen be collected by fingerstick. The Phlebotomist about to preform the fingerstick notices that the hands feel cold. It is appropriate for the phlebotomist to: | warm the patient's skin prior to performing the puncture |
| A patient has a cast on the left arm and an IV in the right forearm. A venipuncture in the patient's right arm must be done: | below the IV, in a different vein |
| To prevent tampering and misidentification of samples for legal purposes, everyone who handles the specimen must provide: | documentation of their identity and the date and time the sample is handled |
| A neonatal bilirubin specimen should be collected in a (n): | amber micro-collection tube and protected from light |
| Peak and trough specimens are collected for therapeutic monitoring. The trough specimen is typically collected: | 30 minutes before a dose |
| A specimen for a blood ammonia test is to be preserved from the time of collection until it is tested in the lab. The best course of action is to keep the tube: | in a cup of ice water |
| The performance and speed of centrifuge should be checked: | every 3 months |
| Which of the following is the proper greeting to say when first approaching a patient? | "Good Afternoon. I'm from the lab. Can you tell me your name please?" |
| Which of the following best describes the safe operation of a centrifuge? | Tube stoppers are left on, the centrifuge is loaded by balancing similar tubes, and the lid is closed during centrifugation |
| the preferred depth of incision for a skin puncture of a premature infant is: | 0.85 mm |
| The arteries used for arterial puncture, listed in order of preference, are: | radial, brachial, femoral |
| The transportation of blood and body fluid specimens by pneumatic tube system: | is not recommended |
| A phlebotomist is asked to assemble the equipment for an arterial puncture. Which of the following would be inappropriate? | tourniquet |
| When collecting blood samples from a patient with a venous access device (VAD): | discard the first 5 mL of blood to flush the VAD |
| The industry- wide stopper color for tubes chemically clean enough to be used for collecting blood specimens for the determination of trace elements is: | royal blue |
| After centrifuging a green topped tube containing blood to be tested for an electrolyte panel, the phlebotomist notes that the serum is pink: indicating: | hemolysis and an unacceptable specimen |
| A phlebotomist must collect from a patient in isolation with contact precautions. The appropriate PPE is: | gloves and gown |
| A GTT calls for blood specimens to be collected at intervals of 30 mins, 1 hr, 2 hr, after the glucose dose ingested. An outpatient scheduled for a GTT arrives at the clinic & finished the beverage at 0730. the first specimen is collected at: | 0800 |
| When a lipid panel is ordered, the patient should be: | fasting for at least 12 hrs; water is allowed but not caffeine or nicotine |
| A patient is given urine collection materials and told to collect urine sample by cleaning the urethral meatus, starting to void w/o collection, and collecting the remainder of the voided urine in a specimen cup. This urine sample is: | a clean-catch, midstream urine |
| the container for a 24-hr urine collection should be: | labeled and stored in a fridge |
| During the collection of a 24-hr urine, it is important to: | avoid contamination of the urine specimen with feces. |
| A phlebotomist is waiting while and elderly patient slowly gets back into bed. The phlebotomist shows appropriate nonverbal communication skills by: | being thoughtful, considerate, and offering to assist. |
| After completing venipuncture by evacuated tube, it is appropriate to: | dispose of the needle in a nearby sharps container |
| When collecting blood with a syringe, pulling back quickly and hard on the plunger can: | collapse the vein and hemolyze the blood |
| A skin puncture for a CBC count is ordered on a newborn. The phlebotomist finds the infant is crying violently, the Phlebotomist should: | if possible wait until the infant has stopped crying for an hour |
| Proper placement of the needle w/in the vein is indicated by all of the following except: | swelling around the venipuncture site |
| Which of the following represents an inappropriate technique for labeling of blood collection tubes? | The phlebotomist labels the vacutainer tubes before calling an outpatient into the drawing area |
| All of the following terms indicate the patient has had nothing to eat, except: | postprandial |
| The term for identifying the means of transmission of a contagious disease from its host is: | chain of infection |
| The most effective means of preventing the spread of infectious diseases is: | to observe proper hand-washing techniques |
| The lab receives a request to collect 450mL of blood for a patient with polycythemia. This blood collection would be called a(n): | therapeutic phlebotomy |
| Care in centrifuging, such as eliminating splashing or splattering and not "popping" off tube tops, are designed to prevent the formation of: | aerosols |
| A phlebotomist performs a venipuncture w/o disinfecting the venipuncture site and leaving the tourniquet on longer than indicated. This would be considered: | Negligence |
| Collecting blood from a VAD can result in: | colonized bacteria the accumulated around the line can be pulled into the line when used for a blood collection |
| A patient has an unsuitable antecubital vein. The next best choice to use for the phlebotomy would be the: | dorsal side of the hand |
| The left ventricle pumps blood into the heart itself and the circulation via the: | aortic artery |
| The principal component of plasma is: | water |
| A patient seeks care at the emergency department with a temp of 101F. A thorough history and physical exam revealed no cause for the increased temp. Blood culture specimens should be collected: | 2 blood cultures at intervals of 45-60 mins. 2 more at 24-48 hrs. |
| A fasting urine specimen is: | the second voided urine specimen of the day |
| An activated partial thromboplastin time (APTT) and fact VIII assay are requested on patient with hemophilia. The appropriate course of action is to: | hold pressure on the collection site for 15-20 mins. |
| When obtaining a routine blood sample and vein is evident, a blood pressure cuff may be used at the following levels: | 60-80 |
| Removal of more than 10% of an infant's blood volume at one time may cause: | cardiac arrest |
| During a trial in which forensic samples were used as evidence, it was noted that method validation for linearity limits were not preformed for the drug-based testing. The evidence is: | unacceptable due to the questionable linearity limits |
| A blood sample for carotene analysis should be labeled and: | wrapped in aluminum foil |
| When a patient seeks care at the emergency department because of complaints of chest pain, acute myocardial infraction (AMI) specimens measuring cardiac markers must be collected: | when the patient arrives, as well as 2-4, 6-8, and 12 hours later |
| A specimen for a cold agglutinin analysis was collected and placed in an incubator. The specimen is unacceptable because: | the sample should have been pre-warmed for 30 mintues |
| Specimens for daily chem testing were placed into the centrifuge. upon starting to spin, the centrifuge began to shake, This could be due to: | an imbalance of tubes |
| The best way to prevent the mislabeling of a tube is to: | label blood tubes after phlebotomy and label the bag |
| Requirements for PPE, Chemical hazards, reactivity and health hazards are found in: | MSDS |
| The phlebotomist must select the appropriate method of obtaining a blood sample after considering the patient's: | age and sample Requirements |
| When preparing to collect a sample for an arterial stick, the radial artery can be recognized by: | it's pulse |
| Which of the following is part of the standard protocol when doing a bleeding test? | a butterfly-type bandage is used |
| When collecting blood using a syringe, samples should be placed into evacuated tubes in the following order: | Blue, lavender, red |
| The outer layer of the heart is the: | Epicardium |
| A platelet count of 650,000 per cubic millimeter is termed: | thrombocytosis |
| A phlebotomist with 6 collection orders for patients in the hospital receives a handwritten order from the lab for a STAT glucose after only completing the fourth phlebotomy. The phlebotomist should: | collect the STAT glucose, deliver it to the lab, and then return o preform the other 2 collections |
| Point-of-care testing (POCT) occurs: | at the bedside, in the emergency department, and homes. |
| Quality control for POCT must be preformed: | each day of use |
| Special considerations for phlebotomy on an elderly person would most likely include: | Decreasing the angle of penetration of the needle |
| a body fluid that should be protected from the light before analysis for bilirubin is: | Amniotic fluid |
| Skin puncture on a infant should be done on the plantar surface of the heel, medial to an imaginary line extending from between the fourth and fifth toes to the heel to avoid injury to the: | Bone |
| The most important part of the blood collection procedure is: | skin antisepsis |
| Veins carry: | Deoxygenated blood to the heart |
| When collecting blood from an artery for ABG, it is not necessary to pull back the plunger of the syringe because: | arterial blood is under pressure from the contraction of the ventricles |
| A plasma protein that is not present in serum is: | fibrinogen |
| A specimen for a peak gentamicin level should be collected: | 30-60 minutes after administration of the drug |
| If a patient indicates the he/she is not fasting, the phlebotomist should: | ask the patient's nurse if he sample should be collected at this time |
| When preforming a skin puncture, which specimen should be collected last? | Heparin mircocollection tubes |
| During venipuncture procedure, place the phlebotomy tray | w/in easy reach on a bedside table |
| Blood samples collected on filter paper for newborn screening tests should not be hung to dry to avoid: | concentration of the blood toward one end of the filter paper |
| Chain-of-custody protocol must be followed when collecting a forensic sample to ensure that: | the integrity of the specimen is accounted for. |
| Blood specimens collected for carotene analysis should be: | protected from light |
| Blood specimens collected for PTT must be analyzed w/in: | 24 hrs of collection |
| When collecting blood for plasma renin activity testing, the blood must be transported: | in ice water |
| The right ventricle of the heart pumps blood into the: | lungs |
| Leukocytes are responsible for: | defending the body against bacteria and viruses |
| The appropriate course of action for a STAT order is: | to send the tubes to the lab immediately upon collection. |
| A fingerstick sample for hemoglobin must be collected from a patient whose middle finger is broken and bandaged. The next best choice for the fingerstick is the: | ring finger |
| When testing for a prothrombin time (PT) with POC instrument, the on-board controls (OBC) will: | be accepted by the user |
| A patient who has had a mastectomy cannot have blood collected from the arm on the same side as the mastectomy due to: | lymphedona- Swelling of the lymph nodes causing infection |
| All testing on CSF samples should be preformed within 1 hour of collection because cytolysis is dependent on: | temperature |
| A phlebotomist used a vaculainer system to collect blood specimens for the following lab tests: CBC, PT, APTT,. The OSHA bloodborne pathogen standard states: | both the needle and holder must be discarded together |
| If a sample is delayed en route to the chem lab, the glycolytic action of blood cells will primarily affect tests for: | Glucose, phosphorus and enzymes |
Created by:
taswind