1
Q
What is the most preferred site for venipuncture?
A
Median Cubital
2
Q
Prior to performing the capillary (dermal) puncture the PT should select the _____
A
Lancet size
3
Q
When collecting blood cultures from an adult patient it is recommended to collect
A
8-10 mL per bottle
4
Q
Feather edge reflects the correct results for a
A
Peripheral Blood Smear
5
Q
What tests require fasting
A
Glucose
Triglycerides
Cholesterol
Vitamin
Mineral problems
Pregnancy
6
Q
When entering a patients room you should
A
introduce yourself and explain procedure
7
Q
What two factors that determine whether a child should have capillary collection by heel or stick?
A
Age & developmental factors
8
Q
What is used to collect cerebrospinal fluid?
A
Lumbar tap
9
Q
T/F: Cerebrospinal fluid is a blood specimen.
A
False
10
Q
What type of alcohol compound is appropriate for a routine skin puncture?
A
70% isopropyl alcohol
11
Q
When running an IV what is the preferred site for drawing blood specimen?
A
Going Distal
12
Q
If during a venipuncture the patient moves and the needle comes out, the PT should
A
Release tourniquet
13
Q
If patient notifies PT of fainting during blood collection you should
A
Position patient in supine position
14
Q
OSHA guidelines are standards for
A
Reduction of risks and injuries to employee
15
Q
The lavender evacuated tube contains which additive?
A
EDTA
16
Q
Stool specimen should be refrigerated for 24 hours when conducting what test?
A
Ova and parasite test
17
Q
If a PT needs to collect a prothrombin test from a patient with difficult veins, which tube is best?
A
light blue tube
18
Q
According to CISI order of draw guidelines, which samples should be collected first?
A
Cultures
19
Q
What is the most important info included on MSDS (Material Safety Data Sheet)?
A
composition of compounds
20
Q
In order for blood alcohol level to be admitted by evidence in court of law, what must be done?
A
PT must document the process of cleansing the site with chlohexadine prep
21
Q
What is needed for proper out-patient ID?
A
Name and DOB
22
Q
If a patient is a contact isolation, which PPE should be worn?
A
Precaution gown and gloves
23
Q
If a female refuses to get blood drawn from a male for religious purposes, what should be done?
A
A female PT should collect the specimen
24
Q
A PT should explain the procedure prior to the venipuncture in order to
A
obtain patient consent
25
According to CISI the standard depth of dermal puncture for infants is
2mm
26
What are one of the complications associated with dermal puncture?
Osteomyelitis
27
What is the most common reason for glucose monitoring through point of care testing?
To monitor glucose levels
28
If a patient had a mastectomy when performing a venipuncture you should
draw from opposite arm
29
When is it appropriate to place specimen in ice when transporting?
for ABG analysis
30
The timing for a Glucose Tolerant Test (GTT) begins when
patient finishes drinking glucose solution
31
The proper order of draw of capillary specimen is
Lavender --> green --> gray --> SST
32
An alcohol level test is ordered, which tube should be used?
Sodium fluoride tube (Gray top)
33
After collecting a bilirubin test the specimen should
be kept away from direct light to ensure accurate results
34
Using antimicrobial sanitizers is a way of preventing what?
nosocomial infections
35
The proper way a PT should instructor their patient to collect a C&S stool specimen is to tell them to
chill stool specimen in a container
36
Which veins should be avoided by PT unless otherwise instructed by Physician?
Dorsalis Pedis
37
When receiving a specimen collected by a patient, the PT should
compare lab requisition form to patient photo ID
38
After cleaning a site, the PT should
always let spot dry
39
What is the most important to verify prior to obtaining specimen?
patient identity
40
When performing a capillary collection serum tubes sample should be drawn?
Last
41
What is a complication that could happen is the needle is too small?
Hemolysis
42
Which veins should be used by a PT at first choice by a venipuncture on a 3yr old?
Dorsal veins of the hand
43
What does warming the site do?
increases blood flow
44
When collecting a bilirubin specimen from a newborn, it must
be protected from the light
45
If a PT is inserting a needle and the patient complains of a sharp radiating pain down his arm, what should you do?
Release tourniquet, remove needle, and apply pressure and cover
46
What is needed for homeostasis to take place?
thrombocytes
47
When collecting a capillary specimen after the site is punctured, you should do what?
wipe the first draw
48
When is the winged infusion needle used?
With patients who have fragile veins
49
If the PT observes a hematoma forming at the site of draw, the PT should
Release tourniquet and stop draw
50
When a PT enters a room without introducing or asking permission to enter its considered
invasion of privacy
51
The duties of a PT are to
instruct and greet patients
52
When drawing blood on a small child, whom must the PT should explain the procedure to?
Parents and child
53
When performing a dermal puncture on patients 1 year or older, they should perform it on which finger?
middle finger
54
A PT has orders to draw blood cultures, CBC, PTT, and iron panels but forgets to draw PTT, what should they do?
Draw a discard tube and redraw blood cultures
55
Quality control testing of glucometer is important to
promote accurate test results
56
What are additives sodium citrate an EDTA used to prevent?
Hemostasis
57
While on flood, a PT is paged for STAT which is the most useful to PT?
Room location
58
During venipuncture the needle is in the and blood flow is established, but when the second tube is attached blood flow stops, the PT should
rotate the bevel of needle
59
While the PT is drawing and patient reports feeling lightheaded and faints, PT should
Remove tourniquet
60
All test results of hospital patients are available to physicians and nursing staff in house via
internet
61
While performing donor phlebotomy for blood bank, the PT should use what size needle?
18-16 gauge
62
Vein located laterally on arm is called
Cephalic
63
Hemoconcentration of a venous blood sample is most often caused when
The tourniquet is in place for more than 2 minutes
64
When performing a draw on a diabetic patient with small fragile veins and PT misses twice, the PT should
Ask another PT to obtain
65
Utilizing tubes that have expired may result in
loss of vacuum
66
What causes hemolysis?
vigorously inverting tubes
67
Dermal puncture performed on an infant are routinely collected from
lateral plantar surface
68
After introducing yourself you should
correctly identify patient
69
what is negligence?
failure to demonstrate proper care that results in an injury to another person
70
Heel sticks are done for which neonatal screening?
PKU
71
for patient compliance with GTT test PT should
Confirm patient has been fasting
72
Sclerosed vein =
hardening of vein
73
Hemoconcentration =
Concentration of blood
74
Hematoma =
accumulation of blood under skin
75
Phlebitis =
inflammation of the vein
76
Thrombus
Blood clot
77
Petechaie
tiny hemorrhage
78
Thrombophlebitis
infected clot in vein
79
Septicemia
infection in the blood
80
Trauma
Bruises
81
When is the povidone iodine solution used?
For collections that require stringent infection control
ex: cultures and arterial punctures
82
When is chlorhexidine gluconate used?
For those allergic to iodine and tests for alcohol
83
What should you do when antibodies are produced in response to an infection?
The specimen must be kept warm until the serum is separated from the cells
84
What specimens must be chilled immediately after collection?
ABG blood gases
ammonia
lactic acid
pyruvate
ACTH
gastrin
parathyroid hormone
85
Which specimens must be protected from light after collection?
Bilirubin
Beta carotene
Vitamin A & B6
Prophyrins
86
Where should dermal puncture be performed for adults?
Distal segment of third or fourth finger of non-dominant hand
87
Where should dermal puncture be performed for infant less than 1 year?
The heel & can't go deeper than 2mm
88
What is order of draw for capillary punctures?
Lavender --> Tubes with additives --> tubes with no additives
89
4 examples of pre-analytical errors
1. Patient misidentification
2. Inadequate fast
3. Patient posture
4. Poor coordination with other treatment
90
3 examples of Post analytical errors
1. Processing delays
2. Failure to separate serum from cells
3. Rimming clots
91
Example of an Intra/Co-analytical error
Under filling tubes
92
After the patient begins to twitch and shake and her eyes roll back, what should the PT do?
Observe patient and help protect against injury
93
If before the draw, the patient was very talkative and after the draw becomes quiet and stares blankly, what should you do?
Ask if he or she is okay and feels faint
94
When collecting blood in an evacuated tube hemolysis would occur with which gauge needle?
25'
95
What are signs a PT should recognize on a patient during venipuncture?
cold, clammy, and diaphoretic skin
96
If a patient turns pale and complains of nausea when PT is about to collect these are signs of what?
Syncope
97
Where should a PT document test preformed with regent products as part of protocol?
on a quality control log
98
To ensure safety of PT and psychiatric patients and others a PT should
Bring all necessary equipment to patients room
99
What does SST in a collection tube indicate?
To indicate if plasma is used and distinguish weather a collection tube contains serum or plasma
100
Because of time between collection and plasma separation the PT should
Centrifuge specimen
101
If a PT is ordered to draw blood from a 6lb newborn from the NICU and the order states blood draw for HCT, HGB, and potassium every 24 hours what is a complication for patient?
Hemolytic anemia
102
What is the percent of body weight is the volume of blood that can be drawn at one time or short period of time before patients faces the risk of iatrogenic anemia?
10-20%
103
What must be followed exactly whenever a PT draws patient test samples that may be used in a legal proceeding?
Chain of custody
104
For inpatient in addition to patients complete name, DOB, and medical record #, what else must be included in the physicians requisition form?
Test to be performed
105
A positive HIV test results are an example of
Point of care testing
106
When labeling a non blood specimen, where must the label be put?
On the container
107
Quality assurance standards include
- Procedure manuals
- Instrument maintenance
- Quality control
- Proficiency testing
108
A STAT electrolyte panels was reported to have critically high sodium levels
Use of gold tube explains pre-analytical
109
What would exclude a patient from donating blood?
Obesity
110
The emergency dept sends 2 swabs from 2 year old child for influenza and step only one swab has patients label PT should
Run test on labeled swap
111
Which is a likely result of filling a light blue tube with a ratio 1:6
False elevation of international normalized ratio
112
When drawing blood PT should instruct the patient to
make a fist do not pump
113
A phlebotomy technician is explaining the venipuncture process to an adult patient. The patient nodes frequently but appears confused. What action should the technician take?
Rephrase the information for the patient
114
A phlebotomy technician should transport a semen sample at which of the following temperatures?
36-38*C
115
A phlebotomy technician has a mild sensitivity to latex. According to the National Institute for Occupational Safety and Health (NIOSH), which of the following actions should the technician take?
Wear nitrile gloves instead of latex gloves
116
A phlebotomy technician Is teaching a patient about collecting a sputum specimen at home. What instructions should the technician include?
Spit thick secretions into the container after coughing deeply
117
A phlebotomy technician is collecting a patients blood specimen in a lavender topped tube. How many times should the technician gently invert the tube before setting it in a specimen collection tray?
8-10 times
118
A phlebotomy technician is preparing several specimens for transport to the facility's laboratory. Which of the following specimens should the technician protect from bright light by placing it in an amber/brown biohazard bag for transport?
Vitamin B6
119
A phlebotomy technician is preparing to collect a blood specimen from a patient who signed a general informed consent form upon admission to the facility. Which of the following actions by the patient indicates implied consent for the venipuncture?
Rolling up his shirtsleeve
120
A phlebotomy technician is preparing to remove personal protective equipment following a venipuncture for a patient in an isolation room. Which of the following pieces of equipment should the technician remove first?
Gloves
121
A phlebotomy technician is required to obtain which of the following from a potential blood donor?
Complete medical history
122
To prevent hospital-acquired infections, a phlebotomy technician should clean items that have been contaminated by blood with a 1:10 dilution of which of the following substances and water?
Sodium hypochlorite
123
Phlebotomy
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