AMCA Phlebotomy Certification Prep

When a phlebotomist observes actions or suspects child abuse, what should be the next step to take?

advise supervisor privately

The principle reason for requiring feedback when communicating with patients is to determine weather they ______________.

have understood what is being said

Implied consent for a venipuncture on an adult requires _____________.

the patient extends their arm to you

How should the phlebotomist dispose of a needle after drawing blood from a patient?

close safety and dispose in a puncture resistant container (sharps container)

The hospital department that is responsible for sterile supplies

Central Supply

The reason a test if ordered timed is to ______________.

Draw it at the best time for accurate results

The patient's specimen is lipemic, this is usually an indicator that the patient ___________.

Has not fasted

Abbreviation for "nothing by mouth"

NPO

The government agency responsible for regulating the safety and health of workers

Occupational Safety and Health Administration (OSHA)

To prevent cross contamination of microorganisms from one patient to another, OSHA standards require ____________.

Barrier protection equipment (PPE personal protective equipment)

The balanced or "steady state" of the body is called:

Homeostasis

The blood vessel that only carries blood away from the heart is _________.

artery

What laboratory document describes in detail the steps to follow for specimen collection?

Procedure manual

Which type of specimen may require collection of a discarded tube before the test specimen is collected?

blood culture specimen

What is the additive in a dark green top tube?

sodium heparin

What item is donned first when wearing full PPE?

gown tied at neck and waist

The liquid portion of a clotted blood specimen is called __________

plasma

Which of the following additives would be found in a yellow topped tube?

SPS

Which test should be collected in a royal blue topped tube?

Trace metal analysis / nutrients and toxicology studies (magnesium)

If a laboratory test requires serum, which vacutainer tube is the tube of choice?

Red

For a bleeding time test, what should you pump the blood pressure cuff to?

40

If you are carrying anything labeled "biohazard" what does it need to have on it?

A biohazard sticker

Order for selecting a venipuncture site

1. Antecubital space (median cubital preferred)

2. Back of hand

3. Back of wrist

4. Ankle or foot (provider permission needed)

If someone has an IV in their right arm, which arm should you draw blood from? / IV in both arms?

Left arm / below IV site. Nurse should turn off IV 2 minutes prior to blood draw

If a criminal comes in for a blood draw and they are cuffed and shackled; which arm do you draw from?

Cuffed arm (realistically BOTH arms should remain cuffed)

If someone makes 2 unsuccessful attempts at a venipuncture they should...

Get someone else to try

The recommended disinfectant for blood and body fluid contamination is?

sodium hypochlorite

Most coagulation tests require a plasma specimen collected in a..

light blue topped tube

Measurement of copper requires blood collection in what tube?

royal blue

A patient came in with a low grade fever of 1 month duration.. the physician ordered an ESR which stands for Erythrocyte Sedimentation Rate.. what color tube?

lavender

Which of the following is required by OSHA?

Hepatitis B vaccine

What is the substance called in a serum separator tube (SST) ?

thixotropic gel

What is the anticoagulant in a gray topped tube?

sodium fluoride

What is the function of an antiglycolitic agent?

eliminates glucose

The phlebotomist uses nitro gloves during finger stick procedure, the use of gloves is considered..

PPE

What is the correct routine blood draw entrance procedure?

bevel up, needle at 15-30 degree angle

What gauge size would be appropriate when drawing a hand with winged infusion needle/butterfly?

23

During venipuncture when should needle safety device be activated?

immediately after specimen collection / after you remove needle from vein

According to CLSI order of the draw which would be filled last?

lavender top

The phlebotomist must collect pro time specimen from a patient with IVs in both arms, where should they draw from?

slightly under IV site, 2 minutes after IV has been turned off

Which of the following specimens would be analyzed in the anatomical pathology area?

biopsy tissue

Which site is best for capillary puncture in an adult?

middle and ring finger tips

How many tubes are drawn for a 3 hour glucose tolerance test? (GTT)

4

Erythrocytes are also known as..

red blood cells (RBCs)

Which structure contains oxygenated blood?

aorta

The muscle layer of the heart is called the

myocardium

The function of the platelet is to

cause blood to clot to stop bleeding

The puncture site may require additional pressure to stop bleeding when the patient is..

on blood thinners (anticoagulants, aspirin)

What is the anticoagulant in a gray topped tube?

potassium oxalate

Measurement of copper requires blood collection in what tube?

royal blue

Measurement of copper requires

If the tourniquet is too small, what should you use?

blood pressure cuff

If the blood specimen is a milky color, what would that mean?

Lipemia - fat

What is the additive for a green topped tube?

Sodium lithium

The normal composition of blood is

55% plasma / 45% formed elements

The clear, colorless liquid that functions to protect and nourish the brain and spinal cord is called..

cerebral spinal fluid

The purpose of the Pulmonary System is to carry..

blood to and from the lungs

Electrolyte testing includes

sodium and potassium

Which of the following is not a part of a complete blood count?

APTT - Activated Partial Thromboplastin Time

TB test administration involves:

Injecting the antigen just under the skin

Which department would perform a CBC?

Hematology

A sample for Fibrin Degradation Product (FDP) testing would be sent to which of the following departments?

Coagulation dept

Which of the following tests may require a special chain of custody form?

drug screening

A phlebotomy student who notices a rash on his/her hands should...

apply antihistamine lotion

The most common point of care test performed at home or in the hospital is..

glucose testing

Which test requires a whole blood specimen?

CBC - Complete Blood Count

The recommended sample for urine pregnancy testing is

first morning

How long do you perform a buccal (cheek) swab?

30 seconds

When should a blood collection tube be labeled?

After the specimen is collected

The 3 components of the chain of infection are...

Source, Mode of Transmission, Susceptible Host

Which of the following precautions require special handling and ventilation?

airborne

The current CDC guidelines for infection control is which of the following precautions?

Standard precautions

An example of a QC (quality control) measure in phlebotomy is..

Recording QA (quality assurance) indicators daily

A tourniquet should not be left on for longer than..

1 minute

Venipuncture is usually performed in the antecubital area. Which vein is usually the best to draw from?

median cubital

What can happen if a tourniquet is left on for too long?

Hemoconcentration

What can happen if blood was drawn from the patient's arm too quickly?

Vein collapse

Jane has never had her blood drawn, the phlebotomist should allow her to..

sit on a chair with arm support

The bevel of the needle should be..

facing upward when inserted into the skin

The dr ordered a CBC (lavender), a comprehensive metabolic panel (SST), PT (light blue stopper), and a set of blood cultures. What is the order of the draw?

cultures, PT, metabolic panel, CBC (yellow, light blue, red/gray, lavender)

The gauge of the needle indicates the following relationship..

The smaller the diameter of the bore

When drawing on blood thinners, what will you use after you complete the draw?

Coband wrap

A needle safety feature that is not activated in the vein or automatically should be activated when?

Immediately after the needle is withdrawn

The following items are minimum requirements for specimen labeling..

The patient's compete name, identification number, date and time the sample was obtained, and collector's initials

The lab is backed up, and one of your specimens is delayed for more than an hour after collection, what do you do?

Tell the patient they will have to come back to repeat the test

Which of the following is a reason for a sample to be rejected by QNS (quantity not sufficient)?

Green PST half full

In which of the following circumstances is it important to verify a chain of custody?

A legal forensic sample

How should you hold a winged infusion collection needle?

By the wings

Which of the following must be done for a blood culture evaluation microorganism growth for septicemia?

Transport on ice and analyze in 15 minutes

Which of the following is a normal result for a fasting glucose test?

Under 100

Sputum is defined as

Mucus from the lungs

The procedure used to collect DNA from the cells inside of a person's cheek is called..

Buccal swab

To avoid patient identification errors, the phlebotomist must identify the patient prior to collecting a sample by?

Checking armbands for acceptable identifiers such as patient's full name and date of birth

A false high potassium or a false low calcium value may be obtained due to

EDTA tubes being collected before serum tubes

Select the correct statement below for preparing the site for blood collection

Use a sterile alcohol prep pad (70% isopropyl alcohol) for cleaning the site

When preparing for a specimen collecting by venipuncture, how should the patient be positioned?

With the arm in a straight line from shoulder to wrist

What does an increase in bilirubin, lipid protein and enzymes indicate?

Intravenous fluids resulting in an edematous area

Where should blood be drawn on a patient who has had a right side mastectomy and lymph node removal?

Left antecubital space

What is the best specimen for urine collection?

clean-catch midstream

What is a major drawback of 24 hour urine collection?

patient cooperation and it is hard to get