Phlebotomy Essentials 7th Edition Unit 3 (Chapters 7-10)

A serum specimen is requested. Which of the following evacuated tubes can be used to collect it?

SST (SEPARATOR SERUM TUBES)

Which of the following are all anticoagulants that remove calcium from the specimen by forming insoluble calcium salts, and therefore prevent coagulation?

Sodium citrate, EDTA, oxalate

In a successful venipuncture, evacuated tubes fill automatically as soon as the tube is pierced because of

premeasured vacuum in each tube

A tube with a green stopper normally contains

Heparin

Which disinfectant is preferred by the HICPAC for use on surfaces and instruments?

EPA-registered sodium hypochlorite product

Safety features on needles work by all of the following methods EXCEPT:

plugging the needle with silicon

What color do sharps containers have to be?

red or opaque

If hands are heavily contaminated with organic material and a sink is not available, the phlebotomist should clean them with?

detergent-containing wipes followed by a sanitizer

When nitrile or vinyl strap tourniquets become soiled with blood, it is best to

Throw them away

Which additive is usually present in a tube with a lavender stopper?

EDTA

Glass particles present in serum separator tubes

clots blood more complete

This antiseptic has been traditionally used to obtain the high degree of skin antisepsis required when collecting blood cultures.

povidone-iodine

Which cannot be used on infants and children younger than 2 years of age

Adhesive bandages

Wearing gloves during phlebotomy is not mandated by:

FDA

What criterion is used to decide needle gauge?

diameter

The purpose of the rubber sleeve that covers the tube end of a multiple sample needle is to:

prevent leakage of blood during tube changes

Which stopper color identifies a tube used for coagulation testing?

light blue

Which of the following substances is an anticoagulant?

Oxalate

Which of the following substance is contained in a serum separator tube (SST)?

Thixotropic gel

During venipuncture the tourniquet should not be left on longer than:

1 minute

The part of the syringe that shows measurements in cc or mL is called the:

barrel

A pink-top tube containing EDTA is primarily used for:

Blood bank tests

While collecting a STAT blood culture and electrolytes on a child in the emergency room, the physician asked the phlebotomist to get an extra tube of blood to check for metal poisoning. Which of the following tubes would the phlebotomist add to the ones already being collected?

Royal blue

Which of the following tubes is filled first when multiple tubes are filled from the syringe?

Blood culture tube

What are the names of the three types of requisitions?

Manual, computer generated, barcode

To examine by touch or feel is to

palpate

To "seat" the needle in the vein means to:

Thread part of the needle within the lumen

The reason a test is ordered "timed" is to:

Draw it at the best time for accurate results

information on a test requisition must include the

Ordering physician

What type of requisition form do you use when your computer system fails?

manual

The unique number assigned to a specimen request is called:

Accession number

A test is ordered "fasting" to:

Eliminate the effects of diet on test results

When properly anchoring a vein, the

thumb is 1-2 inches below the intended site and pulling the skin toward the wrist

What is not a symptom of needle phobia?

Muscle cramps

If a test is ordered STAT, it may mean that the patient is in

critical condition

Which is a common post-op test?

H&H - hemoglobin & hematocrit

Success of pediatric blood collection is most dependent on

Patient immobilization

Hemolysis of the specimen cannot result from:

Leaving the tourniquet tied on the arm too long

DNR means?

do not resuscitate

Laboratory results can be negatively affected if the phlebotomist:

Startles a patient who is asleep while preparing to collect a specimen

Misidentification of a specimen for this test is most likely to have fatal consequences:

type and screen

What would be the system of choice to identify laboratory specimens from an unconscious woman in the ER?

Use a three-part identification band with special tube labels.

An unconscious patient does not have an ID band. The name on the door agrees with the requisition. What should you do?

Do not start any precedure until the nurse attaches an ID bracelet

Your patient is cranky and rude to you. What do you do?

Be as professional as you can and collect the specimen in a normal way

Proper handwashing does not involve:

Using a hand sanitizer just before the hands are dried

Where is the best place to apply the tourniquet?

About 3-4 inches above the venipuncture site

Mandatory information on a specimen label does not include:

Patient room number and bed

You insert a needle into the vein during blood collection. When you advance the tube onto the needle in the holder, you do not get blood flow. You can see the needle is beside the vein. You redirect the needle two times and still do not get blood flow. What should you do next?

Discontinue the draw and try again at a new site

When a vein rolls, the needle typically:

slips beside instead of in the vein

You are collecting a blood specimen. The needle is inserted but the blood is filling the tube very slowly. You see a hematoma forming very rapidly. What has most likely happened is the:

Needle is only partly in the vein

A phlebotomist has tried twice to collect a light blue top tube on a patient with difficult veins. Both times the phlebotomist has been able to collect only a partial tube. What should the phlebotomist do?

Have someone else collect the specimen

Which of the following is the best indication that you have accidentally punctured an artery?

The blood pulses into the tube

Infection from a Venipuncture site can result from:

touching the site after cleaning it

A vascular access pathway that is surgically created to provide access for dialysis is a (n):

AV

You must collect a protime specimen from a patient with IVs in both arms. The best place to collect the specimen is

below one of the IVs

Central venous catheters (CVCs) don't include:

Hep-lock

An outpatient becomes weak and pale after a blood draw. What should the phlebotomist do?

Have the patient lie down until recovered

This is a subcutaneous vascular access device consisting of a small chamber attached to an indwelling line that is implanted under the skin and located by palpating the skin.

CVAD

When a blood specimen is collected from a heparin lock, it is important to draw

a 5-mL discard tube before the specimen tubes

If you have no choice but to collect a specimen from an arm with a hematoma, collect the specimen:

Distal to the hematoma

A vein that feels hard, cord-like, and lacks resiliency is most likely:

Sclerosed

It is not a good idea to collect a complete blood count (CBC) specimen from a screaming infant because the:

The WBCs may be temporarily elevated

Which of the following analytes is the most affected by exercise prior to collection?

enzymes

The serum or plasma of a lipemic specimen appears:

cloudy white

A lipemic specimen is a clue that the patient was:

not fasting

A 12-hour fast is normally required when testing for this analyte.

triglycerides

A patient's arm is swollen. The term used to describe this condition is:

edema

Lymphostasis is:

obstruction of the flow of lymph

Venous stasis is:

Stoppage of the normal venous blood flow

Hemoconcentration from prolonged tourniquet application increases:

Non-filterable analytes

A blood smear is not:

Blood collected on a special filter paper

The calcaneus bone is located in the:

heel

A cyanotic extremity would:

Be bluish in color

A differential is a test that determines all of the following EXCEPT:

packed cell volume

"Feather" is a term used to describe the appearance of:

The thinnest area of a blood film

Which statement most accurately describes capillary puncture blood?

A mix of venous, arterial, and capillary blood

osteochondritis is:

inflammation of the bone and cartilage

What is the medical term for a finger bone?

Phalanx

Which does Capillary specimens NOT contain:

Serous fluids

Strong repetitive pressure, such as squeezing or milking a site during capillary specimen collection:

Can hemolyze and contaminate specimens

The composition of blood obtained by capillary puncture more closely resembles:

arterial blood

A laboratory report form should state that a specimen has been collected by capillary puncture:

Because results can vary by specimen source

Reference values for this test are higher for capillary specimens:

glucose

If collected by capillary puncture, which of the following specimens should be collected in an amber microtube?

bilirubin

Which would not make capillary puncture a poor choice for specimen collection:

Iatrogenic anemia

Which of the following is normally a proper site for finger puncture on an adult?

Distal segment of the middle finger

Which would be eliminated as a capillary puncture site?

Index finger of a woman

It is necessary to control the depth of lancet insertion during a heel puncture to avoid:

Injuring the calcaneus

According to the Clinical and Laboratory Standards Institute (CLSI), depth of heel puncture should not exceed:

2.0 mm

What can be a complication of a heel puncture that is too deep?

Osteomyelitis

What is the safest area of an infant's foot for capillary puncture?

Medial plantar heel

The recommended antiseptic for cleaning capillary puncture sites is:

70% isopropanol

Which color coded tube would be used to collect a CBC?

lavender

What would be less likely to introduce excess tissue fluid into a capillary puncture specimen?

Wiping the alcohol dry

A blood smear is required for this test:

Manual differential

The slanted tip of the needle

bevel

12 hour fast is required for testing this:

Triglycerides

Reference values are higher for this test in capillary specimens

Glucose

What is the tube used for most serum specimens

SST

What is a complication of a heel puncture that is too deep

Osteomyelitis