AMCA Exam

If asked to draw a red, lt. blue, blood cultures and lavender. Which is last?

Lavender

Informed consent is required for

invasive surgery and biopsy

Red top is used for the following tests

Blood pregnancy and hepatic panel

Which vein is the first choice for a routine venipuncture?

Median Cubital

Tiger top is used for what test

Thyroid panel

After the needle is withdrawn , what is the NEXT step?

Activate the safety

Is it okay to use 70% isopropyl alcohol for cleansing the site when drawing blood for ethanol testing?

NO

What is the first think you do in case of an accidental needle stick?

Wash the site for 30/60 seconds with soap and water

When drawing from a patient who has had a mastectomy where is the appropriate place to draw?

Opposite side, on the hand

What is the best side for a dermal puncture on an adult?

Middle finger

If the processing lab is backed up on resulting, what will you do with your samples?

Send them anyway

When drawing from an HIV patient, what extra precautions do you need to take?

None, always wear gloves

What would be a reason for a lt. blue top to be rejected for processing?

QNS

What is the proper blood additive ration for a lt. blue top?

9:1

When does a Phlebotomist wash their hands?

Before and after the draw

What PPE is required when drawing blood and handling blood products?

Gloves

What is the additive in a dark green tube?

Sodium Heparin

How do you explain a phlebotomy procedure to a young child?

In simple terms

What uses heat, steam, and chemicals?

Sterilization

What can be caused by leaving the tourniquet on for too long?

Hemoconcentration

What are the special handling requirements for an ammonia sample?

Place on ice

If a hematoma starts to form and the patients says it hurts what should the Phlebotomist do?

Stop the draw, apply pressure, reasses

What would be the appropriate equipment to use for drawing from a patient with small, thin, fragile, veins?

Butterfly with syringe

How much urine would an adult female patient need to produce for STD testing?

20/30 Mls

If a patient is being drawn for a PT/INR test, what medication are they on?

Warfarin

If a patient comes in asking for results, what should you do?

Advise them to make an appointment with their Dr.

When instructing a patient to collect a stool sample, make sure that you instruct the patient..

Do not mix urine and stool

When drawing blood from a hemophiliac patient, instruct them too..

Hold pressure on the site for two minutes

How often does a centrifuge need to be recalibrated?

Every 6 months

What test do you draw for without a tourniquet?

Lactic acid

If a patient faints during a blood draw, what is the vital sign that needs to be checked before you let them leave?

Pulse

How long can plasma sit at room temp for?

8 hours

How long do you rotate an NP swab in each nostril when collecting a COVID screening test?

15 seconds

How do you collect a POC glucose test?

Strip and a drop of blood

If a patient presents to the lab for a fasting glucose blood draw but indicates that he or she is NOT fast, what should the Phlebotomist do?

Draw anyway and document “non-fasting”

If you suspect child or elder abuse or neglect, what should you do?

Notify your supervisor

What step is NO LONGER recommended for a patient who passes out?

Ammonia inhalants

How long should a patient fast for a fasting blood sugar test?

8 hours

What contains documentation of chemical safety and precautions?

SDS log

What equipment is needed for a urine C&S?

Sterile cup and alcohol wipe (towelette)

What kind of checks needs to be performed on POC equipment in a Dr.’s office?

Quality control checks

What agency mandates a written exposure plan?

OSHA

What is the normal BP for an adult?

120/80

What is outside of the normal range for BP on an adult?

139/94 (high)

If a coworker comes back late from lunch and asks you to cover for him or her, what will you do?

Tell them you cannot cover for them

What test will you collect in an amber colored tube?

Bilirubin

What BBP can remain on surfaces up to 7 days if not properly disinfected?

HBV (Hepatitis B)

If a Dr. orders a CMP, CBC, PT and blood cultures, what is the correct order of draw?

Blood, cultures, lt. blue, SST, lavender

Where is the proper place for a tourniquet to be places during venipuncture?

3 to 4 inches above the site

What is the appropriate equipment used for a hand draw?

A 23-gauge butterfly

What does warming the site do?

Increases localized blood flow

What is the proper needle angle for a routine ETS blood draw?

15-30 degrees

Where does FDP (fibrid degradation products) go for processing?

Coagulation

What is the purpose of checking the arm band on an on-patient who has lab orders

To avoid patient identification errors

If a patient extends his or her arms, this is an example of what type on consent?

Implied consent

What is the #1 way to prevent cross contamination of micro-organisms from one patient to another?

Hand washing/decontamination

How long should a specimen drawn in an SST tube be allowed to sit and clot before centrifugation?

30-60 minutes

According to CLSI standards what is the maximum time a specimen (plasma or serum) should be left at room temp before centrifugating

2 hours

What is it that states that a patient has the right to refuse medical procedures and be informed in all consequences in doing so?

Patient bill of rights

A patient that is on blood thinners or aspirin regimen what should be used after the draw?

Coban

Out of red, green, lt. blue, and lavender tube tops which will produce serum?

Red

What agency is responsible for the health and safety of the workers?

OSHA

Once the draw is complete, what is the next step?

Dispose of the needle into a puncture resistant container (sharps container)

Why is it important to ask for feedback when communicating with a patient?

To make sure they understand what is being said

What type of isolation required special handling and ventilation?

Airborne isolation

If a specimen is lipemic, what can this be an indication of?

Patient is not fasting

What is used to collect DNA samples by swabbing the inside of the cheek?

Buccal Swab

What is the purpose of patient ID numbers being on the tube labels?

To avoid confusing patients with the same last name

When drawing multiple tubes, when would the tourniquet be released?

As soon as blood flow is established

What department is responsible for sterile supplies?

Central supply

What is the most important part of Blood culture collection?

Aseptic procedure

If you have an order to collect a protime Specimens for a patient with IV’s in both arms, where would you draw?

The hand

At what age and weight will you no longer perform a heel puncture?

Older than 12 months and 21 lbs

What can happen if you drawn an EDTA tube before a serum tube?

Cross contamination resulting in high potassium levels and false low calcium levels

What does the term hematoma mean?

Blood leaking from the vessel under the skin

What are special handling requirements for a vitamin B12?

Protect from light

When performing a bleeding timed test, how high should the blood pressure cuff be inflated to?

40 mm hg

Sweating, looking pale, and complaining of blurred vision can be signs of what?

Vasovagal Syncope

Which coagulation tests can be performed at bedside using a point of care instrument?

PTT and INR

What tube is CBC collected in?

Lavender

What tube is an erythrocyte sedimentation rate (ESR) drawn in?

Lavender

According to OSHA why do we activate the safety feature on a needle?

To prevent accidental needle sticks

What does FBS stand for?

Fasting blood sugar

What is the normal range for a fasting glucose for an adult?

Anything below 100

What two analytes are included in an electrolyte panel?

Sodium and postassium

If you draw form a patient without his or her consent what can the phlebotomist be charged with?

Battery

What is the substance at the bottom of a serum separator tube?

Thixotropic Gel

What color tube top will an aluminum test be drawn in?

Royal blue

How many tubes are needed for a 3 hour GTT?

4 tubes

When do you change out the sharps container?

¾ full

What color tubes are used for a hemoglobin A1C, and a PT/PTT drawn in, and what is the correct order of draw?

Lt. blue, lavender

What is the special handling required for paternity testing?

Chain of custody

What does FBS stand for?

Fasting blood sugar

What does QID stand for?

4 times daily

What does PP stand for?

Post prandial (after meal)

What does HS stand for?

Hours of sleep

The patient in the hospital or nursing home should be placed in this position which includes laying on their back with their head and torso raised between 15-45 degrees

Semi-fowlers

What is PKU?

A newborn screening/heel stick test

What is hyperpyrexia?

An extreme fever typically exceeding over 106°F

____ carry blood away from the heart

Arteries