AMCA Phlebotomy Exam

A blood test that requires testing for aluminum would be placed in what tube?

Royal Blue Tube Top

What is the recommended disinfectant for blood and other bodily fluids?

Sodium Hypochlorite

Invasive surgery procedures require what?

Informed Consent

What tube would be used to collect blood for a pregnancy test?

Red Tube Top

What is the best vein to draw from in the antecubital area?

Median Cubital Vein

Which tube would be used for a Thyroid Panel; Tiger Top, Lavender, Light Green, Yellow?

Tiger Top

What additive is in a Dark Green Tube?

Heparin

What tube would produce a serum sample; Green Top, Light Blue, Lavender, Red Top?

Red Top

If a doctor orders a CBC Test (Lavender Top), Comprehensive Metabolic Panel (SST), PT Test (Light Blue Top), and a set of Blood Cultures (BC), what would the order of draw be?

BC, Light Blue, SST, Lavender Top

If a EDTA tube is used before a serum tube it could cause cross contamination and could result in what?

High potassium or a false low calcium value

A CBC is collected into a Lavender tube and collected as what?

Whole Blood Specimen

A CBC would be performed in what department of the lab?

Hematology

What are included in electrolyte testing?

Sodium and Potassium

Coagulation testing requires blood to be collected in what tube?

Light Blue Top

After the needle is withdrawn from the vein, the first thing that needs to be done is what?

Activate the needles safety device

What would be the proper compression rate for a single adult CPR?

30 Compressions and 2 Breaths

What would be the proper cleaning solution to use when performing a blood alcohol test?

Soap and Water

What should be the first thing you do after an accidental needles stick?

Wash the affected area with soap and water

What is the substance called inside a Serum Separator Tube (SST)?

Thixotropic Gel

How many tubes are required for a 3 hour glucose tolerance test?

4 Gray Tube Tops

What tube is used for a hepatic panel test?

Red Tube Top

If you receive an order to draw a Hemoglobin A1C (HA1C) and a PT/PTT test, what would the order of draw be?

Light Blue Top then Lavender Top

What tubes are serum tests and what department do they go to?

Red, Gold, and Tiger Top are Serum tubes and they go to the Chemistry department.

What is the medication for PT/INR test?

Warfarin

How should Ammonia samples be transported?

On Ice

Aseptic sterile techniques must be done for what collection?

Blood Culture Collection

What vitamin must be protected from light?

Vitamin B12

An Erythrocyte Sedimentation Rate (ESR) test is collected in what tube?

Lavender Tube Top

What is the best vein to draw from in the antecubital area?

Median Cubital Vein

You must never use what for cleansing a collection site for a blood and alcohol test?

70% Isopropyl Alcohol

What should you never do from a patients arm whose had a mastectomy on that side?

Never Draw Blood

Over or under filling a Light Blue Top is a reason for a sample to be rejected by?

The ratio must be 9:1

Quality not Sufficient (QNS)

What finger is the best capillary puncture site on an adult?

Middle Finger

Even if the lab is backed up on resulting you should do what anyway?

Send Samples

What should always be worn when performing blood draws?

Gloves

What is the most common way of administering a TB test?

Injecting a TB antigen under the skin

When performing phlebotomy on a young, fearful child, what should you explain to them?

Explain to them in simple terms what will be done

What is the name of the process that uses heat, steam, and chemicals to prevent infectious diseases?

Sterilizing

What is caused by leaving the tourniquet on to long?

It should not be left on for longer than a minute.

Hemoconcentration

What could happen is blood is drawn from a patients arm to quickly?

It could cause the vein to collapse

What does it mean when a patient extends their arm for a blood draw?

Implied Consent

In a Standard Serum Separator Tube (SST), the blood should be allowed to clot for how long?

At least 30 minutes but no longer than 2 hours

What is the most important way to prevent cross-contamination of microorganisms from one patient to another?

Proper Hand Washing

What states a patient has a right to refuse a medical procedure and to be informed of all the consequences of doing so?

A Patients Bill of Rights

What should be used to bandage a patient free a blood draw that is on blood thinners?

Coban Wrap

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

OSHA

After the draw is complete, where will the phlebotomist place the needle?

Puncture Resistant Container

What is the reason for requesting feedback from patients when communicating with them?

To determine if they understand what is being said

Airborne isolation would be a precaution that would require what?

Special Handling and Ventilation

If a hematoma starts to form and the patient says it hurts, what should you do?

Stop the draw immediately and apple pressure with a gauze pad and re-examine the patient to see if it worsens

What disease can remain on surfaces when not properly disinfected?

Hepatitis B (HBV)

How far above should the tourniquet be applied the venipuncture site?

3-4 inches above

What size gauge set would be best for a hand draw?

23 gauge winged infusion set (Butterfly)

If a patient has cold hands or arms what can you do to allow for better blood flow?

Place a warm compress on the draw site

What is the appropriate angle for needle insertion?

15-30 degrees

A sample for Fibrin Degradation Products (FDP) testing would be sent to what department?

Coagulations Department

The bevel of the needle should always be what?

Facing up when inserting into the skin

How do you avoid in patient identification errors?

By checking the arm band on an in patient with the lab

What is a good indicator that a patient is not fasting?

The specimen is Lipemic (fat globs floating in blood)

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

Buccal Swab

What helps to avoid confusing specimens from patients with the same last name?

Patients Identification Numbers on tubes

When should the tourniquet be released?

Once blood flow has been established

What department is responsible for sterile supplies?

Central Supply

If IVs are inserted in the antecubital area of the arms, where must the blood be drawn from?

Below the IV site

A patient who tends to faint during blood draw should what?

Be placed lying down on an exam table or in a reclining chair

A heel puncture should not be performed on an infant older than what?

12 months

A phlebotomist should do what before and after venipuncture?

Wash Hands

Hematoma means what?

Blood has leaked from the vein into the tissues of the skin

What should be placed on the specimen tube?

Patients complete name, date of birth, identification number, date and time of draw, and the collectors initials

When doing a bleeding time test on a patient the blood pressure cuff is inflated to what?

40mm Hg

Where would biopsy tissue be sent to be analyzed?

Anatomical pathology

A patient who is on blood thinners or aspirin regimen may need what?

Additional pressure applied to stop bleeding

When a patient starts to sweat, look pale, and/or complain of blurred vision this could be signs of what?

Vasovagal Syncope (fainting)

What can be tested at the bedside using Point of Care instrument?

PTT and INR

A tourniquet should not be left on longer than what?

1 minute

Winged Infusion Set (Butterfly) should be held by?

Wings for needle insertion

Once the vein is selected the vein should be wiped with what?

70% Isopropyl Alcohol

What is the legislation that sets the standards for Electronic Health Care Transactions?

HIPPA

How should the patient be positioned sitting down when preparing for a venipuncture?

Arm in a straight line from the shoulder to the wrist

What carried blood away from the heart?

Arteries

According to OSHA, activating a safety device on the needle does what?

Prevents accidental needle sticks

What is an example of a professional appearance for a phlebotomy technician?

Fingernails kept short and clean

What is a normal result for a fasting glucose test?

Anything under 100

Performing a procedure on a patient who refuses consent is considered what?

Battery

A sharps container should be replaced when it is how full?

At least 3/4 the way full

Blood leaking into the tissue around the draw site is called what?

Hematoma

What is the standard length of time for a sample to stand before it is loaded into a centrifuge?

30 minutes

A Chain of Custody would be required if what?

A paternity test is ordered

If you have a patient with small, thin, or fragile veins what needle would you use to acquire the specimen?

Butterfly needle with syringe

No more than how many attempts to draw will be permitted by a phlebotomist according to CLSI?

2 attempts

What is Hemoconcentration?

Increased concentration of cells and solids in the blood

What is preanalytical, analytical, and postanalytical?

prior to testing - may include variables involving the process of obtaining the specimen; during testing; after test results are generated

How much urine would a female need to produce for a STD test?

20-30 mls

How do you collect sputum samples?

Have the patient take a deep breath, hold for 5 seconds, slowly breath out, another deep breath & cough hard until sputum comes up, then spit into a plastic cup

What is the reason for taut (pull back) skin?

To anchor the vein so it does not role

What is Semi-Fowlers position and why would you use it?

The patient is usually in their back with the bed angle between 30 & 45 degrees. It is used for difficulty breathing and undergoing breathing treatments.

How do you do proper hand washing and scrub techniques?

Wet hands, apply soap, scrub for at least 20 seconds, rinse & dry

After a patient has fainted during venipuncture and the phlebotomist has removed the tourniquet and needle, what should be done next?

Lower the head to the knees

What is appropriate dress code for a phlebotomist?

Scrubs and closed toe shoes

What is proper cough etiquette?

Cough into a bent elbow