MLT 131: FINAL EXAM

Phlebotomy equipment can be organized in all of the following except:

infant cradle pads.

The primary antiseptic for routine venipuncture is:

chlorhexidine.

A properly tied tourniquet:

permits arterial flow and blocks venous flow.

Which of the following tubes must always be completely filled?

Light blue

All of the following tubes contain a separation gel

except:

green.

Serum separator tubes should not be used for:

all of the above

Packages of evacuated tubes manufactured at the

same time are called a:

lot

In an evacuated tube, blood flow into the tube

depends on:

the vacuum in the tube.

Which of the following tubes contains an anticoagulant that inhibits thrombin?

Light green

When collecting coagulation tests from a patient with polycythemia the:

amount of anticoagulant is decreased.

The tube that will best prevent falsely increased potassium test results is:

light green.

Failing to adequately invert a lavender stopper tube

after collection will:

produce a clotted specimen.

The presence of a clot is acceptable in:

red stopper tubes.

The part of a syringe that is withdrawn after the vein is entered is the:

barrel.

Many newer instruments in the laboratory are able to withdraw patient sample directly through the stopper of an unopened blood collection tube. The instrument identifies the correct tube by means of:

a bar-coded label on the tube.

Basic information that should be present on all requisition forms includes all of the following except the:

type of collection tubes.

All of the following are used to identify a patient

except the:

bed sign.

The most important purpose of a requisition form

is:

authorization to perform the procedure.

When encountering a patient with casts on both arms and no wrist band, the phlebotomist should first

check the patient’s ankles.

Patient reassurance includes:

briefly explaining the procedure.

The vein of choice for routine venipuncture is the:

median cubital.

Palpate means to:

examine by touch.

Prolonged application of a tourniquet will cause:

hemolysis.

Correct palpation of a vein includes all of the following except:

detecting a pulse using the thumb.

Which of the following is not acceptable sterile technique?

Putting on gloves and palpating the cleansed

area

When collecting specimens in a patient’s room, tubes are routinely labeled:

after collecting the blood.

Prior to leaving a patient’s room, a phlebotomist should do all of the following except:

eject the needle from the adapter into a sharps container.

Prior to bandaging the puncture site, the phlebotomist should:

examine the site for bleeding.

When properly used and organized before performing a venipuncture, the patient requisition forms will allow the phlebotomist to do all of the following except:

review previously ordered and collected tests for each patient.

Two identifiers for patient identification before specimen collection are routinely secured by all the following means except:

asking the patient “Are you John Doe?” or “Are you Mary Doe?”

The Clinical Laboratory and Standards Institute (CLSI) recommends that all patient specimens are delivered to the laboratory no more than 2 hours after collection to reduce preexamination variables caused by cellular action and the effects of prolonged exposure of specimens to room temperatures, such as:

glycolysis caused by cells’ use of glucose; hemolysis and leakage of potassium from the cells into the plasma or serum; the destruction of coagulation factors from exposure to room temperatures.

When encountering a patient who is sleeping, the phlebotomist should:

awaken the patient before collecting the specimen.

Specimens for test substances that exhibit diurnal

variation must be collected:

at specific times.

The best way to prevent fainting in a patient during blood collection is to:

have the patient lie down during the phlebotomy.

Patients are most likely to be in a basal state at:

6 a.m.

Blood tests that are affected by the patient’s posture are those that measure:

large molecules.

Collection of specimens from leg veins is not recommended in all of the following except:

patients with multiple fractures.

When collecting blood from a patient with a very edematous right arm and a large hematoma in the antecubital area of the left arm, the phlebotomist should collect the specimen from:

below the hematoma.

Collecting blood from an area containing a tattoo

may result in:

an infection.

When collecting blood from a patient with an intravenous line, the phlebotomist should not:

draw from above the intravenous line.

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

both B and C

After filling the first tube of a three-tube collection, blood does not flow into the second tube. The phlebotomist should:

1. move the needle slightly.

2. remove the tube and try the third tube.

3. try a new second tube.

4. immediately discontinue the phlebotomy and

stick the other arm.

1 and 3

Using a 20-gauge needle and a 10-mL evacuated tube on a small vein may cause:

a collapsed vein.

Failure to remove the tourniquet before removing the needle

may produce hematoma.

Using a small-gauge needle with a large evacuated tube can cause:

hemolysis.

The best reason why the majority of patient samples are drawn in the early morning hours is because:

the patient will be in the basal state, having restrained from strenuous exercise and having fasted for approximately 12 hours.

Commercial identification bands with built-in matching stickers that may be placed on the patient’s blood sample tubes are particularly useful for which of the following types of samples:

transfusion service (blood bank).

Applying a tourniquet to or drawing blood from an arm located on the same side of the body as a recent mastectomy can be harmful to the patient and may produce erroneous test results. The application of a tourniquet as part of such blood collections is discouraged for all of the following reasons except:

may cause a release of harmful cells from the surgical site into the circulation.

A patient who is not allowed to have food or waterfor a specified time is classified as:

NPO.

A phlebotomist who enters a patient’s room to collect a fasting specimen and finds the patient eating breakfast should:

notify the nursing station.

If a supervisor tells the phlebotomist to collect a fasting specimen from a nonfasting patient, the phlebotomist should:

record “nonfasting” on the requisition slip.

The timing for a glucose tolerance test (GTT) begins:

when the patient finishes drinking the glucose.

The term diurnal variation is associated with:

timed collections.

The specimens collected during the glucose tolerance test (GTT) after the patient drinks the glucose will be analyzed at the end of the test. The specimens should be collected in:

gray stopper tubes.

The fasting specimen for a glucose tolerance test (GTT) is drawn at 0700, and the patient finishes drinking the glucose at 0745. The correct time to draw the 1-hour specimen is:

0845.

A phlebotomist who cannot locate the patient on whom a cortisol level is scheduled for collection at 1000 should:

return the requisition to the nursing station for rescheduling

Three blood cultures from a patient requiring ASAP

administration of antibiotics are collected:

immediately from three different sites.

To inoculate blood culture media with blood drawn in a syringe, the phlebotomist:

inoculates anaerobic media first.

Specimens for all of the following should be protected from light except

gastrin.

Chain of custody refers to the:

documentation of specimen handling for legal specimens.

Extra care may have to be taken when positioning the arm of patients with:

both arthritis and paralysis

Performing venipunctures on pediatric patients may require all of the following except:

telling the child it will not hurt.

Select the response that lists the major steps of the 2-hour oral glucose tolerance test (OGTT) in the proper order.

A fasting glucose specimen is collected, patient drinks a 75-g glucose solution within 5 minutes, and patient returns for an additional glucose test in 2 hours.

To ensure patient safety and medication effectiveness, the blood levels of many therapeutic drugs are monitored. The specimens that are typically drawn to do this are:

a trough level drawn before the next scheduled dose is given, and a peak level drawn after the dose is given.

Dermal puncture is preferred over venipuncture in infants because:

all of the above

Blood collected by dermal puncture most closely resembles:

arterial blood.

All of the following are reasons why hemolysis is seen more frequently in specimens collected by dermal puncture than venipuncture except:

lancets make a wider incision.

All of the following are acceptable skin puncture devices except:

surgical blades.

The microspecimen collection container that would hold the largest volume of blood is a:

microcollection tube.

Using a lancet that produces a puncture deeper than recommended may cause:

osteomyelitis.

The calcaneus is located at the:

posterior of the heel.

Which of the following statements is wrong?

Infants are identified by the bassinet label.

How many attempts should a phlebotomist make to obtain an adequate amount of blood by dermal puncture before requesting assistance from another phlebotomist?

Two

The possibility of infection is increased when:

a puncture is made through a previous site.

The presence of air bubbles will most seriously affect a:

platelet count collected in a Unopette.

Laws in all states of the United States require testing for all of the following diseases in newborns using a heel stick specimen except

jaundice or elevated bilirubin.

A physician questions the low bilirubin result on a jaundiced baby. This discrepancy may be due to:

exposing the specimen to the bili light.

The high red blood cell counts normally seen in newborns may cause:

decreased glucose levels.

Failure to completely fill the filter paper circle for a newborn screening test:

can cause a false-negative result.

Multiplication of parasites within red blood cells occurs in:

malaria.

Preparation of a blood smear using a slide that is not clean will result in:

holes in the smear.

A patient is experiencing symptoms of fever and

chills. Which of the following procedures might the

phlebotomist be requested to perform?

Collection of thick and thin blood smears

The Duke bleeding time method has been replaced with the template bleeding time because the template method:

is more standardized.

Blood is removed from the bleeding time incision:

by wicking with filter paper.

When performing a bleeding time on an adult, the incision is made:

horizontal to the antecubital crease.

A bleeding time that continues for 15 minutes should be:

discontinued.

A falsely increased template bleeding time will be caused by:

pressing the puncture site every 30 seconds.

The branch of biology dealing with microbes is called:

microbiology

The governmental agency that oversees public health care matters in the United States is:

Department of Health and Human Services

(DHHS)

One agency that accredits educational programs for clinical laboratory personnel is the:

National Accrediting Agency for Clinical Laboratory Sciences (NAACLS)

Which of the following is NOT an appropriate work practice control or exposure control method for working with strong acids?

Wear latex gloves.

Which laboratory containers can be used to make critical measurements?

volumetric flasks

All of the following are true of pipets EXCEPT:

A TD pipet must be rinsed to ensure the correct volume is delivered

A noncritical measurement can be:

made using an Erlenmeyer flask

Which of the following is true of a pH meter?

measures the hydrogen ion concentration in a solution

In the metric system, body weight is recorded in:

kilograms

When converting metric units to English units:

1 kilogram is equal to 2.2 pounds

Which of the following equivalents is CORRECT?

1 mL is equal to 1,000 μL.

Laboratory data is standardized regionally, nationally, and internationally by reporting in:

SI units

If a 2 M solution is diluted 1:10, which of the following is true?

The concentration of the dilution is 0.2 M.