Midterm exam - Phlebotomy CalReg

According to standard first aid procedures, which action controls severe external bleeding?

Applying direct pressure

Which process should be followed for the HBV vaccination?

A dose of vaccine, another 1 month later, and a final dose 6 months later

Which phrase describes the purpose of "protective" isolation?

Protect susceptible patients from outside contamination

Which is another term for the OSHA Hazard Communication Standard (HCS)?

Right-to-Know law

What is the proper order for putting on PPE?

Gown first, then mask, gloves last

When should the hepatitis B vaccination be made available to employees with occupational exposure risk?

Within 10 working days of initial assignment

First thing the phlebotomist should do after an accidental needlestick?

Decontaminate the site and report the incident to an immediate supervisor

Which is an example of a nosocomial infection?

A catheter site of a patient in ICU becomes infected

Which is an example of a means of transmission that differs from parenteral transmission?

Drinking water from a contaminated glass

In what instance might a patient be placed in protective isolation?

The patient has severe burns

Which is an example of a work practice control that reduces risk of exposure to bloodborne pathogens?

Hand decontamination

Which contact transmission involves transfer to mucous membranes via cough/sneeze?

Droplet

When can occupational exposure to bloodborne pathogens occur while performing work duties?

Blood comes in contact with a cut

True or False? Applying lip-balm in the lab is acceptable with chapped lips.

False

The function of the left ventricle is to deliver

Oxygenated blood to the aorta

The receiving chambers of the heart are the

Atria

The relaxing phase of the cardiac cycle is called

Diastole

Which represents the proper direction of blood flow?

From arterioles to capillaries to venules

A blood clot circulating in the bloodstream is called a/an

Embolus

Which blood cell can pass through blood vessel walls?

Leukocyte

How can you visually tell serum from plasma?

You cannot visually tell them apart

Hemostasis refers to

The stoppage of bleeding

which vein is NOT an antecubital vein?

Femoral

Which test must be performed on whole blood?

CBC

A major difference between arteries and veins is that most veins

Have one-way valves

Best tube for collecting an ethanol specimen?

Sodium fluoride

Which needle gauge has the largest lumen?

18

Tests in this department are typically collected in a light blue stopper tube

Coagulation

A tube with a green stopper normally contains

Heparin

The purpose of an antiglycolytic agent is to

Preserve glucose

Solution normally used to clean site before routine venipuncture

70% isopropanol

When latex/vinyl tourniquets become soiled with blood, it's best to

Throw them away

Most important factor in choosing gauge needle for venipuncture

Size and condition of the vein

Additive usually present in a lavender stopper tube

EDTA

Glass particles present in serum separator tubes

Enhance clotting

The slanted tip of the needle that enters the vein is called the

Bevel

Per CLSI (Clinical and Laboratory Standards Institute) standards, which tube is filled last (2nd to last) using a syringe?

EDTA (before gray due to edta transferring if it goes first)

True or False? EDTA is the most common source of carryover problems.

True

True or False? The 21-gauge multisample needle is standard for routine venipuncture.

True

True or False? In routine ETS venipuncture, red tube drawn before green.

True

Acceptable way to confirm an inpatient's identity ("John Doe")?

Match the ID band and requisition with his verbal statement of ID

Multiple orders, one phlebotomist — which should be collected first?

STAT electrolytes in the ER

Doing this during vein selection is bad for the specimen

Allowing the patient to pump his or her fist

Poor technique before obtaining a blood specimen from a child

Telling the child it won't hurt

Patient finishing a big breakfast when fasting specimen is ordered — phlebotomist should

Check with the patient's nurse to see if the specimen should still be collected

What may happen if you mix a specimen too vigorously?

Hemolysis

Never leave a tourniquet on for more than

1 minute

How can you tell you're in a vein when using a needle and syringe?

You will normally see blood appear in the hub of the needle

Most critical error a phlebotomist can make

Misidentifying a patient specimen

Best way for a newly trained phlebotomist to handle venipuncture on a needle-phobic patient

Ask an experienced phlebotomist to do the draw

System of choice to ID specimens from an unconscious, unidentified patient

Use a three-part identification band and labels

Inpatient's door is closed — phlebotomist should

Knock softly, open it slowly, and ask permission to enter

Patient asks if the draw is for a diabetes test — how should this be answered?

Say, "It's best to discuss that with the doctor."

Which is the job of a student phlebotomist?

Letting the patient know that you are a student phlebotomist

What’s the purpose of waiting 30 seconds for alcohol to dry before needle insertion

• To let evaporation help destroy microbes

• To avoid a stinging sensation

• To prevent hemolysis of the specimen

All of the options are correct

True or False? Restrain a 4-year-old immediately, tell him to be quiet, and say it won't hurt.

False

Which instance most closely resembles basal state?

Just awakened at 0600 after fasting all night

to draw a protime specimen from a patient with IVs in both arms — draw the specimen

Below an IV

It's not good to collect a CBC from a screaming infant because

White blood count may be falsely elevated

you must draw from a site with a hematoma — where should you obtain the specimen?

Distal to the hematoma

Prolonged tourniquet application changes blood composition primarily due to

Hemoconcentration

Two failed attempts drawing a partial tube for a PTT (Partial Thromboplastin Time) — what should the phlebotomist do?

Have another phlebotomist attempt to draw the specimen

Levels of this analyte can differ by 50%+ between morning and late afternoon

Cortisol

Which instance suggests you've accidentally punctured an artery?

The blood pulses into the tube

If blood is drawn too quickly from a small vein, it will tend to

Collapse

A fistula is a(n)

Temporary fusion of an artery and a vein

when a test requires a Fasting specimen, but serum is ___ it is a clue that the patient wasn't fasting

Lipemic

Tests influenced by diurnal variation are often ordered as ___ tests, and it is important to collect them as soon as possible to the timed ordered

Timed

True or False? Peak cortisol levels occur late in the afternoon

False

True or False? if the blood is filling the tube very slowly and a hematoma is beginning to form, the needle may not be in deep enough

true

True or False? if a patient complains about sharp radiating pain from the needle insertion site, the phlebotomist should hurry and finish the draw

false

Why are capillary blood gases less desirable than arterial blood gases (ABGs)?

• Skin puncture blood contains tissue fluid

• Skin puncture blood is only partly arterial

• The blood is exposed to air during collection

• All of the options are correct

All of the options are correct

CLSI (clinical laboratory standards) recommended maximum depth of heel puncture

2.0 mm

Why are EDTA specimens obtained before others when collected by skin puncture?

To minimize effects of platelet clumping

Why should a lab report indicate a specimen was collected by capillary puncture?

Because test results can vary depending on the method of collection

Safest area for infant heel puncture

The lateral plantar surface

A capillary puncture should be done rather than venipuncture except when

A light blue top tube is needed

Purpose of wiping away the first drop of blood during skin puncture

To eliminate tissue fluid contamination

Capillary puncture blood most closely resembles

Arterial blood

What does the term "calcaneus" mean?

Heel bone

Which microcollection container is used to collect a specimen for a CBG? (capillary blood gas)

purple top

It is necessary to control depth of lancet insertion during capillary puncture to avoid

injured heel bone

Purpose of warming the site before a skin puncture

It increases blood flow up to seven times

True or False? A phlebotomist should puncture a finger perpendicular to the fingerprint whorls.

True

True or False? A magnet is used to mix a CBC specimen

True

True or False? If a baby has a huge, fleshy big toe, it is acceptable to collect a bilirubin specimen from it.

False

Of the following tests, which is most likely to result in fatal consequences if the patient is misidentified?

Type and crossmatch

Which test requires strict skin antisepsis procedures before specimen collection?

Blood culture

What type of additive is recommended for collecting an ethanol test specimen?

Sodium Floride

when performing a GTT(Glucose Tolerance Test), the timing should begin

As soon as the patient finishes the drink

When collecting a blood culture specimen directly from a butterfly into blood culture bottles, which should be filled first?

Aerobic

Which of the following tests may require special "chain of custody" documentation when collected?

Drug screen

Identify the condition in which a unit of blood is withdrawn from a patient as treatment

Hemochromatosis

Which of the following tubes can be used to collect blood for a type and crossmatch?

Pink top

An autologous blood transfusion is a transfusion of blood

Donated by the patient for the patient

The most critical aspect of blood culture collection is

Skin antisepsis

This test requires a specimen with a 9:1 ratio of blood to anticoagulant

Prothrombin time

The hormone detected in positive urine pregnancy tests is

HCG (human chorionic gonadotropin)

A 2-hour postprandial specimen should be drawn

2 hours after the patient has had a meal

True or False? Paternity testing is performed to determine the probability that a specific individual fathered a particular child.

True