NHA Phlebotomy Exam

What is the most preferred site for venipuncture?

Median Cubital

Prior to preforming the capillary (dermal) puncture the PT should select the

Lancet size

When collecting blood cultures from an adult patient it is recommended to collect

8-10 mL per bottle

Feather edge reflects the correct results for a

Peripheral Blood Smear

What tests require fasting

Glucose, triglycerides, cholesterol, vitamin & mineral problems and pregnancy

When entering a patients room you should

introduce yourself and explain procedure

What two factors that determine weather a child should have capillary collection by heel or stick?

Age & developmental factors

What is used to collect cerebrospinal fluid, which is a non blood specimen?

Lumbar tap

What type of alcohol compound is appropriate for a routine skin puncture?

70% isopropyl alcohol

When running an IV what is the preferred site for drawing blood specimen?

Going Distal

If during a venipunture the patient moves needle and needle comes out PT should

Release tourniquet

If patient notifies PT of fainting during blood collection you should

Position in supine

OSHA guidelines are standards for

Reduction of risks and injuries to employee

The lavender evacuated tube contains

EDTA

Stool specimen should be refrigerated for 24 hours when conducting what test

Ova and parasite test

If a PT needs to collect a prothrombin time from a patient with difficult veins

A light blue tube is best

According to CISI order of draw guidelines, the following samples should be collected first

Cultures

What is the most important info included on MSDS (material safety data sheet)

The composition of compounds

In order for blood alcohol level to be admitted by evidence in court of law what must be done

PT must document the process of cleansing the site with chlohexadine prep

What is needed for proper out patient ID

Name and DOB

If a patient is a contact isolation

Precaution gown and gloves must be worn

If a female refuses to get blood drawn from a male for religious purposes

A female PT should collect the specimen

A PT should explain the procedure prior to the venipuncture in order to

Obtain patient consent

According to CISI the standard depth of dermal puncture for infants is

2mm

What are one of the complications associated with dermal puncture?

Osteomyelitis

What is the most common reason for glucose monitoring through point of care testing

To monitor glucose levels

If a patient had a mastectomy when preforming a venipuncture you should

Draw from opposite arm

When is it appropriate to place specimen in ice when transporting

For ABG analysis

The timing for a GTT begins when

Patient finishes drinking glucose solution

The proper order of draw of capillary specimen is

Lavender, green, gray, SST

An alcohol level test is ordered

The sodium fluoride tube should be used

After collecting a billirubin test the specimen should

Be kept away from direct light to ensure accurate results

Using antimicrobial sanitizers is a way of preventing

Nosocomial infections

The proper way a Pt should instruct their patient to collect a C&S stool specimen is to tell them to

Chill stool specimen in a container

Which veins should be avoided by PT unless otherwise instructed by Physician

Dorsalis Pedis

When receiving a specimen collected by a patient PT shoudl

Compare the lab requisition form to patient photo ID

After cleansing a site PT should

Always let the spot dry

What is the most important to verify prior to obtaining specimen

Patient identity

When performing a capillary collection serum tubes sample should be drawn when?

Last

What is a complication that could happen is the needle is too small?

Hemolysis

Which veins should be used by a PT at first choice by a venipuncture on a 3 yr old?

Dorsal veins of the hand

What does warming the site do?

Increases blood flow

When collecting a bilirubin specimen from a newborn it must?

Be protected from the light

If PT is inserting needle and patient complains of sharp radiating pain down his arm you should?

Release tourniquet, remove needle and apply pressure and cover

What is needed for homeostasis to take place?

Thrombocytes

When collecting a capillary specimen after the site is punctured you should?

Wipe the first draw

When is the winged infusion needle used?

With patients who have fragile veins

If the PT observes a hematoma forming at the site of draw the PT should?

Release tourniquet and stop draw

When a PT enters room without introducing or asking permission to enter its considered

Invasion of privacy

The duties of a PT are to

Instruct and greet patients

When drawing blood on a small child the PT should explain procedure to

Parents and child

When performing a dermal puncture on patients 1 year or older they should perform it on which finger?

Middle finger

A PT has orders to draw blood cultures, CBC, PTT, and iron panels but forgets to draw PTT what should you do?

Draw a discard tube and redraw blood cultures

Quality control testing of glucometer is important to

Promote accurate test results

What are additives sodium citrate and EDTA used to prevent?

Hemostais

While on flood a PT is paged for a STAT which is the most useful to PT?

Room location

During venipuncture the needle in the vein and bloodflow is established when the second tube is attached blood flow stops the PT should

Rotate the bevel of needle

While the PT is drawing and patient reports feeling lightheaded and faints PT should

Remove tourniquet

All test results of hospital patients are available to physicians and nursing staff in house via

Internet

While preforming donor phlebotomy for blood bank PT should use what size needle?

18-16 gauge

Vein located laterally on arm is called

Cephalic

Hemoconcentration of a venous blood sample is most often caused when

The tourniquet is in place for more than 2 mins

When performing a draw on a diabetic patient with small fragile veins and PT misses twice the PT should

Ask another PT to obtain

Utilizing tubes that have expired may result in

Loss of vacuum

What causes hemolysis

Vigorously inverting tubes

Dermal puncture performed on an infant are routinely collected from

Lateral plantar surface

After introducing yourself you should

Correctly identify patient

What is negligence

Failure to demonstrate proper care that results in an injury to another person

Heel sticks are done for which neonatal screening

PKU

For patient compliance with GTT test PT should

Confirm patient has been fasting

Sclerosed vein

Hardening of vein

Hemoconcentration

Concentration of blood

Hematoma

Accumulation of blood under skin

Phlebitis

Inflammation of the vein

Thrombus

Blood clot

Petechaie

Tiny hemorrhage

Thrombophlebitis

Infected clot in vein

Spticemia

Infection in the blood

Trauma

Bruses

When is povidone iodine solution used?

For collections that require more stringent infection control ex blood cultures and arterial punctures

When is chlorhexidine gluconate used?

For those allergic to iodine and tests for alcohol

What should you do when antibodies are produced in response to an infection?

The specimen must be kept warm until the serum is separated from the cells

What specimens must be chilled immediately after collection?

ABG blood gases, ammonia, latic acid, pyruvate, ACTH, gastrin and parathyroid hormone

Which specimens must be protected from light after collection?

Bilirubin, beta carotene, vitamin A & B6 and prophyrins

Where should dermal puncture be preformed for adult?

Distal segment of third or fourth finger of non dominant hand

Where should dermal puncture be preformed for infant less than 1 year?

The heel cant go deeper than 2 mm

What is order of draw for capillary punctures?

Lavender, tubes with additives, tubes with no additives

Pre analytical errors

Patient misidentification, inadequate fast, patient posture, poor coordination with other treatment

Post analytical erros

Processing delays, failure to separate serum from cells, rimming clots

Intra/ Co analytical errors

Under filling tubes

After draw the patient begins to twitch and shake and her eyes roll back what should PT do

Observe patient and help protect against injury

If before draw pattient was very talkative and after draw becomes quiet and stares blankly you should?

Ask if he or she is okay and feels faint

When collecting blood in an evacuated tube hemolysis would occur with which gauge needle>

25'

What are signs PT should recognize on patient during venipuncture?

Cold, calmmy, and diaphoretic skin

If a patient turns pale and complains of nausea when PT is about to collect these are signs of what

Syncope

Where should a PT document test preformed with regent products as part of protocol

On a quality control log

To ensure safety of PT and psychiatric patients and others a PT should

Bring all necessary equipment to patients room

What does SST in a collection tube indicate

To indicate if plasma is used and distinguish weather a collection tube contains serum or plasma

Because of time between collection and plasma separation the PT should

Centrifuge specimen

If a PT is ordered to draw blood from a 6lb newborn from the NICU and the order states blood draw for HCT, HGB and potassium every 24 hours what is a complication for patient?

Hemolytic anemia