Phlebotomy Exam

1. What temperature should a semen sample be transported?

36-38 degrees C

2. Which of the following would result in a grossly hemolyzed specimen?
a. Incorrect order of draw
b. Incorrect needle gauge
c. Applying tourniquet too close to the draw site
d. Failure to invert tube

b. Incorrect needle gauge

3. Which of the following is proper procedure after collecting ammonia specimen?
a. Protect from light
b. Keep specimen warm
c. Keep specimen at body temp
d. Place specimen in icewater slurry (or a cup of ice)

d. Place specimen in icewater slurry (or a cup of ice)

4. The phlebotomist has a request to collect a CBC from a healthy 10 month old. Which is appropriate?

a. Either heel

5. A phlebotomist is preparing to draw blood from a patient in hospital/ The patient extends his arm and turns head away. Which consent does this indicate?

a. Implied consent

6. Why should phlebotomist document volume of blood drawn from a patient?

a. Iatrogenic anemia could be a result fo too much taken

7. A phlebotomist has a requisition to draw blood on a patient with severe Down's syndrome. What steps would you take?

a. Speak with the patient guardian before performing venipuncture to enmsure the patient understands

8. A 69 year old unconscious patient is brought ot the ER. Several blood tests are ordered. The phlebotomist collects blood under

a. Implied consent

9. Which of the following actions is appropriate when labeling specimens?

a. Label specimens at the time of collection in front of the patient

10. Before collecting blood on an inpatient, the phlebotomist notices there's no wristband on wrist. There is one on the IV pole. What do you do?

a. Don't draw until nurse puts an armband on patient

11. Which is appropriate form of identification in inpatient setting?

a. Verbal and wrist band

12. WBC, RBC, Electrolytes are ordered. Which tubes are used for capillary?

a. Lavender and red

13. A blood specimen is rejected by lab with QNS as the reason? Why?

a. The specimen was insufficient-not enough blood

14. Which of the following is best method to prevent internal or external bleeding from venipuncture site after needle is removed?

a. Apply pressure to prevent leakage of blood into the tissues

15. A physician orders a STAT but phlebotomist forgets to fill out patient ID number. What is appropriate procedure for an improperly labeled specimen when received in lab?

a. Lab rejects the mislabeled specimen

16. Phlebotomist is performing venipuncture and patient begins to seize. What is correct action?

a. Discontinue the draw

17. Phlebotomist receives orders to draw an infant screening card, O2 levels, bilirubin, and DNA. Which is to be drawn first?

a. O2 levels

18. When performing a venipuncture on a patient of average weight, which is the correct technique for needle insertion?

a. Insert until a change in resistance

19. Which is the best method to collect a blood specimen from an older adult patient who has fragile, easy to collapse veins?

a. Choose a syringe and butterfly assembly

20. Which of the following is the term for donation of a patient's own blood for an upcoming surgery?

a. Autologous donation

21. The order of draw for capillary collections is different than venipuncture because

a. Increased risk of coagulation (remember platelets start to form)

22. Upon entering a patient's room for routine blood draw, phlebotomist notices clergy member is with the patient. What should you do?

a. Return later after drawing other patients

23. A phlebotomist notices a hematoma developing at the site of venipuncture. The phlebotomist should

a. Release the tourniquet and stop the draw

24. Know ORDER of DRAW!!

25. A phlebotomist working in an infertility clinic and the patient is to submit a semen specimen. The phlebotomist would tell the patient:

a. As soon as you collect the specimen, keep it next to your body and bring it in right away. (the reason is it needs to stay at body temp and delivered in lab within 2 hours)

26. After placing tourniquet on a patients arm, the phlebotomist notices small red spots below the tourniquet.

a. Petechiae

27. The phlebotomist should examine the antecubital veins of both arms because:

a. The median cubital might be more accessible on one side than the other

28. What is the appropriate cleanser to clean the meatus for a clean catch urine specimen?

a. Benzalkonium chloride

29. When should the code on glucose cuvettes or strips be compared to the code on the glucose meter?

a. When the patient is tested

30. Which of the following is appropriate to use when collecting for a chemistry test that requires serum?

a. SST (this is the red gel tube)

31. A patient state she is a difficult draw and requests a skin puncture. The test is a PTT. Which should you do?

a. Use a syringe and transfer to a light blue tube

32. Industry standard states needle insertion in the antecubital area should be:

a. 15-30 degree angle

33. Tubes with which additive should be used for CBC?

a. EDTA (purple tube)

34. When preparing for transport, which specimen must be placed on ice within 30 minutes after collection?

a. Arterial Blood Gases

35. Which provides the phlebotomist the best protection when drawing blood from a patient with active TB?

a. N-95 respirator mask

36. During a draw, the patient becomes unresponsive. What should you do?

a. Check for breathing

37. Why should a phlebotomist avoid drawing blood from a leg or foot of a diabetic patient?

a. These areas are more susceptible to infection

38. Why is it important to place a specimen in a biohazard specimen bag outside the laboratory?

a. The biohazard bag prevents a possible exposure incident

39. As a student. Proper introduction

a. Hi, my name is Sally Smith. I am a student phlebotomist and I'm here to collect blood specimen

40. When using evacuated tube system (EVS).

a. Position the needle in the same direction as the vein at 30 degree angle

41. What is additive for a PT/PTT?

a. Sodium Citrate (Blue top)

42. Blood cultures have been ordered on ICU patient. You would use:

a. Aerobic and anaerobic bottles

43. A phlebotomist is required to obtain what from a potential donor?

a. Complete medical history

44. Phlebotomist needs to draw a glucose tolerance test on a patient and notices an empty breakfast plate at bedside. What should you do?

a. Ask the patient when he or she ate last

45. Which vein should you attempt first?

a. Median cubital

46. If a phlebotomist is stuck with a used needle, first action is:

a. Flush the area with running water

47. correct specimen handling, what should you put on collection tubes?

Before leaving a patient room, make sure the date, time and initials are on the tubes.

48. When removing the needle from the arm, engage the safety device immediately

49. What can cause hemolysis?

a. Vigorously shaking the tube

50. A phlebotomist must centrifuge a serum separator tube before shipment:

a. Cells must be separated from the serum

51. The phlebotomist draws a CBC at 1800. Lab closed at 1730 and will not process until 500. What temp should the CBC be stored

a. 2-10 degrees C (EDTA tubes may be processed at 12 hours if refrigerated)

52. What test results can be affected if iodine is used to clean the site?

a. Potassium

53. According to CLSI, what is collected first?

a. Blood cultures

54. KNOW ORDER OF DRAW

1. KNOW ADDITIVES

55. KNOW ORDER OF VENIPUNTURE PROCEDURE

56. A physician ordered a Tobramycin level to be drawn one hour after dose. The Tobramycin has been ordered for 11am. What should you do

a. Check with the nurse to make sure meds were given (or not given)

57. phlebotomist notices red spots. What is appropriate action?

a. Apply pressure after collecting During the draw, the the sample

58. What is a potential consequence of mislabeling a blood bank specimen?

a. A Transfusion reaction

59. When should a phlebotomist perform external liquid controls for quality control on CLIA waived point of care test?

a. When a new lot number or kit is opened

60. A 3.3 kg infant has a total blood volume of 240-330ml

61. Cleanse in an outward spiral

62. What would you use for a hand draw?

a. Butterfly or winged infusion set

63. Invert anticoagulant tubes to :prevent coagulation

Name the 3 types of blood samples

whole blood/ plasma/ serum

What two States require licensure

Louisiana & California

When the Phlebotomist collects blood, in which of the patient's zones of interpersonal space is he/she operating?

The patient's Intimate Zone or Space

Define Phlebotomy

An incision into the vein

What is the meaning of these acronyms: ASPT, ASCP, and NHA?

ASPT \= American Society of Phlebotomy Technicians
ASCP \= American Society for Clinical Pathology
NHA \= National Healthcareer Association

Define Reference Laboratory:

A reference laboratory is one that specializes in one test or one group of tests, or where more unusual or obscure tests are performed.

. Number the following items to reflect the correct blood flow through the heart and lungs:

_1\__ Vena Cave (superior/inferior) _7\__ Lungs
_5\__ Pulmonary Valve _6\__ Pulmonary Artery
_13\__ Aorta _9\__ Left Atrium
_2\__ Right Atrium _8\__ Pulmonary Veins
_4\__ Right Ventricle _11\__ Left Ventricle
_3\__ Tricuspid Valve _12\__ Aortic Valve
_10\__ Mitral Valve (aka, Bi-Cuspid)

To whom does the phlebotomist report?

A technical phlebotomy supervisor

What two government agencies administer CLIA?

Center for Medicare/Medicaid Services (CMS)__
FDA

. Is the Joint Commission a non-profit organization?

No, it's a not for profit organization

In what year and by what organization was The Patient's Bill of Rights initiated?

1973 by the American Hospital Association.

. What is Informed Consent?

When you explain the procedure to the patient and they give you verbal or written permission to proceed.

What is Implied Consent?

When you explain the procedure to the patient and they make a gesture that implies their permission to proceed, such as extending their arm, rolling up their sleeve or nodding their head.

What is required to obtain Informed Consent for a child?

You explain the procedure to the parent or legal guardian and obtain their informed consent for the child.

What is the difference between a Criminal Lawsuit and a Civil Lawsuit?

A criminal lawsuit is initiated by the government, a civil lawsuit is between private parties.

What is Assault?

The threat of touching another person without his or her consent and with the intention of causing fear of harm

What is Battery?

Actual harmful touching of another person without his or her consent.

What is Libel?

False defamatory writing that is published.

What is a Sentinel Event?

An unanticipated death or permanent loss of function not related to a patient's illness or underlying condition.

. What does PPE stand for?

Personal Protective Equipment

. How full should you fill the Sharps Container before using a new container?

¾ full

. What is the name of the multi-purpose fire extinguisher?

ABC

To what does the term "aseptic techniques" refer?

Techniques that provide a degree of cleanliness that prevents infection and keeps the phlebotomy environment free of contamination by microorganisms.

. A nosocomial infection is:
a. Something acquired by healthcare workers.
b. Something acquired by visitors to a hospital.
c. Something acquired by patients.
d. A Hospital Acquired Infection.
e. Caused by antibiotic resistant bacteria.
f. Both c and d.
g. Both a and c.

f. Both c and d.
c. Something acquired by patients.
d. A Hospital Acquired Infection

When is hand hygiene performed?
a. When gloves are visibly soiled.
b. Before putting on gloves
c. After removing gloves
d. All of the above
e. Both a and b

d. All of the above
a. When gloves are visibly soiled.
b. Before putting on gloves
c. After removing gloves

Before entering an isolation room, what is the first thing the phlebotomist should do?
a. Wash hands
b. Put on a gown, mask and gloves
c. Read the posted instructions
d. Obtain permission

c. Read the posted instructions

What does the acronym PASS describe and stand for?

It describes the use of a fire extinguisher and stands for: Pull pin, Aim nozzle, Squeeze handle, Sweep from side to side.

What does the acronym RACE stand for?

It stands for what a healthcare worker should do if a fire or explosion occurs in the workplace:
Rescue, Alarm, Contain, Exit

. Before placing a call on hold, a phlebotomist should:
a. record the caller's name.
b. check to see if it is an emergency.
c. transfer the call to the phlebotomy supervisor.
d. tell the caller his or her name.

b. check to see if it is an emergency.

A competent professional demeanor is shown by:
a. neatness and cleanliness.
b. courtesy and cheerfulness.
c. pleasantness.
d. all of the above.

d. all of the above.

Traditional duties of the phlebotomist include all of the following except:
a. correct labeling of all specimens with the required information.
b. selection of the appropriate specimen containers for the specified tests.
c. performance of tests on patient samples in the laboratory.
d. collection of the appropriate amount of blood by venipuncture or dermal puncture.

c. performance of tests on patient samples in the laboratory

. The two major areas of the clinical laboratory are:
a. chemistry and hematology.
b. cytology and histology.
c. anatomical and clinical.
d. urinalysis and microbiology.

c. anatomical and clinical.

The difference between plasma and serum is that:
a. serum contains fibrinogen.
b. serum is obtained from a non-clotted specimen.
c. plasma is obtained from a clotted specimen.
d. plasma contains fibrinogen.

d. plasma contains fibrinogen.

Specimens collected in serum separator tubes are most frequently delivered to:
a. blood bank.
b. serology.
c. hematology.
d. chemistry

d. chemistry.

To prevent blood from clotting the specimen must be:
d. both A and B


c. centrifuged right after collection.
d. both A and B

d. both A and B
d. both A and B

Which of the following pairings is wrong?
a. icteric and yellow.
b. lipemic and cloudy.
c. hemolyzed and red.

d. fasting and cloudy.