Phlebotomy State Practice Test #1

When a patient's vein is small, thin or fragile, what would be the most appropriate equipment selection?

syringe

Which of the following needle gauge sizes has the largest bore (opening)?

18 g

How long should a tube be pre-warmed in an incubator prior to collecting a warmed specimen, such as Cold Agglutinins?

30 minutes

Which cleansing agent is typically not used on venipuncture for the collection of blood cultures or blood alcohol specimens?

isopropyl alcohol

What is an acceptable method of patient identification?

Requesting that the patient provide their name and date of birth

If a patient indicates previous experiences of fainting during venipuncture, what should be done?

You may move them to an area in which they can lie down during the draw

Which of the following tests does not require fasting?

Complete blood count (CBC)

What are the smallest veins in the human body?

venules

Which of the following actions is standard practice when collecting a blood smear?

Cleaning a slide with isopropyl alcohol and letting it dry

What is the smallest gauge needle used for venipuncture?

23 g

Which test is not impacted by fasting?

blood culture

Which of the following is not a standard vacuum tube size?

20 mL

What is the most common cause of blood culture contamination?

Improper skin preparation

When checking inventory, which of the following elements needs to be verified for use?

- The expiration date has not lapsed

- There is no visible damage to the equipment

- There is no heat and moisture damage

Which may occur if additives are not mixed adequately?

- Clotting of the sample

- Erroneous test results

- A repeat draw will be necessary

What action should not be taken when first meeting a patient?

Inquire the reason they need their blood drawn

Under what circumstances should a tube be pre-labeled?

never

The presence of an adequate number of sharps containers reduces the risk of needle injuries occurring from which of the following actions?

- Needle recapping

- Decanting of used sharps container

- Overfilled sharps container

How many unsuccessful attempts at venipuncture are allowed before seeking additional assistance is required?

two

For elderly patients, in what circumstances would a capillary puncture be performed rather than venipuncture?

The patient has a tendency to form clots

Which tube color has no additive?

red

What test requires that it be chilled in ice right after collection?

- Aterial gases

- Ammonia

- Lactic acid

- Pyruvate

- ACTH

If one is used, when should the tourniquet be removed?

Prior to withdrawal

What may occur if a tourniquet is left on too long?

- Numbness

- Skin Tears

- Extremity color and temperature changes

If you cannot palpate a vein on the patient's dominant arm, what should be done?

Check the other arm

What is the maximum depth a heel stick should penetrate?

2.0 mm.

In what location are nutrients and gasses exchanged in the body?

capillaries

Septicemia can be detected by what type of test?

blood culture

Which color tube needs to be filled completely?

blue

What can be done to make drawing easier on a patient with rolling veins?

You can anchor the vein

Which of the following tubes would be filled first?

blue

If an intoxicated person refuses a blood sample to determine the presence of alcohol or drugs at the request of a police officer, what is the best course of action?

Request that the officer get a warrant.

What is the optimal angle in which a needle should be inserted in order to minimize the likelihood that the needle will go all the way through the vein?

15-30 degrees

When performing quality control checks, tubes should be discarded under which circumstances?

The stopper has small cracks

When should tubes be labeled?

After the draw, but before exiting the patient's room

If a patient refuses to have their blood drawn, what is the best course of action?

Notify a supervisor and document the patient's refusal

How long should you observe the site prior to bandaging?

5 seconds

When washing your hands, why is it important to stand back from the sink?

Because the sink may be contaminated

Which of these does not work to control infection?

contamination

Which antiseptic should not be used on pre-term infants or those under 2 months of age?

chlorhexidine gluconate

If a patient indicates an allergy to latex, what is the proper action?

Wearing nitrile gloves

What is the proper material used to stop bleeding after collection?

gauze

When preparing to draw a gentamycin peak and trough, what element should the phlebotomist pay particular attention to?

The timing instructions

Palpation describes what process?

Searching for a vein using pressure and release

What field is unnecessary on an infant's blood sample label?

Infant's first name

Which test requires the collection of both blood and urine at specific intervals?

glucose tolerance testing

What is the best spot for completing a finger stick?

The side of the 3rd finger

Which test requires the sample to be protected from light?

bilirubin

For adult patients, what is the maximum length lancet that should be used for a fingerstick?

2.2 mm

If you experience a patient pumping their fists during a blood draw, what can you do?

Politely explain to them that this can elevate ionized calcium and potassium levels and request that they stop.

During blood coagulation, what is formed?

fibrin clot

If a patient is misidentified, what should happen?

The specimen should be discarded and recollected

The veins of patients undergoing chemotherapy are especially challenging for venipuncture due to what characteristics?

They are smaller, less elastic, and sometimes sclerosed

Which of the following duties is outside the scope of the phlebotomist's practice?

Collecting a tissue sample

In delivering quality patient care, which of the following actions should be avoided?

-Excessive punctures

-Repeated draws

-Probing on their medical condition

If you encounter a hazardous chemical that you need more information about, where can you quickly and accurately locate that information?

Material Safety Data Sheet (MSDS)

Being free from contamination or germs is referred to as what term?

asepsis

Implied consent form a patient to draw blood would be obtained by which action?

The patient extends their arm

When collecting a sample to determine blood alcohol levels, what color tube should be used?

gray

If a sample needs to be diluted, what should be added?

diluent

Potassium EDTA binds to what element in the blood?

Calcium

A failure to fast when ordered can impact a blood sample in which of the following ways?

Increasing its turbidity

If you notice that the name of a patient is spelled differently on the requisition and a patient's armband, what it the best course of action?

Visit with your manager to verify the information and have it corrected.

Anchoring a vein properly requires which of the following actions?

Placing the thumb of your free hand below the vein and stretching the skin.

The most common cause of contamination in blood cultures is which of the following?

Improper site preparation

What is another name for a thrombocyte?

platelet

Inserting a needle at the point of divergence between veins can result in what?

An increased chance of a hematoma.

Which is a complication that can arise in capillary sampling?

- Collapse of veins

- Nerve Damage

- Scarring

Approximately how many liters of blood is generally found in the adult human body?

5 liters

Which is a cause for rejection of a specimen?

- improper specimen

- incomplete chain of custody documentation

- insufficient quantity

A failure to allow alcohol to completely dry during site preparation can lead to what?

hemolysis

The process of maintaining control of a specimen from the point of collection until testing is complete is referred to as what?

Chain of custody

An incident reporting system should include which of the following components?

- Details of the incident

- Potential causes

- Management of adverse events

Which of the following is not required on a correctly completed requisition?

patient history

Which of the following is a National Patient Safety Goal(s)?

- Identify the patient correctly

- Prevent infection

- Improve communication

Workplace safety in a lab is governed by which agency?

Occupational Safety and Health Administration (OSHA)

What is the proper sequence for putting on PPE?

Gown, Mask, Gloves

When should a sharps container be disposed of?

3/4 full

The additive 3.2% sodium citrate results in what?

The prevention of clotting by binding calcium

Venipuncture should not be performed on which of the following sites?

- Sites with scar tissue

- Sites with hematomas present

- Sites with vascular grafts

The use of povidone iodine for site preparation can result in a false increase in what level?

- Potassium

- Phosphorus

- Uric Acid

Prior to drawing from a sleeping patient, what should be done?

Gently wake them up, and when they are ready, request they provide verification of their identity.

What type of draw is generally performed for patients in infancy?

heel stick

Which of the following would not be required for a finger stick?

syringe

Which of the following is a characteristic of capillaries?

They are found in every square inch of the human body

What action can prevent bruises from forming due to a blood draw?

Applying firm pressure immediately after and keeping a bandage on for several hours.

Which test order should be given the most priority?

STAT

Which of the following is not a primary method of venipuncture?

Lancet

Why is blood drawn in a specific order?

To avoid cross-contamination of additives

When a sample is rejected for QNS, what is the appropriate response?

Collect another sample with sufficient quantity

Which of the following examples is not a HIPAA violation?

Providing court-ordered health information.

What is the first step in dealing with a patient that appears nervous?

Assess their cause for concern and provide reassurance

Which of the following terms describes a management function whereby control of the quality of raw materials, assemblies, produced materials and components; services related to production; and management, production and inspection processes is exercised for the purpose of preventing undetected production of defective material or rendering of faulty services?

quality control

Which of the following can reduce your risk of infection after being exposed to a bloodborne pathogen such as Hepatitis B or HIV?

Taking a post exposure prophylaxis

What types of safety hazard might you encounter while working as a phlebotomist?

- Biological

- Electrical

- Radioactive

Which can result in legal or criminal actions against the phlebotomist?

- Breach of confidentiality

- Holding a patient down to obtain a sample

- Median nerve damage related to a negligent draw

The additive in a pink tube is

EDTA

What is a normal life span of an RBC?

120 days

How many times should a gray tube be inverted?

8 times

What are Meninges?

protective membranes that surround the brain and spinal cord