Obtaining Blood Samples Test Review

42% of the test

What additive prevents glycolysis?

a) EDTA

b) Heparin

c) Potassium oxalate

d) Sodium fluoride

d) Sodium fluoride

The following supplies were gathered for a routine venipuncture. Which item is incorrect?

a) ETS tubes

b) Iodine swab

c)Safety needle

d) Tourniquet

b) Iodine swab

Which of the following tubes can be used to collect a serum specimen?

a) Light blue top

b) Green top

c) PST

d) Red top

d) Red top

A tourniquet is used in venipuncture to:

a) Concentrate the blood specimen

b) Find the enter veins more easily

c) Keep the vein from collapsing

d) All the above

b) Find the enter veins more easily

You are about to perform routine venipuncture on a patients with no known allergy to antiseptics. Which of the following substances would you use to clean the site?

a) 5.25% sodium hypochlorite

b) 70% isopropyl alcohol

c) Antibacterial soap and water

d) Povidone-iodine

b) 70% isopropyl alcohol

Which of the following needles has the largest diameter?

a) 18-gauge

b) 20-gauge

c) 21-gauge

d) 23-gauge

a) 18-gauge

What causes evacuated tubes to fill with blood automatically?

a) Arterial blood pressure

b) Fist pumping by the patient

c) Pressure from the tourniquet

d) Premeasured tube vacuum

d) Premeasured tube vacuum

Lavender-top tubes are most commonly used to collect:

a) Chemistry tests

b) Coagulation specimens

c) Hematology tests

d) Immunology tests

c) Hematology tests

Of the following tubes or containers, which is filled last to recommended order of draw?

a) Blood culture bottle

b) Lavender top

c) Light blue top

d) Red top

b) Lavender top

A butterfly is typically used for:

a) Coagulation specimens

b) Difficult and hand veins

c) Draws from the basilic vein

d) All the above

b) Difficult and hand veins

EDTA can be found in:

a) Lavender-top tubes

b) Purple-top tubes

c) White-top tubes

d) All of the above

d) All of the above

Blood in which type of tube normally clots within five minutes?

a) PST

b) RST

c) SPS

d) SST

b) RST

Which of the following is a biocide?

a) 70% isopropanol

b) Hydrogen peroxide

c) Povidone-iodine

d) All of the above

d) All of the above

Mixing an additive correctly involves turning the wrists how many degrees and back again?

a) 45

b) 90

c) 120

d) 180

d) 180

If a CBC, PT, plasma potassium, and glucose (drawn with a glycolysis inhibitor) are all to be collected during a multiple-tube draw on a patient, which of the following choices shows the correct stopper colors to use in the correct order of draw?

a) Lavender, light blue, gold, green

b) Light blue, green, lavender, gray

c) Red, royal blue, green, lavender

d) Yellow, orange, lavender, gray

b) Light blue, green, lavender, gray

A green-colored stopper indicates the tube contains:

a) Citrate

b) EDTA

c) Heparin

d) Oxalates

c) Heparin

A trace element-free tube stopper is:

a) Green/gray

b) Lavender

c) Royal blue

d) Yellow

c) Royal blue

Thixotropic gel is found in:

a) PPTs

b) PSTs

c) SSTs

d) All of the above

d) All of the above

A transillumination device is used to:

a) Contain sharps

b) ID patients

c) Locate veins

d) Transfer blood

c) Locate veins

The ratio of blood to anticoagulant is most critical for:

a) Coagulation specimens

b) Light blue stoppers

c) Sodium citrate tubes

d) All the above

d) All the above

NPO means

a) new patient orders

b) needed postoperative

c) nothing by mouth

d) nutrition postoperative

c) nothing by mouth

Which of the following is required requisition information?

a) Ordering physician’s name

b) Patient’s first and last names

c) Type of test to be performed

d) All of the above

d) All of the above

The following test orders for different patients have been received at the same time. Which test would you collect first?

a) Fasting glucose

b) STAT glucose in the ER

c) STAT hemoglobin in the ICU

d) ASAP CBC in the ICU

b) STAT glucose in the ER

A member of the clergy is with the patient when you arrive to collect a routine specimen. What should you do?

a) Ask the patient’s nurse what you should do

b) Come back after the clergy person has gone

c) Fill out a form saying you were unable to collect the specimen

d) Say “Excuse me, I need to collect a specimen from this patient”

b) Come back after the clergy person has gone

You are asked to collect a blood specimen from an inpatient. ID bands are required at this facility, but the patient is not wearing one. What is the best thing to do?

a) Ask the patient’s name, and collect the specimen if it matches the requisition

b) Ask the patient’s nurse to attach an ID band before you draw that patient

c) Identify the patient by the name card on the door

d) Refuse to draw the specimen, and cancel the request

b) Ask the patient’s nurse to attach an ID band before you draw that patient

If a patient adamantly refuses to have blood drawn, you should

a) convince the patient to be cooperative

b) notify the patient’s nurse or physician

c) restrain the patient, and draw the blood

d) write a note to the patient’s physician

b) notify the patient’s nurse or physician

An inpatient is eating breakfast when you arrive to collect a fasting glucose. What is the best thing to do?

a) consult with the patient’s nurse to see if the specimen should be collected

b) Draw the specimen quickly before the patient finishes eating

c) Draw the specimen and write “nonfasting” on the requisition

d) Fill out a form stating the patient had eaten so the specimen was not drawn

a) consult with the patient’s nurse to see if the specimen should be collected

After cleaning the venipuncture site with alcohol the phlebotomist should

a) allow the alcohol to dry completely

b) fan the site to help the alcohol dry

c) dry the site with gauze pad or cotton ball

d) insert the needle quickly before alcohol dries

a) allow the alcohol to dry completely

The tourniquet should be released

a) as soon as blood flow is established

b) before needle removal from the arm

c) within one minute of its application

d) all of the above

d) all of the above

What is the recommended angle of needle insertion when performing venipuncture on a arm vein and on a hand vein, respectively?

a) 20 degrees or less, 20 degrees or less

b) 25 degrees or less, 15 degrees or less

c) 30 degrees or less, 10 degrees or less

d) 45 degrees or less, 20 degrees or less

c) 30 degrees or less, 10 degrees or less

After inserting a butterfly needle, the phlebotomist must “seat” it, meaning the phlebotomist will

a) have the patient make a fist to keep it in place

b) keep the skin taut during the entire procedure

c) push the bevel against the back wall of the vein

d) slightly thread it within the lumen of the vein

d) slightly thread it within the lumen of the vein

Blood collection tubes are labeled

a) as soon as the test order is received

b) before the specimen is even collected

c) immediately after specimen in collection

d) whenever it is the most convenient

c) immediately after specimen in collection

What is the best approach to use on a eight year-old child who needs to have blood drawn?

a) Explain the draw in simple terms, and ask for the child’s cooperation

b) Have someone restrain the child, and collect the specimen

c) Offer the child a treat or a toy if he or she does not cry

d) Tell the child it won’t hurt and will only take a few seconds

a) Explain the draw in simple terms, and ask for the child’s cooperation

Which type of patient is most likely to have an arteriovenous fistula or graft?

a) Arthritic

b) Dialysis

c) Hospice

d) Wheelchair-bound

b) Dialysis

Which of the following is proper procedure when dealing with an elder patient?

a) Address your questions to an attendant if the patient has a hearing problem

b) Make certain to hold adequate pressure after the draw until bleeding stops

c) Speak extra loud in order to be certain that the patient can hear you

d) Tie the tourniquet extra tight to make veins more prominent

b) Make certain to hold adequate pressure after the draw until bleeding stops

Where is the tourniquet applied when drawing a hand vein?

a) A tourniquet is not required

b) Above the antecubital fossa

c) Just distal to the wrist bone

d) Proximal to the wrist bone

d) Proximal to the wrist bone

Specimen hemolysis can result from

a) filling tubes with a transfer device at an angle

b) leaving the tourniquet on until the last tube

c) mixing anticoagulant tubes several extra times

d) using a large-volume tube with a 23-gauge needle

d) using a large-volume tube with a 23-gauge needle

A critical aspect of the ability to obtain adequate specimens from toddlers while ensuring their safety is:

a) allowing the child to sit with one arm bracing the other

b) having a parent leave the room until the draw is over

c) keeping the tourniquet on throughout the draw

d) selecting an adequate method of immobilization

d) selecting an adequate method of immobilization

Criteria used to decide which needle gauge to use for venipuncture include

a) how deep the selected vein is

b) the size and condition of the vein

c) the type of test being collected

d) your personal preferences

b) the size and condition of the vein

Which of the following venipuncture steps are in the correct order?

a) Apply tourniquet, position arm, select vein

b) Insert needle, release tourniquet, engage ETS tube

c) Remove needle, place gauze, activate safety device

d) Select vein, clean site, release tourniquet

c) Remove needle, place gauze, activate safety device

Which of the following is the best way to handle a needle-phobic patient?

a) Ask the most skilled phlebotomist to do the draw

b) Have the patient lie down for the procedure

c) Place an ice pack to the site before the draw

d) All the above

d) All the above

How long should the site be examined to determine if bleeding has stopped?

a) 5-10 seconds

b) 10-15 seconds

c) 20-25 seconds

d) 25-30 seconds

a) 5-10 seconds

Examples of timed tests include

a) basic metabolic panel, potassium, and glucose

b) blood cultures, cardiac enzymes, and cortisol

c) calcium, ferritin, and complete blood count

d) creatinine, lactic acid, and reticulocyte count

b) blood cultures, cardiac enzymes, and cortisol

Bending the arm up to apply pressure to the site after venipuncture has been shown to do all the following except

a) disrupt the platelet plug when the arm is eventually lowered

b) enable the site to quickly stop bleeding after needle removal

c) increase the possibility of bruising and hematoma formation

d) keep the wound open, especially if it is at the side of the arm

b) enable the site to quickly stop bleeding after needle removal

The unique number assigned to a specimen request is called the

a) accession number

b) healthy facility number

c) patient date of birth

d) patient ID number

a) accession number

Which of following tests requires an arterialized specimen?

a) Bilirubin

b) Blood gases

c) Electrocytes

d) Glucose

b) Blood gases

Capillary puncture supplies include all the following except a

a) gauze pad

b) lancet

c) microcollection device

d) povidone-iodine pad

d) povidone-iodine pad

Capillary puncture blood contains

a) arterial blood

b) interstitial fluids

c) venous blood

d) all of the above

d) all of the above

The concentration of which substances is higher in capillary blood than in venous blood?

a) Blood urea nitrogen

b) Carotene

c) Glucose

d) Total protein

c) Glucose

Capillary puncture is typically performed on adults when

a) no accessible veins can be located

b) patients have thrombotic tendencies

c) veins are saved for chemotherapy

d) all of the above

d) all of the above

If collected by capillary puncture, which of the following is collected first?

a) CBC

b) Electrocytes

c) Glucose

d) Phosphorus

a) CBC

Which of the following conditions disqualifies a site for capillary puncture?

a) Cyanotic

b) Edematous

c) Swollen

d) All of the above

d) All of the above

Which of the following is the least hazardous area of an infant’s foot for capillary puncture?

a) Central area of the heel

b) Lateral plantar heel surface

c) Medial area of the arch

d) Posterior curvature of the heel

b) Lateral plantar heel surface

According to CLSI, a heel puncture lancet should puncture no deeper than

a) 1.5 mm

b) 2.0 mm

c) 2.5 mm

d) 3.0 mm

b) 2.0 mm

Which of the following is a proper capillary puncture procedure?

a) Clean the site thoroughly with povidone-iodine

b) Milk the site to keep the blood flowing freely

c) Puncture parallel to fingerprint grooves

d) Wipe away the first drop of blood

d) Wipe away the first drop of blood

When making a routine blood smear, the “pusher slide” is normally used at an angle of how many degrees?

a) 15

b) 30

c) 45

d) 60

b) 30

The blood specimen for which test is placed in circles on special filter paper?

a) Bilirubin

b) CBGs

c) PKU

d) Malaria

c) PKU

Which of the following fingers is the best choice for a capillary puncture?

a) Index

b) Middle

c) Pinky

d) Thumb

b) Middle

Which test cannot be collected by capillary puncture and taken to the laboratory for processing testing?

a) Bili

b) Hgb

c) Lead

d) PTT

d) PTT

Capillary action is a term used to describe how

a) arterial blood enters the capillaries

b) blood fills a microhematocrit tube

c) cells spread across a blood smear

d) waring can increase blood flow

b) blood fills a microhematocrit tube

Fluid in the spaces between the cells is called

a) interstitial fluid

b) intracellular fluid

c) lymphatic fluid

d) peritoneal fluid

a) interstitial fluid

Correct newborn screening test collection or handling includes

a) applying blood drops to both sides of the filter paper

b) hanging a specimen slip to dry in a vertical position

c) layering successive blood drops in a collection circle

d) using one large drop to entirely fill a collection circle

d) using one large drop to entirely fill a collection circle

Strong repetitive pressure, such as squeezing or milking a site during capillary specimen collection

a) can hemolyze and contaminate specimens

b) improves the accuracy of CBC test results

c) increases venous blood flow into the area

d) is necessary to obtain adequate blood flow

a) can hemolyze and contaminate specimens

Neonatal screening is the testing of

a) babies for contagious diseases

b) infants with certain symptoms

c) newborns for certain disorders

d) pregnant women for diseases

c) newborns for certain disorders

In an infant’s heel, the primary blood supply is located

a) between 0.35 and 1.6 mm deep

b) from 1.00 mm to 2.00 mm deep

c) in the top layer of the epidermis

d) starting at around 2.4 mm deep

a) between 0.35 and 1.6 mm deep

The primary reason for performing arterial puncture is to

a) determine hemoglobin levels

b) evaluate blood gases

c) measure potassium levels

d) obtain calcium values

b) evaluate blood gases

The first-choice location for performing arterial puncture is the:

a) Brachial artery

b) Ulnar artery

c) Femoral artery

d) Radial artery

d) Radial artery

ABG supplies include:

a) 18-gauge needles

b) Heparinized syringes

c) Tourniquets

d) All of the above

b) Heparinized syringes

Commonly measured ABG parameters include:

a) pH

b) PaCO₂

c) O₂ saturation

d) All of the above

d) All of the above

A phlebotomist has a request to collect an ABG specimen while the patient is breathing room air. When the phlebotomist arrives to collect the specimen, the patient is still on a ventilator. What should the phlebotomist do?

a) Call the phlebotomy supervisor, and ask how to proceed

b) Consult with the patient’s nurse to determine what to do

c) Draw the ABG and note the oxygen setting on the request

d) Take the patient off the ventilator and draw the specimen

b) Consult with the patient’s nurse to determine what to do

The purpose of the modified Allen test is to determine:

a) Blood pressure in the ulnar artery

b) If collateral circulation is present

c) If the patient is absorbing oxygen

d) The clotting time of both arteries

b) If collateral circulation is present

Which of the following is an acceptable angle of needle insertion for radial ABGs?

a) 10 degrees

b) 20 degrees

c) 45 degrees

d) 90 degrees

c) 45 degrees

Which of the following complications are associated with arterial puncture?

a) Arteriospasm

b) Hematoma

c) Infection

d) All of the above

d) All of the above

Which of the following can cause erroneous ABG values?

a) The presence of air bubbles in the specimen

b) Delay in analysis exceeding 30 minutes

c) Inadequate mixing results in microclots

d) All of the above

d) All of the above

Which of the following would cause you to suspect that a thrombus had formed in the artery while you were collecting an ABG?

a) A hematoma quickly form at the site

b) The patient complains of extreme pain

c) The pulse distal to the site is very weak

d) All of the above

c) The pulse distal to the site is very weak

The best way to tell that a specimen is arterial is the blood:

a) Has lots of air bubbles

b) Looks bright red in color

c) Needs to be aspirated

d) Pulses into the syringe

d) Pulses into the syringe

The term for a reflex contraction of an artery is:

a) Arteriospasm

b) Hypovolemia

c) Transitory thrombus

d) Vasovagal response

a) Arteriospasm

Heparin is used in arterial sample collection to:

a) Increase blood flow in the area

b) Numb the area around site

c) Prevent clotting of the specimen

d) Stabilize the oxygen content

c) Prevent clotting of the specimen

Prior to ABG collection, a patient should have been in a steady state for at least:

a) 5 to 10 minutes

b) 10 to 15 minutes

c) 15 to 20 minutes

d) 20-30 minutes

d) 20-30 minutes

When performing the modified Allen test, which artery is released first?

a) Brachial

b) Femoral

c) Radial

d) Ulnar

d) Ulnar