Unit 3 Exam Questions

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

ETS tubes

retractable lancet

multisample safety needle

tourniquet

retractable lancet

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

red top

Which of the following needles has the largest diameter?

18-gauge

What causes evacuated tubes to fill with blood automatically?

premeasured tube vacuum

Lavender top tubes are most commonly used to collect:

Hematology test

Light Blue top tubes are used to collect:

Coagulation test

Of the following tubes or containers, which is filled last in the recommended order of draw for a venipuncture collection?

Lavender top

EDTA can be found in:

pink tops

lavender tops

royal blue tops

all of the above

all of the above

A green colored stopper indicates the tube will contain:

Heparin

SST is most commonly used in the collection of:

clinical chemistry specimens

What is the correct ratio of blood to additive in a Light Blue top tube?

9:1

Healthcare Infection Control Practices Advisory Committee (HICPAC), Hand hygiene refers to …

handwashing using plain soap and water.

using an antiseptic hand rub (e.g alcohol, chlorhexidine, iodine).

handwashing using antimicrobial soap and water.

All the choices are correct

All the choices are correct

NPO means:

nothing by mouth

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

STAT glucose in the ER

You are asked to collect a specimen from an inpatient, but the patient is not wearing an armband.  What do you do?

Do not collect the specimens. You must "Stop the Line" call the patient's nurse to identify the patient and put an armband on the patient before you can proceed with the specimen collection. 

Alcohol-based hand rubs are indicated for all of the following clinical situations except . . .

when the hands are visibly soiled.

BSWH policy and procedure clearly states blood collection tubes should be labeled: 

immediately after collection at the bedside in the presence of the patient

The tourniquet should be released:

as soon as blood flow is established

before the needle is removed from the patient's arm

within one minute of the application

all of the above

all of the above

Evacuated tubes containing an anticoagulant additive must be gently mixed to:

Prevent blood from clotting

A butterfly needle (winged infusion set) is used in which of the following situations?

When drawing from fragile veins

When drawing from small veins

When drawing from veins in the hand

All of the above

All of the above

A PST vacuum tube contains which additive

lithium heparin

Where should the tourniquet be placed on the patient before draw?

Three to four inches above the intended site

Criteria used to decide which needle gauge to use for a routine venipuncture include:

the size and condition of the vein

Which of the following venipuncture steps are in the correct order to show the proper use of a tourniquet?

Establish blood flow, release tourniquet, fill tubes in the correct order of draw

Which of these tests are affected if the patient is not fasting?

Glucose and triglycerides

When the arm of a patient is swollen with excessive tissue fluid this condition is called

edema

Which situation would be most likely to allow reflux to occur during venipuncture?

allowing the tubes to fill from the stopper end first

Which situation can result in hemoconcentration?

leaving the tourniquet on for more than a minute

Most test results reference ranges are values for:

healthy individuals

When blood is being collected for a glucose tolerance test the patient should fast for:

8-12 hours

A basal state exists:

in the early morning, 8-12 hours after the last ingestion of food

Which of the following is another term for fainting?

syncope

When collecting blood from a patient that is known to faint, the phlebotomist should put the patient in which position before collecting the specimens?

recumbent

Which of the following is a commonly used intravenous device that is sometimes used in the collection of blood from patients who are difficult to collect blood from by conventional methods?

butterfly needle

Which of the following has been reported to erroneously affect laboratory test results in newborns, leading to falsely elevated WBC counts?

crying

Swelling in the area around a venipuncture site usually leads to

hematoma formation

What is the acceptable number of times a phlebotomist can attempt a venipuncture?

twice

Which of the following should stop a phlebotomist from collecting blood from this patient's arm.

mastectomy on that side

When hemoglobin is released from RBCs and serum becomes tinged as pink or red this condition is referred to as 

hemolysis

A decrease in the plasma volume occurring with an increased concentration of cells and larger molecules such as cholesterol is referred to as 

hemoconcentration

If a patient begins to have a seizure during the venipuncture, the phlebotomist should immediately:

release the tourniquet, remove the needle and hold pressure on the site

Which test result is affected when the sodium citrate tube is under or over filled?

PT

Petechiae appear:

when small amounts of blood escape into skin epithelium

Why is it important to ask if a patient is fasting before collecting a blood specimen for laboratory testing?

some laboratory test can be affected by the ingestion of food or drink

What additive is found in the gray top tube?

Sodium fluoride

If the antecubital area cannot be used for the venipuncture what would be an alternate site 

dorsal side of the hand

During a typical venipuncture the needle should be inserted at what angel to the skin?

30 degrees or lower

During the venipuncture what should the phlebotomist do after the needle is inserted and good blood flow is established?

release the toruniquet

When using the evacuated tube system for a venipuncture, select the correct order of collection for the following tubes: chemistry tube, coagulation tube, hematology tube

Light blue, PST, Lavender

Which of the following information is essential for labeling a laboratory specimen?

Patient's full name, MRN, Date & Time of collection, Collectors Initials

The first step in the identification process is :

Ask the patient to state their full name and date of birth

One reason for hematoma formation during venipuncture is that the :

needle is partially inserted in the vein allowing blood to seep out into the surrounding tissue

Where should the tourniquet be placed on the patients arm during a venipuncture procedure?

3 to 4 inches above the venipuncture site

Which of the following helps with needle phobia?

showing compassion and understanding

When a patient has "difficult veins" which strategy can be used to improve the likelihood of a successful venipuncture?

taking your time to find and acceptable vein, and using a butterfly

When using a butterfly and syringe to collect the blood sample, what is an acceptable way to transfer the blood from the syringe to the evacuated tubes?

remove the needle from the syringe and discard into the sharps container, then screw on a transfer device and fill each tube using the ASCP order of draw being careful to let the vacuum tubes pull the blood from the syringe naturally 

Which anticoagulant is used for a hematology test

EDTA

Which is not an anticoagulant?

clot activator

When collecting a blood specimen with a butterfly method and the only test being collected is a PT and PTT what is the correct procedure?

Use a discard tube and then collect a sodium citrate tube

What is the purpose of the "Order of Draw" when collecting specimens using the evacuated tube system?

to avoid cross contamination of tube additives

Generally speaking, what should the phlebotomist do with the first drop of blood after a fingerstick is performed?

wipe it off with gauze

Excessive massaging or milking of the finger during a skin puncture procedure can cause:

hemolysis and contamination fo the specimen with tissue fluids

Fingerstick procedure cannot be performed when which test is ordered?

blood cultures

Another instance when a fingerstick should not be performed on a patient is when the following test has been ordered

D-dimer

Capillary puncture supplies include all the following except:

povidone-iodine pad

When collecting specimens by capillary puncture which microtainer is collected first

lavender top

Which location is the least hazardous for an infant's foot when collecting blood by capillary puncture?

lateral plantar heel surface

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

Ring finger

When performing a capillary puncture on a finger the puncture should be

slightly off center to avoid penetrating the bone and avoided the nail bed

TAT refers to:

the time it takes for laboratory test to be resulted

Which of the following is a possible occurrence if a blood specimen tube for hematology testing is filled correctly but not mixed?

Micro clots will form in the specimen

Cooling a blood specimen causes:

slowing of metabolic process

Which of the following is considered confidential patient information?

clinical laboratory results

Which laboratory test requires the sample be put on ice a the time of collection?

ammonia

Specimens being tested would not require centrifugation in which of the following department?

hematology

How long does the processor have to wait for a clot to form in an SST or Red top tube before spinning the tube to get a serum sample for a STAT chemistry test?

30-60 minutes

How long does the processor have to wait before spinning a PST or Lt Green top tube to get a plasma sample for a STAT chemistry test?

there is no wait time the specimen can be immediately spun 

A patient's stress/anxiety can affect the pre-examination phase of laboratory testing. True or false

True

Coagulation specimen should be rejected if they are clotted or hemolyzed. True or False

True

The Lt blue top tube contains lithium heparin. True or false

False

21 gauge multisampling needles are commonly used for adult venipunctures when using the ETS. True or False

True

An abnormal accumulation of fluid in the intercellular space may cause hemolysis. True or False

False

It is an acceptable practice to mix two half-filled tubes when you need one completely filled tube, but only if the patient is a very difficult draw and you note "hard stick" on the sample label. True or false

False

Hemoconcentration causes an increase in the plasma volume with a decreased concentration of cells and larger molecules. True or False

False

Veins may collapse when blood is withdrawn too quickly during venipuncture collection. True or False

True

Phlebotomist place the patients arm in a downward motion to avoid the risk of backflow of an anticoagulant by allowing the blood to fill from the bottom of the tube to the top. True or False

True

You should release the tourniquet at the end of the venipuncture procedure after the needle is removed from the patient's arm. True or False

False

A blood specimen can be rejected if the collection tube is out-of-date.  Another term for this is expired. True or False

True

To avoid unlabeled specimens, all tubes should always be prelabeled prior to blood collection. True or False

False

When drawing healthy outpatients, it is acceptable to allow them to stand at the counter during blood collection. True or false

false

When your sharps container is full it is acceptable to recap your needle just until you get a new sharps container. True or false

false

Collection tube additives may be accidentally transferred from one specimen tube to the next when the tubes are not collected in the correct order of draw. true or false

true

Alcohol that has not dried prior to a skin puncture can cause hemolysis of blood cells. true or false

true

Because a finger stick and a venipuncture are not sterile procedures it is acceptable practice to blow on or fan the alcohol to get it to dry faster.  true or false

false

Pediatric heel stick devices can only be used as finger lancets with adults that have thick skin on their fingers. true or false

false

For infants, a depth of less than 2 mm on heel sticks is recommended to avoid penetrating the heel bone. true or false

true

Sodium heparin is contained in the Dark Green top collection tube. true or false

true

Disposable, onetime use, sterile lancets are used to avoid bloodborne pathogen exposure when performing capillary draws. true or false

true

Disposable, onetime use, sterile lancets can be placed in the trash because the needle springs back into the device after use and cannot stick again. true or false

false

The most common butterfly sizes are 19 g and 18 g . true or false

false