What is the most important venipuncture step?
Collecting the specimen
Positioning the patient
Selecting supplies
Identifying the patient
Which test is time-dependent?
Glucose
Cholesterol
Bilirubin
Potassium
Which sterilizer is used for blood cultures?
Alcohol
Lidocaine
Bacitracin
Chlorhexidine
What is the most commonly used vein?
Median cubital
Cephalic
Radial
Basilic
A hemogram is drawn in which color tube?
Lavender top
Green top
Blue top
Red top
Why is disposable equipment used?
To reduce the spread of infection
It's inexpensive
For variety
To take up less space
The venipuncture site is cleansed with 70% _____.
iodine
water
isopropyl alcohol
betadine
Which needle has the smallest diameter?
20-gauge
23-gauge
18-gauge
21-gauge
Which cells transport oxygen to the tissues?
White blood cells
Red blood cells
Platelets
Squamous cells
How long can a tourniquet remain on the arm?
1 minute
2 minutes
5 minutes
10 minutes
Specimens need to be shipped in what type of container?
Watertight
Paper
Egg crate
Plastic
Where can a patient acquire a nosocomial infection?
At work
At the doctor's office
In the hospital
At home
Specimens used as criminal tracking evidence are called _____.
privileged
private
chain of custody
bad
The process of killing all microorganisms in an area is called ______.
cleaning
sterilization
autoclaved
disinfection
Which body system regulates water balance and blood pH?
Urinary
Cardiovascular
Respiratory
Digestive
Which element is bound by EDTA to prevent clotting?
Calcium
Magnesium
Sodium
Blood cultures require which samples for collection?
anaerobic/aerobic
aerobic/saline
CO2/saline
anaerobic/CO2
Which is not a VAD device?
PICC line
central venous line
shunt
sphygmomanometer
What can reduce pain at the venipuncture site?
EMLA
A tighter tourniquet
Warm water
Topical antiseptic
What site would be preferred with an open IV?
In the IV tubing
Above the IV
Below the IV
It cannot be done
All chemical supply manufacturers must provide this with their products?
Material Safety Data Sheets (MSDS)
Free disposal
Warning signs
Product pricing
Which body system is involved with breathing?
Nervous
The heart is part of which body system?
Skeletal
Muscular
Integumentary
Which national organization recently changed its name to CLSI?
OSHA
NCCLS
ASCP
JCAHO
What does QNS mean?
Not enough specimen
Hard draw
Patient was insulting
Test ordered wrong
The lab test for extrinsic function is ____.
partial thromboplastin time (PTT)
prothrombin time (PT)
platelet function time (PFT)
lupus anticoagulation (LA)
Which tube is used when drawing alcohol specimens?
Plain red top
EDTA
Sodium fluoride
Sodium citrate
Tiny clots in additive tubes are due to ______.
a traumatized draw
not enough specimen
insufficient mixing
centrifuging too long
Which has the highest occurrence in healthcare?
Hepatitis B
HIV
Hepatitis C
TB
The process where an area becomes unclean is called _____.
sterile
contaminated
prepped
good enough
The most common nosocomial infection is ______.
urinary tract
dermal
respiratory
surgical
Grey tubes have which additive?
SPS
Tubes without an additive are what color?
Skin punctures on adults are performed on which finger(s)?
First finger
Heel or foot
Third or fourth finger
Second finger
What is the most frequently used needle gauge?
21
18
23
16
The smallest human veins are called ________.
capillaries
arteries
venules
arterioles
The smallest human arteries are called _______.
If a hematoma starts to form, what should you do?
Finish drawing, not to worry
Release tourniquet, remove needle, apply pressure
Apply pressure above site
Reposition needle
A protime is collected in what color tube?
Light blue top
AIDS stands for ______.
auto immune deficiency symptom
acquired immune disease state
acquired immune deficiency syndrome
auto inflammation disease state
The cellular components of blood are _______.
All of the above
When making blood smear slides, what angle works best?
5 degrees
10 degrees
30 degrees
90 degrees
Which color tube needs a 9:1 ratio to be accepted by the lab?
Plain red top - blood bank
Lavender top - hematology
SST - chemistry
Light blue top - coagulation
Which drawing method has the highest number of injuries?
Tube holders
Winged infusion sets (butterflies)
Evacuated draws
Capillary draws
Which protection works best for blood and skin contact?
Gloves
Respirator
Gown
Mask
What patient identification is a must besides name?
Date of birth
Diagnosis
Address
Social security number
Which test is used for diabetes mellitus or hyperglycemia?
Glucose tolerance
Hemogram
Urinalysis
How do you encourage bleeding on an infant heelstick?
An ice pack
Multiple punctures
Squeezing hard
Pre-warming
If a patient needs to collect urine for 24 hours, which container would work best?
2 mL
20 mL
200 mL
2,000 mL
Which technique works best if a patient has excessive arm hair or frail skin?
Tie tourniquet over clothing
Tie tourniquet tighter
Don't use a tourniquet
Find a different site
The site of a finger stick is cleansed and ______
soaped
swabbed with iodine
allowed to dry
No prep is needed
Physician and patient visits are considered privileged, which means ________.
open to anyone
not important
confidential
not available to the patient
Which technique will minimize aerosol contamination in the lab?
Keeping the centrifuge lid closed
Keeping doors closed
Wearing gloves
Opening all windows
Why is a 2.4 mm lancet not recommended for an infant heelstick?
It can cause injury to the heel.
It may not puncture deep enough.
It may take multiple tries.
It may require you to squeeze harder.
Fibrin strands may be caused by _______.
centrifuging at too high a speed
centrifuging before the sample has clotted
centrifuging after 2 hours
How soon after drawing should mixing begin?
Immediately
It's not needed
Once all tubes are drawn
After sitting
Can a phlebotomist draw blood from a patient that refuses?
No.
Yes, if a doctor tells them it's okay.
Yes, if a nurse tells them it's okay.
Yes, there's no choice in the matter.
A patient who stays overnight in the hospital is called a(n) _______.
outpatient
inpatient
resident
If you have been vaccinated for Hepatitis B, which would be your next threat?
H1N1
Herpes
Which organism can not live in human fluids?
Bacteria
Fungus
Virus
Ticks
Why are tourniquets used during a blood draw?
To eliminate pain
To locate veins
To distract the patient
They are not needed
Why is protective isolation used?
To protect phlebotomists
To protect doctors
To protect patients
To protect everyone from germs
Sterility must be used when handling _____.
IV supplies
needle holders
lab coats
venipuncture trays
A glucose meter is used on patients with ______.
diabetes mellitus
anemia
leukemia
arthritis
Which is a blood borne pathogen?
Urinary tract infection
Strep throat
Malaria
Influenza
Phlebotomists should check blood tubes for _____.
expiration dates
faded labels
warnings
manufacturer's name
What do you do if a patient stops breathing while drawing blood?
Keep drawing
Stop and call for help
Don't worry
Shake them awake
Which National Fire color and number indicates that a chemical is easily dispersed and will burn?
Blue, 2
Red, 4
White, 4
Yellow, 1
If a patient's bracelet and requisition do not match, what's your next step?
Change the paper to match the bracelet
Do not draw until resolved
Ask a nurse to identify
Ask the patient's roommate
If you lower a bed rail to draw a child, what do you do before leaving the room?
Leave it down
Return it to the upright position
Ask the child which position they prefer
Don't worry about it
What is the first step after you perform a skin puncture?
Wipe away the first drop
Immediately start collecting
Make a blood smear just in case
Clean with water
Which test must be kept warm and delivered directly to the lab?
Cold agglutinin
CBC
Blood typing
Blood gases
What is the life span of a red blood cell?
60 days
120 days
5 days
25 days
Why do you need a feathered edge when making blood smears?
It spreads the cells out to a single layer.
It helps the slides dry faster.
It stains better.
It's not necessary.
Why does a rubber sleeve cover one side on a multi-sample needle?
It prevents blood from leaking into the holder.
It makes tubes easier to push on.
It decreases needle sticks.
It keeps tubes from being contaminated.
For which test does a patient need to be fasting?
Lipid
Which of these organisms serve as a reservoir host?
Animals
Humans
Plants
When additive tubes are centrifuged, what is spun to the bottom?
Plasma
Phlebotomists should wash their hands _____.
even if gloves are used
before collection
after collection
What do you do if the collection tube has blood on the outside of it?
Wipe it down with disinfectant
Discard the tube and redraw
Pour it into a clean tube
Sharps containers must have all of the following features except being _____.
mold proof
spill proof
puncture proof
tamper proof
Squeezing the finger too hard can cause false results due to ______.
dilution with tissue fluid
bacteria
contamination
clotting
OSHA is required to train staff for all of the following except ______.
identification errors
blood-borne diseases
needle safety
sharps disposal
If a patient starts to get raised, red blotches by the tourniquet, what should the phlebotomist do?
Treat it as a possible latex reaction
Ignore it
Continue to draw
Ask the patient if they're okay
If blood and urine specimens are lost for 2 weeks, can they still be used?
No
Only if you hurry
Only if you refrigerate overnight
Yes, if run within 24 hours
Which is not important when drawing a tube with an additive?
Mixing the tube adequately
Filling in order
Filling until full
Keeping the tourniquet on until the last tube is filled
Venipuncture should not be performed on a left arm if ______.
there is an IV running in the left hand
there is a full-arm cast
there is a recent mastectomy
Treating all specimens as if they are hazardous and infectious is the basis of ______.
universal precautions
hazardous control
patient education
good practice
How are slides used to make blood smears disposed of?
Sharps container
Regular trash
Sealed in biohazard waste
Left out on the counter
What post-draw technique would you not use after drawing from an ill neonate (baby)?
Label tubes
Remove tourniquet
Use tape
No precautions need to be taken
A skin puncture sample is a good choice for testing when _______.
veins are bruised and fragile
a large amount of blood is needed
multiple tests have been ordered
at any time
The collection site is cleansed in a circular motion, starting ______.
counter-clockwise
from the center to the peripheral edge
from the peripheral edge to the center
any way
Phlebotomists should not draw too much blood from a small baby because the baby could be in danger of _______.
a bad experience
becoming anemic
needing more blood later
No danger
Which is not included in the patient bill of rights?
Preferred nurse
Refusal of treatment
Informed consent
Right to know
Where is the preferred collection site on an infant heel?
Anywhere
Posterior curve
Middle of heel
Medial or lateral aspect
A hemolyzed specimen can be caused by ________
a traumatic venipuncture
the wrong tube being drawn
failure to mix the tube
an overfilled tube
What step should a phlebotomist take if they have a needle stick exposure?
Tell their supervisor
Go home at the end of their shift
Ask the patient if they have anything
What is the most important information if a patient needs a GTT?
No instructions are needed
Eat right before
Should be fasting for accurate results
No testing is needed
What is the first step to take when entering a patient's room?
Introduce and explain
Check for a tray table
Make sure they are sleeping
Don't talk
A cholesterol (lipid) is best drawn ______.
right after a big meal
while fasting
in the afternoon
after urinating
The artery in the wrist is called the ______.
radial
jugular
femoral
cephalic
Which is the least appropriate for an infant venipuncture?
Butterfly (winged infusion set)
15-gauge needle
Pediatric tubes
3 cc syringe
Centers for Medicare and Medicaid regulates all lab testing in the US through _____.
HIPAA
CLIA
What does the lab need to know when drawing therapeutic drug levels?
Time of last dose
Patient's diagnosis
Time next dose is due
Nothing
Which additive is used in microbiology blood culture tubes?
If a patient has 3 orders from 3 different doctors, what should the phlebotomist do?
Draw all of them
Draw them an hour apart
Check for duplicate orders
Toss out 2
If a glucose meter is cleaned, it is important to ______.
call the company and ask
check controls
do nothing
ask the patient if their results are okay
The HIPAA act requires the Department of Health and Human Services to establish national standards for _____.
improving customer services
electronic healthcare transactions
food services
phlebotomy uniforms
If you need to mail a specimen, the label must include ______.
the name and address of the lab
warning labels
"in case of leaking, send to the CDC"
Which of these may result in a failure to collect a specimen?
Making a fist
If the tourniquet is too loose
Insufficient needle depth
If the patient is taking medication
Which of these is a globally-recognized organization that develops and oversees standards and guidelines in lab testing?
NCA
Which blood test should be protected from the light?
A patient who donates blood for their own surgery is called a ______ donor.
transfusion
autologous
blood typing
This procedure is not done.
Phlebotomists are involved in which phase of testing?
Pre-analytical
Analytical
Post-analytical
None of the above
Why is it important to keep a log of all specimens collected?
For pre-analytical QC
For analytical QC
For post-analytical QC
No record is needed
If a patient's sleeve is too tight to pull up, what would you do?
Tell them to reschedule
Offer them a gown to change into
Pull it up anyway
Refuse to draw them
A centrifuge is used in a clinical laboratory setting to _____.
sort tubes of different colors
store tubes at the correct temperatures
measure blood oxygen levels
separate liquid from the cells in the blood
When you send blood tubes by mail in a watertight container, they should be enclosed in a _____.
paper box
second durable watertight container
secured, certified mail envelope
overnight envelope
Anticoagulants are used to _____.
fight infection
prevent blood from clotting
neutralize stomach acid
inhibit bacterial growth
EMLA is a mixture of lidocaine and prilocaine that can be used to _____.
sterilize a venipuncture site
anticoagulate whole blood
topically anesthetize a draw site
put a phlebotomy patient under
When blood seeps into the surrounding tissue during a venipuncture, a _______ can form.
petechiae
carbuncle
hematoma
hemolysis
The term that refers to right or wrong conduct is ______.
empathy
sympathy
ethics
rights
The purpose of the bleeding time test is to assess ______.
platelet plug formation in the capillaries
the pressure of the blood vessels
elasticity in the major blood vessels
the amount of blockage in the veins
Skin punctures may be indicated for use when ______.
the patient is an infant, toddler, or preschooler
only a small amount of blood is needed
the patient's vein needs to be preserved for IV therapy
If a biohazard spills in the laboratory, a phlebotomist should first try to ______.
call a physician to the site
wash his/her hands
contain the spill safely
pull the fire alarm
The federal law that expanded in 2000 to protect the confidentiality of electronically stored health information is abbreviated as _____
EPA
A vein might be prone to collapse if the _______.
vacuum tube is too large for the vein, the syringe plunger is pulled back too quickly, the vacuum tube loses its vacuum, or the tourniquet is too tight
vacuum tube is too large for the vein, the syringe plunger is pulled back too quickly, or the vacuum tube loses its vacuum
the vacuum tube loses its vacuum or the tourniquet is too tight
vacuum tube is too large for the vein or the syringe plunger is pulled back too quickly
Before entering designated isolation rooms, phlebotomists should always ______.
put on masks and foot coverings
put on gowns and tie them
check requirements on signs
call a nurse or physician
The phase of laboratory testing that refers to test orders, test collection, and test sample preparation are all part of the _____ phase.
exponential
pre-analytical
testing
post-prandial
Hemolysis would cause rejection of a sample collected for _______ testing.
potassium
pregnancy
rubella
pyruvate
In performing phlebotomy on children, it is best to ____.
talk softly and gently
enlist the help of parents
tell the truth if asked
One test often used to assess hemostasis before surgery is ____.
blood culture
hemoglobin
platelet count
bleeding time
The anticoagulant EDTA works by ______.
binding prothrombin
lysis of red blood cells
inactivating thrombin
binding calcium
A tube of blood that arrives in the laboratory without a label must be _____.
labeled by the phlebotomist
labeled by the doctor
labeled by the nurse
rejected automatically
The ____ must be followed exactly whenever drawing patient test samples that may be used in a legal proceeding.
chain of command
standard deviation
coefficient of variation
Knowing when to collect peak and trough levels is important when drawing ______.
blood cultures
therapeutic drugs
cortisol levels
estrogen levels
An appropriate means of communicating with a patient who is profoundly hearing-impaired might include ______.
ignoring the patient entirely
talking only to a hearing relative
using written communication
trying to speak a little louder
If a nurse stops to ask you to draw a patient for a post-prandial glucose, what would you need to know?
When they last ate
If they have showered
When they will eat next
If they have therapy scheduled
Where would be the best location option for blood collection on this patient?
Hematoma
IV in hand
Mastectomy
2-finger amputation - 5 years ago
How would you confirm diabetes in a patient?
Lipid test
A1C
While working the lab, you pick up a pen left on the counter and place it in your mouth. What type of exposure would this be?
Strict
Vector
Contact
Vehicle