CPT - Test 1 Questions

To correctly don PPE's, all except which of the following equipment must be available? A. Waste bin. B. Mask. C. Face shield. D. Size-appropriate gloves.

A is correct. PPEs usually consist of a mask, face protection, gown, and gloves. In a medical setting, PPE also includes a waste bin or biohazard container. However, a waste bin is not donned.

Which of the following occurs when the body uses up a lot of clotting factors as a result of coagulation happening everywhere in the body due to several infected injuries? A. Disseminated intravascular coagulation. B. Hemophilia. C. Deep vein thrombosis. D. Clot lysis.

A is correct. Pathogens and the inflammatory reaction during sepsis may trigger the coagulation process to ensue throughout the body, resulting in disseminated intravascular coagulation.

Your patient suddenly starts to have a seizure while you are collecting blood. Which of the following should you do first? A. Remove the tourniquet and needle, apply pressure to the site, and summon help. B. Forcibly restrain the patient. C. Run to the nurse station to summon help. D. Turn the patient's head to one side and insert a tongue depressor in the mouth.

A is correct. While it is rare, venipuncture may trigger seizures. When a patient suddenly starts having jerky movements and is unresponsive, immediately release the tourniquet and withdraw the needle. Apply pressure to the venipuncture site. While doing this, call for help. Make sure the patient is safe from possible injuries. Turn their head to one side. Do not attempt to place any object in their mouth. Do not leave the patient.

Why do most tests require wiping off the first drop of blood when collecting dermal puncture specimens? A. It avoids comtamination. B. It increases blood flow. C. It prevents the formation of a round drop of blood. D. It prevents blood-borne infections.

A is correct. Wipe off the initial drop of blood using a gauze unless the tests require otherwise. This practice avoids collecting samples contaminated with residual alcohol or tissue fluids.

Your new colleague has forgotten his password to the LIS and is asking you to lend your password so he can print out requisition forms. You should do which of the following? A. Give him your password. B. Print out the requisition forms yourself. C. Give him your password, but immediately change it after he uses your account. D. All of the above.

B is correct. In this case, the best option would be to print out the requisition forms yourself since you would be accountable for any mistakes your colleague may make. Never share your password with anyone. All data within the LIS may be traced back to who has inputted it or handled the specimen.

Malabsorption of lactose can be detected in the breath through which of the following tests? A. C-urea breath test. B. Hydrogen breath test. C. Alcohol breath test. D. Carbon dioxide breath test.

B is correct. Increasing levels of hydrogen in breath indicate malabsorption or indigestion of lactose in the gastrointestinal tract, which may aid in the diagnosis of lactose intolerance.

Why are most routine venipunctures often collected early in the morning? A. The physicians make rounds in the morning and need these results early. B. The patient is well-rested and fasting. C. The patient will have already had breakfast. D. Fewer adverse reactions (i.e., nausea, fainting) are encountered.

B is correct. It is preferable to obtain specimens during the basal state. This is when the patient is well-rested and fasting (no food or drinks except water for the last 12 hours). This is often early in the morning. Venipuncture during the basal state achieves the best comparison of patient test values with reference ranges.

What happens when the patient is allowed to pump their fists while you are extracting blood? A. Hemolysis. B. Hemoconcentration. C. Hematoma. D. Skin blanching.

B is correct. Pumping the fists causes hemoconcentration. This action is ideal for blood donation, but not for laboratory testing.

When it is necessary to take a blood culture sample from patients who are already taking antibiotics, you must do which of the following? A. Ask the nurse to discontinue the patient's antibiotics for 24 hours. B. Collect the sample in special bottles containing activated charcoal. C. Ensure that the patient has taken activated charcoal first. D. Ask the nurse to skip the patient's antibiotics right before your collection.

B is correct. Special blood culture bottles are available when it is necessary to take a blood culture sample from patients already taking antibiotics. These may contain resins (antimicrobial removal devices) or activated charcoal (fastidious antimicrobial neutralization) designed to inactivate antibiotics.

Which of the following specimens may be used to investigate the organisms or crystals in the joints? A. Amniotic fluid. B. Synovial fluid. C. Cerebrospinal fluid. D. Serous fluid.

B is correct. Synovial fluid is also known as joint fluids. This acts as a lubricant during movement.

Which of the following is the ideal time for collecting a blood culture? A. After the height of fever. B. Just before the height of fever. C. After giving antibiotics. D. During a patient's basal state.

B is correct. The blood culture is usually collected as two sets of blood taken 30 minutes or 1 hour apart. Some physicians may request the cultures to be collected just before the height of the fever (based on the patterns in the temperature charts) to collect the most concentration of pathogens.

Which of the following is a large artery branching near the aorta and is often used as a site for identifying pulse in the event of an emergency? A. Radial. B. Carotid. C. Superior vena cava. D. Pulmonary.

B is correct. The carotid artery is often used to spot pulses during emergencies. It is a large artery branching near the aorta, while the rest of the choices are veins.

Which of the following tests is used to evaluate the function of the extrinsic coagulation pathway? A. Activated partial thromboplastin time. B. Prothrombin time. C. Thrombin time. D. D-dimer.

B is correct. The prothrombin time can estimate the function of the extrinsic pathway and is useful in monitoring the response to warfarin therapy.

A tourniquet was used to find the vein. How long is the interval before it can be reapplied to draw the blood? A. 60 seconds. B. 120 seconds. C. 180 seconds. D. 5 minutes.

B is correct. The tourniquet should be used only for a maximum of 1 minute. You will often apply the tourniquet twice. First, choosing the venipuncture site, and second, right before you draw blood. CLSI recommends waiting for at least 2 minutes before reapplying the tourniquet. Ideally, one new disposable, latex-free tourniquet is used for one patient.

The butterfly system is preferred for use in venipuncture on which of the following patients? A. A 70-year-old active man. B. A 24-year-old undergoing chemotherapy. C. A 30-year-old businesswoman. D. A 15-year-old boy.

B is correct. The winged collection set, or "butterfly" system, is routinely used for IV infusions and venipuncture in smaller and very fragile veins. These are often encountered in cancer patients, small children, and geriatric patients.

Which of the following are considered the most common leukocyte found in the body? A. Lymphocytes. B. Neutrophils. C. Monocytes. D. Basophils.

B is correct. These types of leukocytes (neutrophils) make up an average of 40% to 60% of all leukocytes found in the human body.

Preexamination variables are those that affect the integrity of the specimens and alter test results. Which of the following statements is correct? A. When a patient has not complied with fasting, you must cancel the venipuncture. B. Patients should lie down for 30 minutes before drawing blood for aldosterone tests. C. Following short-term exercise, oxygen and hemoglobin levels are lower. D. At higher altitudes, oxygen and hemoglobin levels are lower.

B is correct. Values for renin and aldosterone, and catecholamines, can increase to twice their original values in an hour after shifting positions. For such tests, patients are instructed to stay recumbent for at least 30 minutes before blood is drawn. Additionally, you must note down on the requisition forms the patient's position during venipuncture.

Why is warming the site recommended in dermal puncture? A. It prevents hemolysis. B. It increases blood flow. C. It prevents the formation of microclots. D. It is soothing for the patient.

B is correct. Warming the fingers and heels increases blood circulation, which eases specimen collection. This is optimal for collecting multiple samples, capillary blood glucose sampling, and cold and cyanotic areas.

You are assigned to collect dermal punctures for newborn spot tests. Before you enter the neonatal ICU, which of the following is your priority? A. Greeting the nurses. B. Washing your hands. C. Donning a gown and gloves. D. Putting on a mask.

B is correct. Washing your hands should be the first thing you do.

Which of the following needle positions causes hematoma by puncturing the veins through the tissue? A. Bevel too close to the vessel wall. B. Needle advanced too deep into the vein. C. Needle angle too narrow. D. Needle not inside the vein.

B is correct. When using the ETS, you must firmly brace the holder as you insert or change the tubes. If you fail to do so, the needle may puncture too deep into the vein. This goes through the vein and into the tissues. This obstructs blood flow and creates a hematoma. Slowly pulling the needle may remedy this situation. Be sure to apply additional pressure on the puncture site to reduce the risk of hematoma.

Which of the following statements describes a properly collected newborn screen sample? A. Using one drop of blood from a heel puncture to fill and soak one circle. B. Using multiple drops of blood to fill and soak one circle. C. Using a capillary pipette to apply a uniform drop of blood on each circle. D. Applying one drop of blood to each side of the filter paper.

A is correct. The blood from the heel puncture is blotted on an area marked by circles on the specimen card. To ensure the sample's integrity, you must avoid contaminating this area with other chemicals or even your fingerprints. Use only one drop of blood on each circle and apply each to the same side. Do not touch the paper to the infant's heel. An adequate sample is also visible on the back side of each card. Each circle must be adequately filled.

Which of the following is the proper sequence for removing PPE? A. The most contaminated items are removed first. B. The least contaminated items are removed first. C. The first PPE worn is removed first. D. The last PPE worn is removed first.

A is correct. When removing PPE, the most contaminated items must be removed first. Make sure these do not contact your skin. The order for removing PPE is gloves first, then goggles or face shields, gown and mask.

Where is the pulse commonly felt? A. The neck, elbow crease, and wrists. B. The chest, neck, and thigh. C. The forearm. hands, and knee. D. The neck, below the thumb, and the sides of the forehead.

A is correct. When you are feeling someone's pulse, you are feeling the rhythmic waves that travel through the arteries from the pumping heart. Common areas to locate the pulse are the neck (carotid artery), the anterior elbow crease (brachial artery), and the wrist (radial artery).

When attempting venipuncture on a dialysis patient with an AV graft, you should do which of the following? A. Apply the tourniquet 3 inches below the AV graft. B. Collect blood from the AV graft. C. Collect blood from the other arm. D. Only A and B.

C is correct. Patients undergoing hemodialysis often have a venous access device. It is more prone to infection and prolonged bleeding. Only trained staff can draw blood from these areas. You must first be sure that the arm has no grafts or fistulas before you apply a tourniquet. Compressing the vessels of these arms can compromise the integrity of these devices. Draw blood only on the arm without an arteriovenous graft or fistula.

Which of the following is the correct blood culture volume requirement for infants weighing less than 5 kilograms? A. 1 to 3 mL of blood per pediatric bottle. B. 0.5 mL of blood per pediatric bottle. C. 1 mL in only one pediatric bottle. D. only 0.5 mL per kilogram.

C is correct. Pediatric bottles are available for use on children. The volume of blood collected is computed based on the child's weight. From an infant weighing less than 5 kg, collect only 1 mL in one bottle.

The contents of a phlebotomy tray include all except which of the following? A. ETS. B. Tourniquet. C. Urine cups. D. Syringe.

C is correct. Routine equipment seen on a phlebotomist's tray includes materials for the ETS, syringes, winged collection set, tourniquets, antiseptic skin solutions, gloves, gauze, slides, markers, transfer devices, and a sharps disposal container. The phlebotomist is not expected to carry urine collection cups.

Which of the following is true when collecting forensic samples for use in legal proceedings? A. The specimen must be collected in front of two witnesses. B. Only the physician may draw the blood. C. You should document your name and the date and time on the chain-of-custody form. D. You will be asked to identify the patient in court.

C is correct. Specimen handling is documented extensively when collecting forensic samples for legal proceedings. Each person involved in the chain of custody must document their name and the date and time they handled the specimen.

Agents of infections are described as linked together to form a chain. A susceptible host may, in turn, become which of the following? A. Portal of exit. B. Mode of transmission. C. Reservoir. D. Infectious agent.

C is correct. The chain of infection consists of 6 links. Take note from the scenarios that the susceptible host who contracts the disease becomes the new reservoir.

Which of the following blood vessels carries deoxygenated blood? A. Pulmonary vein. B. Carotid artery. C. Pulmonary artery. D. Aorta.

C is correct. The pulmonary artery is the only artery carrying deoxygenated blood. It gains the name "artery" because, like all the other arteries, it carries blood away from the heart.

Performance of which of the following tests is subject to proficiency testing? A. Waived test. B. Provider-performed microscopy. C. High-complexity. D. Moderate-complexity.

C is correct. These procedures utilize complex instrumentation. Interpretation requires higher levels of understanding, and the performance of these tests is subject to proficiency testing.

Where is the proper position of the tourniquet on the patient's arm? A. At least 2 inches above the elbow crease. B. At least 1- or 2-inches superior to the antecubital fossa. C. At least 3- or 4-inches superior to the antecubital fossa. D. Applied securely around a joint or bony area.

C is correct. To properly apply the tourniquet, choose a site on the arm at least 3- or 4-inches superior to the antecubital fossa. The tourniquet should be applied to a muscle.

You find out that a patient has not complied with fasting requirements for a blood cholesterol determination. You inform the nurse. She says to go ahead with the procedure. You should do which of the following? A. Argue with the nurse. B. Report the nurse to your supervisor. C. Draw the blood as instructed and make sure to note "not fasting" on the requisition form. D. Wait to hear the instructions directly from the physician.

C is correct. Verify special preparations. These include appropriate fasting and skipping medications. In cases when the patient has not complied, report it to the nurse. If the nurse informs you that the physician still requires the specimen, document it on the requisition form and the specimen label as "not fasting".

A chilled specimen should not be used for which of the following tests? A. Arterial blood gases. B. Serum potassium. C. ACTH. D. PTH.

B is correct. Chilling is not suitable for testing some analytes. Potassium increases in a chilled tube. Electrolyte tests must be collected separately when drawing blood with chilling requirements.

Which of the following chemicals is added to tubes to prevent glycolysis? A. Na heparin. B. Na fluoride. C. Na polyanethol sulfate. D. Na citrate.

B is correct. Sodium fluoride prevents glycolysis and stabilizes glucose for 24 hours.

Before meeting any patient, which of the following is the routine policy OSHA encourages for controlling the spread of infection? A. Emergency precautions. B. Standard precautions. C. Universal precautions. D. Blood-borne precautions.

B is correct. Standard precautions include PPE, such as gloves, masks, gowns, etc. These precautions are used for all patients, even if they may not have an infection. This helps prevent the spread of pathogens from patient to patient.

The ventral cavities contain all except which of the following organs and subcavities? A. Thoracic. B. Abdominal. C. Cranial. D. Pelvic.

C is correct. Within the ventral cavity are the thoracic, abdominal, and pelvic subcavity.

Waived testing sites are not regularly inspected. Under which of the following circumstances will CMS inspect these sites? A. When a complaint has been raised. B. To ascertain whether these sites are performing only the tests they are permitted to. C. To gather data on waived tests. D. All of the above.

D is correct.

Communicating effectively involves which of the following? A. Tone of voice. B. Listening skills. C. Gestures. D. All of the above.

D is correct. Communicating effectively involves listening, gestures, and an appropriate tone of voice.

Which of the following are important data to write on the specimen labels? A. Patient ID number. B. The requesting physician's name and signature. C. Test(s) requested. D. Special handling requirements for the tests requested.

A is correct.

The gauge of the needle to collect blood should be which of the following? A. 16- or 17-gauge. B. 17- or 18-gauge. C. 23-gauge. D. 25-gauge.

A is correct. A large-gauge needle (16- or 17-gauge) is necessary to prevent hemolysis and allow large volumes to be collected.

On which area should you view the slide under the microscope to ensure that your sample is representative of the patient's blood? A. On the feathered edge. B. Around the holes. C. At the thickest area. D. At the creases.

A is correct. A properly prepared smear has a smooth film covering about 2/3 of the slide without any creases or holes. It ends smoothly, as a feathered edge. This area ensures that the cells are spread in a single even layer. The feathered edge is the area viewed under the microscope to ensure that the reading is looking at a sample representative of the patient's blood.

Which of the following stipulates the standards that every laboratory must follow in the course of diagnostic procedures, professional qualifications, quality-management systems, and handling complaints? A. CLIA. B. HIPAA. C. OSHA. D. CAP.

A is correct. CLIA stipulates these standards. These are set by the Center for Medicare & Medicaid Services (CMS).

Which of the following areas are suitable for venipuncture? A. Below a hematoma. B. Above a hematoma. C. Sclerosed veins. D. Healed burns or scars.

A is correct. Do not perform venipuncture in areas with possible infections, contamination, or low blood flow. Avoid venipuncture over hematomas, on edematous limbs, on sclerosed veins, or on burns, scars, or a new tattoo. When no other veins are suitable except for one near a hematoma, always puncture inferior to the hematoma. This ensures a sample of circulating blood.

Which of the following is avoided by not rimming a clot from the sides of a tube? A. Hemolysis. B. Hemoconcentration. C. Hematoma. D. Blood-borne pathogen exposure.

A is correct. Do not rim a clotted tube. This can lead to hemolysis.

How long can ESR specimens in EDTA tubes be refrigerated? A. 12 hours. B. 24 hours. C. 48 hours. D. 72 hours.

A is correct. Erythrocyte sedimentation rates should be analyzed from 4 hours of collection in EDTA tubes kept at room temperature. Refrigeration may extend this limit by up to 12 hours.

Which of the following is a method of obtaining a sterile urine sample for bacterial cultures from patients who are bedridden or unable to void? A. Catheter collection. B. Use of a collection bag. C. Midstream clean-catch sample. D. First-morning void.

A is correct. For bacterial cultures, especially on bedridden patients or infants, trained personnel collect a sample by passing a sterile catheter into the patient's urethra under aseptic conditions.

The correct method of collecting a nasopharyngeal swab involves which of the following? A. Immersing the swab in saline and mixing it vigorously. B. Crushing the contents of the ampule of transport media. C. Disposing of the swab, along with excess liquid. D. Transporting the swab to the laboratory on an ice slurry.

A is correct. For nasopharyngeal swabs, after collection, it is immersed and mixed in a saline transport medium vigorously. Any excess liquid should be squeezed out of the swab before disposing of it. The tube, not the swab, is transported on an ice slurry.

Hemoconcentration is produced by which of the following? A. Performing venipuncture on sclerotic veins. B. Removing the tourniquet before 1 minute. C. Failing to instruct the patient to pump their fist. D. Inverting the evacuated tubes.

A is correct. Hemoconcentration affects many test results. It can be caused by venipuncture on sclerotic veins or edematous limbs.

Which of the following procedures allows a person to preemptively donate a unit of their blood to be transfused during or after the operation? A. Autologous donation. B. Heterologous donation. C. Homologous donation. D. Self-donation.

A is correct. Of the choices, only A is correct. Patients who need elective surgery may preemptively donate a unit of their blood to be transfused during or after their operation. An autologous donation avoids transfusion reactions and exposure to bloodborne pathogens.

Which of the following is a term attributed to the pain and swelling of a vein that develops as a result of carelessness when doing phlebotomy work? A. Phlebitis. B. Thrombosis. C. Aneurysm. D. Arteriosclerosis.

A is correct. Phlebitis is a condition that phlebotomists can inflict if they are not being careful. This refers to pain and swelling of the vein. An indwelling IV cannula can also be the culprit of this condition.

Which of the following refers to the bacteria in the bloodstream causing symptoms of fever and tachycardia? A. Sepsis. B. Bacteremia. C. Meningitis. D. Allergy.

A is correct. Sepsis is the clinical term used when the patient has a systemic inflammation (such as fever and increased heart rate, or increased white cell counts), along with bacteremia, or the presence of bacteria in the bloodstream.

When necessary, small veins on the dorsum of the hand can be used for venipuncture. Which of the following blood collection systems is best for this area? A. Winged collection system. B. Syringe system. C. ETS. D. Never be used.

A is correct. Small superficial veins are also found on the dorsum of the hand. These may be suitable for venipuncture. Smaller needles or butterfly sets are used to collect blood from this area. Often, this area is reserved for IV lines.

The elbow lies proximal to the hand. This means that the elbow is which of the following? A. Nearer to the center of the body than the hand. B. Farther to the center of the body than the hand. C. Toward the midline of the hand. D. On the side of the hand.

A is correct. The directional term proximal was used, which describes the structure as nearer to the center of the body. Therefore, the elbow is nearer to the body's center than to the hand.

Which of the following is the correct instruction for patients before collecting sputum specimens? A. Do not eat or drink. B. Smoking is allowed. C. Swallow a glass of water right before expectorating. D. Take a sample right before going to bed.

A is correct. The first-morning sample is ideal to ensure a large enough collection. Patients are instructed to collect the samples before a meal and without smoking. Moments before the expectoration of sputum, have the patient gargle with water (but do not swallow) to obtain a sample with the least contamination.

Which of the following planes cuts the body into an anterior and posterior section? A. Frontal. B. Sagittal. C. Midsagittal. D. Transverse.

A is correct. The frontal plane cuts the body into anterior and posterior sections.

Blood pressure determines the pressure subjected to the blood vessel walls during the systole and diastole. It is reported as two readings in millimeters of mercury. Which of the following is the number written above? A. Systolic blood pressure. B. Diastolic blood pressure. C. Pulse rate. D. Pulse pressure.

A is correct. The one above is the systole, while the one below is the diastole. This is normally at 120/80 mmHg for adults.

Which of the following tests have a relatively lower risk of false results and no training requirement? A. Waived test. B. Provider-performed microscopy. C. Moderate complexity. D. High-complexity.

A is correct. These diagnostic procedures are simple. No training is required. There is little to no risk of error when following the box instructions.

The ideal time to centrifuge a specimen is which of the following? A. 2 hours after refrigeration. B. 2 hours after receiving. C. 4 hours after refrigeration. D. 4 hours after receiving.

B is correct. Centrifugation must be completed within 2 hours of receiving the specimen to avoid analyte changes.

Which of the following is a suitable cleanser for clearing bacteria off the skin in a newborn? A. Chlorhexidine gluconate. B. 70% isopropyl alcohol. C. 40% isopropyl alcohol. D. ChloraPrep swabs.

B is correct. Chlorhexidine gluconate is not suitable for use on infants below 2 months old. It is highly irritating to their sensitive skin and can possibly cause chemical burns. ChloraPrep swabs contain a mixture of chlorhexidine gluconate and alcohol. Of the choices, only 70% isopropyl alcohol is adequate and safe for cleansing the skin of a newborn.

Which of the following is a specialized tissue that provides a scaffold for the organs? A. Epithelial. B. Connective. C. Muscular. D. Nervous.

B is correct. Connective tissue provides a scaffold of support for the organs. The epithelial tissues cover the lining of the body. The muscles are specialized for movement. The nervous tissues are specialized for impulse transmission.

As blood flows down the tube, the phlebotomist should do which of the following? A. Instruct the patient to pump their fist. B. Instruct the patient to open their fist. C. Tighten the tourniquet. D. Loosen the tourniquet.

B is correct. During a successful venipuncture, instruct the patient to open their fist as soon as the blood starts flowing down the tube. The tourniquet is released only if the procedure takes more than 1 minute.

Which of the following is a condition caused by the lack of an enzyme to break down a sugar found in milk and results in an accumulation in the blood? A. Phenylketonuria. B. Galactosemia. C. Cystic fibrosis. D. Congenital hypothyroidism.

B is correct. Galactosemia is due to the lack of an enzyme that normally metabolizes galactose, which is found in milk. This accumulates in the blood and causes problems in multiple organs, such as the liver, brain, and kidneys. The damage is prevented by placing these infants on a lactose-free and galactose-free diet.

Consent is implied for an adult patient for blood extraction under which of the following conditions? A. They sign the consent form. B. They extend their left arm. C. They nod in agreement. D. There is a witness present.

B is correct. Implied consent is commonly encountered with venipuncture. The patient implies consent when they allow you to proceed by extending or exposing their arm. Nodding in agreement is insufficient to imply consent in this case.

How long can a prothrombin time specimen remain at room temperature? A. 2 hours. B. 4 hours. C. 8 hours. D. 24 hours.

D is correct. Prothrombin time specimen may remain at room temperature for up to 24 hours. Chilling is not recommended, as it can activate factor VII.

Which of the following types of waste refers to objects that may cut or puncture? A. Pathologic/anatomical. B. Recyclable. C. Chemical. D. Sharp.

D is correct. Sharps waste does not only refer to needles and blades. It includes metals or glass with edges that may cut or puncture.

An improper dermal puncture, which fails to cut perpendicular to the fingerprint, will do which of the following? A. Cause significant discomfort to the patient. B. Cause blood to collect and flow in the grooves. C. Contaminate the sample. D. Hemolyze the sample.

B is correct. In performing finger punctures, the device's blade is aligned across the grooves of the skin to create a perpendicular cut. This allows you to collect most of the blood, as it does not flow into these grooves.

Which of the following characteristics would make a volunteer eligible to donate blood? A. 16 years old. B. Weight of 48 kg. C. Blood pressure of 180/110 mmHg. D. Hemoglobin count of 13 g/dL.

D is correct. The eligibility criteria for blood donation allow a 16-year-old to donate blood only with consent from their parents or guardians. Volunteers should weigh at least 50 kg, be afebrile, with normal blood pressure, with hemoglobin greater than 12.5 g/dL, and hematocrit greater than 38%.

Before proceeding with a venipuncture, you must do which of the following? A. Read out the patient's name; check if they nod or say yes. B. Ask every patient to verbally state their first and last names and birth date. C. Check only the patient's ID band with the requisition form. D. Check only the ID numbers, since this is reliable.

B is correct. CLSI standards require two identifiers. Ask every patient to verbally state their first and last name, spell them out, and give their birth date. Compare these to the data written on their ID bands with the requisition forms.

Which of the following may cause a falsely low blood alcohol level? A. Using 70% isopropyl alcohol as a skin cleanser. B. Underfilling the gray tube. C. Overfilling the gray tube. D. Using Zephiran chloride as a skin cleanser.

B is correct. Alcohol is a volatile substance and may escape into the surrounding air. Gray tubes (with sodium fluoride) must be filled until the vacuum is exhausted. They must remain covered until testing. Underfilling allows alcohol to escape in the surrounding air left in the tube, causing falsely low blood alcohol levels.

EDTA prevents blood from clotting through which of the following actions? A. Releasing heparin. B. Binding calcium. C. Binding thrombin. D. Binding fibrinogen.

B is correct. Anticoagulants prevent blood clot formation by binding calcium (ethylenediaminetetraacetic acid) or inhibiting thrombin (heparin).

Which of the following evacuated tubes is coated with an additive that inhibits thrombin? A. Lavender. B. Green. C. Black. D. Yellow.

B is correct. Anticoagulants prevent the formation of blood clots. Tubes containing heparin include green, light-green, lime-green, royal-blue, and red/green cell preparation tubes.

Being sensitive to cultural diversity is a desirable professional trait in the health care staff. A phlebotomist can respond appropriately by doing which of the following? A. Stereotyping patients. B. Noticing the patient's reactions and accommodating them. C. Examining the patient's arm very quickly. D. Invading the patient's personal space.

B is correct. Being sensitive to cultural diversity is a desirable professional trait in the health care staff. A phlebotomist can respond appropriately by paying attention to the patient's reactions.

Which of the following categories of infectious substances do newborn screening cards belong to? A. Category A. B. Category B. C. Category C. D. Category D.

B is correct. Biohazardous material may be designated one of two classifications. Most laboratory specimens fall in category B - not generally disabling or life-threatening to humans or animals.

Which of the following technical errors leads to a hematoma formation? A. Releasing the tourniquet before withdrawing the needle. B. Applying pressure to the site. C. Using a large needle on a small vein. D. All of the above.

C is correct.

When you are receiving a 24-hour urine sample from a patient, he mentions that he forgot to collect a small amount when he went to urinate at night. You should do which of the following? A. Immediately refrigerate the specimen. B. Dilute the sample with a preservative. C. Ask the patient to submit a new one. D. Accept the specimen.

C is correct. A 24-hour urine collection is used to provide a quantitative measure of urine analytes. In this situation, you should politely reject the specimen and remind the patient of the importance of collecting all the samples to keep the results accurate.

As today's health care system is evolving, some phlebotomists may be trained to perform additional duties, such as which of the following? A. Specimen transport. B. Dermal puncture. C. Taking vital signs. D. Selecting specimen containers.

C is correct. A phlebotomist may be assigned other tasks, including performing additional responsibilities related to patient care, such as taking vital signs.

When using a pneumatic tube system, all except which of the following is correct? A. Tubes must be properly cushioned. B. Keep specimens in leak-proof biohazard containers. C. Tubes may be used to transport specimens collected through invasive means. D. All of the above.

C is correct. A pneumatic tube system is available in many hospitals to facilitate the delivery of specimens from the wards to the laboratory. Tubes must be properly cushioned and kept in leak-proof biohazard containers. Specimens collected through invasive means must be transported only by hand. This avoids any untoward incidents from a pneumatic tube transit.

Which of the following is a correct practice when performing dermal punctures? A. Restrain every pediatric patient, as they might be uncooperative. B. Promise that the procedure will be quick and painless. C. Make a note of agitation and crying in the requisition form. D. It is unnecessary to document consent when a child is simply wrapped in a blanket for the dermal puncture.

C is correct. Agitation and crying may affect white cell counts and blood glucose levels. Make a note of this on the requisition form.

Capillary blood contains higher levels of which of the following analytes? A. Potassium. B. Albumin. C. Glucose. D. Calcium.

C is correct. Analytes from capillary blood may require a different set of reference values. It contains higher glucose levels and lower potassium, calcium, and protein levels than venous blood.

When the patient's elbow is allowed to bend over the site without applying adequate pressure, which of the following happens? A. Hemolysis. B. Hemoconcentration. C. Hematoma. D. Skin blanching.

C is correct. Ensure the needle is removed from the vein before applying any pressure to the site. Keep pressure on the site. Or, if the patient is capable, ask them to hold down the gauze for about 2 to 3 minutes. Bending the elbow is not advisable, as it does not provide enough pressure. This causes blood to leak into the tissues, contributing to a hematoma.

It is acceptable to have another person verify a patient's identity when the patient is which of the following? A. A teenager. B. Elderly. C. Cognitively impaired. D. Combative.

C is correct. For patients who are too young, have cognitive impairments, or do not speak English, CLSI requires patient information to be provided by a caregiver. In some instances, the nurse may verify the patient's identity. You must document the informant's name on the requisition form.

Which of the following is the ideal temperature for storing serum or plasma, which cannot be tested after 48 hours? A. 27 degrees C. B. 10 degrees C. C. -20 degrees C. D. 7 degrees C.

C is correct. Freezing may be done if testing is expected to be done beyond 48 hours. This is achieved at temperatures -20 degrees C or lower.

A requisition form is valid if received through which of the following? A. The patient. B. The pneumatic tube system. C. The hospital information system. D. All of the above.

D is correct. Venipuncture begins when a phlebotomist receives the requisition form. It may be brought in by a patient from their doctor's clinic, received through the pneumatic tube, or electronically encoded in the hospital information system.

Following successful blood donation, volunteers should be instructed to do all except which of the following? A. Drink plenty of fluids. B. Avoid strenuous activities. C. Lie down if they feel dizzy or nauseous. D. Return to work involving lifting heavy objects.

D is correct. A significant amount of blood has been removed during the blood collection. Donors should replenish their fluids by drinking plenty of fluids and avoid complications by refraining from strenuous activities or heavy lifting during the day. They cannot be allowed to return to work involving lifting heavy objects, as this might cause them to faint from the strain.

You are asked to do a venipuncture on a comatose patient. There is no ID band on the patient. Which of the following actions is appropriate? A. Ask the other patients in the ward to identify the patient. B. Postpone the procedure; leave the requisition with the nurses. C. Wait for a family member. D. Find the nurse to attach an ID band to the patient.

D is correct. All admitted patients should have an ID band. If the band is missing, the correct action should be to find the nurse to replace the bands before you draw the blood. A nurse may be allowed to sign the requisition slip to verify the patient's identity, but you still need to compare the patient's ID band with the requisition form.

Which of the following is a federal law that stipulates the confidentiality of patient information? A. CLIA. B. CLSI. C. TJC. D. HIPAA.

D is correct. As outlined in HIPAA, all health care providers, including you as a phlebotomist, must obtain a patient's express consent in writing to share their information. By releasing patient information to the patient's relatives or your fellow healthcare workers, or by inappropriately accessing electronic records, you can be charged with violating HIPAA. Consequences may range from suspension to imprisonment. You may even be charged with defamation for breaching a patient's confidentiality.

Which of the following CSF tubes is correctly paired with its intended department? A. Tube 1 for chemistry. B. Tube 2 for microbiology. C. Tube 3 for hematology. D. All of the above.

D is correct. CSF is collected in three sterile tubes labeled according to the order of collection. The first tube is intended for chemistry and immunoserology assays. The second tube is for microbiology, and the third is for hematology and cytology.

Donor units are routinely tested for the presence of which of the following bloodborne pathogens? A. Human immunodeficiency virus. B. Treponema pallidum. C. HTLV. D. All of the above.

D is correct. Donor screening also involves testing a sample of the blood for ABO and Rh blood type and testing for the presence of blood-borne pathogens. Donor units are tested for parasites, such as Trypanosoma cruzi, and viruses, such as HIV, hepatitis B and C, HTLV, and West Nile virus. Testing to Treponema pallidum is also done.

On which patient population is a dermal puncture appropriate? A. Cancer patients on chemotherapy. B. Elderly patients. C. Patients on glucose monitoring. D. All of the above.

D is correct. Instances when adults require a dermal puncture include all of the above (chemotherapy patients, elderly, and those on glucose monitoring) as well as burn patients, and those with scarred and inaccessible veins (i.e., thrombosed, obesity).

Which of the following can cause a specimen to be rejected? A. Clotted red tubes. B. Using a partial-draw tube. C. Incompletely filling an SST. D. Clotted lavender tubes.

D is correct. Lavender tubes contain EDTA as an anticoagulant. They should be inverted 8 times to ensure proper mixing. A clotted lavender tube will be rejected.

Which of the following tests may be run on capillary blood? A. ESR. B. Blood culture. C. Coagulation tests. D. Newborn screening test.

D is correct. Newborn screening tests use a specialized filter paper (Guthrie card), which relies on blood collected from a dermal puncture. Using capillary pipettes and other methods causes scratches and blood layering., which interferes with the integrity of the sample. A dermal puncture cannot provide adequate blood volume to run tests requiring larger volumes, such as coagulation assays, ESR, and blood cultures.

Which of the following types of serous fluid is located between the membranes of the abdominal cavity? A. Pleural. B. Pericardial. C. Parietal. D. Peritoneal.

D is correct. Peritoneal fluid is found between the membranes of the abdominal cavity. An increase in the peritoneal fluid is also ascites.

Which of the following statements on the consequences of improper transport is true? A. Glycolysis causes falsely high blood glucose values. B. Hemolysis causes falsely low serum potassium values. C. Coagulation factors are increased at room temperature. D. Bilirubin is photosensitive; the tube must be wrapped in foil during transport.

D is correct. Photosensitive analytes deteriorate upon exposure to light or ultraviolet radiation. These specimens may be wrapped in aluminum foil or collected in amber-colored tubes.