PHLEBOTOMY AMT

f levels of blood components fluctuate according to circadian cycle, it means that fluctuations occur

24 HOUR CYCLE

How far above the venipuncture site should the tourniquet be wrapped around the arm?

3-4 inches

Complete clotting of a blood specimen can take up to

30 minutes at room temperature

How long does the College of American Pathologists (CAP) recommend discontinuing drugs that interfere with blood tests prior to a procedure?

4-24 hours urine is 24-48

When instructing patients in the collection of a 24-hour urine specimen, which patient should be asked about possible leakage when laughing or coughing?

60 y/o pregnant women

The most common antiseptic for routine blood collection is

70% isopropyl alcohol

Phlebotomists should clean and sanitize all work surfaces at the end of each shift with Select one: a. 5% bleach solution (1:20). b. 10% bleach solution (1:10). c. 50% bleach solution (1:2). d. concentrated bleach.

.b. 10% bleach solution (1:10).

Chemical and microscopic changes that invalidate the results obtained from a urine specimen if the urine is kept at room temperature for what period of time?

1 hour

When blood is inoculated into blood culture bottles using a butterfly apparatus the Select one: a. anaerobic bottle is inoculated first. b. safety device is activated first. c. aerobic bottle in inoculated first. d. volume of blood inoculated is increased.

aerobic bottle in inoculated first. because the butterfly tubing has air in it.

The medical word root that means vessel is Select one: a. angi- . b. arteri- . c. erythr- . d. hemat- .

angi-

What department is responsible for reporting a patient's blood type? Select one: a. Chemistry b. Blood Bank c. Hematology d. Microbiology

b. Blood Bank

Blood specimens should be drawn according to standards of the Select one: a. College of American Pathologists (CAP) b. Clinical and Laboratory Standards Institute (CLSI) c. Centers for Disease Control and Prevention (CDC) d. Occupational Health and Safety Administration (OSHA)

b. Clinical and Laboratory Standards Institute (CLSI)

A patient has come in for a blood draw. The phlebotomist cleanses the patient's skin with a Betadine® swab and notices that the patient's skin has turned red and bumpy. What question should the phlebotomist have asked prior to the cleansing? Select one: a. Are you feeling ok? b. Do you have any allergy to iodine? c. Do you have any allergy to alcohol? d. No questions are to be asked as the Betadine® will turn the skin red

b. Do you have any allergy to iodine?

Which of the following would be the very first step in performing a routine venipuncture on a patient? Select one: a. Identify the patient b. Identify yourself c. Explain the procedure d. Apply the tourniquet

b. Identify yourself

If serum is left to remain on the blood clot for more than one hour, which of the following most likely will occur? Select one: a. Serum glucose levels increase b. Serum glucose levels decrease c. Serum potassium levels increase d. Serum potassium levels decrease

b. Serum glucose levels decrease RBCs in the blood clot would continue to metabolize glucose resulting in decreased values.

What abnormal color will be observed in serum collected from a patient with jaundice due to elevated bilirubin levels?

b. Yellow

A written court order addressed to a specific person, requiring that person's presence in court at a specific time, is Select one: a. a contract. b. a subpoena. c. an agent. d. an agreement.

b. a subpoena.

When blood is collected from a patient, the serum should be separated from the blood cells as quickly as possible to avoid Select one: a. glycolysis b. hemolysis c. hemostasis d. hemoconcentration

b. hemolysis

Which of the following is the most common type of urine sample that may be obtained at any time of the day? Select one: a. timed urine specimen b. random urine specimen c. first morning urine specimen d. clean-catch midstream urine specimen

b. random urine specimen

Heparinized plasma is preferred over serum for some chemistry tests. Heparin prevents clotting by

inactivating thrombin.

Careful site selection and limited needle relocation helps to prevent

injury

The liquid portion of an anticoagulated blood specimen is called

plasma

Testing for human chorionic gonadotropin assesses the status of

pregnant women

The clear, yellow liquid that remains after a blood clot forms is the Select one: a. interstitial fluid. b. whole blood. c. serum. d. pus.

serum

One of the most important pieces of communication equipment in a medical practice is the Select one: a. facsimile machine. b. telephone. c. pager. d. computer.

telephone

Where is the most appropriate place in a clinical setting to find information on a substance's hazards and recommended safety precautions? Select one: a. The bottle's label b. The Internet c. The MSDS d. The NFPA

the MSDS

A pregnant patient who tells you that she is having pain during urination or in the kidney area may be experiencing

urinary infection or kidney stones

Residual urine is

urine remaining in the bladder after voiding.

A blood sample is needed from a dialysis patient. Which of the following is an acceptable procedure?

x Draw from the vein with a cannula x. Draw from the vein with a fistual c. Draw from a hand vein x. Either (a) or (b) would be acceptabl

The phlebotomist would collect a blood sample in a tube containing the anticoagulant sodium citrate (which inhibits glycolysis) for which type of laboratory test?

x. Electrolytes x. Blood Glucose x. Ionized Calcium d. Erythrocyte Sedimentation Rate (ESR)

Which of the following tubes is normally used to collect a serum sample? Select one:

x. Green top x. Purple top c. Red Top x. Blue top

Which of the following is proper care of a patient following collection of an arterial blood specimen?

x. Have the patient to apply pressure immediately to the puncture site. x. Ask the patient to check the site after 3 minutes to see if there is any bleeding. c. Apply firm pressure to the puncture site for a minimum of 3-5 minutes. x. Request that the patient applies pressure on the site until a nurse comes to check the site for bleeding.

What information would NOT be indicated on the label of a blood bank specimen?

x. Patient's date of birth b. NPO status of the patient and time of last meal x. Date and time of specimen collection x. Patient's full name including middle initial

A urine sample collected for a glucose tolerance test (GTT) must contain what additional information on the label?

x. Patient's initials x. Patient's telephone number c. Time of collection x. Location of collection

What antiseptic should the phlebotomy technician use to collect a blood culture?

x. Peroxide x. Witch hazel x. Isopropyl alcohol d. Chlorhexidine gluconate

Which of the following is the most appropriate procedure when preparing a patient for blood specimen collection?

x. The phlebotomist should always ask the patient if they know why they are having blood drawn for testing. b. If a patient asks the phlebotomist to explain the purpose of a blood test, the question should be referred to the doctor or nurse to answer. x If a patient asks why so many tubes of blood need to be drawn, the phlebotomist should reassure the patient that the lab needs extra blood in case they make a mistake running the test or if a tube should break. x. Prior to the blood draw, the phlebotomist should ask each patient if he or she has a needle phobia.

If additive contamination occurred from an EDTA evacuated tube, what test would potentially be affected?

x. White blood cell count x. Differential cell count c. Potassium level x. Red cell morphology

A basal-state specimen, used to establish reference ranges for inpatients, is best collected

x. anytime, because the patient is confined to the hospital. b. early in the morning, after fasting for 12 hours. x. in the morning, immediately following breakfast . x. anytime a patient is fasting.

A skin puncture is preferred over a venipuncture when the patient

x. is severely dehydrated. x. has chronic poor circulation. x. is extremely cold. d. has severe burns.

Older patients are more prone to hematoma formation because

x. they have smaller veins. x. tourniquets must be tied tighter. c. their veins have decreased elasticity. x. they have difficulty making a fist.

When the laboratory computer connects to interact with the main hospital intranet it is called Select one: a. randon-access memory. b. middleware. c. interfacing. d. logging on.

c. interfacing.

Blood vessels are lined with the same cells as the heart's

endocardium

The preferred urine specimen used for urine pregnancy testing should be collected

first thing in the morning

Which substance has a higher concentration in capillary blood than in venous blood?

glucose

Swelling caused from blood leaking from a blood vessel is

hematoma.

What is the term used to describe a portion of a specimen used for testing, usually prepared by transferring some of the specimen into other tubes with the same identification information?

Aliquot

The most common venipuncture site is located in which one of the following areas?

Antecubital area of the arm

The medical term for the study of blood is: Select one: a. Phlebotomy. b. Morphology. c. Hematology. d. Hepatology.

Hematology

When patients are dehydrated the plasma decreases causing _____________ in the blood specimen. Select one: a. hemodilutation b. hemoconcentration c. hemostasis d. hemolysis

Hemoconcentration

A ____ is a rule of conduct established and enforced by an authority or governing body, such as the federal government. Select one: a. principle b. law c. tort d. policy

Law

Which of the following best describes the proper collection of a sputum specimen? Select one: a. Saliva is spit out of the mouth into a sterile cup b. The mouth is rinsed with water and followed by spitting into a sterile cup c. Coughing into a microbiology culture plate d. Mucus is coughed up from deep in the lung and expel sputum into a sterile cup

Mucus is coughed up from deep in the lung and expel sputum into a sterile cup

If a phlebotomist fails to exercise the level of care expected of any reasonable phlebotomist, the phlebotomist could be charged with Select one: a. negligence. b. breach of confidentiality. c. fraud. d. invasion of privacy.

NEGLIGENCE

The branch of surgery that works to maintain function of the musculoskeletal system is called

Orthopedics

Why is it necessary to wipe the first drop of blood away when performing a capillary procedure?

To reduce interstitial fluid contamination

A synovial fluid specimen is obtained from

a joint

A physician must be consulted prior to performing a venipuncture or capillary puncture on

a prior mastectomy patient

The liver and pancreas are part of which body system? Select one: a. Digestive system b. Endocrine system c. Urinary system d. Respiratory system

a. Digestive system

The study of human body tissues and cells is

a. Histology

Which of the following information does not necessarily need to be on a laboratory requisition form? Select one: a. Home phone number b. Ordering physician c. Patient's name and date of birth d. Type of test performed

a. Home phone number

What type of consent exists when an emergency procedure such as CPR is provided? Select one: a. Implied consent b. Refusal consent c. Expressed consent d. Procedural consent

a. Implied consent

How long should a tourniquet be placed around a patient's arm?

a. No more than one minute

Which of the following is not mandated to be on a label of a blood specimen collected for blood transfusion testing?

a. Patient's phone number x. Patient's full name x. Patient's date of birth x. Phlebotomist's initials

Which of the following is the most critically affected analyte in a hemolyzed specimen?

a. Potassium x. Albumin x. Total Protein x. Calcium

The most effective way to determine whether you are communicating negatively is to Select one: a. ask for feedback. b. observe yourself in the mirror. c. speak clearly. d. observe body language.

a. ask for feedback.

Which of the following is an example of positive communication? Select one: a. asking a patient to repeat your instructions b. interrupting a patient when he/she does not understand c. treating all the patients the same d. informing patients when you cannot spend any more time with them

a. asking a patient to repeat your instructions

If a patient feels threatened by the phlebotomist, he or she may bring suit under civil law for Select one: a. assault. b. battery. c. direct injury. d. negligence.

a. assault.

A sweat sample collected by forearm stimulation with the use of pilocarpine nitrate is a process known as

a. iontophoresis. x. electrophoresis. x. chlorophoresis. x. fibroesis.

National Patient and Safety Goals (NPSGs) are developed and maintained by Select one: a. the Joint Commission. b. College of American Pathologists. c. Centers for Medicare and Medicaid Services. d. Clinical and Laboratory Standards Institute.

a. the Joint Commission.

What amount of residual urine is considered abnormal?

above 50cc

The addition of which preservative allows urine to be stored at room temperature while still providing results comparable to refrigerated urine?

boric acid

When a patient with the flu describes how he has been unable to sleep, the empathic phlebotomist most appropriately responds with Select one: a. "I feel sorry for you." b. "It will get better soon." c. "I know how the flu can disrupt sleep." d. "You cannot expect to sleep when you are sick."

c. "I know how the flu can disrupt sleep."

hich of the following sections is found in the Anatomical Pathology section of the clinical laboratory? Select one: a. Microbiology b. Immunology c. Cytology d. Immunohematology

c. Cytology

Which one of the following is sufficient proof that deviation from a standard of care has occurred? Select one: a. Liability b. Performance c. Documentation d. Specimen collection

c. Documentation

You have to draw a 7 year old child for some blood work, what would be the best approach you should use when it is a child getting blood drawn? Select one: a. Have a colleague restrain the child while you collect the specimen. b. Offer the child a toy if he or she let's you draw the sample. c. Explain what you are going to do in simple terms and ask the child for his or her cooperation. d. Let the child know that this won't hurt and will only take a few seconds.

c. Explain what you are going to do in simple terms and ask the child for his or her cooperation.

Each of the following tests are used to evaluate urinary system function EXCEPT Select one: a. BUN b. Creatinine c. Glucose d. Osmolality

c. Glucose

Specimens are scheduled for collection at specific times for different reasons. Which of the following is most likely not a factor? Select one: a. Measuring the body's metabolism of the test substance b. The substance exhibits diurnal variation c. Patients must be tested 2 hours before meals d. To determine blood levels of medications prior to next dose

c. Patients must be tested 2 hours before meals

The phlebotomist has to prepare a blood smear for a leukocyte alkaline phosphatase (LAP). What is the correct procedure? Select one: a. Perform the skin puncture and touch the slide to first drop of blood b. Perform the skin puncture and smear the slide with the first drop of blood c. Perform the skin puncture, wipe away the first drop of blood and then touch the slide to the next drop of blood d. Perform the skin puncture, wipe the first drop and then get a large drop and place in center of slide and place a cover slip over the drop

c. Perform the skin puncture, wipe away the first drop of blood and then touch the slide to the next drop of blood

Which of the following would require the most attention when scheduling specimen collection assignments? Select one: a. 24-hour urine specimens b. Random urine specimens c. Tolerance test specimens d. Urine culture and sensitivity specimen

c. Tolerance test specimens

A benefit of a voice mail system is that Select one: a. a receptionist routes calls to the appropriate extension. b. a person answers the telephone. c. callers never receive a busy signal. d. callers receive information on how to locate a doctor.

c. callers never receive a busy signal.

Malpractice lawsuits are part of ____ law. Select one: a. statutory b. common c. civil d. criminal

c. civil

A physician is said to have been ____ if a patient shows that the physician failed to comply with the standards of the profession. Select one: a. liable b. in breach of contract c. derelict d. in arbitration

c. derelict

In order to avoid electrical hazards or injury Select one: a. avoid all electrical equipment. b. have surge protectors. c. do not use extension cords. d. keep all equipment plugged in to avoid surges.

c. do not use extension cords.

When performing a heel puncture on an infant, proper technique includes Select one: a. having the parent or guardian hold the infant's foot so the phlebotomist can perform the puncture. b. firmly holding the puncture device in place on the skin until blood appears. c. placing the lancet flat against the skin on the medial or lateral plantar surface of the heel. d. not discarding the puncture device until blood appears so the device could be used again to ensure a good puncture.

c. placing the lancet flat against the skin on the medial or lateral plantar surface of the heel.

A phlebotomist would help to prevent needle sticks by Select one: a. putting an uncapped needle in the sharps container. b. recapping needles. c. using OSHA approved safety needles. d. putting a used needles directly into the biohazard.

c. using OSHA approved safety needles.

The process by which complex substances are broken down into simple substances is called Select one: a. anabolism. b. catabolism. c. metabolism. d. hemeostasis.

catabolism

Agglutination is the Select one: a. clotting of red blood cells. b. break down of red blood cells. c. clumping of red blood cells. d. separation of red blood cells.

clumping of rbc

Which of the following situations should be reported to the supervisor? Select one: a. A patient is complaining that you are collecting too much blood in the evacuated tube. b. A nurse asks you to transport an additional specimen to the lab. c. A patient is being visitred by a member of the clergy and a routine blood draw cannot be performed at that time. d. A co-worker is not following proper blood draw technique.

d. A co-worker is not following proper blood draw technique.

Which of the following body systems provides support and allows the body to move? Select one: a. Reproductive b. Muscular c. Digestive d. Skeletal

d. Skeletal

A caller listening to a recorded menu and, in response, pressing a number on the telephone keypad is an example of using Select one: a. multiple telephone lines. b. a pager. c. an answering machine. d. an automated menu.

d. an automated menu.

One of the major effects of chemotherapy on a blood test results is

decreased blood cells, especially WBC

The physician order says to puncture the skin, which of the following would the phlebotomist perform? Select one: a. Venipuncture b. Dermal puncture c. Phelbotomy d. Cut down

dermal puncture

A postprandial specimen is collected

directly after a meal is consumed.

What is the test status designation which takes priority when considering the collection time? Select one: a. Postop b. ASAP c. Medical Emergency d. Preop

medical emergency