CH 11: Special Collections and POC Testing + CH 12: Computers and Specimen Handling and Processing
A patient scheduled for a 2-hour PP should be prepared to have their blood collected A. 1 time B. 2 times C. 4 times D. 5 times
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A patient scheduled for a 3-hour GTT should be prepared to have their blood collected A. 1 time B. 2 times C. 4 times D. 5 times
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A patient scheduled for a GTT should be instructed to do all of the following except A. eat a diet containing 150g of carbohydrates at each meal for three days prior to the test B. drink adequate amounts of water during the test C. fast for a minimum of 16 hours prior to the test D. none of the above
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If using a butterfly collection set for blood cultures it is recommended to fill the A. anaerobic bottle first B. aerobic bottle first C. bottle closest to you D. discard tube first
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This is a source of preanalytical error that occurs before specimen collection. A. dehydrated patient B. misidentified patient C. mislabeled ETS tube D. wrong collection time
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A patient scheduled for a GTT must drink the prescribed glucose beverage within A. 5 minutes B. 10 minutes C. 15 minutes D. 20 minutes
A. 5 minutes
What is the correct order of draw for a QUANTIFERON GOLD Test? A. GGYP B. GYPG C.PYGG D. YGPG
A. GGYP
Which of the following is the recommended intermediate tube for blood cultures? A. SPS B. ACD C. EDTA D. SST
A. SPS
A computer terminal is A. a keyboard and computer screen workstation B. the last computer in a series of matching terminals C. a printer where information can be displayed D. a screen that visually displays data to the user
A. a keyboard and computer screen workstation
All of the following are donor unit collection principles except the A. additives EDTA and sodium fluoride are contained in the collection bag B. collection bag is placed on a mixing unit while the blood is being drawn C. collection unit is a closed system connected to a tube and a 16 - 18 g needle D. unit is filled by weight, which normally corresponds to 450 mL when full
A. additives EDTA and sodium fluoride are contained in the collection bag
The blood bank section of the laboratory is performing a type and crossmatch. While mixing the patient's and donor's blood, clumping occurs. The medical term for this reaction is A. agglutination B. phagocytosis C. glycolysis D. hemolysis
A. agglutination
Which of the following would be a preanalytical error related to specimen transport? A. agitation-induced hemolysis B. contamination caused by dust C. incorrect collection tube D. strenuous, recent exercise
A. agitation-induced hemolysis
Which blood culture container is inoculated first when the specimen has been collected by syringe? A. anaerobic vial B. aerobic media C. ARD container D. it does not matter
A. anaerobic vial
Computer input can come from all of the following except A. applications B. keyboards C. light pens D. scanners
A. applications
Which of the following tests is collected from patients with fever of unknown origin (FUO) to rule outsepticemia? A. blood culture B. nasopharyngeal cultures C. urine culture and sensitivity (C & S) D. wound culture
A. blood culture
What is the recommended blood culture site disinfectant for infants 2 months and older? A. chlorhexidine gluconate B. isopropyl alcohol swab C. benzalkonium chloride D. Povidone-iodine swab
A. chlorhexidine gluconate
TDM is used by physicians to A. determine a beneficial drug dosage for a patient B. maintain "peak" levels of a drug in a patient's system C. maintain "trough" levels of a drug in a patient's system D. screen for illegal drug use
A. determine a beneficial drug dosage for a patient
Which of the following tests may require special "chain of custody" documentation when collected? A. drug screen B. blood culture C. crossmatch D. TDM
A. drug screen
HIPAA was enacted to do all of the following except: A. examine all patient healthcare records B. protect privacy of patient information C. provide guidelines for sharing PHI D. standardize electronic transfer of data
A. examine all patient healthcare records
Which of the following would be a preanalytical error related to specimen storage? A. exposure to light B. faulty technique C. inadequate fast D. under-filled tube
A. exposure to light
All of the following types of tubes can be used to collect blood for a type and screen except A. large gel-barrier tube B. lavender colored top C. non-additive red top D. pink stopper EDTA
A. large gel-barrier tube
You have a laboratory requisition to draw a PT/INR. What color tube will you draw? A. light blue B. EDTA C. royal blue D. red
A. light blue
The process of entering a password and gaining access to a computer is called A. logging on B. accessioning C. interfacing D. networking
A. logging on
Which departments are involved in the coordination of TDM? A. pharmacy and laboratory and nursing B. respiratory therapy and nursing C. radiology and pharmacy D. all listed
A. pharmacy and laboratory and nursing
Inadequate mixing of gel separation tubes may: A. prevent proper functioning of the additive and incomplete clotting B. cause hemolysis C. cause microclot formation D. prevent plasma to separate during centrifuging
A. prevent proper functioning of the additive and incomplete clotting
What type of additive is best for collection of a GTT or PP? A. sodium fluoride B. EDTA C. sodium citrate D. royal blue
A. sodium fluoride
What type of additive is recommended for collecting an ethanol test? A. sodium fluoride B. EDTA C. sodium citrate D. SST
A. sodium fluoride
When performing a glucose tolerance test, the fasting specimen is drawn at 0815 and the patient finishes theglucose beverage at 0820. When should the 1-hour specimen be collected? A. 0915 B. 0920 C. 0945 D. 0950
B. 0920
Blood cultures are commonly collected in sets of: A. 6 B. 2 C. 8 D. 4
B. 2
Which point-of-care test helps a physician differentiate chronic obstructive pulmonary disease (COPD)and congestive heart failure (CHF)? A. ALT B. BNP C. Hgb D. Tn 1
B. BNP
A computer networking system created to share resources within a facility or organization is also called a A. CPU B. LAN C. RAM D. ROM
B. LAN
Common chemistry tests performed by POCT instruments include A. Hgb and Hct B. Na+ and K+ C. PT and PTT D. T4 and TSH
B. Na+ and K+
Which of the following must remain consistent throughout an oral glucose tolerance test? A. arm used for the draw B. blood specimen source C. position of the patient D. size of ETS tubes used
B. blood specimen source
A transfusion of incompatible blood is often fatal because it A. causes a major allergic reaction, releasing too much histamine B. causes lysis, or rupturing, of red blood cells within the vascular system and can lead to kidney and liver failure C. overwhelms the patient's lungs with nonfunctioning red blood cells D. results in hemochromatosis in the patient's circulatory system
B. causes lysis, or rupturing, of red blood cells within the vascular system and can lead to kidney and liver failure
Post-procedure care and documentation for blood culture specimens includes A. cleansing the puncture site with iodine and indicating the collection site on the specimen label B. cleansing the puncture site with alcohol and indicating the collection site on the label C. applying a special identification system to the patient and specimen container D. none of the above
B. cleansing the puncture site with alcohol and indicating the collection site on the label
This is an example of a preanalytical error made at the time of collection. A. delay in transporting B. failing to mix tubes C. incomplete requisition D. delay in centrifugation
B. failing to mix tubes
When using a cell salvaging procedure during surgery, what analyte must be evaluated before the patient's blood can be re-infused? A. chemical toxins B. free hemoglobulin C. plasma glucose D. white cell count
B. free hemoglobulin
Timing of collection is most critical for drugs with short half-lives such as A. digitoxin B. gentamicin C. methotrexate D. phenobarbital
B. gentamicin
A test that measures packed cell volume is the A. ECG B. hematocrit C. hemoglobin D. troponin
B. hematocrit
TDM peak concentration may be defined as the A. maximum effectiveness of the drug B. highest concentration of the drug during a dosing interval C. lowest concentration of the drug during a dosing interval D. time when the amount of drug entering the body is equal to the amount leaving the body
B. highest concentration of the drug during a dosing interval
The number of tube inversions required during specimen collection depends on all of the following except A. absence of an additive in the tube B. how difficult it was to collect the blood C. manufacturer-suggested inversions D. presence of an additive in the tube
B. how difficult it was to collect the blood
An example of a preanalytical error happening during specimen processing is A. faulty collection technique B. inadequate centrifugation C. insufficient specimen D. patient stress and anxiety
B. inadequate centrifugation
Tubes should be transported with the stopper up for all of the following reasons except that A. it encourages complete clot formation B. it maintains the sterility of the sample C. it minimizes stopper-caused aerosols D. it reduces agitation-caused hemolysis
B. it maintains the sterility of the sample
Which of the following would NOT be considered a preanalytical error? A. failing to mix an additive tube B. misreporting patient results C. mislabeling an aliquot tube D. using the wrong order of draw
B. misreporting patient results
This is a term for a group of computers linked together for the purpose of sharing information A. junction B. network C. node unit D. terminal
B. network
Which coagulation specimen requires a discard tube? A. PTT B. no discard tube necessary if not using a butterfly C. PT D. blood cultures
B. no discard tube necessary if not using a butterfly
You are beginning to perform a venipuncture for collection of blood cultures. You are unsure of the veinlocation after the prepping procedure is complete. Because you always maintain a high standard of practiceyou know the most appropriate action to take is A. aim for the anatomical location of the median cubital vein B. repalpation should only be done above or below the site of needle entry (or remove tourniquet and start over C. cleanse your gloved finger with alcohol and quickly repalpate for the vein D. repalpate with your gloved finger since your gloves are considered clean
B. repalpation should only be done above or below the site of needle entry (or remove tourniquet and start
Blood culture bottles A. should not be inverted or mixed B. should be marked at the minimum and maximum fill lines C. should be filled until the vacuum is exhausted D. should be positioned above the venipuncture site while filling
B. should be marked at the minimum and maximum fill lines
When drawing a blood alcohol, it is acceptable to clean the arm with A. methanol B. soap and water C. 70% isopropyl alcohol D. tincture of iodine
B. soap and water
Why would blood cultures be collected with an antimicrobial adsorbing resin? A. the patient has fever spikes B. the patient is on antimicrobial therapy C. to eliminate contaminating normal flora D. to remove bacteria-caused contamination
B. the patient is on antimicrobial therapy
Scrubbing the skin of a neonate too aggressively may cause A. acrocyanosis B. the skin to tear C. hemoconcentration D. hemolysis
B. the skin to tear
What is the meaning of the abbreviation TAT? A. test alternative tube B. turnaround time C. test after test D. time accurate testing
B. turnaround time
When does a blood glucose level in normal individuals typically peak after glucose ingestion? A. 15 to 20 minutes B. ½ hour to 1 hour C. 1 hour to 1 ½ hours D. roughly 2 hours
B. ½ hour to 1 hour
What is the estimated percentage of laboratory errors that occur during the preanalytical phase? A. 25% - 45% B. 46% - 68% C. 50% - 70% D. none listed
C. 50% - 70%
Which test may be ordered to monitor heparin therapy A. PT B. BT C. PTT D. TnT
C. PTT
Which test requires strict skin antisepsis procedures before specimen collection? A. blood urea nitrogen B. complete blood count C. blood culture D. type and crossmatch
C. blood culture
Random access memory (RAM) A. includes data, software, hardware, and peripherals B. instructs the computer to carry out user operations C. can be lost when the computer program is closed D. is permanent memory installed by manufacturers
C. can be lost when the computer program is closed
The CPD additive in a donor unit of blood serves to do all of the following except A. provide nutrition for the cells B. prevent the blood from clotting C. control bacterial contamination D. stabilize the pH of the plasma
C. control bacterial contamination
When transporting specimens, rough handling and agitation can do all of the following except A. activate the platelets B. affect coagulation tests C. elevate WBC counts D. hemolyze specimens
C. elevate WBC counts
This test is used to evaluate long-term effectiveness of diabetes therapy. A. 2-hour postprandial B. glucose tolerance C. hemoglobin A1c D. random glucose
C. hemoglobin A1c
Blood cultures are typically ordered A. when the fever has subsided B. in the early morning C. immediately before or during the fever spikes D. after the fever spike
C. immediately before or during the fever spikes
When collecting a chain of custody drug screen the phlebotomist should do all of the following except A. attach the specimen label(s) to the container(s) while the donor is present B. record the specimen temperature C. indicate where the donor should place the specimen before leaving the laboratory area D. allow the donor to initial the seal(s) on the container(s)
C. indicate where the donor should place the specimen before leaving the laboratory area
Some individuals lack the necessary mucosal enzyme to convert which of the following sugars so that itcan be digested? A. glucose B. glucagon C. lactose D. pentose
C. lactose
Which of the following specimens is collected in a trace element free tube? A. ABG's B. BUN C. lead D. occult blood
C. lead
TDM trough concentration may be defined as the A. highest concentration of the drug during a dosing interval B. time when the amount of drug entering the body is equal to the amount leaving the body C. lowest concentration of the drug during a dosing interval D. maximum effectiveness of the drug
C. lowest concentration of the drug during a dosing interval
The nutrient broth found in blood culture bottles is also referred to as A. bacteria banquet B. gel C. medium D. charcoal
C. medium
Inadequate mixing of an anticoagulant tube can lead to A. hemolysis of the specimen B. lipemia of the specimen C. microclots in the specimen D. the sample clotting too fast
C. microclots in the specimen
Removing a unit of blood from a patient and not replacing it is used as a treatment for A. arthritis B. leukemia C. polycythemia D. tuberculosis
C. polycythemia
Removing a unit of blood from a patient and not replacing it is used as a treatment for A. autologous donation B. ABO Rh incompatibility C. polycythemia D. leukemia
C. polycythemia
Computer peripherals include all of the following except: A. keyboard B. modem C. programs D. scanner
C. programs
Applications software A. controls normal computer operation B. is the equipment used to process data C. refers to programs from software companies D. all listed
C. refers to programs from software companies
ARD or FAN blood culture bottles A. detect problems in carbohydrate metabolism B. eliminate vital interference from blood cells C. remove or neutralize antibiotics that are in the blood D. treat bloodborne pathogens in the circulation
C. remove or neutralize antibiotics that are in the blood
Clinical and Laboratory Standards Institute (CLSI) and Occupational Safety and Health Administration(OSHA) guidelines do not require specimen transport bags to have A. a visible biohazard logo B. liquid-tight closure C. shock resistance features D. slip pockets for paperwork
C. shock resistance features
Which of the following statements is not true regarding site preparation for blood cultures? A. the site is cleansed from the center outward B. the antiseptic must be allowed to dry C. the site is cleansed from the outside to the center D. a two-step prepping procedure may be performed
C. the site is cleansed from the outside to the center
All of the following statements about autologous donations are true except A. blood can be collected up to 72 hours before surgery B. patients must have a written order from their physician C. unused autologous units may be used by other patients D. using the patient's own blood eliminates many risks
C. unused autologous units may be used by other patients
This is permanent computer memory that instructs the computer to carry out user-requested operations A. CPU B. LIS C. RAM D. ROM
D. ROM
Which of the following is a protein that is specific to cardiac muscle? A. ALT B. BNP C. LDL D. TnT
D. TnT
Which of the following is used by the laboratory to identify a specimen throughout the testing process? A. hospital number B. mnemonic code C. password D. accession number
D. accession number
Tests that can be performed using special POCT instruments or test kits include A. arterial blood gases B. glucose C. occult blood D. all listed
D. all listed
Which of the following are considered forensic specimens? A. blood alcohol B. drug screen C. DNA D. all listed
D. all listed
Which of the following tests cannot be performed on a hemolyzed specimen? A. plasma hemoglobin B. most enzyme tests C. potassium D. all listed
D. all listed
As the outstanding phlebotomist that you are, you understand that anticoagulant specimens A. must be gently inverted 3 - 4 times depending on the manufacturers' instructions B. may be rejected if microclots have formed C. must never be mixed together from partially filled tubes D. all of the above
D. all of the above
Which of the following should be avoided during a glucose tolerance test (GTT)? A. chewing sugarless gum B. drinking sugar-free tea C. smoking low-tar cigarettes D. all of the above
D. all of the above
You have successfully collected a blood culture specimen by syringe. When transferring the blood from thesyringe to the culture bottles it is recommended A. that the culture bottle not be held in the hand B. that the blood should be directed to flow along the side of the container C. that the vacuum in the container be allowed to pull the blood into the container D. all of the above
D. all of the above
A patient on antimicrobial therapy is receiving A. anticoagulants B. antiglycolytic agents C. antiseptics D. antibiotics
D. antibiotics
A phlebotomist arrives to collect a 2-hour postprandial (PP) glucose specimen on an inpatient and discovers2 hours have not elapsed since the patient's last meal. What should the phlebotomist do? A. come back later at the time the patient says is correct B. draw the specimen and write the time drawn on the specimen label C. fill out an incident report and return to the laboratory D. consult with the patient's nurse to verify the correct time to draw the specimen
D. consult with the patient's nurse to verify the correct time to draw the specimen
An autologous blood transfusion is a transfusion of blood A. directly from the donor to the patient B. donated by a relative C. from an anonymous donor D. donated by a patient for his or her own use
D. donated by a patient for his or her own use
If drawing blood cultures along with additional blood work, where do they fall in the proper order of draw? A. last B. always after the sodium citrate tube C. second D. first
D. first
Identify the condition in which a unit of blood is withdrawn from a patient as treatment. A. ABO Rh incompatibility B. autologous donation C. leukemia D. hemochromatosis
D. hemochromatosis
All of the following are reasons why specimen handling is very important except A. effects of mishandling are not always obvious B. improper handling can affect quality of results C. many lab errors occur in the preanalytical phase D. mishandling effects can be corrected if identified
D. mishandling effects can be corrected if identified
Which tube theoretically does not require mixing. (Mixing does not hurt it, and should be done with the other tubes). A. clot activator B. gel separator C. liquid EDTA D. plain glass red top
D. plain glass red top
This test requires a specimen with a 9:1 ratio of blood to anticoagulant. A. ethanol B. glycohemoglobin C. zinc D. prothrombin time
D. prothrombin time
Trace element tubes are usually A. lavender B. green C. light blue D. royal blue
D. royal blue
The correct order when collecting a blood culture is: A. cleanse bottle tops, select equipment, perform friction scrub, perform venipuncture B. perform friction scrub, select equipment, perform venipuncture, cleanse bottle tops C. select equipment, cleanse bottle tops, perform friction scrub, perform venipuncture D. select equipment, perform friction scrub, cleanse bottle tops, perform venipuncture
D. select equipment, perform friction scrub, cleanse bottle tops, perform venipuncture
The most critical aspect of blood culture collection is: A. needle gauge B. specimen handling C. volume of blood collected D. skin antisepsis
D. skin antisepsis
The laboratory has a computerized laboratory information system (LIS). Once an inpatient specimen hasbeen collected by a phlebotomist and returned to the laboratory, what occurs next? A. a collection list is generated B. all lab test orders are retrieved C. collection labels are printed D. specimen collection is verified
D. specimen collection is verified
The PFA test assesses the functioning of which of the following cellular elements A. erythrocytes B. leukocytes C. neutrophils D. thrombocytes (Platelets)
D. thrombocytes (Platelets)
Potassium plays a major role in all of the following except A. muscle function B. nerve conduction C. osmotic pressure D. transporting Hgb
D. transporting Hgb
Of the following tests, which is most likely to result in fatal consequences for the patient if the specimen is misidentified. A.blood cultures B. drug screen C. postprandial glucose D. type and crossmatch
D. type and crossmatch
Proper specimen management begins A. as soon as the specimen is collected B. during specimen collection procedures C. in the course of patient identification D. when the test is ordered
D. when the test is ordered
