Phlebotomy Ch. 4 Laboratory & Blood Collection Procedures
What should be the minimum volume of the capillary tube used to collect a specimen for capillary blood gas analysis?
.25 mL
For an ABG collection, what is the required amount of sample?
1 mL
For capillary collection from infants, a lancet with which of the following lengths should be used to avoid penetrating the bone?
1.5 mm
Normal Prothrombin time (PT) is
11-15 seconds
The normal sodium blood level is
136-145 mEq/L
What is the best angle for a needle insertion during venipuncture?
15°
After how many unsuccessful attempts at obtaining a good blood sample should you seek assistance from your supervisor or the doctor?
2
A skin puncture on infants should not be more than how deep?
2.4 mm
What gauge needles are commonly used for phlebotomy
21
The needle gauge with the smallest diameter is
23
What is the usual dose of D-xylose administered to the patient in the D-xylose tolerance test?
25g
If a tube of blood is allowed to stand undisturbed, it will separate into
3 major components
The normal range for Potassium in the blood is
3.5-5.1 mEq/L
The best angle for spreading a blood smear using two glass slides is
30°
When using a pusher slide, which is the correct angle?
30°
How many counting chambers are used to count white blood cells?
4
For the Surgicut bleeding time test, the blood pressure cuff must be inflated on the patient's upper arm to
40 mm Hg
For the Surgicutt Bleeding time test, the blood pressure cuff must be inflamed on the patient's upper arm to
40 mm Hg
Lancets with which of the following maximum lengths are suitable for older children?
5 mm
To help minimize dizziness or fainting, blood donors should eat within ____ hours of donating blood.
6
The general lab centrifuge (GLC) is calibrated every
6 months
The most common antiseptic for a routine blood draw is
70% isopropyl alcohol
The normal blood glucose level is
74-120 mg/dl
A substance that when present on the surface of red blood cells causes the formation of antibodies that interact specifically with it are called:
Antigens
A blood collection vacuum tube is part of the
B-D Vacutainer system
Which of the following blood chemical constituents is light sensitive?
Bilirubin
Which of the following dyes would be used to test a patient's liver function?
Bromsulphalein dye
Which of the following additives is found in a royal-blue stoppered vacuum tube?
EDTA
The laboratory test for Prothrombin time would be for
Evaluating anticoagulant drugs
A properly collected sputum specimen should contain both mucus coughed up from the respiratory tract and saliva.
False
A stool specimen that is mixed with urine is an appropriate specimen for examination.
False
Arterial punctures have a lower risk of infection.
False
Bacteria placed in a culture plate grows sufficiently within one hour.
False
Bacteria reproduce very slowly.
False
Gram-positive bacteria lose purple color and picks up the red color of safranin.
False
High-Density Lipoprotein Cholesterol is known as the "bad" cholesterol.
False
The most common type of culture medium used in the laboratory is blood sugar.
False
The optimal temperature to promote growth of bacteria in a culture medium is 37° C.
False
Untreated strep throat is not serious and does not lead to complications.
False
Which of the following is not included in testing for blood gas assay?
H2O
Enzyme-linked immunosorbent assay (ELISA) and Western blot tests are used to confirm which of the following disorders?
HIV infection
In arterial blood gas procedure for adults, which of the following anticoagulants is added to coat the syringe barrel?
Heparin
The test that requires passing a tube through the patient's nose is called
Hollander test
Which of the following anticoagulants re found in the pink plastic blood collection vacuum tube?
K2EDTA
Spinal fluid cultures are used to determine
Meningitis
The most common skin test performed is
PPD
Serum glucose and ____ could not be tested from the same tube.
PT
Which method is the most common bleeding time test?
Surgicutt
Cholesterol and ____ could be tested from the same tube.
TSH
A clay sealer tray is used to plug the open end of microhematocrit tubes.
True
A preparation of a specimen in a liquid that allows the organisms to remain alive and mobile while being identified is a wet mount.
True
A smear is a specimen spread thinly and unevenly across a slide.
True
Bright red blood spurting into the tube is the instant indicator that an artery has been punctured, rather than a vein.
True
Disposing of the needle immediately after withdrawing from the patient's vein is a habit that should be second nature to the phlebotomist.
True
Following the needle disposal, the tubes should be immediately labeled.
True
Following the removal of the needle during routine venipuncture, direct pressure is applied to the site with a gauze pad, for 3-5 minutes.
True
For anticoagulants to totally prevent clotting, specimens must be throughly mixed immediately following collection.
True
If blood gas does not appear, the bevel may be resting against the wall of the vein, rotating the needle a quarter of a turn will allow the blood to flow freely.
True
If the physician suspects a patient has a disease such as cancer, colitis, or bacterial protozoa or parasitic infections, the physician may order a stool sample.
True
Often, a patient has veins that are more prominent in the dominant arm.
True
Routine venipuncture is the main method used to obtain a blood sample for diagnostic testing.
True
The 10 cc syringe is the most common size used for routine venipuncture.
True
The most common device for obtaining cultures is the sterile swab.
True
The phlebotomist is often assigned other responsibilities related to specimen collection and handling of non-blood specimens.
True
Using an evacuation tube that is too large, or pulling back on the plunger of a syringe too quickly creates suction pressure that can cause a vein to collapse and stop blood flow.
True
When obtaining a throat culture specimen from a patient wear examination gloves, goggles, and mask or face shield.
True
When preparing a wet-mount, mix a small amount of the specimen with a drop of 0.9% sodium chloride on a glass slide.
True
White blood cells help fight infections.
True
A percentage of each type of white blood cell in a total of 100 white blood cells observed is referred to as
a differential
on a typical microcollection tray you would not find
a patient's chart
An instrument which can be used to determine the concentration of a solution by measuring the light transmitted or absorbed by the solution is called
a spectrophotometer
The phlebotomist would play an active role in patient education for which the following procedures?
a. 24 hour urine samples b. urine culture c. glucose tolerance test
The Complete Blood Count (CBC) includes which of the following tests?
a. Hgb b. Hcr or crit c. RBC
Which of the following is used in bedside glucose testing?
a. acu-Check II b. iascan c. glucocheck (d.) all of the above
Which of the following items are needed to collect a blood culture specimen?
a. alcohol preps b. iodine scrub swabsticks c. disposable gloves
Which of the following conditions listed affect laboratory tests on blood specimens?
a. altitude b. needle inserted through the vein c. humidity
When performing an arterial puncture, you should:
a. apply pressure to the site for 3 minutes after collection b. not apply pressure on the site after collection c. apply pressure on the site for 15 minutes after collection (d.) none of the choices
What is a reference point with which test results are compared?
a. basal state b. thromboplastin time c. differential (d.) none of the choices
The laboratory test for glucose tolerance would be
a. confirming diabetes mellitus b. hypoglycemia
A centrifuge is a piece of laboratory equipment used for which of the following?
a. hemacytology b. spinning test tubes at high speeds c. separating the cellular and liquid portions of the blood
Which of the following complications could be associated with the collection of arterial blood gas?
a. infection b. arteriospasm c. hematoma (d.) all of the choices
Which of the following factors result in failure to draw blood during venipuncture?
a. losing the vacuum in the tube b. veins are sclerosed c. needle inserted through the vein
A prolonged bleeding time for a patient may be caused by the patient's intake of
a. mithramycin b. dextran c. aspirin
A labeled specimen must include
a. name and ID number b. date of collection c. time of collection
Which of the following are tourniquets used in venipuncture?
a. rubber hose b. blood pressure cuff
If a blood specimen is allowed to clot, without added anticoagulant, this is what remains:
a. serum b. blood cells c. fibrin clot
Hemoconcentration can be caused by
a. squeezing or probing the site b. long term IV therapy c. tourniquette left on for extended periods
Which of the following may cause changes in basal state?
a. stress and drugs b. exercise c. diet
Which of the following would be a reason to reject a specimen for testing?
a. use of expired collection tubes b. unlabled specimen tubes c. discrepancies on the requisition
The normal pH of blood is
about 7.4
Lab results are unreliable if specimens are collected
after ingestion of alcohol
The laboratory test for hematocrit would be for which of the following?
aiding in diagnosis of anemia
Inaccurate test results may occur in certain tests when what is used to prepare the skin prior to venipuncture?
alcohol
When drawing a specimen to test blood alcohol, the site cannot be prepared with
alcohol
Which of the following is generally used to cleanse the skin before drawing blood?
alcohol
To evaluate the endocrine system, one would
analyze hormone levels
An erythrocyte count (RBC) test is used to identify
anemia
A state of abnormal variations is the size of red blood cells in the blood is
anisocytosis
The most common site to perform a venipuncture, or bend of the arm is called
antecubital fossa
Serum that contains antibodies is referred to as
antiserum
If during the course of venipuncture, the patient starts to bleed severely, you should
apply pressure to the site
In a normal hematocrit, the buffy coat accounts for
approximately 1% of whole blood
Which of the following is characteristic of lancets?
are small disposable instruments with a sharp point used to puncture the skin
The action by which a fluid will enter a tube or pipet because of the attraction between the glass and the liquid is?
aspiration
The laboratory test for Creatinine would be for
assessing glomerular filtration rate
The laboratory test for bleeding time would be for
assessing hemostasis
The laboratory test for cholesterol would be for
assessing risk of coronary heart disease
Phlebotomy needles should be stored
at room temperature
A fasting blood specimen is needed for which of the following clinical laboratory assays?
b. triglyceride c. cholesterol
The temperature of the centrifuge is checked at the
beginning of each day
Two primary tests for platelet activity are the ____ time, which is used to assess platelet function, an the ____ count, which evaluates platelet production.
bleeding and platelet
The Ivy method and the Duke method are used to measure
bleeding time
Which of the following test uses a template instrument to obtain blood for testing plategrity?
bleeding time
Yellow stoppered tubes are used for
blood culture
Which of the following tests require the use of a blood collection tube with a gray stopper?
blood glucose
A light colored layer of leukocytes and platelets which forms on the top of the red cell layer when a sample of blood is centrifuged or allowed to stnd
buffy coat
What is the commonly identified pathogenic agent causing skin nosocomial infections?
candida albicans
Which procedure for obtaining a blood sample in adults and children is usually performed on the middle or ring finger?
capillary puncture
Which of the following is obtained through a lumbar puncture?
cerebrospinal fluid
Which of the following would you include when preparing a venipuncture site?
cleanse the venipuncture site using a circular motion starting at the center and working outward
The ova and parasite procedure usually is performed in which of the following sections?
clinical chemistry
Therapeutic drug monitoring usually is performed in which of the following sections?
clinical chemistry
Of the following lab tests, which procedure requires 10mL normal saline and 2 or 3 M1 disposable syringes?
collecting blood through CVC's
Of the following, which is not considered a timed blood specimen?
cortisol
Which of the following blood analysis has a rise and fall in values with the time of day, and thus must be collected on time?
cortisol
What is the name of the compatibility test performed before a unit of blood is determined to be suitable for transfusion?
crossmatch
The laboratory test for a white blood cell count would be for
detecting inflammation or infection
The laboratory test for blood culture is used for which of the following?
diagnose bacteremia
Which of the following assays is performed in the immunohematology section?
direct Coombs test
The laboratory test for sedimentation rate is described as the time required for
erythrocytes to settle to the bottom of an upright tube at room temperature
Which blood collection device uses interchangeable collection tubes that allow you to draw several blood specimens from the same venipuncture site?
evacuation system
What is the name of the small metal bar that is inserted into the tube after collection of a capillary blood gas specimen used to aid in mixing the anticoagulant by means of a magnet?
flea
Blood tests for Potassium and Sodium identify
fluid and electrolyte imbalances
Which of the following is not skin puncture equipment?
forceps
Anticoagulants prevent the blood from
forming a clot
Which of the following is important when drawing blood from children?
gather your supplies and samples quickly as possible to avoid alarming the child with blood-collection tubes
A measure of the diameter of a needle is?
gauge
Needles are color coded according to
gauge
Which of the following would be part of the preparation for an oral glucose tolerance test?
give the patient a high carbohydrate drink immediately after the first blood draw
Which blood test usually does not require skin puncture?
glucose
What tests may be affected most if the patient is not fasting?
glucose and triglycerides
The test that is required to test the patient's insulin releasing mechanism is called?
glucose tolerance
Sodium heparin is the anticoagulant found in which color tube?
green
The best site for drawing blood from an infant is the
heel
Which of the following procedures usually requires a lavender stopper collection tube?
hematocrit
Which of the following identifies how much of the volume of a sample is made up of red blood cells after the sample has been spun in a centrifuge?
hematocrit determination
The value of a total protein test due to prolonged use of a tourniquet can produce changes in
hemoconcentration
When blood is collected from a patient, the serum should be separated from the blood cells as quickly as possible to avoid
hemoconcentration
Which of the following is a special piece of equipment that allows one to count blood cells by examining a diluted blood sample under a microscope?
hemocytometer
When blood is collected from a patient with a syringe, and needs to be transferred to an evacuated tube, the phlebotomist should never push the blood into the tube, because it will cause:
hemolysis
The rapid sequence of vascular spasms platelet plug formation an coagulation is known as
hemostasis
What is the special winged needle set that can be left in a patient's vein for up to 48 hours and is used to administer medication and draw blood?
heparin lock
Which effect does warming the site have on venipuncture?
increases localized blood flow
Maintenance at a specific temperature for a specific amount of time until growth or a reaction occurs is?
incubation
A temperature controlled chamber into which inoculated media is placed so that bacterial growth will occur is call a/an
incubator
Which of the following would you include when performing a venipuncture using an evacuation system?
insert the needle at a 15° angle with the bevel side up
An accumulation in the body of substances, known as ketones, which may be detected by testing urine, commonly observed in starvation, pregnancy and diabetes is
ketosis
A blood urea nitrogen (BUN) test is used to identify
kidney disorders
Which of the following is used in the capillary puncture technique?
lancet
Which of the following sites is not recommended to collect capillary blood gases?
lateral anterior area of the elbow
Of the following veins, which would be most frequently used for venipuncture?
median and cubital vein
The most common sites for venipuncture are the
median cubital and cephalic veins
A hematocrit performed on a small sample of blood is?
microhematocrit
A small, calibrated glass tube that holds a precise volume of fluid is called a
micropipette
What is the ACT used to determine?
monitoring heparin therapy
A retractable sheath is part of a
multiple draw needle
Venipuncture at sites with each of the following could affect test results except
near a tattoo
Which method of drawing blood would you use on a patient with small or fragile veins?
needle and syringe system
Hematoma during venipuncture results from which of the following?
needle bevel is partially inserted in the vein
A prolonged bleeding time is indicative of low
platelet count
Therapeutic phlebotomy is used in the treatment of
polycythemia
Which of the following is important when drawing blood from an elderly patient?
recognize changes in skin conditions that increase bruising
A blood collection tube that requires no additive is what color?
red
Blood grouping, typing, and an AIDS antibody test must be performed with a collection tube of what color?
red/glass tube
If a hematoma starts to form during the course of a phlebotomy, which of the following should be done?
remove needle and apply pressure to the site
Pathogenic bacteria or blood poisoning in the blood is called
septicemia
A series of tests measuring enzymes released into the blood after a heart attack is
serum enzyme test
A puncture resistant, leak-proof container used to dispose of needles, lancets, and other sharp objects is
sharps container
Hemoguard is a type of
sheath
What additive is in a tube with a light blue stopper?
sodium citrate
A measurement of density is called
specific density
Which of the following methods is used for detecting meningitis?
spinal fluid culture
Which of the following is used to prepare the skin before a venipuncture when alcohol causes inaccurate results for certain tests?
sterile solution
The alternate syringe order of draw is
sterile-light blue-lavender-green-gray-red
The NCCLS Order of draw using Vacutainer tubes with Hemoguard closure
sterile-red-light blue-gold-light green-green-lavender-gray
Which of the following fluid is extracted from joint cavities?
synovial fluid
Which of the following is a characteristic of the capillary puncture?
the patient's non-dominant hand is used for the procedure
What is the Allen test used to determine?
the presence of circulation
Why does the blood separate into three layers when centrifuged?
their various densities
Which of the following additives is found in a orange plastic vacuum tube?
thrombin
Why is it necessary to control the depth os a lancet insertion during skin puncture?
to avoid excessive bleeding
A test of the body's ability to absorb and utilize a particular substance is which of the following?
tolerance
Which blood test identifies coronary artery disease and atherosclerosis?
total cholesterol
The bevel of the needle should be in which position before entering a vein?
upward
Gout is identified by which type of blood test?
uric acid
Which of the following procedures is not done to obtain blood if a problem occurs during collection?
use an IV line
The prothrombin in the blood clotting process is dependent upon which of the following?
vitamin k
The NCCLS Order of Draw using conventional stoppers is
yellow-red-light blue-red/gray-green/gray-green-lavender-gray
