Phlebotomy Chapter 12

This organization develops standards for specimen handling and processing a. CDC b. CLIA c. CLSI d. FDA

CLSI

What does the laboratory use to identify a specimen throughout the testing process? a. accession number b. hospital number c. LIS menu/icon d. mnemonic code

accession number

A separator gel prevents glycolysis a. after the specimen is centrifuged b. as soon as the specimen is collected c. in tubes for serum samples only d. when the specimen is thoroughly mixed

after the specimen is centrifuged

which of the following would be a pre analytical error related to specimen transport a. agitation-induced hemolysis b. contamination by dust c. incorrect collection tube d. strenuous, recent exercise

agitation induced hemolysis

Transferring specimens into aliquot tubes has inherent risks. Which of the following involves the least risk? a. aerosols created during transfer b. aliquot tubes that are pre-labeled c. serum and plasma's similar color d. specimens that are biohazardous

aliquot tubes that are pre-labeled

Repeated centrifugation of a specimen can a. alter test results b. deteriorate analytes c. cause hemolysis d. all the above

all the above

Special hand-held computer systems used in laboratory medicine are capable of a. displaying what tubes to collect b. generating labels c. reading barcodes d. all the above

all the above

Types of intrafacility specimen transport systems include a. pneumatic tube b. robot courier c. vertical track d. all the above

all the above

a strong computer password a. contains upper and lowercase letters b. has one or more special characters c. is easy to remember but hard to guess d. all the above

all the above

which of the following samples are time sensitive a. ESR determination in EDTA tubes b. PTT samples that have been opened c. RNA samples in PPT tubes d. all the above

all the above

It is unnecessary to protect this specimen from light a. ammonia b. bilirubin c. vitamin b2 d. vitamin c

ammonia

which specimen needs to be transported on ice a. ammonia b. bilirubin c. carotene d. potassium

ammonia

which of the following is least likely to take place in central processing or triage a. accessioning or logging b. analysis and reporting c. evaluation for suitability d. sorting by department

analysis and reporting

the CLSI quality management systems (QMS) documents use the term "examination" instead of a. analytical b. inspection c. measured d. processing

analytical

according to CLSI, when an uncentrifuged blood specimen is sent to the lab from a drawing station, the blood must a. arrive in a time limit that protects analyte stability b. be kept at body temperature c. have a clot activator added prior to transport d. remain refrigerated until arrival at the laboratory

arrive in a time limit that protects analyte stability

If a specimen has inadequate identification, the specimen processor may a. add the missing information to the label b. ask the phlebotomist to get a new sample c. contact the patient to get correct information d. refer the tube to the laboratory supervisor

ask the phlebotomist to get a new sample

which statement describes proper centrifuge operation a. balance specimens by placing tubes of equal fill and size opposite each other b. centrifuge serum specimens before they form clots c. never centrifuge serum and plasma in the same centrifuge d. remove the stoppers from evacuated tubes before placing them in the centrifuge

balance specimens by using tubes of equal fill and size

which of the following agencies sets guidelines for specimens transported by courier and other air or ground mail systems a. CLIA b. CMS c. FDA d. IATA

IATA

systems software includes a. coded instructions that control processing of data b. programs from software companies sold as a unit c. the central processing unit and all hardware additions d. word processing, spreadsheet, and graphic programs

coded instructions that control processing of data

A mnemonic is a

Memory aid

which of the following is the best way to prepare routine blood specimen tubes for transport to an off site lab a. place the tubes in ice slurry b. seal the tubes in biohazard bags c. wipe each tube with alcohol d. wrap the tubes in requisitions

seal the tubes in biohazard bags

A USB drive is a a. network connection device b. secondary storage device c. terminal linking device d. word processing device

secondary storage device

When a non-additive specimen is spun in a centrifuge, the substance that comes to the top is

serum

If a serum specimen is not completely clotted before it is centrifuged the a. buffy coat may not form properly b. red blood cells may hemolyze c. separator gel may come to the top d. serum may have fibrin clots in it

serum may have fibrin clots in it

which test specimen is negatively affected by transport in a pneumatic tube system a. alkaline phosphatase b. blood creatinine c. serum potassium d. total bilirubin

serum potassium

CLSI and OSHA guidelines do not require specimen transport bags to have: a. a visible biohazard logo b. liquid tight closure top c. shock resistance features d. slip pockets for paperwork

shock resistance features

A glucose specimen collected in a sodium fluoride tube is generally stable at room temperature for a. 6 hrs b. 12 hrs c. 24 hrs d. 48 hrs

24 hrs

which of the following is an acceptable temperature for a specimen that requires transport and handling at room temp a. -20 C b. 8 C c. 25 C d. 37 C

25 C

Minimum pre-centrifugation time for a specimen drawn in SST tube is a. 10 mins b. 15 mins c. 20 mins d. 30 mins

30 minutes

a specimen must be transported at or near normal body temperature. which of the following temperatures meets this requirement a. 25 C b. 37 C c. 50 C d. 98 C

37 C

ESR determinations on specimens held at room temperature must be made within a. 1 hr b. 4 hrs c. 12 hrs d. 24 hrs

4 hours

Glycolysis by the cells in blood specimens can falsely lower glucose values at a rate of up to: a. 1-3% per hour b. 3-5% per hour c. 4-6% per hour d. 5-7% per hour

5-7% per hour

which of the following doesn't need to be centrifuged a. BUN in a red/gray SST b. CBC in a lavender tube c. Potassium in a green tube d. PTT in a light blue tube

CBC in a lavender tube

A pneumatic tube is a A. Compressed air transport system B. Temporary computer data storage unit C. Tube connection between two computers D. Type of collection tube for blood gases

Compressed air transport system

central processors who send out specimens to another location must be certified by a. ASCP b. CLIA c. CLSI d. DOT

DOT

Computerized analyzers in the laboratory can read barcodes and ID patients if A. Barcode is anywhere on the specimen B. Label is placed horizontally on the tube C. Label is placed correctly on the tube D. Specimen is in the right evacuated tube

Label is placed correctly

which of the following tests on required 3-4 inversions of the tube a. CBC b. HbA1c c. PTT d. RBC

PTT

This is a permanent computer memory that instructs the computer to carry out user requested operations A. CPU B. LIS C. RAM D. ROM

ROM

which specimen has priority over all other specimens during processing and testing a. ASAP b. Timed c. STAT d. Fasting

STAT

A linear barcode is a A. Coded instruction needed to control computer hardware B. Confidential computer code required by HIPAA C. Series of bars and spaces representing numbers or letters D. Unique number given to each test request

Series of bars and spaces representing number or letters

random access memory (RAM) a. can be lost when the program is closed b. includes data, software, hardware, and peripherals c. instructs the computer to carry out user operations d. is permanent memory installed by manufacturers

can be lost when the computer program is closed

which of the following specimens are least likely to require special handling a. bilirubin b. cholesterol c. gastrin d. homocysteine

cholesterol

which of the following collection circumstances is least likely to delay clotting in a serum gel tube a. collection was difficult, hemolyzing RBC b. patient has elevated WBC count c. patient is taking anticoagulant medication d. specimen is chilled after collection

collection was difficult, hemolyzing RBC

Stoppers should be left on tubes awaiting centrifugation to prevent

contamination

Processing specimens requires various types of PPE, but this type is unnecessary a. covers for footwear b. disposable gloves c. fluid resistant apron d. protective goggles

covers for footwear

a bidirectional computer interface allows a. computer RAM storage capacity to double in size b. data to upload or download between two systems c. info to go from two analyzers to the LIS d. two persons to use a computer at the same time

data to upload or download between two systems

This is a source of preanalytical error that occurs before specimen collection a. dehydrated patient b. incorrect needle size c. mislabeled ETS tube d. wrong collection

dehydrated patient

tests performed on plasma samples are

drawn in anticoagulant tubes

In specimen handling it is very important to appreciate that a. effects of mishandling are not always obvious b. centrifuging specimens are considered to be error free c. most laboratory errors occur in the post analytical phase d. quality of results is not affected by collection procedure

effects of mishandling are not always obvious

rough handling is bad for specimens, but it will not a. activate platelets b. affect coagulation tests c. elevate WBC count d. hemolyze RBC

elevate WBC count

which of the following would be described as "logging on" a. accessing the internet b. entering a password to access the LIS c. turning the terminal to "on" d. using menus to navigate the program

entering a password to access the LIS

which of the following would be a pre analytical error related to storage a. exposure to light b. faulty technique c. inadequate fasting d. underfilled tube

exposure to light

this is an exmaple of a pre analytical error made at the time of collection a. delay in transporting b. failing to mix tubes c. incomplete requisition d. waiting to centrifuge

failing to mix tubes

which of the following is unaffected by hemolysis a. amylase b. hemoglobin c. magnesium d. potassium

hemoglobin

The Cobas, an automated chemistry instrument, is temporarily inoperable because of a serum sample. What could be the cause? a. fibrin clot in the SST b. hemolysis in the PST c. lipemia in a SST d. microclot in an EDTA

fibrin clot in the SST

cellular metabolism in specimens that have not been separated will affect which analyte a. amylase b. glucose c. hemoglobin d. triglycerides

glucose

a specimen processor delivers several specimens to a testing area and places them on a device rotating back and forth, the department is most likely a. chemistry b. coagulation c. hematology d. microbiology

hematology

which of the following describes proper aliquot preparation a. immediately covering aliquot tubes after transferring b. labeling tubes after pipetting the sample c. pouring plasma from different additive tubes into one aliquot tube d. pouring samples into aliquot tubes instead of using transfer pipettes

immediately covering aliquot tubes after transferring the specimen

How should a cryofibrinogen specimen be transported? a. at room temperature b. immersed in ice slurry c. in a 37 C heat block d. protected from light

in 37 C heat block

an example of a pre analytical error happening during specimen processing is a. faulty collection technique b. inadequate centrifugation c. insufficient specimen d. patient stress and anxiety

inadequate centrifugation

interface means a. checking quality control results on instrumentation b. entering data into a lab info system c. interacting through the connection of computers d. standardizing all lab ordering and testing

interacting through the connection of computers

a computer terminal is a

keyboard and computer screen workstation

according to CLSI there is a two hour time limit for separating serum and plasma from cells for which test a. lactic acid b. creatinine c. total bilirubin d. troponin T

lactic acid

to process input data, a computer user must a. log off the web b. move the cursor c. press the enter key d. select an icon

press the enter key

in computer language, a hard copy is

processed data printed on paper

it is unlikely that removing the stopper from a specimen will cause a. contamination b. evaporation c. increase in pH d. loss of iCa2+

loss of iCa2+

Transporting blood specimens with the stopper up has nothing to do with a. encouraging complete clot formation b. maintaining sterility of sample c. minimizing stopper caused aerosols d. reducing hemolysis

maintaining sterility of sample

you have a STAT specimen in PST that needs to be centrifuged. No other specimens are ready. what do you do? a. balance with a serum specimen that is almost clotted b. centrifuge it by itself c. make a water balance of the same size and fill level d. wait until another specimen is ready

make a water balance

The number of tube inversions required during specimen collection depends on a. how difficult it is to draw the blood b. manufacturer recommended inversions c. the amount of blood in the ETS d. which needle gauge was used for collection

manufacturer recommended inversions

RFID, as used in health care, is a/an a. abbreviation for a disinfectant b. LIS mnemonic for a chemistry test c. method of specimen identification d. a new fire extinguisher safety code

method of specimen ID

Inadequate mixing of an anticoagulant tube can lead to a. hemolysis b. lipemia c. microclots d. sample clotting too fast

microclots

Computer verification of test orders is best described as a process that allows a user to a. access the system to view patient diagnosis b. confirm that the test was ordered by a physician c. establish that the appropriate test was ordered d. modify, delete, or accept test orders after review of data

modify, delete, or accept test orders after review of data

this is the term for a group of computers linked together for the purpose of sharing information a. junction b. network c. node unit d. terminal

network

the most probable reason a phlebotomist would wrap a specimen in aluminum foil would be to: a. cool the specimen b. cover a contaminated tube c. maintain a 37 C temperature d. protect it from room light

protect it from room light

according to CLSI, which tubes should be placed upright as soon as they are mixed a. gel tubes with anticoagulant b. light green gel barrier tubes c. light blue coagulation tubes d. non anti coagulant tubes

non anticoagulant tubes

This specimen would most likely be accepted for testing despite this problem a. expired tube b. incomplete ID c. not initialed by phlebotomist d. quantity not sufficient

not initialed

critical potentially life threatening values are also called a. alarm values b. at risk values c. panic values d. unstable values

panic values

which of the following actions will compromise the quality of the specimen a. drawing a BUN in an amber serum tube b. mixing an SST by inverting 5 times c. partially filling a tube for a platelet count d. transporting cryofibrinogen at 37 C

partially filling a tube for a platelet count

which of the following is confidential and unique to a single user a. entry icon b. ID code c. LIS menu d. password

password

When using computer-generated specimen labels, what information must typically be added to the label after a specimen is collected? a. medical record number b. patient complete name c. patient DOB d. phlebotomist initials

phlebotomist initials

Which of the following methods should be used to prevent exposure to aerosols generated when transferring plasma or serum to the aliquot tube a. pipetting liquid to the secondary tube held behind a shield b. pouring the serum from the primary tube to the aliquot tube c. withdrawing the specimen through the stopper by syringe d. all the above

pipetting liquid to the secondary tube held behind a shield

an aliquot is a

portion of a specimen being tested

Chilling can cause erroneous results for this analyte a. ammonia b. glucagon c. lactic acid d. potassium

potassium

results for this test should be normal despite a delay in processing lasting longer than 2 hours a. carbon dioxide b. fasting glucose c. ionized calcium d. pregnancy test

pregnancy test

Which of the following is not a valid reason for why blood slides made from EDTA specimens must be prepared within 1 hour of collection a. ensure they are made before clots appear b. minimize RBC distortion on the smear c. preserve the integrity of blood cells d. prevent artifact formation from additive

preserve the integrity of blood cells

which specimen is likely to be rejected if the tube is not filled until the vacuum is exhausted a. CBC b. plasma electrolytes c. postprandial glucose d. prothrombin time

prothrombin time

which of the following is a function of a computer monitor a. instructs the computer to carry out user requested operations b. manages the processing and completion of user required tasks c. performs mathematical processes and comparisons of data d. provides visible display of info being processed

provides visible display of info being processed

which gel tube does not require mixing a. clot activator b. gel separator c. liquid EDTA d. red/light gray

red/light gray

chemistry tests are often collected in heparin tubes to a. ensure adequate coagulation b. maximize diagnosis potential c. minimize hemolysis d. reduce turnaround time

reduce turnaround time

You are the only phlebotomist in an outpatient drawing station. A physician orders a test with which you are not familiar. What is the appropriate action to take? a. call the office for assistance b. draw both a serum and plasma specimen c. refer to the user manual for instructions d. send the patient to another drawing station

refer to the user manual for instructions

to avoid airborne infection while processing a. apply the brake when stopping centrifuge b. pop tube stoppers when opening serum tubes c. pour specimens directly into aliquot tubes d. remove tube stoppers behind splash shield

remove tube stoppers behind splash shield

the "order inquiry" function allows the user to a. check physician's diagnosis b. edit or delete duplicate orders c. find errors in patient ID d. retrieve all test orders on a patient

retrieve all test orders on a patient

Data can be entered or input into a computer from a. applications b. modems c. printers d. scanners

scanners

some blood specimens require cooling to a. avoid hemolysis b. prevent clotting c. promote serum separation d. slow metabolic processes

slow metabolic processes

it is important to note the type of heparin in a tube because a. a few types do not require inversion b. not all types of heparin prevent complete coagulation c. some types of heparin can affect certain results d. some types of heparin make centrifugation unnecessary

some types of heparin affect certain results

The laboratory has a computerized laboratory information system (LIS). Once an inpatient specimen has been 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

specimen collection is verified

which of the following specimens is unlikely to be rejected for analysis a. electrolytes that are hemolyzed b. fasting glucose that is lipemic c. platelet count with microclots d. total bilirubin that is icteric

total bilirubin that is icteric

the best way to chill a specimen is to a. cool the tube before venipuncture b. place it in a chilled canister c. put it in a small container of ice cubes d. transport in a commercial cooling tray

transport in a commercial cooling tray

To be considered computer literate, an individual must be able to a. explain how POCT instruments are connected to the LIS b. design programs for job specific problems in your area c. perform daily QA documentation in database softwarae d. understand the computer and the functions it performs

understand the computer and the functions it performs

Proper specimen handling begins a. as soon as the specimen is collected b. during specimen collection procedure c. in the course of patient ID d. when the physician orders the test

when the physician orders the test