Collections Interactive Review
A patient arrives an an outpatient draw station for a glucose tolerance test collection. The phlebotomist has verified that the patient has been fasting for 10 hours. Place the steps below in the correct order for performing the test. 1. Instruct the patient to drink the predetermined dose of the glucose beverage 2. Collect the initial blood specimens for glucose and insulin levels 3. Collect blood specimens at physician prescribed intervals 4. Start the timing for the glucose tolerance test
2, 1, 4, 3
A phlebotomist is assigned to manage an outpatient draw station. Prioritize the following patients in the correct order. 1. 2-hour post prandial glucose level due in 40 minutes 2. STAT troponin level on a patient sent over from a doctor's office 3. weekly PT/INR 4. type and screen on a pre-operative patient due for surgery that day
2, 4, 1, 3
Place the options below in the correct order of draw for micro containers 1. heparin 2. no additive 3. EDTA 4. sodium fluoride
3, 1, 4, 2
Place the tubes below in the correct order of draw 1. EDTA 2. SST 3. SPS 4. heparin
3, 2, 4, 1
A requisition order requires a phlebotomist to draw a BMP, CBC, PTT, and lactic acid. Place the options below in the correct order of draw. 1) CBC 2) Lactic acid 3) PTT 4) BMP
3, 4, 1, 2
A phlebotomist has to draw lavender, gold, light blue and gray top tubes for the following tests. Place the tests listed below in the correct order. 1. CBC 2. cholesterol 3. glucose 4. prothrombin
4, 2, 1, 3
A patient who received a vasectomy 90 days ago reports to the lab for a semen analysis. The patient will be collecting the sample at home. To avoid sample rejection the phlebotomist should instruct the patient to keep the specimen A) at body temperature and return it to the lab within 30 minutes B) at room temperature and return it to the lab within 30 minutes C) in a zip locked bag over ice and return it to the lab within 30 minutes D) in a zip lock bag over ice and return it to the lab within 8 hours
A
A phlebotomist collects citrate, EDTA, and oxalate tubes in that prder. Which of the following is the correct lab department for each tube? A) Citrate to coagulation, EDTA to hematology, and oxalate to chemistry B) Citrate to hematology, EDTA to hematology, oxalate to immunology C) Citrate to coagulation, EDTA to immunology, oxalate to chemistry D) Citrate to hematology, EDTA to immunology, and oxalate
A
A phlebotomist is asked to process a bilirubin level collected in a red top tube. The phlebotomist should centrifuge the specimen A) At least 20 minutes after collection and aliquot into an amber tube B) At least 20 minutes after collection and aliquot into a plain tube C) 60 Minutes after collected and aliquot into an amber tube D) 60 minutes after collected and aliquot into a plain tube
A
A phlebotomist is to draw blood from a psychiatric patient. The patient does not understand what is being done. Which of the following is the appropriate action the phlebotomist should take to ensure the safety of all? A) perform the blood draw in the presence of the physician B) explain the procedure to the patient thoroughly C) confirm the patient's identity and perform the draw D) take patient restraints into the room
A
The doctor has ordered occult blood test and sent the patient to the lab to pick up the testing materials. After instructing the patient how to collect the specimen, it is very important to tell him to A) follow dietary guidelines specifically for the test B) inform the doctor about any gastric ulcers he may have C) clean the area thoroughly D) stop taking medications during the collection period
A
The phlebotomist noticed that the patient's INR is in the critical value range. Which of the following should the phlebotomist contact regarding the critical result? A) the doctor who ordered the test B) the doctor's nurse C) the doctor's medical assistant D) the lab manager
A
When collecting blood for a neonatal screening, the phlebotomist should A) use a capillary collection procedure B) use special patient identification banding C) maintain a warm temperature at the site D) use syringe method
A
Which of the following is the reason a phlebotomist should avoid milking a finger during a capillary puncture? A) The specimen may be contaminated with interstitial fluid B) The specimen may be contaminated with staphylococcus aureus C) The specimen may be contaminated with isopropyl and cause hemolysis D) The collection site may be contaminated by the phlebotomist's gloves
A
Which of the following tubes is most likely to be centrifuged? A. tiger top SST B. yellow ACD C. royal blue EDTA D. yellow SPS
A
Which of the following tubes needs time to clot before centrifuged? A. red B. gray C. green D. light blue
A
While providing patient education on 24-hour urine collection for creatine clearance, it is imperative to tell the patient A) To keep the specimen refrigerated at all times B) To maintain particular dietary restrictions C) Start collection 96 hours after any procedure using contrast dye D) To avoid laxatives during the collection process
A
Which of the following should the phlebotomist tell the patient when giving instructions to a patient for sputum collection? (2 answers) A) collect a first morning specimen B) collect the specimen 1 hour after eating a meak C) gargle with mouthwash before collection D) consumer only clear liquids prior to collection E) rinse the mouth with sterile water prior to collection
A, B
When anchoring a vein the phlebotomist should (2 answers) A) place the thumb 1-2 inches below venipuncture B) apply direct downward pressure C) draw the skin away from the site D) place the pointer finger 1-2 inches below the venipuncture site E) place the thumb below and the index finger above the site
A, C
The phlebotomist must label blood bank specimens with which of the following information? (3 answers) A) patient's date of birth B) patient's room number C) patient's first and last name D) date and time of collection E) physician's name
A, C, D
When ordering a PT, PSA and CBC, which of the following tubes are needed to effectively draw these labs? (3 answers) A) light blue B) gray C) lavender D) gold gel barrier E) yellow ACD
A, C, D
Which of the following is a phlebotomist required to do when preparing to aliquot a specimen? (3 answers) A) match the labels on the tubes B) invert the tubes 8 to 10 times before centrifuging C) prepare under a bench top splash shield D) pour the specimen directly into the aliquot container E) use a disposable transfer pipette
A, C, E
Which of the following statements made by a phlebotomist indicated understanding of proper specimen processing? (2 answers) A) "I must pre-label aliquot tubes one patient at a time" B) "I must centrifuge a gray top tube for whole blood testing" C) "I must label aliquot tubes one patient at a time immediately after aliquoting" D) "I must aliquot a K level into an amber tube" E) "I must remove stoppers from tubes using a face shield"
A, E
A 76-year-old patient has fragile skin with little elasticity. The best choice to ensure his skin doesn't tear should be A) silk tape B) paper tape C) surgical tape D) a band-aid
B
A patient visits the lab for a routine venipuncture collection and informs the phlebotomist that she recently had a mastectomy of the right breast. Which of the following is the appropriate draw site? A) right arm B) left arm C) either arm D) either hand
B
A phlebotomist has completed a dermal puncture on a on-year-old patient who is completing an annual physical. Children this age should not have a bandage applied because A) they run a higher risk of contamination B) they run a risk of choking C) clotting occurs quickly for children this young D) they run a higher risk of petechiae
B
A phlebotomist has just drawn a chemistry tube on an inpatient at the hospital. The tube has been spun down and opened so that an aliquot could be taken from the sample. A request for a blood alcohol level has been ordered on the same patient. Which of the following should the phlebotomist do? A) Add the test to the aliquot B) Draw a new chemistry tube on the patient C) Call for permission to add the test to the aliquot D) Allow the patient sufficient time before drawing a new tube
B
A phlebotomist has just gathered her supplies for an out-patient procedure and has selected grey, red, light blue, and lavender tubes. Which of the following is the appropriate order of draw? A) lactic acid, ESR, D-dimer, RPR B) D-dimer, RPR, ESR, lactic acid C) HIV, CTGC, D-dimer, RPR D) D-dimer, RPR, CTGC, HIV
B
A phlebotomist in central processing discovers an unspum glucose specimen in a gray top tube kept at room temperature for four hours after it was collected. The phlebotomist should A) Transfer the specimen to the chemistry department for testing B) Transfer the specimen to the centrifuge to be spun down C) Reject the specimen due to the delay in processing D) Reject the specimen because the temperature requirement was not met
B
A phlebotomist is tasked with drawing a STAT CBC and a CMP. After palpation, no veins can be felt and there are no visible veins on the back of the hand. The phlebotomist decides to perform a capillary stick. Which of the following microtainers should the phlebotomist choose? A) 1 polymer gel and 1 without an additive B) 1 EDTA and 1 heparin C) 1 polymer gel and 1 EDTA D) 1 heparin and 1 without an additive
B
A phlebotomist must collect ESR, STAT electrolytes, D-Dimer and estrogen. Which of the following correctly lists the appropriate tubes in the CLSI recommended order of draw? A) red, light blue, green, lavender B) light blue, red, green, lavender C) light blue, red, lavender, green D) red, light blue, lavender, green
B
A specimen processor receives a lipemic glucose specimen, a clotted HCG, a moderately hemolyzed electrolyte panel specimen, and an icteric bilirubin specimen. Which of the following is likely yo be rejected for analysis? A) Glucose and bilirubin B) Glucose and electrolytes C) HCG and bilirubin D) HCG and electrolytes
B
A trough Dilantin (phenytoin) level is ordered to be collected at 12:30 PM. The phlebotomist arrives at 12:20 PM to collect the specimen and notices the patient is receiving an infusion of normal saline in the right arm and Dilantin in the left arm. Which of the following is the appropriate course of action? A) Collect the specimen distal to the normal saline infusion and label it as peak level B) verify the time of collection with the patient's nurse or physician C) Consult the patient's chart to determine appropriate collection time D) contact the laboratory supervisor to confirm peak or trough collection
B
A urine drug screen has been ordered for the patient and instructions for how to void have been provided. When the phlebotomist is given the specimen, she must immediately A) prepare the specimen for transport B) read the temperature strip C) ask patient what medications he is taking D) wash her hands
B
After a course of antibiotics for a UTI a patient returns for a follow up urinalysis. The order calls for a midstream clean catch specimen. In order to prevent contamination, the phlebotomist should provide the patient with which of the following antiseptics? A) iodine wipes B) castile soap wipes C) betadine wipes D) alcohol wipes
B
At what point should specimen labeling occur? A) during assembly of the equipment B) upon completion of the blood draw C) before approaching the patient's side D) after the patient is released
B
In order to prevent post-puncture hematoma formation at the antecubital fossa after a successful venipuncture, the phlebotomist must apply firm and direct pressure with cotton A) gauze and instruct the patient to bend the arm B) gauze and instruct the patient not to bed the arm C) balls and instruct the patient to bend the arm D) balls and instruct the patient not to bed the arm
B
The doctor has ordered a fecal occult blood specimen to be collected by the patient. Which of the following preparatory instructions should the phlebotomist give the patient? A) Consume 8 ounces of fiber before collection B) Avoid taking vitamin C prior to collection C) Stop taking prescription medication 12 hours prior to collection D) Fast for 8 hours before collection
B
The phlebotomist has orders to draw blood cultures on a patient with fragile veins and decides to use a butterfly system. Which of the following should be drawn first? A) Anaerobic B) Aerobic C) Pediatric D) Mycobacterium
B
The physician has ordered a sputum collection. Which of the following patient instructions must be given before collection of the sputum? A) "Breathe deeply in and out" B) "Rinse the mouth with warm water" C) "Cough several times" D) "Brush your teeth and use mouthwash"
B
When performing a blood draw on a 75-year-old patient with thin, papery skin, the phlebotomist should A) apply the tourniquet directly to the skin above the site B) wrap the arm in gauze and apply the tourniquet C) do not apply a tourniquet D) use a cloth tourniquet
B
When processing a specimen in a centrifuge the phlebotomist should ensure that all the A. sampled are centrifuged at 3000 rpm B. samples are balanced in the centrifuge C. samples are spun for at least 20-30 minutes D. tubes are allowed to clot for 10 minutes before spinning
B
Which department within the lab should a BMP be delivered to? A) Serology department B) Chemistry department C) Blood bank department D) Coagulation department
B
Which of the following is the best way to properly anchor the vein? A) use the thumb and index finger to stretch the skin B) place the thumb 1 to 2 inches below the site C) use two fingers and stretch the skin toward the forearm D) hold skin with thumb tightly and pull forward toward forearm
B
Which of the following sites is contradicted for a patient with diabetes? A) antecubital area B) foot/ankle C) hand D) lower forearm
B
Which of the following specimens is likely to be considered STAT? A) therapeutic drug levels B) lactic acid C) electrolytes D) blood smears
B
Which of the following types of medication work to inhibit blood from clotting? A) antihypertensives B) anticoagulants C) antiglycolytics D) antihistamines
B
Which of the following urine samples should be used for a cortisol level? A) timed B) 24 hour C) Random D) Clean catch
B
Which of the following tests can be collected by capillary puncture? (Select the two (2) correct answers.) A) Blood cultures B) Blood gas C) Bilirubin D) Erythrocyte sedimentation rate E) PTT
B and C
A phlebotomist working in an outpatient setting has just received a set of guaiac smears from a patient that must be processed. How should the phlebotomist process the specimen? (2 answers) A) develop with 70% isopropyl alcohol B) keep at room temperature C) develop with hydrogen peroxide D) keep chilled E) develop with normal saline
B, C
A patient is receiving therapeutic medication. Which of the following is the correct way to draw trough levels. A) 60 minutes prior to medication administration B) 30 minutes after medication administration C) 30 minutes prior to medication administration D) 10 minutes after medication administration
C
A patient with pseudomonas aeruginosa is receiving gentamicin antibiotic for therapy. A) stay with the patient the initial two hours to monitor status B) collect two trough samples C) collect the blood sample before the drug is administered D) label all tubes simultaneously before drug monitoring starts
C
A phlebotomist performs a blood draw testing for CBC, chemistry, and bilirubin. After the draw, the phlebotomist wraps the bilirubin tube in aluminum foil. Which of the following was the reason for wrapping the bilirubin tube? A. To cool down the specimen B. To maintain the specimen at 37 degrees celsius C. To protect specimen from light D. To prevent contamination of the specimen
C
After a tiger top tube was centrifuged the phlebotomist noticed that the serum was milky white. Which of the following conditions does this indicate? A) Diabetes B) Anemia C) Icterus D) Lipemia
C
After drawing a patient with hemophilia the phlebotomist should A) bandage the patient as normal B) apply an extra layer of gauze C) hold pressure for 5-10 minutes D) lower the patient's head
C
During a venipuncture the patient has excessive bleeding and then states she forgot to mention her anticoagulant (Coumadin) therapy. Which of the following should the phlebotomist do immediately after removing the needle? A) immediately apply a pressure bandage B) ask the patient to hold pressure on the site and then look for a physician C) hold pressure on the site for a minimum of five full minutes until the bleeding stops D) hold pressure on the site until the bleeding begins to stop and apply a bandage
C
The doctor who ordered the following lab tests: CBC, calcium, glucose, ABO group, Rh typing, aPTT. Which of the following is the correct order of draw for these tests? A) gold, lavender, pink, gray, light blue B) lavender, gray, gold, light blue, pink C) light blue, gold, lavender, pink, gray D) light blue, lavender, gold, pink, gray
C
The phlebotomist collects electrolytes and ammonia specimens from the same patient in lithium heparin tubes, and places them in ice slurry while collecting other specimens before transporting them to the lab 15 minutes later. The results for electrolytes were incorrect, most likely because the specimen was A) Collected in the wrong tube B) Not processed in a timely manner C) Not transported at the correct temperature D) Not protected from light
C
The phlebotomist draws blood from a patient in an isolation room. The specimen should be properly taken to the lab in a A. red biohazard bag B. yellow bag C. biohazard transport bag D. brown paper bag
C
Which clinical laboratory department do ANA, HIV, and HCG specimens go to? A) Microbiology B) Biochemistry C) Serology/Immunology D) Hematology
C
Which of the following are required for a sputum collection? A) Sterile cup, 24 hour collection B) Plastic transport cup, immediate delivery to lab C) Sterile cup, immediate delivery to lab D) Plastic transport cup, 24-hour collection
C
Which of the following is the correct order for filling micro collection tubes when multiple tests are ordered? A) EDTA, non-additive tubes, other additive tubes B) Non-additive tubes, EDTA, other additive tubes C) EDTA, other additive tubes, non-additive tubes D) Non-additive tubes, other additive tubes, EDTA
C
Which of the following is the correct order of draw when one or more tubes containing anticoagulant are collected? A) green, red, light blue B) red, green, light blue C) light blue, red, green D) green, light blue, red
C
Which of the following laboratory departments should a rapid plasma reagin (RPR) be delivered to? A) Hematology B) Microbiology C) Immunology D) Histology
C
Which of the following samples is still acceptable when kept at room temperature for 8 hours after collection? A. A urine sample B. A stool culture C. A glucose test in a gray top tube D. a B12 test in a red top tube
C
Which of the following should the phlebotomist do if urine testing will be delayed more than an hour? A) Place the urine on ice, then in the refrigerator B) Protect the specimen from light C) Place the urine specimen in the refrigerator D) Store the urine at room temperature
C
Which of the following should the phlebotomist do with a patient known to have a fainting problem? A) inform the physician that the patient cannot be drawn B) give the patient orange juice C) position the patient supine D) ask a co-worker to assist
C
A hospital phlebotomist is conducting routine glucose monitoring for a patient. Why should the first drop of blood be wiped away prior to applying the test strip? A) the 70% isopropyl can contaminate the blood sample and give elevated results B) the patient may have bacteria on their finger, which can cause abnormal results C) the first drop is over oxygenated D) the first drop of blood may contain fluid from the tissues
D
A new bariatric patient has come to the lab for CMP and CBC. Inspection of both arms did not reveal any veins. The patient tells the phlebotomist that blood is usually drawn from her hand. Which of the following should the phlebotomist use to draw blood from this patient's hand? A) 21g needle at a 40 to 45 degree angle B) 21g needle at a 10 to 15 degree angle C) 23g needle at a 40 to 45 degree angle D) 23g needle at a 10 to 15 degree angle
D
A phlebotomist is preparing to draw an 85-year-old patient whose skin is thin and paper like. Which of the following should the phlebotomist use to secure the gauze? A) paper tape B) bandage C) micropore D) Coban
D
A phlebotomist is tasked with drawing an ESR, CMP, PT/INR, and a lactic acid level. Which of the following is the correct order of draw? A) gold, lavender, pink, grey B) grey, lavender, gold, light blue C) pink, light blue, grey, gold D) light blue, gold, lavender, grey
D
A three-month-old patient was sent to the lab for an H&H. How should the phlebotomist collect the sample? A) Venipuncture, antecubital fossa B) Dermal puncture, great toe C) Dermal puncture, middle finger D) Dermal puncture, heel stick
D
If alcohol is used to decontaminate the capillary puncture site, which of the following should the phlebotomist do? A) Use two alcohol pads for cleaning B) Dilute the strength of the alcohol C) Wipe away the 2nd drop after the puncture D) Allow the site to air dry before the puncture
D
The doctor has ordered a CBC, Cholesterol, and PT on a fasting patient. The phlebotomist is in the process of collecting the last tube when the nurse walks in with an add-on for a glucose test. Which of the following tubes should the phlebotomist use to collect the glucose test? A) light green top B) SST C) lavender top D) gray top
D
The phlebotomist has orders for an FBS, INR, and CBC Stat. Which of the following is the correct tube selection and order of draw? A) red, lavender, light blue B) red, light blue, lavender C) lavender, light blue, gray D) light blue, lavender, gray
D
Which of the following correctly matches the test with the appropriate special handling instructions? A. Vitamin A specimen kept warm using a heating pack B. Cryoglobulin level protected from light with aluminum foil C. Ammonia level kept warm using a heating pack D. Lactic acid chilled in slurry of ice and water
D
Which of the following is a coagulation test that can be performed with a POC machine or instrument? A) HCT B) BUN C) D-dimer D) INR
D
Which of the following is the CLSI recommended order of draw for a BMP, CBC, and PTT? A) EDTA, heparin, sodium citrate B) heparin, EDTA, serum separator C) serum separator, heparin, EDTA D) sodium citrate, heparin, EDTA
D
Which of the following is the appropriate antiseptic to use in order to achieve a high degree of antisepsis prior to blood culture collection on a 6-month-old infant? A) Benzalkonium chloride B) Povidone-iodine (PVP) C) Betadine D) Chlorhexidine gluconate
D
Which of the following laboratory departments should a pap smear be delivered to? A) Hematology B) Immunology C) Microbiology D) Cytology
D
Which of the following specimens is most susceptible to contamination and should always be drawn first? A) hematocrit B) serum cholesterol C) complete blood count D) blood culture
D
Which of the following tubes contains an anticoagulant that prevents platelets from clumping and preserves the appearance of blood cells for microscopic prep? A) light green B) dark green C) light blue D) lavender
D
Which of the following specimens is likely to be considered STAT? a. therapeutic drug levels b. lactic acid c. electrolytes d. blood smears
b
Which of the following blood tests require special handling? (Select the three correct answers.) A. CBC B. Ammonia C. Cold addlutinin D. Blood Culture E. Bilirubin
b, c, e
A glucose specimen collected in a gel barrier tube from a hyperglycemic patient was left in a pneumatic tube system for four hours before being centrifuged. The test results were unusually low. Which of the following specimen handling errors is most likely to have caused the inaccurate results? A. the specimen was not protected from light and cells were not separated from serum or plasma within the time limit. B. the specimen was not protected from light and was not placed on ice. C. the specimen was transported in a pneumatic tube system and was not placed on ice. D. The specimen was transported in a pneumatic tube system and cells were not separated from serum or plasma within the time limit
d
