Phlebotomy CH 7 - 11 Study Questions

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The maximum length of time the tourniquet should be applied is:

1 minute

The maximum length of a puncture device used on the heel is:

2 mm.

Which of these needles has the smallest diameter?

23-gauge needle

Before mailing a newborn screening test to the reference laboratory, the blood spots must dry for:

3 hours

When a blood smear is prepared, the proper angle of the spreader slide is:

30 degrees

The trough level for therapeutic drug monitoring is collected:

30 minutes before the medication is administered.

Which test would be collected for a forensic analysis?

Alcohol and drug level

To prevent rolling veins, the venipuncture step of primary importance is:

Anchoring the vein while inserting the needle.

Which of the following methods can be used to located veins that are not prominent?

Applying heat for 3 minutes.

A phlebotomist who encounters a comatose patient with no ID band should:

Ask the nurse to band the patient.

The blood specimen for this test must be protected from light:

Bilirubin

An arterialized specimen must be collected for which of the following tests?

Blood gases

The order of draw for a bilirubin, blood smear, and CBC by dermal puncture is:

Blood smear, CBC, and bilirubin

Before you draw a blood specimen from a patient, you must always:

Check the patient's ID band number and name Ask the patient for his or her first and last names.

Which of the following is correct when cleansing the venipuncture site with alcohol?

Cleansing with a back and forth motion

Which of these would cause a laboratory to reject a specimen?

Clots in a lavender stopper tube.

Using evacuated tubes past their expiration date may result in

Clotted anticoagulated tubes

Which of the following is acceptable when collecting blood using a winged blood collection set?

Collecting blood into a syringe

Which of the following exhibits diurnal variation?

Cortisol

At 0730, a phlebotomist receives requests for a cortisol level on Unit 4B, a fasting blood sugar (FBS) level on Unit 4A, and a STAT crossmatch on the ED. In which order should the phlebotomist collect these specimens?

Crossmatch, FBS, cortisol

Which of the following areas should be used for venipuncture?

Deep cephalic veins.

When a patient refuses to have his or her blood drawn, the phlebotomist should:

Document the patient's decision and notify nursing personnel.

When a patient develops a seizure, the phlebotomist should:

Document the time the seizure started and ended.

Which of the following is correct for positioning the patient for a venipuncture procedure?

Extending the arm down from the shoulder

Which of the following techniques will avoid causing a hemotoma?

Firmly anchoring the vein during needle insertion

The puncture site may require additional pressure to stop bleeding when the patient

Frequently takes aspirin.

Which of the following techniques is acceptable when blood is not obtained after needle insertion?

Gently pulling the needle back and redirecting the needle in a forward motion.

What should a phlebotomist do when a patient is sleeping?

Gently wake the patient and allow him or her to become oriented.

The concentration of this analyze is higher in blood collected by dermal puncture than by venipuncture:

Glucose

What test results is markedly decreased when a patient fasts for longer than 16 hours?

Glucose

Which of the following has a self-sealing septum that is accessed with a noncoring needle?

Implanted port

When should you label blood collection tubes?

In the presence of the patient.

Failure to allow alcohol to dry on the puncture site may cause:

Inability to form a round drop, specimen contamination, and RBC hemolysis

Hemoconcentration can be caused by:

Inadequate mixing of tubes.

For maximum antisepsis when blood cultures are collected, how long must the chlorhexidine gluconate dry on the patient's arm before venipuncture?

It must dry for 30 seconds.

Which tube must always be filled to the correct ratio?

Light blue stopped tube

According to the CLSI, which of the following is an acceptable order of tube draw?

Light blue, light green, and lavender

What complication can occur when you draw blood from an arm located on the same side of the body as a patient's mastectomy?

Lymphedema

What can cause blood to flow slowly into the tube while leaking into the tissue, causing a hematoma?

Needle insertion angle is too shallow.

Which of the following tests must be collected by capillary blood?

Newborn screening tests

A patient verbalizes a shooting, burning, and tingling pain when the needle is inserted. This could be caused by a:

Nicked nerve

A test included in a newborn screen that requires placement of blood in circles on filter paper is:

PKU

The information that must be present on a specimen label is:

Patient's first and last names, date and time of the collection, and the phlebotomist's initials.

What information is required on a requisition form?

Patient's first and last names, patient's identification number, and the test requested.

Why do phlebotomists perform their routine blood collections early in the morning?

Patients are in a basal state.

A properly tied tourniquet:

Permits arterial flow and blocks venous flow

A reclining phlebotomy chair is part of a:

Phlebotomy drawing station

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

Potassium

Wiping away the first drop of blood:

Prevents specimen contamination

What should you do first when a patient develops syncope?

Remove the tourniquet and needle.

How will leaving a green stopped tube for a bilirubin test on the counter for 1 hour affect the result?

Result will be falsely decreased

Which of the following can be used to obtain a serum specimen?

SST

Contaminated needles must be placed in the:

Sharps container with the safety device activated.

Which tube additive preserves glucose?

Sodium fluoride

A patient who appears pale and has cold, damp skin may develop:

Syncope

Blood cannot be drawn from a PICC line that is infusing:

TPN

If the plunger on the syringe is pulled back too quickly:

The specimen may be hemolyzed.

Why should a dermal puncture collection site be warned?

To increase blood flow

Why are specimens collected at specific times?

To measure the body's metabolism of a test substance.

Which of the following tubes contains an anticoagulant that inhibits thrombin?

Tube with a green stopper

What must be considered when choosing the correct equipment for venipuncture?

Type of blood collection system, age of the patient, and amount of blood to be collected.

Which of the following is not routinely carried on a phlebotomist's tray?

Urine collection cups

When encountering a patient with an AV fistula, the phlebotomist should:

Use the other arm.

What error in technique can hemolyze a blood specimen?

Using a needle with too small of a diameter.

When must a phlebotomist document the name of the person who has verified a patient's identify?

When the patient is cognitively impaired.

When venipuncture is performed on a crying child, which analyze is transiently elevated?

White blood cell count

After collection and delivery to the laboratory, when must clotted and anticoagulated tubes be centrifuged?

Within 4 hours

What is the correct identification procedure when an unidentified person is brought to the emergency department?

You must cross-reference the temporary identification number to the permanent identification number assigned to the patient.

Specimens collected for forensic studies require:

a chain-of-control form be completed.

Specimens that require chilling immediately after collection are placed in:

a container of crushed ice and water

The equipment required for a dermal puncture excludes:

a tourniquet

Before disposing of a contaminated needle, you must:

activate the safety device

When blood is inoculated into blood culture bottles using a winged blood collection set, the:

aerobic bottle is inoculated first.

Inaccurate CBG results are caused by:

air bubbles in the collection tube

EDTA, sodium citrate, and potassium oxalate anticoagulants prevent blood clotting in blood collection tubes by:

binding calcium

The advantage of an ETS system is that:

blood is directly collected into the evacuated tube.

Failure to puncture across the fingerprint will cause:

blood to run down the finger

When a dermal puncture device is selected, the most critical consideration is the:

depth of the incision

Correct palpation of a vein excludes:

detecting a pulse using the thumb

Before bandaging the puncture site, you should:

examine the site for bleeding

Physician approval is required when collecting blood from:

foot and leg veins.

The winged blood collection set is used primarily for:

hand veins

Drawing excess amounts of blood from a premature infant can cause:

iatrogenic anemia

When greeting a patient, you must:

identify yourself

Two blood culture sets from a patient requiring STAT administration of antibiotics are collected:

immediately from two different sites.

A tourniquet is used in routine venipuncture to:

impede venous blood flow

The primary antiseptic for routine venipuncture is:

isopropyl alcohol

Specimens for cold agglutinins must be:

kept warm

A thick blood smear is required for:

malaria

On newborns, dermal punctures are performed on the:

medial or lateral plantar areas of the heel

The vein of choice for venipuncture is the:

median cubital

Yellow ACD blood collection tubes are used for:

molecular diagnosis tests

Dermal punctures are often performed on:

patients receiving chemotherapy, geriatric patients, diabetic patients

Selection of an improper heel puncture site can result in:

puncture of the calcaneus

The timing for an OGTT begins when:

the patient finishes drinking the glucose.

A falsely decreased blood alcohol level may be obtained when:

the tube is only partially filled

Geriatric patients are more prone to hematoma formation because:

their veins have decreased elasticity

Specimens for ammonia levels must be:

transported on ice

The needle is inserted into the vein with the bevel:

up at an angle of 15 to 30 degrees


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