Phlebotomy N

Which of the following tube tops contain silica particles to enhance clotting and a thixotropic gel to assist in the separation of serum and blood cells? A. Marbled red and grey B. Lavender C. Green D. Blue

A. Marbled red and grey Marbled red and gray top tubes contain silica particles enhance the clot formation of whole blood. When the sample is centrifuged, the gel will form a barrier between the serum and blood cells, with the serum portion on top. Lavender, green, and blue topped tubes all have anticoagulants that inhibit the clotting process.

Which of the following is an appropriate alternative to using a rubber tourniquet when attempting a venipuncture on a known patient who is difficult to obtain a sample from? A. blood pressure cuff B. non-adherent gauze C. hypoallergenic tape D. elastic bandage

A. blood pressure cuff

During processing, the centrifuge rotor lid should be kept A. closed to maintain an airtight seal. B. unlocked to promote safe access to contents. C. open to allow optimum visibility. D. partially vented to release pressure.

A. closed to maintain an airtight seal. To ensure safety, the lid of a centrifuge should remain closed, locked and sealed until the rotor reaches a complete stop. A centrifuge is not a pressure device, therefore venting is not appropriate. The lid should be closed, locked and sealed while in operation to contain all contents should a tube break and disperse sample and/or glass (or other parts) around the inside of the centrifuge.

The medical assistant is instructed to perform a capillary stick for newborn screening. Which of the following collection devices should the medical assistant use? A. heel stick lancet B. needle and syringe C. evacuated tube D. finger stick lancet

A. heel stick lancet

Which of the following should be avoided as a form of patient identification? A. insurance number B. social security number C. date of birth D. full name

A. insurance number

The phlebotomist should send a specimen collected in a yellow stopper tube with SPS additive to which of the following laboratory departments? A. microbiology B. immunohematology C. chemistry D. hematology

A. microbiology Blood cultures are collected in yellow-top tubes with SPS (sodium polyanethole sulfonate), a constituent in blood culture media used to grow bacteria from patients suspected of bacteremia, i.e. bacteria in the blood. SPS prevents the patient's blood from killing any bacteria in the sample through the blood's own immune response to infection, allowing the bacteria to multiply so they can be identified. Additional antimicrobial susceptibility testing can help the physician in prescribing antibiotics.

A syringe is preferred over a vacuum collection device when A. the patient's veins are fragile. B. the sample must be drawn from a large antecubital vein. C. many tests have been ordered and multiple tubes must be drawn. D. collecting a sample for newborn PKU screening.

A. the patient's veins are fragile. A needle and syringe would be chosen over a vacuum collection device when a patient has fragile veins. The vacuum pressure of evacuated tubes can collapse small or fragile veins such as those on the back of the hand. When many tests requiring multiple tubes are collected, vacuum devices are preferred. A capillary puncture would be indicated for a newborn screening PKU test since it is collected on filter paper.

Prior to any type of inpatient specimen collection, a phlebotomist must correctly verify their patient's identity by using which two-step procedure? A. Check ID bracelet and IV bag. B. Check ID bracelet, and ask patient to verbally confirm their identity. C. Check ID bracelet and foot bed chart. D. Check foot bed chart, and ask patient to verbally confirm their identity.

B. Check ID bracelet, and ask patient to verbally confirm their identity.

Using the guidelines for any method of venipuncture, which of the following actions should the medical assistant perform directly after confirming patient identity? A. Assemble the appropriate equipment and select the proper evacuated tubes for test to be performed B. Review the requirements for collecting and handling the blood specimen as ordered by the physician C. Apply the tourniquet and thoroughly palpate the selected vein D. Position the patient's arm and cleanse the site with an antiseptic wipe

B. Review the requirements for collecting and handling the blood specimen as ordered by the physician

Which of the following forms is the medical assistant responsible for having the patient sign when a specimen is being collected for substance abuse screening for employment? A. advance directive B. chain-of-custody C. informed consent D. release of medical Information

B. chain-of-custody A Chain-of-custody form is used to maintain a legal record of individuals who have had physical possession of the specimen. It prevents the possiblity of tampering. An Advance Directive is a legal document that allow someone to spell out medical decisions about end-of-life care ahead of time. Informed Constent recognizes the need of a patient to know about a procedure, surgery, or treatment, before deciding whether to have it. No medical information may be released without proper authorization (Medical Release form) from the patient or legal guardian, currently dated and signed.

Which of the following additives protects serum from interacting with red blood cells after a specimen has been centrifuged? A. sulfosalicylic acid B. gel separators C. clot activators D. anticoagulant

B. gel separators

Which of the following evacuated tubes should the medical assistant select for collection of electrolytes? A. blue-top B. green-top C. grey-top D. lavender-top

B. green-top A green top tube contains heparin. Green tops are used for collection of heparinized plasma or whole blood for special tests. Note: After the tube has been filled with blood, the tube is inverted several times to prevent coagulation. Note: Green top tubes can contain ammonium, lithium, and sodium in addition to the heparin. In this instance, lithium heparin would be the green-top of choice (and sodium heparin would NOT be used for an electrolyte test). Electrolytes can also be collected in a red-top tube.

In which of the following time frames should a tourniquet be routinely released on a patient while performing a blood draw? A. within 30 seconds B. within one minute C. within three minutes D. within five minutes

B. within one minute

The laboratory requisition indicates that you are to collect a venous blood specimen for hematology CBC testing, serum chemistry testing, and coagulation studies. What is the proper order of collection for these tubes? A. Red, light blue, lavender B. Yellow, red, light blue C. Light blue, red, lavender D. Red, lavender, yellow

C. Light blue, red, lavender

Which of the following tests is required in all 50 states to screen newborns for metabolic disease? A. HIV B. RSV C. PKU D. Rh Factor

C. PKU The government has mandated newborn screening for the purpose of early diagnosis and treatment of Phenylketonuria (PKU). It is an inherited disease that may lead to mental retardation if not detected. The specimen for the test is usually collected in the newborn nursery via heel stick between 48-72 hours of life.

Name the two most used patient identifiers. A. Bed number/Physicians name B. Medical record number/date of birth C. Patient's name/date of birth D. Patient's name/Physicians name

C. Patient's name/date of birth

A medical assistant has active symptoms of the common cold. Under which of the following conditions may he perform venipuncture? A. The medical assistant may not perform venipuncture with an active cold. B. The medical assistant may perform venipuncture provided the patient is wearing a mask. C. The medical assistant may perform venipuncture provided he is wearing a mask and afebrile. D. The medical assistant may perform routine venipuncture as usual

C. The medical assistant may perform venipuncture provided he is wearing a mask and afebrile.

hich of the following steps is completed first in performing venipuncture? A. apply the tourniquet B. cleanse site with an alcohol wipe C. identify the patient D. arrange tubes in order of draw

C. identify the patient

The phlebotomist is drawing blood from a patient that is taking blood thinners. Which of the following is a necessary piece of additional equipment to have at the drawing station? A. paper tape B. elastic gauze C. non-adhering bandage D. adhesive tape

C. non-adhering bandage

Which of the following is the proper way to identify a patient prior to performing a venipuncture? A. Ask the patient if he/she is a certain patient (i.e. "Are you Steven Smith?"). B. Verify the patient's order against the name on the chart .C. Ask the nurse what the patient's name is. D. Ask the patient to state his/her full name and DOB and compare to the chart.

D. Ask the patient to state his/her full name and DOB and compare to the chart.

Which of the following actions by the medical assistant demonstrates safe use of a centrifuge? A. Ensure all specimen tubes are uncapped. B. Open at timed intervals to monitor proper function. C. Open the centrifuge during operation to ensure the separation of blood cells from serum. D. Balance the tube load to prevent breakage.

D. Balance the tube load to prevent breakage. It is important to properly balance a centrifuge, equally distributing the samples. An imbalance of weight could cause the centrifuge core to break while spinning, and/or cause damage to the rotors, brushes, or other components. The shaking of an imbalanced centrifuge could also lead to tube breakage. Tubes within a centrifuge should be capped at all times (to contain all samples and aerosols). It is not necessary to stop the centrifuge to make sure samples are separating or to monitor function.

Which of the following Vacutainer tubes is routinely used for hematology testing? A. Red-topped B. Green-topped C. Yellow-topped D. Lavender-topped

D. Lavender-topped Hematology is a general term or branch of medicine that studies blood, the organs that form blood, and blood disorders and diseases. The most common hematology test is a complete blood count (a.k.a. CBC- collected in a lavender topped tube), often ordered with a cell differential. The other tube options listed in this example are generally collected for chemistry testing, serology testing, and blood cultures.

A centrifuge functions in which of the following ways? A. slowly warms a refrigerated blood specimen to room temp B. magnifies cellular blood components C. measures the amount of glucose in a patient's blood D. rotates to separate components of a patient's blood

D. rotates to separate components of a patient's blood A centrifuge rotates to separate components of a patient's blood. Depending on specimen requirements for a particular test, certain samples must be processed by centrifugation to maintain the integrity for testing. A centrifuge does not serve as a specimen warmer, nor does it magnify sample components (microscopes are used for magnification). Glucose measurements are obtained by analyzing the sample on a glucose meter or designated laboratory instrument, not the centrifuge.

The medical assistant has an order to collect a CBC with diff, PT, a basic metabolic panel (BMP), and blood cultures. Place the collection tubes in the correct order of draw. (Click and drag the options in the left column to their correct order in the right column).

blood culture bottles, light blue, red, lavender

111. Place the following steps in the correct sequence when preparing to perform a venipuncture.

identify the patient and explain the procedure, wash hands and put on gloves, apply tourniquet, palpate the antecubital space of the arm, locate an acceptable vein

110. The patient was sent to the lab to have CBC (lavender), PT/PTT (light blue), CMP (green), and glucose (grey). Place the evacuated tubes in the correct order of draw.

light blue, green, lavender, gray