NHA CPT Exam Part 5

What is the normal blood glucose range?

100-126 mg/dL

How many times should a tube be inverted to be mixed appropriately?

5-8

Phlebotomists should visually inspect the needle after removing the cover or cap because, although rare, manufacturer's defects include all of the following except:

Beveled tip

At what time of day are electrolytes at their lowest concentration in the urine?

Early morning

Pleural fluid is:

Fluid from the lungs

What color blood sample tube is used for glucose testing?

Gray

Which of the following anticoagulants does not bind calcium in the blood?

Heparin

To collect a capillary blood specimen, what is the correct way to fill a microtube?

Hold it upright just below the blood drop, not touching the skin

When is a fasting sample to be taken from a patient?

In the morning before the patient has had anything to eat

Explaining the sample collection procedure accomplishes all of the following except:

Increasing the chance that nothing is wrong with the patient

Anchoring the vein below the venipuncture site:

Is meant to prevent rolling veins

Which allergy could potentially affect venipuncture specimen collection?

Latex

When considering timed samples, what is a major concern for documentation aside from properly identifying the patient?

Making sure the draw time on the tube and in the computer match exactly

What is commonly being tested for when performing a throat swab?

Microorganisms

What is sputum?

Mucus/phlegm coughed out from respiratory tract

When are blood samples drawn above an IV site acceptable?

Never

Is a 25-gauge needle appropriate for drawing blood samples from a patient? Why or why not?

No, a 25-gauge needle is too small and would destroy the blood cells when blood is pulled through the bore of the needle

More experienced phlebotomists can perform advanced procedures such as injections, tuberculin skin tests, and arterial punctures. What is usually required for these advanced phlebotomy procedures?

Observed competency check-off

A phlebotomist working in a doctor's office is paged by one of the new nurses who has a question. The nurse says that the doctor has ordered a urine specimen for culture on a child that is approximately 12 months old, and she would like assistance to catheterize the child. What should the phlebotomist do to assist the new nurse?

Offer assistance with collecting a bagged urine sample instead

What is the maximum allowable time between application of the tourniquet and removal of the tourniquet from the patient's arm?

One minute

What is the size of the blood drop needed for a good blood smear?

One to two millimeters

Newborn/neonatal screening (NBS) tests are important because some health conditions present at birth may not show signs right away but can be life-threatening. All of the following may contaminate the NBS results, except:

Oxygen

What is the first thing that is needed when collecting a sample for drug testing?

Patient consent

The term "geriatric" refers to:

Patients over the age of 65

In paternal testing cases, how does a phlebotomist prove the samples were collected from the correct individuals?

Photos are taken of all individuals and sent with the sample

Why are arterial sites more prone to extended bleeding than venous sites?

Pressure is higher inside arteries than in veins

When testing for vitamins (such as vitamins C, E, and K), what consideration must be made for the sample immediately following collection?

Protection from light

Which of the following is not a step in the blood collection technique?

Receive verbal order from nurse

Joe was recently hired as a phlebotomy technician in an outpatient laboratory known as a Patient Service Center (PSC). During his orientation, his preceptor told him that one of his responsibilities would be to perform Quality Control (QC) checks on the centrifuges. Joe correctly suspects that this will involve:

Recording the date and time of routine maintenance tasks on designated logs

What should a phlebotomist not do immediately following obtaining a blood sample?

Remove the tube holder from the needle

What is a generally accepted form of a secondary container?

Self-sealing bag

Following a venipuncture procedure, patient care should include all of the following except:

Shake the patient's hand before removing gloves

A 16-year-old female arrives at the physician's office for treatment. She is alone and has not told her parents that she was going to the doctor. Which of the following is true?

She cannot give consent for treatment because she is not at the age of majority

The T-Spot blood test for tuberculosis requires what type of blood tube additive?

Sodium heparin

What additive(s) does the dark green-top blood collection tube contain?

Sodium heparin or lithium heparin

Peter is a phlebotomist in a pediatric office. His first appointment of the morning is a new mother who has brought in her baby for a follow-up galactosemia test. The mother makes a statement to Peter that she is sure nothing is wrong with her baby. "She is already five days old, and she looks fine. I'm sure everything is going to be alright." Peter knows which of the following is true?

Some forms of galactosemia do not require treatment

What device is used to measure bleeding time?

Surgicutt

John is performing single site blood cultures x2 on a patient with a Fever of Unknown Origin (FUO). Which collection device should he fill first?

The aerobic vial

Which arm should be used in patients who have had a mastectomy?

The arm on the opposite side

Who is a key figure in developing trust with a patient with a psychiatric disorder?

The caregiver that works with the patient on an ongoing basis

When collecting a 24-hour urine sample, what is the last sample the patient should be instructed to collect?

The first void of the second morning

What major concern should a phlebotomist have when attempting to perform venipuncture on the patient's leg or foot veins?

The formation of clots

What is the relationship between syringe size and vacuum force created?

The larger the syringe, the greater amount of vacuum obtained

What is meant by the term "best practices"?

The most efficient and effective way of accomplishing a task, process, or activity based on repeatable procedures that have proven themselves over time for large numbers of people

What does a sign reading "NPO" on a patient's door mean?

The patient is not to have anything to eat or drink

Restraining a pediatric patient for venipuncture is necessary for which of the following reasons?

The safety of the patient

Which of the following would be a reason a blood tube is rejected by a laboratory?

The tube is past its expiration date

When performing a blood draw, why are the veins of the antecubital fossa preferred over those located on the back of the hand or wrist?

The veins in the antecubital fossa are larger and do not cause as much patient discomfort

Point-of-Care Testing (POCT) instruments such as the HemoCue Plasma or Low Hemoglobin analyzer can detect free hemoglobin levels prior to autologous donation. A high free hemoglobin level indicates that:

There is a possibility of renal dysfunction if blood is reinfused

What is the purpose of wrapping a sample container in an absorbent material?

To absorb specimens in case of tube breakage

When using the syringe and needle technique to draw blood from a patient, why does the phlebotomist pull back on the plunger?

To create a vacuum in the syringe, which pulls blood in from the patient's vein

What is a stool sample useful for?

To detect gastrointestinal disorders

Why are blood culture tubes collected first?

To prevent contamination of the blood culture sample

Why is there an order of draw for blood collection tubes?

To prevent the additives of one tube from interfering with the blood in another tube

Which of the following is not a function of a sharps container?

To safely transport blood samples

Which of the following definitions correctly identifies the medial aspect of the body?

Toward the midline, or middle, of the body

How long after administering an oral glucose tolerance test must a patient's blood be drawn to determine glucose levels?

Two hours

What is the most common type of diabetes?

Type 2

All of the following are reasons why masks are valuable as a form of Personal Protective Equipment (PPE) except:

Typical masks can be worn indefinitely and with multiple patients

Which of the following is the first site a phlebotomist should look for a suitable vein for venipuncture?

Upper arm

Sputum samples are collected by coughing up phlegm and mucus from the:

Upper respiratory tract

What is the function of the gray top urine collection tube?

Urine cultures

What test result can be altered if there are bacteria in the urine?

Urine glucose levels

All of the following can cause hemolysis except:

Using a 20-gauge safety needle

Older fecal occult blood tests, also called guaiac stool tests, require what kind of diet for three days prior to specimen collection?

Vegetarian diet

In some cases, the phlebotomist may be called to assist other healthcare professionals with specimen collection. In a case where venous access is poor, the phlebotomist can collect a capillary specimen, except for:

Westergren Erythrocyte Sedimentation Rate (ESR)

To prepare a blood smear, what should the phlebotomist do after performing a capillary puncture?

Wipe away the first drop

How can a phlebotomist prevent a patient from vomiting if the patient reports nausea?

Apply cold compresses to the patient's forehead and place the patient in a position of comfort

How does aspirin affect bleeding time?

Aspirin prolongs bleeding time

Which of the following does not affect bleeding time?

Blood glucose levels

The speed and time of centrifugation are important specifications for each lab. Which setting would likely result in the best separation of serum from cells?

1,200 g for 10 minutes

How many milliliters are in one liter?

1000

A phlebotomy technician working in a critical care unit is using an i-STAT portable testing machine for a B-type Natriuretic Peptide (BNP) result. Which of the following is most critical to report immediately?

1000 pg/ml

The phlebotomist calculated the total blood volume of a 33.4 kg pediatric patient to be 2,672 mL. If the total amount of blood drawn during a hospitalization (up to 30 days) should not exceed 5% of total blood volume, what is the maximum amount of blood that can be collected from the patient?

133.6 mL

If the average blood volume for a geriatric client is 70 milliliters (mL) per kilogram (kg) of body weight, what is 2.5% of the total blood volume in a patient that weighs 212 pounds?

168.28 mL

What is the smallest gauge needle that can be used for blood donor unit collection?

18 gauge

How much time is allowable between inflation of the blood pressure cuff and incision during a bleeding time test?

30 seconds

What is the minimum amount of time any antiseptic should be in contact with the skin to consider it clean?

30 seconds

What temperature is considered appropriate for warm samples?

37 degrees Celcius

When collecting an arterial blood gas sample, at what angle should the needle be inserted into the skin?

45 degrees

What is the ideal temperature needed to preserve a urine sample?

5 degrees Celcius (41 F)

What strength of purified protein derivative (PPD) is injected under the skin to test for tuberculosis?

5-TU (toxin units)

To calculate total blood volume in an elderly patient at risk of iatrogenic anemia, which is the most appropriate conversion factor?

70 milliliters (mL) of blood per 1 kilogram (kg) of body weight

What is a typical length of time a patient is asked to fast before a blood test?

8-12 hours

Which of the following size needles is inappropriate for blood collection?

A 25-gauge needle

Blood donation centers follow guidelines for donor collection and patient safety that are set by:

AABB

Which of the following is not a common role of the phlebotomist?

Administering pain medications

A patient with active herpes zoster (shingles) infection and vesicular skin eruptions would most likely be on:

Airborne precautions

Which of the following patients is most at risk for an error in white blood cell (WBC) count?

An extremely anxious patient

If a needle and syringe are used when a blood culture test is ordered, which blood collection tube must be filled first?

Anaerobic bottle

How does posture affect blood pressure and blood volume?

As the patient stands from sitting or laying, blood pressure goes down, and blood volume goes up

Which of the following is the phlebotomist not required to report to their supervisor?

A patient compliment

When are fasting samples generally taken?

In the morning

What is needed in order for laboratories to release patient results to the patients themselves?

A signed release form

What additive(s) does the tan-top blood collection tube contain?

Dipotassium EDTA

Which of the following is not an indication for a nasopharyngeal swab?

Down syndrome

When does gestational diabetes typically occur?

During pregnancy

Anne is a phlebotomist who is employed by a visiting physician that makes house calls. Part of her job requires her to obtain blood samples at patient homes using lab-in-a-box kits. After preparing the specimens, what is the best way Anne can coordinate processing?

Call a lab courier with special training in specimen transport to pick up the lab box

Which of the following tests require warming after collection?

Cold agglutinins

In addition to ejaculation, what else should the phlebotomist ensure the male patient has not done three days prior to providing a fertility semen sample?

Consumed alcohol