Phlebotomy CH 7 - 11 Study Questions
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
