Phlebotomy Chapter 12
This organization develops standards for specimen handling and processing a. CDC b. CLIA c. CLSI d. FDA
CLSI
What does the laboratory use to identify a specimen throughout the testing process? a. accession number b. hospital number c. LIS menu/icon d. mnemonic code
accession number
A separator gel prevents glycolysis a. after the specimen is centrifuged b. as soon as the specimen is collected c. in tubes for serum samples only d. when the specimen is thoroughly mixed
after the specimen is centrifuged
which of the following would be a pre analytical error related to specimen transport a. agitation-induced hemolysis b. contamination by dust c. incorrect collection tube d. strenuous, recent exercise
agitation induced hemolysis
Transferring specimens into aliquot tubes has inherent risks. Which of the following involves the least risk? a. aerosols created during transfer b. aliquot tubes that are pre-labeled c. serum and plasma's similar color d. specimens that are biohazardous
aliquot tubes that are pre-labeled
Repeated centrifugation of a specimen can a. alter test results b. deteriorate analytes c. cause hemolysis d. all the above
all the above
Special hand-held computer systems used in laboratory medicine are capable of a. displaying what tubes to collect b. generating labels c. reading barcodes d. all the above
all the above
Types of intrafacility specimen transport systems include a. pneumatic tube b. robot courier c. vertical track d. all the above
all the above
a strong computer password a. contains upper and lowercase letters b. has one or more special characters c. is easy to remember but hard to guess d. all the above
all the above
which of the following samples are time sensitive a. ESR determination in EDTA tubes b. PTT samples that have been opened c. RNA samples in PPT tubes d. all the above
all the above
It is unnecessary to protect this specimen from light a. ammonia b. bilirubin c. vitamin b2 d. vitamin c
ammonia
which specimen needs to be transported on ice a. ammonia b. bilirubin c. carotene d. potassium
ammonia
which of the following is least likely to take place in central processing or triage a. accessioning or logging b. analysis and reporting c. evaluation for suitability d. sorting by department
analysis and reporting
the CLSI quality management systems (QMS) documents use the term "examination" instead of a. analytical b. inspection c. measured d. processing
analytical
according to CLSI, when an uncentrifuged blood specimen is sent to the lab from a drawing station, the blood must a. arrive in a time limit that protects analyte stability b. be kept at body temperature c. have a clot activator added prior to transport d. remain refrigerated until arrival at the laboratory
arrive in a time limit that protects analyte stability
If a specimen has inadequate identification, the specimen processor may a. add the missing information to the label b. ask the phlebotomist to get a new sample c. contact the patient to get correct information d. refer the tube to the laboratory supervisor
ask the phlebotomist to get a new sample
which statement describes proper centrifuge operation a. balance specimens by placing tubes of equal fill and size opposite each other b. centrifuge serum specimens before they form clots c. never centrifuge serum and plasma in the same centrifuge d. remove the stoppers from evacuated tubes before placing them in the centrifuge
balance specimens by using tubes of equal fill and size
which of the following agencies sets guidelines for specimens transported by courier and other air or ground mail systems a. CLIA b. CMS c. FDA d. IATA
IATA
systems software includes a. coded instructions that control processing of data b. programs from software companies sold as a unit c. the central processing unit and all hardware additions d. word processing, spreadsheet, and graphic programs
coded instructions that control processing of data
A mnemonic is a
Memory aid
which of the following is the best way to prepare routine blood specimen tubes for transport to an off site lab a. place the tubes in ice slurry b. seal the tubes in biohazard bags c. wipe each tube with alcohol d. wrap the tubes in requisitions
seal the tubes in biohazard bags
A USB drive is a a. network connection device b. secondary storage device c. terminal linking device d. word processing device
secondary storage device
When a non-additive specimen is spun in a centrifuge, the substance that comes to the top is
serum
If a serum specimen is not completely clotted before it is centrifuged the a. buffy coat may not form properly b. red blood cells may hemolyze c. separator gel may come to the top d. serum may have fibrin clots in it
serum may have fibrin clots in it
which test specimen is negatively affected by transport in a pneumatic tube system a. alkaline phosphatase b. blood creatinine c. serum potassium d. total bilirubin
serum potassium
CLSI and OSHA guidelines do not require specimen transport bags to have: a. a visible biohazard logo b. liquid tight closure top c. shock resistance features d. slip pockets for paperwork
shock resistance features
A glucose specimen collected in a sodium fluoride tube is generally stable at room temperature for a. 6 hrs b. 12 hrs c. 24 hrs d. 48 hrs
24 hrs
which of the following is an acceptable temperature for a specimen that requires transport and handling at room temp a. -20 C b. 8 C c. 25 C d. 37 C
25 C
Minimum pre-centrifugation time for a specimen drawn in SST tube is a. 10 mins b. 15 mins c. 20 mins d. 30 mins
30 minutes
a specimen must be transported at or near normal body temperature. which of the following temperatures meets this requirement a. 25 C b. 37 C c. 50 C d. 98 C
37 C
ESR determinations on specimens held at room temperature must be made within a. 1 hr b. 4 hrs c. 12 hrs d. 24 hrs
4 hours
Glycolysis by the cells in blood specimens can falsely lower glucose values at a rate of up to: a. 1-3% per hour b. 3-5% per hour c. 4-6% per hour d. 5-7% per hour
5-7% per hour
which of the following doesn't need to be centrifuged a. BUN in a red/gray SST b. CBC in a lavender tube c. Potassium in a green tube d. PTT in a light blue tube
CBC in a lavender tube
A pneumatic tube is a A. Compressed air transport system B. Temporary computer data storage unit C. Tube connection between two computers D. Type of collection tube for blood gases
Compressed air transport system
central processors who send out specimens to another location must be certified by a. ASCP b. CLIA c. CLSI d. DOT
DOT
Computerized analyzers in the laboratory can read barcodes and ID patients if A. Barcode is anywhere on the specimen B. Label is placed horizontally on the tube C. Label is placed correctly on the tube D. Specimen is in the right evacuated tube
Label is placed correctly
which of the following tests on required 3-4 inversions of the tube a. CBC b. HbA1c c. PTT d. RBC
PTT
This is a permanent computer memory that instructs the computer to carry out user requested operations A. CPU B. LIS C. RAM D. ROM
ROM
which specimen has priority over all other specimens during processing and testing a. ASAP b. Timed c. STAT d. Fasting
STAT
A linear barcode is a A. Coded instruction needed to control computer hardware B. Confidential computer code required by HIPAA C. Series of bars and spaces representing numbers or letters D. Unique number given to each test request
Series of bars and spaces representing number or letters
random access memory (RAM) a. can be lost when the program is closed b. includes data, software, hardware, and peripherals c. instructs the computer to carry out user operations d. is permanent memory installed by manufacturers
can be lost when the computer program is closed
which of the following specimens are least likely to require special handling a. bilirubin b. cholesterol c. gastrin d. homocysteine
cholesterol
which of the following collection circumstances is least likely to delay clotting in a serum gel tube a. collection was difficult, hemolyzing RBC b. patient has elevated WBC count c. patient is taking anticoagulant medication d. specimen is chilled after collection
collection was difficult, hemolyzing RBC
Stoppers should be left on tubes awaiting centrifugation to prevent
contamination
Processing specimens requires various types of PPE, but this type is unnecessary a. covers for footwear b. disposable gloves c. fluid resistant apron d. protective goggles
covers for footwear
a bidirectional computer interface allows a. computer RAM storage capacity to double in size b. data to upload or download between two systems c. info to go from two analyzers to the LIS d. two persons to use a computer at the same time
data to upload or download between two systems
This is a source of preanalytical error that occurs before specimen collection a. dehydrated patient b. incorrect needle size c. mislabeled ETS tube d. wrong collection
dehydrated patient
tests performed on plasma samples are
drawn in anticoagulant tubes
In specimen handling it is very important to appreciate that a. effects of mishandling are not always obvious b. centrifuging specimens are considered to be error free c. most laboratory errors occur in the post analytical phase d. quality of results is not affected by collection procedure
effects of mishandling are not always obvious
rough handling is bad for specimens, but it will not a. activate platelets b. affect coagulation tests c. elevate WBC count d. hemolyze RBC
elevate WBC count
which of the following would be described as "logging on" a. accessing the internet b. entering a password to access the LIS c. turning the terminal to "on" d. using menus to navigate the program
entering a password to access the LIS
which of the following would be a pre analytical error related to storage a. exposure to light b. faulty technique c. inadequate fasting d. underfilled tube
exposure to light
this is an exmaple of a pre analytical error made at the time of collection a. delay in transporting b. failing to mix tubes c. incomplete requisition d. waiting to centrifuge
failing to mix tubes
which of the following is unaffected by hemolysis a. amylase b. hemoglobin c. magnesium d. potassium
hemoglobin
The Cobas, an automated chemistry instrument, is temporarily inoperable because of a serum sample. What could be the cause? a. fibrin clot in the SST b. hemolysis in the PST c. lipemia in a SST d. microclot in an EDTA
fibrin clot in the SST
cellular metabolism in specimens that have not been separated will affect which analyte a. amylase b. glucose c. hemoglobin d. triglycerides
glucose
a specimen processor delivers several specimens to a testing area and places them on a device rotating back and forth, the department is most likely a. chemistry b. coagulation c. hematology d. microbiology
hematology
which of the following describes proper aliquot preparation a. immediately covering aliquot tubes after transferring b. labeling tubes after pipetting the sample c. pouring plasma from different additive tubes into one aliquot tube d. pouring samples into aliquot tubes instead of using transfer pipettes
immediately covering aliquot tubes after transferring the specimen
How should a cryofibrinogen specimen be transported? a. at room temperature b. immersed in ice slurry c. in a 37 C heat block d. protected from light
in 37 C heat block
an example of a pre analytical error happening during specimen processing is a. faulty collection technique b. inadequate centrifugation c. insufficient specimen d. patient stress and anxiety
inadequate centrifugation
interface means a. checking quality control results on instrumentation b. entering data into a lab info system c. interacting through the connection of computers d. standardizing all lab ordering and testing
interacting through the connection of computers
a computer terminal is a
keyboard and computer screen workstation
according to CLSI there is a two hour time limit for separating serum and plasma from cells for which test a. lactic acid b. creatinine c. total bilirubin d. troponin T
lactic acid
to process input data, a computer user must a. log off the web b. move the cursor c. press the enter key d. select an icon
press the enter key
in computer language, a hard copy is
processed data printed on paper
it is unlikely that removing the stopper from a specimen will cause a. contamination b. evaporation c. increase in pH d. loss of iCa2+
loss of iCa2+
Transporting blood specimens with the stopper up has nothing to do with a. encouraging complete clot formation b. maintaining sterility of sample c. minimizing stopper caused aerosols d. reducing hemolysis
maintaining sterility of sample
you have a STAT specimen in PST that needs to be centrifuged. No other specimens are ready. what do you do? a. balance with a serum specimen that is almost clotted b. centrifuge it by itself c. make a water balance of the same size and fill level d. wait until another specimen is ready
make a water balance
The number of tube inversions required during specimen collection depends on a. how difficult it is to draw the blood b. manufacturer recommended inversions c. the amount of blood in the ETS d. which needle gauge was used for collection
manufacturer recommended inversions
RFID, as used in health care, is a/an a. abbreviation for a disinfectant b. LIS mnemonic for a chemistry test c. method of specimen identification d. a new fire extinguisher safety code
method of specimen ID
Inadequate mixing of an anticoagulant tube can lead to a. hemolysis b. lipemia c. microclots d. sample clotting too fast
microclots
Computer verification of test orders is best described as a process that allows a user to a. access the system to view patient diagnosis b. confirm that the test was ordered by a physician c. establish that the appropriate test was ordered d. modify, delete, or accept test orders after review of data
modify, delete, or accept test orders after review of data
this is the term for a group of computers linked together for the purpose of sharing information a. junction b. network c. node unit d. terminal
network
the most probable reason a phlebotomist would wrap a specimen in aluminum foil would be to: a. cool the specimen b. cover a contaminated tube c. maintain a 37 C temperature d. protect it from room light
protect it from room light
according to CLSI, which tubes should be placed upright as soon as they are mixed a. gel tubes with anticoagulant b. light green gel barrier tubes c. light blue coagulation tubes d. non anti coagulant tubes
non anticoagulant tubes
This specimen would most likely be accepted for testing despite this problem a. expired tube b. incomplete ID c. not initialed by phlebotomist d. quantity not sufficient
not initialed
critical potentially life threatening values are also called a. alarm values b. at risk values c. panic values d. unstable values
panic values
which of the following actions will compromise the quality of the specimen a. drawing a BUN in an amber serum tube b. mixing an SST by inverting 5 times c. partially filling a tube for a platelet count d. transporting cryofibrinogen at 37 C
partially filling a tube for a platelet count
which of the following is confidential and unique to a single user a. entry icon b. ID code c. LIS menu d. password
password
When using computer-generated specimen labels, what information must typically be added to the label after a specimen is collected? a. medical record number b. patient complete name c. patient DOB d. phlebotomist initials
phlebotomist initials
Which of the following methods should be used to prevent exposure to aerosols generated when transferring plasma or serum to the aliquot tube a. pipetting liquid to the secondary tube held behind a shield b. pouring the serum from the primary tube to the aliquot tube c. withdrawing the specimen through the stopper by syringe d. all the above
pipetting liquid to the secondary tube held behind a shield
an aliquot is a
portion of a specimen being tested
Chilling can cause erroneous results for this analyte a. ammonia b. glucagon c. lactic acid d. potassium
potassium
results for this test should be normal despite a delay in processing lasting longer than 2 hours a. carbon dioxide b. fasting glucose c. ionized calcium d. pregnancy test
pregnancy test
Which of the following is not a valid reason for why blood slides made from EDTA specimens must be prepared within 1 hour of collection a. ensure they are made before clots appear b. minimize RBC distortion on the smear c. preserve the integrity of blood cells d. prevent artifact formation from additive
preserve the integrity of blood cells
which specimen is likely to be rejected if the tube is not filled until the vacuum is exhausted a. CBC b. plasma electrolytes c. postprandial glucose d. prothrombin time
prothrombin time
which of the following is a function of a computer monitor a. instructs the computer to carry out user requested operations b. manages the processing and completion of user required tasks c. performs mathematical processes and comparisons of data d. provides visible display of info being processed
provides visible display of info being processed
which gel tube does not require mixing a. clot activator b. gel separator c. liquid EDTA d. red/light gray
red/light gray
chemistry tests are often collected in heparin tubes to a. ensure adequate coagulation b. maximize diagnosis potential c. minimize hemolysis d. reduce turnaround time
reduce turnaround time
You are the only phlebotomist in an outpatient drawing station. A physician orders a test with which you are not familiar. What is the appropriate action to take? a. call the office for assistance b. draw both a serum and plasma specimen c. refer to the user manual for instructions d. send the patient to another drawing station
refer to the user manual for instructions
to avoid airborne infection while processing a. apply the brake when stopping centrifuge b. pop tube stoppers when opening serum tubes c. pour specimens directly into aliquot tubes d. remove tube stoppers behind splash shield
remove tube stoppers behind splash shield
the "order inquiry" function allows the user to a. check physician's diagnosis b. edit or delete duplicate orders c. find errors in patient ID d. retrieve all test orders on a patient
retrieve all test orders on a patient
Data can be entered or input into a computer from a. applications b. modems c. printers d. scanners
scanners
some blood specimens require cooling to a. avoid hemolysis b. prevent clotting c. promote serum separation d. slow metabolic processes
slow metabolic processes
it is important to note the type of heparin in a tube because a. a few types do not require inversion b. not all types of heparin prevent complete coagulation c. some types of heparin can affect certain results d. some types of heparin make centrifugation unnecessary
some types of heparin affect certain results
The laboratory has a computerized laboratory information system (LIS). Once an inpatient specimen has been collected by a phlebotomist and returned to the laboratory, what occurs next? a. a collection list is generated b. all lab test orders are retrieved c. collection labels are printed d. specimen collection is verified
specimen collection is verified
which of the following specimens is unlikely to be rejected for analysis a. electrolytes that are hemolyzed b. fasting glucose that is lipemic c. platelet count with microclots d. total bilirubin that is icteric
total bilirubin that is icteric
the best way to chill a specimen is to a. cool the tube before venipuncture b. place it in a chilled canister c. put it in a small container of ice cubes d. transport in a commercial cooling tray
transport in a commercial cooling tray
To be considered computer literate, an individual must be able to a. explain how POCT instruments are connected to the LIS b. design programs for job specific problems in your area c. perform daily QA documentation in database softwarae d. understand the computer and the functions it performs
understand the computer and the functions it performs
Proper specimen handling begins a. as soon as the specimen is collected b. during specimen collection procedure c. in the course of patient ID d. when the physician orders the test
when the physician orders the test