Deck 17: Phlebotomy

Question 1

All of the following are guidelines that should be followed when assembling equipment and supplies for a venipuncture except:

A) Check each blood tube for damage.
B) Do not substitute one blood tube for another.
C) Check the expiration date of the blood tubes.
D) Label each blood tube with one unique patient identifier.

Answer 1

Label each blood tube with one unique patient identifier.

Question 2

Which of the following are characteristics of the brachial artery (located in the antecubital space)?

A) Pulsates when palpated
B) Has a more elastic and thicker wall than a vein
C) If punctured,blood is bright red in color
D) If punctured,patient feels more than usual amount of pain
E) All of the above

Answer 2

All of the above

Question 3

The purpose of applying a tourniquet when performing venipuncture is to

A) make the patient's veins more visible and easier to palpate.
B) prevent hemolysis of the blood specimen.
C) make the procedure more comfortable for the patient.
D) make it easier to insert the needle.

Answer 3

make the patient's veins more visible and easier to palpate.

Question 4

When performing a venipuncture,which of the following techniques represents a violation of the OSHA standard?

A) Applying the tourniquet 1 inch above the bend in the elbow
B) Using a small-gauge needle to collect the specimen
C) Not labeling the blood tube
D) Removing the plastic holder from the needle for reuse

Question 5

How is serum obtained?

A) From whole blood that has been centrifuged
B) By using a tube containing an anticoagulant
C) From clotted blood that has been centrifuged
D) From whole blood that has been left standing

Question 6

Why should the veins of the hands be used as a venipuncture site only as a last resort?

A) They have a tendency to roll.
B) They are more difficult to stick.
C) The procedure is more uncomfortable for the patient.
D) The hand veins are more susceptible to collapsing.
E) All of the above

Question 7

An individual who collects blood specimens is known as a(n)

A) vampire.
B) venipuncturist.
C) optometrist.
D) phlebotomist.

Question 8

Which of the following may occur if a tourniquet is applied too tightly?

A) It may be uncomfortable for the patient.
B) Inaccurate test results may occur.
C) The arterial blood flow may be obstructed.
D) The venous blood flow may be obstructed.
E) All of the above

Question 9

Which of the following antecubital veins is considered the best vein to use for a venipuncture?

A) Basilic vein
B) Cephalic vein
C) Brachial vein
D) Median cubital vein

Question 10

On standing,a blood specimen to which an anticoagulant has not been added separates into

A) plasma and blood cells.
B) serum and blood cells.
C) plasma,buffy coat,and blood cells.
D) serum,buffy coat,and blood cells.

Question 11

When collecting a venous blood specimen to be transported to an outside laboratory for testing,which of the following should be consulted for information on collecting and handling requirements?

A) Laboratory directory
B) Manufacturer's instructions of the test system
C) Physicians' Desk Reference
D) Medical dictionary

Question 12

Which of the following is the proper method for identifying a patient before performing a venipuncture?

A) State the patient's full name and DOB and ask the patient to verify this information.
B) Ask the patient to state his or her full name and date of last visit.
C) Ask the patient to state his or her full name and DOB.
D) Ask the patient for two forms of written identification.

Question 13

Which of the following represents an error in technique when selecting a vein for venipuncture?

A) Examining the antecubital veins of both arms
B) Using the thumb to palpate the vein
C) Determining the size and depth of the vein
D) Tracing the path of the vein

Question 14

What position should be used for a venipuncture if a patient appears nervous or has fainted in the past from a venipuncture?

A) Semi-Fowler
B) Prone
C) Sims
D) Sitting

Question 15

Whole blood is obtained by

A) using a tube containing an anticoagulant.
B) centrifuging a clotted blood specimen.
C) using a red-stoppered tube.
D) using a tube that does not contain an anticoagulant.

Question 16

Phlebotomy includes which of the following?

A) Skin punctures
B) Arterial punctures
C) Venipunctures
D) All of the above

Question 17

On standing,a blood specimen to which an anticoagulant has been added separates into

A) plasma and blood cells.
B) serum and blood cells.
C) plasma,buffy coat,and blood cells.
D) serum,buffy coat,and blood cells.

Question 18

You need to collect a venous blood specimen from a patient to run an FBG.Which of the following would be an inappropriate statement to make to the patient during this procedure?

A) "Which arm was used in the past to draw blood from you?"
B) "Please do not move during this procedure."
C) "This procedure will not hurt."
D) "When did you last eat or drink?"

Question 19

When collecting a blood specimen using the vacuum tube method of venipuncture,venous reflux is prevented by

A) Keeping the patient's arm in a downward position
B) Inserting the needle at a 15-degree angle to the patient's arm
C) Filling the evacuated tube to the exhaustion of the vacuum
D) Removing the tourniquet before withdrawing the needle from the patient's arm

Question 20

All of the following are correct techniques for applying a tourniquet except:

A) Placing the tourniquet 3-4 inches above the bend in the elbow
B) Asking the patient to clench his or her fist
C) Applying the tourniquet so that it is snug,but not tight
D) Leaving the tourniquet on for at least 3 minutes before drawing the specimen

Question 21

Which of the following is another name for the butterfly method of venipuncture?

A) Winged infusion method
B) Syringe method
C) Luer adapter method
D) Z-track method

Question 22

What may occur if an angle of less than 15 degrees is used to perform the venipuncture?

A) The needle may enter the skin above the vein and not puncture it.
B) The needle may go completely through the vein.
C) The vein may collapse.
D) The needle may penetrate a tendon.

Question 23

Which of the following results in patient discomfort during the venipuncture procedure?

A) Allowing the alcohol to dry before making the puncture
B) Moving the needle after it has been inserted into the vein
C) Using the flange to change from one tube to another
D) Removing the needle at the same angle as insertion

Question 24

Which of the following should be performed if an evacuated tube contains a clot activator?

A) Push the posterior needle through the tube stopper before puncturing the vein.
B) Fill the tube only half-full with blood.
C) Gently invert the tube five times after drawing it.
D) Centrifuge the tube immediately after drawing it.

Question 25

The size of the evacuated tube you choose to obtain a venous blood specimen depends on the

A) size of the patient's veins.
B) patient's clinical diagnosis.
C) color of the evacuated tube stopper.
D) amount of specimen required for the test.

Question 26

On palpation,a scarred vein feels

A) elastic and pliable.
B) stiff and hard.
C) soft and pliable.
D) swollen.

Question 27

What may occur if an outdated evacuated tube is used to collect the blood specimen?

A) The specimen may become hemolyzed.
B) The tube may crack.
C) The tube may no longer have a vacuum.
D) The test results may be inaccurate.

Question 28

An evacuated tube with a red stopper contains

A) heparin.
B) EDTA.
C) nothing.
D) potassium oxalate.
E) sodium citrate.

Question 29

During the venipuncture procedure,a sudden swelling occurs in the area around the puncture site.You should

A) apply pressure to the area with an antiseptic wipe.
B) continue with the venipuncture.
C) immediately remove the tourniquet and then the needle.
D) call 911.

Question 30

Which of the following techniques can be used to prevent a vein from rolling?

A) Applying firm pressure below and to the side of the vein
B) Applying the tourniquet tightly
C) Inserting the needle at a 10-degree angle
D) Inserting the needle {1/2} inch below the puncture site

Question 31

Which of the following should not be used as a venipuncture site?

A) Scarred skin
B) Bruised skin
C) An area that is painful to the patient
D) Burned skin
E) All of the above

Question 32

Which of the following indicates the correct order of draw for the vacuum tube method of venipuncture?

A) Red,green,lavender,gray
B) Red,lavender,gray,green
C) Lavender,red,gray,green
D) Red,gray,lavender,green

Question 33

An evacuated tube with a lavender stopper contains

A) heparin.
B) EDTA.
C) nothing.
D) potassium oxalate.
E) sodium citrate.

Question 34

Which of the following represents an error in technique when working with evacuated tubes?

A) Using a computer bar code label to identify the tube
B) Filling tubes to the exhaustion of the vacuum
C) Shaking a tube containing an anticoagulant after drawing it
D) Removing the last tube from the plastic holder before removing the needle

Question 35

What color stopper tube is used to collect a blood specimen for a prothrombin time test?

A) Red
B) Lavender
C) Gray
D) Green
E) Light blue

Question 36

All of the following tubes can be used to collect serum except:

A) Lavender-stoppered
B) Red/gray-stoppered SST
C) Gold-stoppered Hemogard SST
D) Red-stoppered

Question 37

If you think a vein selected for venipuncture may collapse,you should

A) use an 18-gauge needle to collect the specimen.
B) use the butterfly method to perform the venipuncture.
C) fill the tube only one-half full with blood.
D) insert the needle slowly into the vein.

Question 38

Which of the following gauge needles is used most often to perform a routine venipuncture using the vacuum tube method?

A) 16 G
B) 18 G
C) 21 G
D) 25 G

Question 39

Which of the following veins is most likely to collapse when performing a venipuncture?

A) Veins that roll
B) Scarred veins
C) Sclerosed veins
D) Small veins

Question 40

What color stopper tube is used to collect a blood specimen for a complete blood cell count (CBC)?

A) Red
B) Lavender
C) Gray
D) Green
E) Light blue

Question 41

Which of the following is found in the serum of blood?

A) Glucose
B) Hormones
C) Chloride
D) Antibodies
E) All of the above

Question 42

Which of the following may result in hemolysis of the blood specimen?

A) Storing evacuated tubes at room temperature
B) Using a needle with a small lumen to collect the specimen
C) Allowing the evacuated tube to fill to the exhaustion of the vacuum
D) Removing the needle before removing the tourniquet
E) All of the above

Question 43

Which of the following represents an error in technique when obtaining a capillary blood specimen?

A) Warming the patient's finger by massaging it
B) Allowing the antiseptic to dry before making the puncture
C) Making the puncture perpendicular to the lines of the fingerprint
D) Using the first drop of blood for the test

Question 44

Which of the following sites can be used to make a skin puncture on an adult?

A) Earlobe
B) Lateral part of the index fingertip
C) Tip of the little finger
D) Lateral part of the third fingertip

Question 45

What may occur if a finger puncture is made that is deeper than 3.1 mm?

A) Damage to nerves in the finger
B) Penetration of the bone
C) Inaccurate test results
D) Excessive bleeding

Question 46

Hemolysis of a blood specimen results in

A) collection of an insufficient quantity of blood.
B) inaccurate test results.
C) a contaminated specimen.
D) exposure of the medical assistant to bloodborne pathogens.

Question 47

What may occur if the needle is removed from the arm before removing the tourniquet?

A) The patient may experience pain.
B) The blood specimen may become hemolyzed.
C) Bleeding may occur around the puncture site.
D) The evacuated tube may not fill completely.
E) All of the above.

Question 48

When performing a capillary puncture,the finger should not be squeezed,to avoid

A) diluting the blood sample with tissue fluid.
B) excessive bleeding around the puncture site.
C) exposure of the medical assistant to bloodborne pathogens.
D) bruising of the patient's finger.

Question 49

After drawing a blood specimen for an electrolyte profile,the next step is to

A) centrifuge the specimen for 10 minutes.
B) allow the specimen to stand in an upright position for 30-45 minutes.
C) pipet the serum and place it in a transfer tube.
D) place the tube in the refrigerator.

Question 50

You are performing a venipuncture,and the patient becomes dizzy and is about to faint.Your first priority in this situation should be to

A) protect the patient from injury.
B) place the patient in a reclining position.
C) protect the blood specimen from hemolysis.
D) obtain the patient's consent for treatment.

Question 51

If a fibrin clot formed in the serum layer of a blood specimen,it would

A) interfere with adequate serum collection.
B) result in hemolysis of the blood cells.
C) cause evaporation of the serum.
D) lead to inaccurate test results.

Question 52

Your provider has requested an electrolyte profile on a patient.The laboratory directory indicates this test requires 4 mL of serum.Which of the following tubes should be used to collect the specimen?

A) A 4-mL SST
B) A 7-mL SST
C) A 10-mL SST
D) A 4-mL lavender-stoppered tube
E) A 7-mL lavender-stoppered tube