Deck 9: Considerations and Complications of Phlebotomy

Question 1

Which of the following complications is caused by insufficient blood flow to the brain?

A) Seizure
B) Hematoma
C) Syncope
D) Petechiae

Answer 1

C

Question 2

Fainting may be caused by hypovolemia in which of these situations?

A) Routine blood collection for laboratory testing
B) Blood donation collection
C) Both a and b
D) None of the above

Answer 2

B

Question 3

This complication is seen as small red dots near the phlebotomy site that indicate the patient may have a tendency for prolonged bleeding following the procedure.

A) petechiae
B) edema
C) syncope
D) hematoma

Answer 3

A

Question 4

Which of the following demonstrates correct procedure when finding a patient absent when entering the room for venipuncture specimen collection?

A) Return to the lab and report that the patient was not available.
B) Attempt to locate the patient by asking the charge nurse.
C) Inform the patient's nurse of the inability to collect the specimen.
D) All of the above are correct.

Question 5

This common complication occurs when the needle is improperly placed in a vein,and the blood is allowed to escape from the vein and collect under the skin.

A) Seizure
B) Hematoma
C) Syncope
D) Petechiae

Question 6

Which of the following should not be a cause of inability to obtain blood? The:

A) needle has penetrated all the way through the vein
B) needle is centered in the lumen of the vein
C) needle is only partially inserted into the vein
D) tube has lost its vacuum

Question 7

A short draw in a blue-top anticoagulated tube could lead to which of the following?

A) Patient must be drawn
B) Inaccurate test results
C) Specimen rejected by laboratory
D) All of the above

Question 8

Which of the following is not correct in regards to drawing from a damaged or scarred vein?

A) Blood may be difficult to obtain
B) Venipuncture in this area can be painful to the patient
C) A larger needle may be necessary to obtain an adequate specimen
D) An alternate collection site should be selected

Question 9

Which of the following is not a possible reason for short draw?

A) Needle bevel against vein wall
B) Collapsed vessel
C) Syringe plunger withdrawn slowly
D) Needle not inserted far enough

Question 10

What does a sclerosed or scarred vein feel like?

A) Hard and cordlike
B) Resilient
C) It pulsates
D) Soft and mushy

Question 11

The best way to avoid potential patient complications is to:

A) lay every patient down
B) ask the patient's venipuncture history
C) have ammonia salts ready
D) draw the blood specimen while the patient is sleeping

Question 12

If a patient is sleeping when the phlebotomist enters the room,the proper procedure is to:

A) Gently wake the patient and begin the venipuncture
B) Perform the venipuncture quietly so as not to wake the patient
C) Come back when the patient wakes up
D) Leave a note for the doctor that the patient was asleep and blood could not be collected

Question 13

Which of the following patient types could be uncooperative?

A) Normal adult patients
B) Pediatric patients
C) Patients with mental dysfunction
D) All of the above

Question 14

Which of the following should not be done when a patient is coherent but refuses to allow a blood specimen to be collected?

A) Attempt to persuade the patient to cooperate with blood collection.
B) Explain to the patient that the physician has ordered the blood test and needs the results to provide proper medical care.
C) Enlist the assistance of other medical staff to restrain the patient until the specimen is collected.
D) Ask the patient's nurse to help convince the patient to cooperate.

Question 15

The most common complication from a venipuncture is:

A) hematoma
B) petechiae
C) seizures
D) syncope

Question 16

Which of the following is least likely to result in hematoma formation when collecting a specimen by venipuncture?

A) Inadequate pressure is applied to the site after needle withdrawal
B) The needle has penetrated through the back of the vein
C) The needle bevel is centered in the lumen of the vein
D) The needle bevel is only partly inserted in the vein

Question 17

If during venipuncture the phlebotomist notices swelling around the venipuncture site while the needle is still inserted,the proper procedure is to:

A) remove the needle and discontinue the venipuncture
B) continue venipuncture if collecting less than two additional tubes
C) contact the patient's nurse or physician immediately
D) call a code

Question 18

Which of the following is not proper procedure for collecting blood from a patient with a running IV?

A) Draw blood from below the IV insertion site.
B) If blood is drawn above the IV site,the IV should be turned off by nursing personnel before collection,and it should be noted on the label.
C) If blood is drawn above the IV site,the IV should be turned off by the phlebotomist and turned back on immediately after completion of the blood draw.
D) Draw blood from an arm that does not have an IV insertion site.

Question 19

Edematous areas should be avoided for venipuncture because:

A) It may be difficult to locate a vein because of the swelling of tissue surrounding the vein.
B) The specimen collected from the site may be contaminated with tissue fluid and therefore diluted.
C) Both a and b
D) None of the above

Question 20

The proper procedure to follow when a patient faints during the phlebotomy procedure includes all of the following,except:

A) Immediately stopping the procedure
B) Finishing the procedure while holding the patient to keep him or her from falling
C) Calling for assistance
D) Provide immediate relief for the patient,including lowering his or her head and applying cold compresses

Question 21

Which of the following is least likely to cause hemolysis of a specimen?

A) Collecting more than one tube of blood
B) Mixing tubes too vigorously
C) Pulling blood into a syringe too quickly
D) Using a needle with too small a bore

Question 22

Which of the following will be true if an unintentional arterial puncture occurs during a routine phlebotomy procedure?

A) The blood would be bright red and appear to "pulse" into the collection tube.
B) The procedure should be immediately stopped.
C) Extra pressure should be applied to the puncture site to prevent bleeding.
D) All of the above.

Question 23

A faulty collection tube with poor vacuum may result in which of the following?

A) Hematoma
B) Scarring
C) Short draw
D) Syncope

Question 24

The phlebotomist must never do which of the following when dealing with a convulsing patient?

A) Protect the patient's head
B) Move anything that could be harmful to the patient
C) Leave the patient
D) Discontinue venipuncture

Question 25

If the patient complains of shooting pain during phlebotomy,the phlebotomist should:

A) discontinue venipuncture immediately
B) continue venipuncture if pain subsides in time
C) continue probing for a better location
D) redirect the needle to attempt to relieve the patient

Question 26

Which of the following would not cause hemolysis?

A) Withdrawing blood too quickly when using a syringe
B) Forcing blood into tube from a syringe through a needle by pushing on the plunger quickly
C) Pediatric venipuncture
D) Vigorously shaking the tube of blood

Question 27

Which of the following is true regarding labeling of blood specimens?

A) Tube should be labeled carefully after blood collection following proper institution protocol.
B) A mislabeled specimen will result in the need to collect a new specimen.
C) A mislabeled specimen could result in serious medal complications for the patient.
D) All of the above.

Question 28

Which of the following could not cause a clot to form in an anticoagulated tube?

A) Inversion of the anticoagulated tube 10 times immediately following collection
B) Blood expelled slowly from a syringe draw into an evacuated tube
C) Anticoagulant inactive or not present in proper quantity
D) Anticoagulated tube out of date

Question 29

Prolonged tourniquet application may cause a change in blood composition primarily because of:

A) hemoconcentration
B) hemolysis
C) hemoglobin
D) homeostasis

Question 30

Advancing the stopper of a vacuum tube past the mark on the needle adaptor while assembling the equipment will:

A) cause a loss of vacuum
B) produce a more stable collection assembly
C) ensure that the evacuated tube is working properly
D) result in hemolysis

Question 31

The serum or plasma of a hemolyzed specimen would appear:

A) clear yellow
B) cloudy
C) dark yellow
D) pink or reddish

Question 32

Hemolysis can be defined as:

A) destruction of white blood cells
B) discoloration of plasma
C) destruction of red blood cells
D) discoloration of serum