Deck 9: Blood Specimen Handling

Question 1

__________are designed to spin blood specimens down, separating the cells from the liquid portion.

A) Robotic specimen delivery systems
B) Large and small centrifuges
C) Pneumatic tube system
D) Conveyer belt system

Answer 1

Large and small centrifuges

Question 2

Separation of blood specimens involves (check all that apply)

A) aliquoting
B) centrifuging
C) pipetting
D) labeling
E) All of the above

Answer 2

All of the above

Question 3

Which blood tests is LEAST affected by a delay of more than two hours prior to testing?

A) cell counts
B) coagulation tests
C) enzyme tests
D) glucose

Answer 3

cell counts

Question 4

Use of the pneumatic tube system (check all that apply)
i. is not allowed for transport of laboratory specimens.
ii. may agitate specimens and cause hemolysis.
iii. allows for quick delivery of specimens to the laboratory.
iv. must be validated prior to use for patient specimen delivery.

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 5

Reasons to use a pneumatic tube system for delivery of laboratory specimens include:
i. when test results are required STAT.
ii. when specimens need to be processed soon after collection.
iii. keeping the phlebotomist out of the laboratory.
iv. sending specimens to other facilities.

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 6

If a specimen requires separation, CLSI standards recommend doing so within:

A) one hour
B) two hours
C) three hours
D) four hours

Question 7

A laboratory courier is picking up specimens from a client after business hours. Which image represents the specimen storage container that he would look for?

A) Image A
B) Image B
C) Image C
D) Image D

Question 8

-A laboratory courier is picking up specimens from a client after business hours. Which image represents the container he would use to transport specimens?

A) Image A
B) Image B
C) Image C
D) Image D

Question 9

-A phlebotomist is working in a hospital setting. Which image represents how the phlebotomist transports specimens to the laboratory? (check all that apply)

A) Image A
B) Image B
C) Image C
D) Image D
E) All of the above

Question 10

A reference laboratory is a laboratory
i. that may offer tests that the local hospital does not perform
ii. is usually used for stat testing only
iii. may be located at another hospital
iv. may be a commercially run laboratory

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 11

Laboratory personnel reject specimens because they

A) do not want to do the test.
B) want to ensure quality results.
C) have no concern for patient complaints.
D) are trying to create more work for the phlebotomist

Question 12

A patient may NOT refuse a blood collection for alcohol or drugs: (check all that apply).

A) under any circumstances
B) when the doctor insists on the tests
C) if it is obvious that he/she is drunk and cannot make a competent decision
D) when there is a court order negating the patient's right of refusal

Question 13

In addition to date and time, chain-of-custody documents include: (check all that apply)
i. Name of patient
ii. Name of phlebotomist
iii. Type of specimen
iv. Where specimen was collected

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 14

Therapeutic drug monitoring is performed to

A) establish correct dosage.
B) see if the patient is compliant.
C) provide evidence in a court of law.
D) detect drug interactions.

Question 15

How does blood collection for blood alcohol testing differ from routine draws?

A) A sterile technique is used instead of an aseptic technique.
B) No iodine or alcohol is used for skin preparation.
C) No touriquet is used for blood alcohol specimens.
D) The patient must always be fasting.

Question 16

Specimens for forensic studies require the use of

A) a no-tourniquet draw procedure.
B) standard specimen handling.
C) chain-of-custody forms.
D) sterile gloves to avoid contamination.

Question 17

A blood collection for alcohol includes using the following as a disinfectant (check all that apply)
i. alcohol prep pad
ii. green surgical soap
iii. iodine swabs
iv. hydrogen peroxide

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 18

When shipping a specimen to a reference laboratory, which container should be wrapped in an absorbent material?

A) primary
B) secondary
C) shipping

Question 19

When shipping a specimen to a reference laboratory, which container should hold a cooling pack or dry ice?

A) primary
B) secondary
C) shipping

Question 20

When shipping a specimen to a reference laboratory, which container should have accompanying paperwork attached? (check all that apply)

A) primary
B) secondary
C) shipping

Question 21

When shipping a specimen to a reference laboratory, which container should have specimen identification attached? (check all that apply)
i. primary
ii. secondary
iii. shipping

A) i and ii
B) i and iii
C) ii and iii

Question 22

Which of the following containers is an acceptable shipping container? (check all that apply)
i. ziploc plastic bag
ii. wooden crate
iii. fiberboard box
iv. cardboard mailing tube

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 23

Which of the following containers is an acceptable secondary container for shipping patient specimens? (check all that apply)
i. Ziploc plastic bag
ii. screw-top plastic canister
iii. plastic container sealed with tape
iv. cardboard mailing tube

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 24

Which of the following containers is an acceptable primary container for shipping patient specimens? (check all that apply)
i. original glass evacuated tube
ii. screw-top plastic transfer tube
iii. original plastic evacuated tube
iv. screw-top glass transfer tube

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 25

Special specimen handling is required for specimens that (check all that apply)
i. are routine blood collections
ii. need to be cooled upon collection
iii. need to be warmed upon collection
iv. need to be light protected upon collection

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 26

Any specimen that is not handled properly, such as cooling, warming, or protecting from light, may result in erroneous test results due to variables at which phase of laboratory testing?

A) Evaluation
B) Pre-evaluation
C) Post-evaluation
D) All phases of testing

Question 27

For which of the following tests should specimens be placed in ice water upon collection?

A) Acid phosphatase
B) Ammonia
C) Bilirubin
D) Cold agglutinins

Question 28

For which of the following tests should specimens be placed in a body temperature heater upon collection?

A) Alcohol
B) Ammonia
C) Blood gasses
D) Cold agglutinins

Question 29

What special handling is needed when collecting specimens for blood alcohol levels?

A) collecting the specimen in an amber microcollection container
B) wrapping the specimen tube with foil
C) collecting the specimen without the use of alcohol
D) placing the specimen on ice

Question 30

What special handling is needed when collecting specimens for blood lactic acid levels?
i. placing the specimen in a heel warmer
ii. wrapping the specimen tube with foil
iii. collecting the specimen without the use of a tourniquet
iv. placing the specimen on ice

A) i and ii
B) iii and iv
C) i and iii
D) ii and iii

Question 31

Blood specimens for the testing of what Vitamin levels must be protected from light? (check all that apply)
i. Vitamin A
ii. Vitamin B₆
Iii. Vitamin D
iv. Beta-Carotene

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 32

Which image represents the proper handling of specimens for cold agglutinins? (check all that apply)

A) Images A, B
B) Images B, D
C) Images A, C
D) Images D, A

Question 33

Which image represents the proper handling of specimens for bilirubin testing? (check all that apply)

A) Images C, B
B) Images B, D
C) Images A, C
D) Images A, D

Question 34

Which image represents the proper handling of specimens for blood gasses? (check all that apply)

A) Image A
B) Image B
C) Image C
D) Image D

Question 35

Which image represents the function of a laboratory courier?

A) Image A
B) Image B
C) Image C
D) Image D

Question 36

A phlebotomist is in the process of completing documentation for a legal specimen she collected. Before a courier can pick up the specimen, the phlebotomist must leave to collect a STAT draw. When the phlebotomist returns, she discovers that the courier had come and taken the specimen to the reference laboratory. The results obtained were not able to be used in court. What might have contributed to this rejection? (check all that apply)

A) The chain of custody was not followed.
B) The specimen was not kept at the correct temperature.
C) The specimen may not have been protected from light.
D) It took too long to get the specimen to the reference laboratory.

Question 37

A phlebotomist is in the process of completing documentation for a legal specimen she collected. Before a courier can pick up the specimen, the phlebotomist must leave to collect a STAT draw. When the phlebotomist returns, she discovers that the courier had come and taken the specimen to the reference laboratory. The results obtained were not able to be used in court. What should the phlebotomist have done? (check all that apply)
i. The phlebotomist should have asked another phlebotomist to collect the STAT.
ii. The phlebotomist should have placed the specimen in a locked box until she returned.
iii. The phlebotomist should have signed the chain of custody form over to another person.
iv. The phlebotomist should not have begun processing the specimen.

A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv

Question 38

Most laboratory specimens that need separation are centrifuged for:

A) one minute
B) 15 minutes
C) 30 minutes
D) one hour

Question 39

You are assigned to process blood and have one tube that needs to be centrifuged. What is your course of action?

A) Centrifuge the one tube.
B) Wait for another tube to arrive.
C) Obtain any size or volume tube to place across from the specimen.
D) Obtain a tube of water filled to the same volume to place across from the specimen.

Question 40

As you operate a small table-top centrifuge, it begins to vibrate and make a noise. This indicates that: (check all that apply)
i. the centrifuge is operating normally
ii. the centrifuge needs calibration
iii. the centrifuge is not properly balanced.
iv. a tube may have broken in the centrifuge.

A) i and ii
B) iii and iv
C) i and iii
D) ii and iii

Question 41

Safe operation of a centrifuge includes (check all that apply)
i. centrifuging only one specimen at a time
ii. ensuring that specimens are balanced
iii. opening the lid before the centrifuges is completely stopped
iv. cleaning any spills and calibrating on a regular basis

A) i and ii
B) ii and iv
C) i and iii
D) ii and iii

Question 42

You are processing a light sensitive specimen to send out to a reference laboratory. Which image represents the most appropriate primary container?

A) Image A
B) Image B

Question 43

Which of the following blood specimens needs protection from light?

A) Vitamin A
B) Lactic Acid
C) Cold agglutinins
D) Blood alcohol

Question 44

Which image represents a specimen that will be rejected by the laboratory? (check all that apply)

A) Image A
B) Image B
C) Image C
D) Image D
E) All of the above

Question 45

Which of the following specimens would be rejected?

A) An ACTH blood test placed in an ice-water mixture.
B) A RBC blood test with hemolysis.
C) A PSA test delivered to the lab within an hour.
D) A blood alcohol test that includes a chain-of-custody form.

Question 46

As you process specimens, some of them need to be transferred to another tube for shipping to a reference laboratory. Other specimens need to have aliquots sent to different sections of your laboratory. What is the proper way to label the secondaryspecimen containers?

A) Only the name of the patient needs to be on the secondary container.
B) Only the laboratory accession number needs to be on the secondary container.
C) All patient information that is on the original specimen must appear on separated specimens.
D) All patient and phlebotomist information that is on the original specimen must appear on separated specimens.

Question 47

The specimen in this image needs to be recollected because

A) it has an incorrect additive to blood ratio.
B) RBCs have been destroyed, releasing calcium and potassium.
C) coagulation proteins have been activated.
D) the patient may not have been fasting.

Question 48

The specimen in this image needs to be recollected because

A) it has an incorrect additive to blood ratio.
B) RBCs have been destroyed, releasing calcium and potassium.
C) coagulation proteins have been activated.
D) the patient may not have been fasting.

Question 49

The specimen in this image needs to be recollected because

A) it has an incorrect additive to blood ratio.
B) RBCs have been destroyed, releasing calcium and potassium.
C) coagulation proteins have been activated.
D) the patient may not have been fasting.

Question 50

The specimen in this image needs to be recollected because

A) it has an incorrect additive to blood ratio.
B) RBCs have been destroyed, releasing calcium and potassium.
C) coagulation proteins have been activated.
D) the patient may not have been fasting.

Question 51

Which image shows the proper placement of same volume specimens when using the centrifuge? (check all that apply)

A) Images A, B
B) Images B, D
C) Images A, C
D) Images D, A