Deck 10: Special Phlebotomy Procedures
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Deck 10: Special Phlebotomy Procedures
1
Conditions that may require arterial blood measurements include (check all that apply)
A) pulmonary disease
B) cardiac failure
C) lung cancer
D) sever shock
E) All of the above
A) pulmonary disease
B) cardiac failure
C) lung cancer
D) sever shock
E) All of the above
All of the above
2
Which of the following tests requires an arterial specimen?
A) Ammonia
B) Blood culture
C) Blood gases
D) Microhematocrit
A) Ammonia
B) Blood culture
C) Blood gases
D) Microhematocrit
Blood gases
3
When collecting a specimen for blood culture some blood is placed into an anaerobic bottle and will be exposed to a(n)
A) oxygen rich environment
B) room air environment
C) oxygen-free environment
D) gas-free environment
A) oxygen rich environment
B) room air environment
C) oxygen-free environment
D) gas-free environment
oxygen-free environment
4
When collecting a specimen for blood culture some blood is placed into an aerobic bottle and will be exposed to a(n)
A) oxygen rich environment
B) room air environment
C) oxygen-free environment
D) gas-free environment
A) oxygen rich environment
B) room air environment
C) oxygen-free environment
D) gas-free environment
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5
Sterile technique is required during blood collection for culture to
A) create confidence in the patient because of the lengthy procedure
B) ensure no normal flora are sampled
C) promote growth of pathogens in the sample
D) stimulate blood flow to the surface veins
A) create confidence in the patient because of the lengthy procedure
B) ensure no normal flora are sampled
C) promote growth of pathogens in the sample
D) stimulate blood flow to the surface veins
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6
The liquid in the blood culture bottles
A) removes antibiotics
B) promotes bacterial growth
C) inhibits normal flora
D) destroys pathogens
A) removes antibiotics
B) promotes bacterial growth
C) inhibits normal flora
D) destroys pathogens
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7
The ARD resin in some blood culture bottles
A) removes antibiotics
B) promotes bacterial growth
C) inhibits normal flora
D) destroys pathogens
A) removes antibiotics
B) promotes bacterial growth
C) inhibits normal flora
D) destroys pathogens
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8
How much blood is usually needed for each blood culture bottle for blood cultures on adults?
A) 1 to 2 ml
B) 3 to 5 ml
C) 5 to 8 ml
D) 8 to 10 ml
A) 1 to 2 ml
B) 3 to 5 ml
C) 5 to 8 ml
D) 8 to 10 ml
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9
Using blood cultures to differentiate among bacteria in the blood provides information for
A) avoiding cross contamination
B) selecting appropriate culture media
C) prescribing the most effective antibiotics
D) identifying other cultures that should be performed
A) avoiding cross contamination
B) selecting appropriate culture media
C) prescribing the most effective antibiotics
D) identifying other cultures that should be performed
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10
False positive blood culture results may occur due to (check all that apply)
A) circular cleaning of the puncture site
B) allowing the cleaning agent to dry on the skin
C) wiping the tube stopper with alcohol prior to collection
D) re-palpating the puncture site after cleansing
A) circular cleaning of the puncture site
B) allowing the cleaning agent to dry on the skin
C) wiping the tube stopper with alcohol prior to collection
D) re-palpating the puncture site after cleansing
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11
Which procedure(s) must be performed using a sterile technique?(check all that apply)
A) Therapeutic drug monitoring
B) Malaria smear preparation
C) Forensic specimen collection
D) Blood culture
A) Therapeutic drug monitoring
B) Malaria smear preparation
C) Forensic specimen collection
D) Blood culture
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12
Which procedures are performed using aseptic technique?(check all that apply)
i. Therapeutic drug monitoring
ii. Malaria smear preparation
iii. Forensic specimen collection
iv. Blood culture
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
i. Therapeutic drug monitoring
ii. Malaria smear preparation
iii. Forensic specimen collection
iv. Blood culture
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
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13
False negative blood culture results may occur due to (check all that apply)
A) waiting 30 minutes for a same site collection
B) using different sites for blood collection
C) overfilling the bottles
D) under filling the bottles
A) waiting 30 minutes for a same site collection
B) using different sites for blood collection
C) overfilling the bottles
D) under filling the bottles
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14
Blood cultures may be collected using (check all that apply)
i. evacuated tube system
ii. syringe and transfer device
iii. winged infusion set (butter-fly)
iv. dermal puncture lancets
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
i. evacuated tube system
ii. syringe and transfer device
iii. winged infusion set (butter-fly)
iv. dermal puncture lancets
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
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15
While preparing a blood smear slide, you have just backed up the spreader slide toward the frosted end until the spreader touches the blood drop. What will you do next?
A) Apply a drop of blood to the slide ½ inch from the edge.
B) Place the edge of the spreader slide close to the unfrosted edge.
C) Allow the smear to air dry before staining.
D) Allow the blood drop to spread almost to the edges of the spreader slide.
A) Apply a drop of blood to the slide ½ inch from the edge.
B) Place the edge of the spreader slide close to the unfrosted edge.
C) Allow the smear to air dry before staining.
D) Allow the blood drop to spread almost to the edges of the spreader slide.
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16
Some vitamin dependent hormones are dependent on the presence of
A) biotinidase
B) thyroid hormones
C) phenylalanine
D) galactose
A) biotinidase
B) thyroid hormones
C) phenylalanine
D) galactose
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17
Cystic fibrosis causes damage to the (check all that apply)
i. skeletal system
ii. digestive system
iii. neuromuscular system
iv. respiratory system
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. skeletal system
ii. digestive system
iii. neuromuscular system
iv. respiratory system
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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18
Vitamin supplements may be used to treat
A) biotinidase deficiency
B) galactosemia
C) phenylketonuria
D) sickle cell anemia
A) biotinidase deficiency
B) galactosemia
C) phenylketonuria
D) sickle cell anemia
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19
A special diet low in dairy products may help relieve
A) biotinidase deficiency
B) galactosemia
C) phenylketonuria
D) sickle cell anemia
A) biotinidase deficiency
B) galactosemia
C) phenylketonuria
D) sickle cell anemia
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20
A special diet low in certain amino acids may reduce the effects of
A) biotinidase deficiency
B) galactosemia
C) phenylketonuria
D) sickle cell anemia
A) biotinidase deficiency
B) galactosemia
C) phenylketonuria
D) sickle cell anemia
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21
Staying well hydrated may reduce the effects of
A) biotinidase deficiency
B) galactosemia
C) phenylketonuria
D) sickle cell anemia
A) biotinidase deficiency
B) galactosemia
C) phenylketonuria
D) sickle cell anemia
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22
To correct a thin blood smear that is too short use a:(check all that apply)
i. smaller drop of blood
ii. slower spreading speed
iii. shallower angle of the spreader slide
iv. start and stop motion
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. smaller drop of blood
ii. slower spreading speed
iii. shallower angle of the spreader slide
iv. start and stop motion
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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23
To correct a thin blood smear that is too long use a:(check all that apply)
A) smaller drop of blood
B) slower spreading speed
C) shallower angle of the spreader slide
D) start and stop motion
A) smaller drop of blood
B) slower spreading speed
C) shallower angle of the spreader slide
D) start and stop motion
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24

-The appearance of this blood smear is caused by using(check all that apply)
i. too small of a drop of blood
ii. too slow of a spreading speed
iii. too steep of an angle of the spreader slide
iv. a start and stop motion
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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25
To correct the appearance of this blood smear the phlebotomist should use a(check all that apply)
i. smaller drop of blood
ii. slower spreading speed
iii. shallower angle of the spreader slide
iv. start and stop motion
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. smaller drop of blood
ii. slower spreading speed
iii. shallower angle of the spreader slide
iv. start and stop motion
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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26

-The appearance of this blood smear is caused by using(check all that apply)
i. too small of a drop of blood
ii. too slow of a spreading speed
iii. too shallow of an angle of the spreader slide
iv. a start and stop motion
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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27
To correct the appearance of this blood smear the phlebotomist should use a(check all that apply)
i. smaller drop of blood
ii. slower spreading speed
iii. steeper angle of the spreader slide
iv. start and stop motion
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. smaller drop of blood
ii. slower spreading speed
iii. steeper angle of the spreader slide
iv. start and stop motion
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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28

-The appearance of this blood smear is caused by using (check all that apply)
A) a slide with fingerprints on it
B) unequal pressure on the spreader slide
C) a chipped slide for the spreader slide
D) a start and stop motion
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29

-The appearance of this blood smear is caused by using (check all that apply)
A) a slide with fingerprints on it
B) unequal pressure on the spreader slide
C) a chipped slide for the spreader slide
D) a start and stop motion
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30

-The appearance of this blood smear is caused by using (check all that apply)
A) a slide with fingerprints on it
B) unequal pressure on the spreader slide
C) a chipped slide for the spreader slide
D) a start and stop motion
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31
A thick blood smear is used to screen for:(check all that apply)
A) Red blood cell disorders
B) White blood cell disorders
C) Platelet disorders
D) Malaria
A) Red blood cell disorders
B) White blood cell disorders
C) Platelet disorders
D) Malaria
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32
Which portion of a blood smear is used to perform a differential?
A) Thick portion
B) Critical area
C) Thin portion
D) Feathered edge
A) Thick portion
B) Critical area
C) Thin portion
D) Feathered edge
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33
A thin blood smear should have feathered edge that is
A) straight
B) angled
C) jagged
D) wavy
A) straight
B) angled
C) jagged
D) wavy
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34
Which medical personnel are allowed to perform arterial puncture?(check all that apply)
i. nurses
ii. physicians
iii. respiratory therapists
iv. phlebotomists
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
i. nurses
ii. physicians
iii. respiratory therapists
iv. phlebotomists
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
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35
Venous access devices, such as heparin locks (check all that apply)
A) may be used by phlebotomists for routine blood collections
B) are used primarily for repeated phlebotomy during a 3 hour glucose tolerance
C) must be flushed with saline prior to collection for special coagulation studies
D) are used to administer medication and should not be used for blood collection
A) may be used by phlebotomists for routine blood collections
B) are used primarily for repeated phlebotomy during a 3 hour glucose tolerance
C) must be flushed with saline prior to collection for special coagulation studies
D) are used to administer medication and should not be used for blood collection
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36
Glucose testing includes (check all that apply)
A) fasting blood draw
B) 3 hour tolerance
C) 2 hour post parandial
D) 1 hour challenge
E) All of the above
A) fasting blood draw
B) 3 hour tolerance
C) 2 hour post parandial
D) 1 hour challenge
E) All of the above
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37
Specialized training beyond phlebotomy certification is required in order for phlebotomists to be able to perform (check all that apply)
i. arterial blood collection
ii. collection of blood cultures
iii. collection of units from blood bank donors
iv. neonatal blood screening collection
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. arterial blood collection
ii. collection of blood cultures
iii. collection of units from blood bank donors
iv. neonatal blood screening collection
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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38
When preparing blood smears with blood from newborns, you notice that the smears are usually shorter than using blood from older children. What may be causing this to happen?
A) Newborns normally have higher hematocrits than older children.
B) The use of the heel stick procedure causes the blood to thicken.
C) Capillary blood is thicker than venous.
D) Babies usually cry during blood collections.
A) Newborns normally have higher hematocrits than older children.
B) The use of the heel stick procedure causes the blood to thicken.
C) Capillary blood is thicker than venous.
D) Babies usually cry during blood collections.
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39
When preparing blood smears with blood from newborns, you may need to adjust your technique to include using a (check all that apply)
i. smaller drop of blood
ii. slower spreading speed
iii. shallower angle of the spreader slide
iv. corner of the spreader slide and a circular pattern
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. smaller drop of blood
ii. slower spreading speed
iii. shallower angle of the spreader slide
iv. corner of the spreader slide and a circular pattern
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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40
Which statements is true regarding an order for Type and Screen?
A) Routine blood collection procedures are used.
B) This is performed on a blood donor.
C) Is part of a therapeutic phlebotomy procedure.
D) Type and Screen is included in Type and Crossmatch.
A) Routine blood collection procedures are used.
B) This is performed on a blood donor.
C) Is part of a therapeutic phlebotomy procedure.
D) Type and Screen is included in Type and Crossmatch.
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41
Which of the following is correct when banding patients for blood bank collections?(check all that apply)
i. The hospital ID bracelet is removed and the patient is banded with a special blood bank bracelet.
ii. A special blood bank bracelet is placed above or below the hospital ID bracelet.
iii. When multiple blood bank collections are needed, the patient is banded with additional bracelets.
iv. When multiple blood bank collections are needed, the expired blood bank bracelet is removed first, then the patient is banded with the new blood bank bracelet.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. The hospital ID bracelet is removed and the patient is banded with a special blood bank bracelet.
ii. A special blood bank bracelet is placed above or below the hospital ID bracelet.
iii. When multiple blood bank collections are needed, the patient is banded with additional bracelets.
iv. When multiple blood bank collections are needed, the expired blood bank bracelet is removed first, then the patient is banded with the new blood bank bracelet.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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42
Healthy adults may have blood removed for (check all that apply)
i. transfusion for other patients.
ii. transfusion for themselves.
iii. removal of excess iron.
iv. removal of excess blood.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. transfusion for other patients.
ii. transfusion for themselves.
iii. removal of excess iron.
iv. removal of excess blood.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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43
Patients who are ill may have blood removed for (check all that apply)
i. transfusion for other patients.
ii. transfusion for themselves.
iii. removal of excess iron.
iv. removal of excess blood.
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
i. transfusion for other patients.
ii. transfusion for themselves.
iii. removal of excess iron.
iv. removal of excess blood.
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
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44
The collection of blood for use in transfusions requires (check all that apply)
i. the use of aseptic technique for site preparation.
ii. the use of sterile technique for site preparation.
iii. collection of blood into a sterile bag containing CPD.
iv. collection of blood into pink-stoppered EDTA tubes.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. the use of aseptic technique for site preparation.
ii. the use of sterile technique for site preparation.
iii. collection of blood into a sterile bag containing CPD.
iv. collection of blood into pink-stoppered EDTA tubes.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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45
The collection of blood for type and crossmatch requires (check all that apply)
i. the use of aseptic technique for site preparation.
ii. the use of sterile technique for site preparation.
iii. collection of blood into a sterile bag containing CPD.
iv. collection of blood into pink-stoppered EDTA tubes.
A) i and ii
B) ii and iv
C) i and iv
D) ii and iii
i. the use of aseptic technique for site preparation.
ii. the use of sterile technique for site preparation.
iii. collection of blood into a sterile bag containing CPD.
iv. collection of blood into pink-stoppered EDTA tubes.
A) i and ii
B) ii and iv
C) i and iv
D) ii and iii
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46
Polycythemia is a disease that (check all that apply)
i. causes the body to produce too many blood cells.
ii. results in the body storing abnormal amounts of iron.
iii. may put the body's organs under a great deal of stress.
iv. is treated by removing large amounts of blood.
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
i. causes the body to produce too many blood cells.
ii. results in the body storing abnormal amounts of iron.
iii. may put the body's organs under a great deal of stress.
iv. is treated by removing large amounts of blood.
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
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47
Hemochromatosis is a disease that (check all that apply)
i. causes the body to produce too many blood cells.
ii. results in the body storing abnormal amounts of iron.
iii. may put the body's organs under a great deal of stress.
iv. is treated by removing large amounts of blood.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. causes the body to produce too many blood cells.
ii. results in the body storing abnormal amounts of iron.
iii. may put the body's organs under a great deal of stress.
iv. is treated by removing large amounts of blood.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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48
Where do blood donations occur? (check all that apply)
A) Blood donor centers.
B) Hospital blood banks.
C) Community centers.
D) Schools and churches.
E) All of the above
A) Blood donor centers.
B) Hospital blood banks.
C) Community centers.
D) Schools and churches.
E) All of the above
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49
A unit of blood can yield
A) blood cells
B) plasma
C) proteins
D) reagents
E) All of these
A) blood cells
B) plasma
C) proteins
D) reagents
E) All of these
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50
A female student is registering to become a blood donor at a community blood drive being held at her college. Which of the following characteristics disqualifies her from being an eligible donor at this time? (check all that apply)
A) She is 19 years old.
B) She weighs 105 pounds.
C) Her hematocrit is 40%.
D) Her body temperature is 98.7.
A) She is 19 years old.
B) She weighs 105 pounds.
C) Her hematocrit is 40%.
D) Her body temperature is 98.7.
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51
Potential blood donors may be disqualified if they (check all that apply)
i. have recently travelled out of the country.
ii. are on medications or have taken drugs.
iii. live a sexually promiscuous lifestyle.
iv. on a diet or have been fasting.
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
i. have recently travelled out of the country.
ii. are on medications or have taken drugs.
iii. live a sexually promiscuous lifestyle.
iv. on a diet or have been fasting.
A) i, ii, and iii
B) i, iii, and iv
C) ii, iii, and iv
D) i, ii, and iv
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52
Which statement(s) describe(s) the collection of a unit of blood? (check all that apply)
i. A 23-guage needle is used for the blood collection.
ii. Any large vein in the antecubital area may be used.
iii. Blood is collected into a bag containing acid citrate dextrose.
iv. The amount of blood collected is 450 to 500 milliliters.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. A 23-guage needle is used for the blood collection.
ii. Any large vein in the antecubital area may be used.
iii. Blood is collected into a bag containing acid citrate dextrose.
iv. The amount of blood collected is 450 to 500 milliliters.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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53
Which statement(s) describe(s) the collection of a unit of blood? (check all that apply)
i. A 19-guage needle is used for the blood collection.
ii. Any large vein in the dorsal arch may be used.
iii. Blood is collected into a bag containing citrate dextrose phosphate.
iv. The amount of blood collected is 200 to 400 milliliters.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
i. A 19-guage needle is used for the blood collection.
ii. Any large vein in the dorsal arch may be used.
iii. Blood is collected into a bag containing citrate dextrose phosphate.
iv. The amount of blood collected is 200 to 400 milliliters.
A) i and ii
B) ii and iv
C) i and iii
D) ii and iii
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