Deck 53: Assisting in Phlebotomy

Question 1

Capillary blood is a mixture of arterial blood and venous blood.

Answer 1

True

Question 2

If a hematoma forms while you are performing a blood draw, you should move the needle around until you have re-entered the vein.

Answer 2

False

Question 3

According to the American Society of Clinical Pathologists, nearly 80% of physicians' decisions are based on laboratory test results.

Answer 3

True

Question 4

It is important to shake a Vacutainer tube after collecting a blood sample so that the sample and additive are properly mixed.

Question 5

The Vacutainer tube with a marbled red-gray top contains silica particles to enhance clotting and a thixotropic gel to assist in the separation of serum and blood cells.

Question 6

A patient must give verbal consent before venipuncture can be performed.

Question 7

If you are drawing blood on an elderly patient with a history of collapsed veins, you should try to collect the blood sample with a syringe.

Question 8

When the needle is inserted into the vein during a routine venipuncture, the bevel of the needle should be facing down.

Question 9

Once the top of a Vacutainer tube has been punctured, it cannot be reused, even if the needle that punctured it was sterile.

Question 10

A tourniquet should never be used when a venous blood sample is to be drawn from the hand.

Question 11

Under OSHA guidelines, needle holders for Vacutainers can be reused for multiple patients, because they are not contaminated during the blood draw.

Question 12

You notice that a patient is developing petechiae during a blood draw.This typically means that the patient has a bleeding disorder.

Question 13

If a patient has had a mastectomy on the left side, you should never draw blood on that side.

Question 14

The smaller the gauge of the venipuncture needle, the less likely it is that hemolysis of blood cells will occur.

Question 15

Needles used during venipuncture may be used only once.

Question 16

When a medical assistant obtains a capillary blood sample, it is important that he or she squeeze and "milk" the finger to obtain an adequate amount of blood.

Question 17

The NCCLS has recommended that a red-topped "waste" tube be drawn before a light blue-topped Vacutainer tube, because thromboplastin released from cells during the venipuncture can interfere with coagulation tests.

Question 18

The tourniquet should be left tied on the arm no longer than 5 minutes.

Question 19

With regard to venipuncture needles, the smaller the gauge number, the larger the lumen of the needle.

Question 20

Rubbing alcohol is commonly used to prevent infection during venipuncture.

Question 21

All Vacutainer tubes should be inverted three to five times to mix the blood sample with the tube additive.

Question 22

A tourniquet is used during the phlebotomy procedure to:

A)collapse the artery
B)prevent venous flow out of the site
C)cause the vein to bulge
D)B and C
E)all of the above

Question 23

The basilic vein is a common location for venipuncture procedures.

Question 24

The ____________ is the part of the venipuncture needle that fits into the syringe or Vacutainer adapter.

A)shaft
B)bevel
C)hub
D)retractable sheath

Question 25

Plasma could be retrieved from a:

A)lavender tube
B)SST red-gray tube
C)PST green-gray tube
D)B and C
E)all of the above

Question 26

The needle size most commonly used by the blood bank for donations is _____ gauge.

A)16
B)10
C)35
D)21

Question 27

A tourniquet should remain tied on a patient's arm no longer than:

A)3 minutes
B)2 minutes
C)5 minutes
D)1 minute
E)necessary

Question 28

With phlebotomy on teenage patients, it is important to make sure a parent is present during the blood draw to give permission for the procedure.

Question 29

The needle size most commonly used for adult venipuncture is _____ gauge.

A)18
B)10
C)12
D)21

Question 30

If the patient complains of tingling or numbness during a phlebotomy procedure, the medical assistant should continue the procedure to get it completed as soon as possible.

Question 31

No anticoagulants are found in which of the following tubes?

A)Lavender topped
B)Red topped
C)Green topped
D)Yellow topped

Question 32

The needle size most commonly used in infants and the elderly is _____ gauge.

A)16
B)23
C)35
D)21

Question 33

_________ is an anticoagulant that prevents platelets from clumping and preserves the appearance of blood cells for microscopic preparation.

A)Thrombin
B)Sodium heparin
C)Ethylenediamine tetraacetic acid (EDTA)
D)Sodium polyanetholsulfonate

Question 34

The slant at the open end of a needle used for venipuncture is called the:

A)lumen
B)bevel
C)shaft
D)bore

Question 35

If blood is flowing into the Vacutainer too slowly, you should withdraw the needle slightly to center it in the vein.

Question 36

Blood should be collected only by dermal puncture in children under age 2.

Question 37

Which of the following Vacutainer tubes is routinely used for hematology testing?

A)Lavender topped
B)Red topped
C)Green topped
D)Light blue topped

Question 38

Which type of tube should be used to collect blood specimens during a glucose tolerance test?

A)Lavender topped
B)Red topped
C)Gray topped
D)Yellow topped

Question 39

Without a clot activator, whole blood typically clots in _____ minutes.

A)1 to 2
B)60 to 90
C)30 to 60
D)5 to 10

Question 40

Thixotropic gel, found in the SST red-gray marbled-topped Vacutainer tube is:

A)the same density as red blood cells
B)more dense than red blood cells and less dense than serum
C)more dense than red blood cells and less dense than white blood cells
D)less dense than red blood cells but more dense than serum

Question 41

During a routine venipuncture, when should the phlebotomist request that the patient "make a fist"?

A)After applying the tourniquet and before inserting the needle
B)After the last tube has been drawn
C)After the procedure is finished and the gauze has been applied so that bleeding stops
D)Only if a tourniquet is not used

Question 42

Leaving a tourniquet tied on a patient's arm for longer than the recommended time results in:

A)syncope
B)hemoconcentration
C)hematoma formation
D)bifurcation

Question 43

You are required to collect a venous sample for a typical hematology test, the complete blood count.You collect:

A)red-topped and lavender-topped tubes
B)yellow-topped, red-topped, light blue-topped, green-topped, and lavender-topped tubes
C)a lavender-topped tube
D)a red-topped tube

Question 44

You are performing a capillary puncture on a patient and are having difficulty collecting an adequate sample.Which of the following is an accepted method to encourage blood flow from the site?

A)Squeeze the finger.
B)Wrap the finger in a cool towel.
C)Make a second puncture mark close to the first.
D)Gently rub the finger along the sides.

Question 45

Before a routine venipuncture or capillary puncture, the site typically is cleaned with:

A)isopropyl alcohol
B)ethyl alcohol
C)povidone-iodine solution
D)soap and water

Question 46

In a routine venipuncture, the angle at which the needle enters the arm should be _____ degrees.

A)80 to 90
B)30
C)15
D)0 to 5

Question 47

A syringe is preferred over a Vacutainer collection device when:

A)the patient's veins are fragile
B)the sample must be drawn from the hand veins
C)many tests have been ordered, and multiple tubes must be drawn
D)all of the above

Question 48

Why should a tourniquet not be tied too tightly?

A)It impedes arterial blood flow.
B)It restricts venous blood return.
C)It results in poor venous distention.
D)All of the above are correct.

Question 49

A winged infusion set is also known as a:

A)Hemagard tube
B)Velcro tourniquet
C)butterfly needle
D)Luer adapter

Question 50

The device used for dermal puncture is a(n):

A)Unopette
B)lancet
C)butterfly
D)Vacutainer

Question 51

Which is the most correct method for performing a capillary puncture?

A)Squeeze the finger to get an adequate blood sample.
B)Use the anterior surface of the finger.
C)Wipe away the first drop of blood and then collect the sample.
D)Cleanse the finger with an alcohol antiseptic and immediately perform the finger puncture.

Question 52

The proper procedure for collecting a serum specimen is to:

A)use a green-topped tube
B)allow the specimen to clot
C)use a microhematocrit tube
D)use a red or marbled-top tube
E)B and D

Question 53

The most common phlebotomy site in adults is/are the:

A)radial vein
B)brachial artery
C)veins in the antecubital space
D)veins in the popliteal area

Question 54

Which vein(s) can be used for routine venipuncture?

A)Medial cephalic
B)Medial basilic
C)Supplementary cephalic
D)All of the above

Question 55

Blood obtained via capillary puncture can be collected:

A)in Microtainer tubes
B)in capillary tubes
C)in microhematocrit tubes
D)onto filter paper
E)all of the above

Question 56

When is the correct time to remove the tourniquet during a routine venipuncture?

A)Immediately after the needle punctures the vein
B)As the last tube to be drawn begins to fill
C)After the last tube has been drawn and the needle has been removed from the vein
D)After the vein has been located, before the venipuncture actually begins

Question 57

A hematoma can be caused by:

A)excessive probing to locate a vein
B)failure to insert the needle far enough into the vein
C)penetration of the needle through a vein
D)all of the above

Question 58

During a routine venipuncture, when should the phlebotomist request that the patient "release the fist"?

A)When the procedure is finished, after the tourniquet has been removed
B)When the last tube has been filled, before the tourniquet is removed
C)When blood enters the first tube being drawn
D)When the procedure is finished, and the bleeding has stopped

Question 59

A needle-stick is more likely to occur if:

A)an attempt is made to recap a needle
B)a needle of inappropriate gauge is used
C)a Vacutainer set is used to obtain a specimen
D)needles are immediately retracted into a safety device after use
E)all of the above

Question 60

The laboratory requisition indicates that you are to collect a venous blood specimen for hematology testing, serum chemistry testing, and coagulation studies.What is the proper order of collection for these tubes?

A)Red, light blue, lavender
B)Yellow, red, light blue
C)Light blue, red, lavender
D)2 lavender, 1 red

Question 61

Capillary blood samples may be collected at all of the following sites except the:

A)antecubital space
B)heel
C)earlobe
D)fingertip

Question 62

Using a collection needle with a wider lumen reduces the chance that __________ will occur.

Question 63

The clear part of whole blood that contains clotting agents is:

A)plasma
B)blood cells
C)serum
D)hemoglobin
E)B and D

Question 64

The typical site for a capillary puncture on an infant is the medial or lateral side of the __________.

Question 65

A(n) __________ is a special laboratory filter paper that is used to collect a blood sample from newborns.

Question 66

Describe the postexposure management of a needle stick.

Question 67

A(n) __________ is applied to the skin 30 to 60 seconds before the blood draw to prevent infection at the puncture site.

Question 68

The color of the tube top for collection of a coagulation test is:

A)green
B)light blue
C)gray
D)lavender

Question 69

The best prevention for needle-stick injuries after venipuncture is the use of __________.

Question 70

Describe the steps medical assistants must take to protect themselves and co-workers against needle-stick injuries.

Question 71

Securing a patient in a blood collection chair helps prevent injuries if the patient experiences __________.

Question 72

Which is the proper technique for performing a venipuncture?

A)The needle bevel is face up, and the needle is inserted at a 15-degree angle.
B)The needle bevel is face down, and the needle is inserted at a 15- to 30-degree angle.
C)The needle bevel can be oriented in either direction, but the needle must be inserted at a low angle.
D)The needle bevel is face up, and the needle is inserted at a 20- to 30-degree angle.

Question 73

__________ are used for small veins, such as those in the hand or in a pediatric patient.

Question 74

List the information required on the laboratory requisition.

Question 75

The physician has ordered a number of laboratory tests for a patient, and you must make sure you are obtaining the blood samples in the correct order.Summarize the proper order of draw for a multitube procedure.

Question 76

__________ is the liquid portion of the blood that contains clotting agents.

Question 77

The liquid portion of blood that remains after the blood has clotted in a collection tube is the __________.

Question 78

The typical site for a capillary puncture in an adult is the __________ finger.

Question 79

The largest of the Vacutainer tubes typically used for phlebotomy fills to a volume of 10 mL.Approximately _____ tubes are needed to fill a pint (473 mL).

Question 80

Leaving a tourniquet on longer than 1 minute greatly increases the chance of __________.