Deck 5: Phlebotomy

Question 1

Phil is preparing to collect a blood specimen. During his examination of the patients arm for a potential site, Phil observes the presence of petechiae scattered across both of the patients' arms. Phil understands what this indicates. He proceeds with the venipuncture, allowing extra time to make sure the site has completely stopped bleeding before leaving the patient. Why did Phil do this?

A)Petechiae indicate possible clotting problems.
B)Petechia indicates possible blood pressure problems.
C)Petechia indicates possible infectious disease.
D)Petechia indicates possible areas of inflammation.

Answer 1

Petechiae indicate possible clotting problems.

Question 2

Which of the following is not a special consideration phlebotomists should consider when working with older adults?

A)Mobility issues.
B)Visual acuity.
C)Provide a protective environment.
D)Thin fragile veins.

Answer 2

Provide a protective environment.

Question 3

Which of the following is not a special consideration when working with newborns?

A)Provide a protective environment.
B)Accurately monitor the total volume of withdrawn blood.
C)Ensure warmth.
D)Use protective restraints where necessary.

Answer 3

Use protective restraints where necessary.

Question 4

Kendra is gathering equipment for an arterial puncture. She has gathered the following equipment: heparin solution of 1,000 IU per ml, sterile gauze, betadine wipes, sterile needle, and syringe. What has Pheona forgotten?

A)Container of ice water.
B)Alcohol wipes.
C)Tourniquet.
D)Requisition form.

Question 5

What is the difference between fainting and hypovolemic shock?

A)Hypovolemic shock is a medical emergency.
B)Fainting is a medical emergency.
C)Fainting may be caused by an emotional reaction or pain.
D)A and C

Question 6

Phil has just successfully performed his first venipuncture using a syringe! He was careful not to pull up too quickly on the plunger when collecting the specimen or push it down too forcefully when transferring the blood from the syringe to the specimen container. What purpose do the special precautions used when performing a syringe serve?

A)To prevent bacterial contamination.
B)To prevent adulteration of the specimen.
C)To prevent hemolysis.
D)To prevent a needle stick accident.

Question 7

Kendra is about to perform venipuncture on a patient who had a mastectomy on the right side. What special precautions should Kendra observe for this patient?

A)Pheona should avoid the right arm.
B)Pheona should keep the patient in a flat position.
C)There are not any special precautions for this situation.

Question 8

What are the symptoms of a latex allergy?

A)Skin redness, hives.
B)Shortness of breath.
C)Runny nose, watery eyes.
D)All of the above.

Question 9

Phil's patient just returned from a radiology test that included an IV injection of dye. Phil collects the blood specimen and notes the radiographic test and time it was performed on the requisition form. Why did Phil do this?

A)To inform the lab of possible adulterants.
B)To inform the lab of a procedure that may affect the blood test.
C)To inform the lab of other departments involved in the patients care.
D)To inform the lab of possible time delays.

Question 10

Which term refers to the process through which the human body attempts to maintain internal stability in response to stimuli disturbing its normal condition?

A)Hemostasis.
B)Hemolysis.
C)Homeostasis.

Question 11

Phil is selecting a vein for venipuncture. After applying a tourniquet, and palpating the vein, he is sure he has found a suitable vein. The chosen vein feels very big and cord-like. Has Phil made a good choice?

Question 12

For which of the following test(s) should alcohol wipes NOT be used when drawing samples?

A)ETOH level
B)Complete blood count
C)Blood cultures
D)A and C

Question 13

Which of the following is the "proper order of draws"?

A)Red top, yellow top, light blue top, additive tubes
B)Light blue top, red top, additive tubes
C)Hey, trick question! None of these answers is right!
D)Yellow top, light blue top, red top, additive tubes.

Question 14

Phil is collecting blood from a finger-stick. Phil is concerned he may not have collected enough blood drops; he is worried he may have to re-stick his patient. Phil is able to squeeze out a few more drops of blood by squeezing and milking the fingertip. What (if anything) did Phil do wrong, and why?

A)Phil did not do anything wrong.
B)Phil should not milk the site; milking hurts the patient more than a re-stick.
C)Phil should not squeeze and milk the site; fluid from the fingertip tissue may be squeezed into the blood drops.
D)Phil contaminated the site and sample by squeezing and milking.

Question 15

What does ARD stand for, and what is its purpose?

A)Antibiotic recovery device. Used when testing for appropriate antibiotic therapy.
B)Account receivable department. Used for billing purposes.
C)Antibiotic removal device. Used when blood cultures are drawn after the patient has received antibiotics.
D)None of the above.

Question 16

Phil is drawing for multiple tests: a CBC, PT & PTT, blood glucose level and thyroid panel. Phil recalls from class that collection tubes are drawn in order. Phil arranges the collection tubes in this order: lavender top, light blue top, gray top and SST/ tiger top. What (if anything) has Phil done wrong?

A)Phil used too many tubes.
B)Phil did not follow the order of draws. Correct order is: light blue top, SST/tiger top, lavender top, and gray top.
C)Phil has not done anything wrong.
D)Phil did not follow the order of draws. Correct order is: SST/tiger top, light blue top, lavender top, and gray top.

Question 17

Which is first in the order of draws, a SST or PST?

A)Hey, trick question! It is the same tube, just a different name.
B)PST is first.
C)SST is first.
D)Since there is not a risk of additive cross-contamination, the order of draw does not apply.

Question 18

Which colored top indicates a tube containing the additive EDTA?

A)Light blue
B)Dark blue
C)Lavender
D)Gray

Question 19

Phil has entered his patients' room. Phil knows the first step in the phlebotomy procedure is to identify his patient. He greets and identifies his patient by saying "Hi, I'm Phil; I'm here to draw a little blood. Are you Mrs. Jane Doe?" What (if anything) has Phil done wrong?

A)Phil should allow the patient say her name first.
B)Phil did not do anything wrong.
C)Phil should not speak so casually to the patient.

Question 20

Is it necessary to follow an order of draws when using micro-containers?

A)What is a micro-container?
B)No
C)Yes

Question 21

Phil is performing a heel puncture. He is inspecting the infant's heel for an appropriate puncture site. Phil gently, yet firmly, holds the infants heel, while imagining a V-shaped boundary line, with the center point at the back of the heel. Phil chooses his puncture site on the left side of the heel, on the outside of the V-shaped boundary line. What (if anything) has Phil done wrong?

A)Phil should have chosen a site inside the V-shaped boundary.
B)Phil should have inverted the V-shaped boundary line.
C)Phil should have used a circle-shaped boundary line.
D)Phil did not do anything wrong.

Question 22

What is the difference between serum and plasma?

A)There is not a difference.
B)Serum contains proteins and no clotting factors; plasma contains serum and clotting factors.
C)Serum contains clotting factors; plasma contains serum and proteins.
D)Serum and plasma contain clotting factors. Serum also contains proteins; plasma also contains lymph fluid.

Question 23

What is glycolysis?

A)The additive used to preserve glucose in blood.
B)The destruction of red blood cells.
C)The process of breaking down glucose for energy.

Question 24

Phil has a stat draw. The patient and physician are in deep discussion when Phil enters the patients' room. He immediately leaves the room, respecting the patients' right to privacy. He plans to return after completing a routine draw from the patient across the hall. What (if anything) did Phil do wrong?

A)Phil did not do anything wrong.
B)Because it was a stat draw, Phil should interrupt the discussion by informing the physician an important stat draw is due, and draw the sample.
C)Phil should introduce himself, explain to the patient and physician why he is in the room, and follow-up by asking if he may draw the specimen.
D)Phil should stand quietly in the room until the discussion is over, and then draw the specimen.

Question 25

Kendra is preparing to perform an arterial puncture. What area of the patient's body should Pheona examine first for a suitable site?

A)The antecubital area of both arms.
B)The thumb side of the wrist.
C)The brachial artery.
D)The femoral artery.

Question 26

Phil is observing Kendra's technique while she performs an arterial puncture. One of the most striking differences he observes is the angle of the needle she is using. Pheona has inserted the needle at a 45-degree angle. Is Pheona demonstrating proper technique?

Question 27

Phil is feeling a bit distracted. He is finishing one specimen collection and thinking about the stat draw he was just notified of, as well as the timed draw already scheduled on his run. After the collection tube is filled to the correct level, Phil quickly removes the needle, covers the puncture site with gauze, labels the specimen, and leaves the patients room. What (if anything) has Phil done wrong?

A)Phil hasn't done anything wrong.
B)Phil did not remove the tourniquet.
C)Phil did not check the site for bleeding before leaving the room.
D)B and C

Question 28

Phil is selecting a needle for a butterfly syringe, intended for drawing a blood specimen from a pediatric patient. His patient's veins are small, so he wants a small sized needle. He chooses a 23-gauge needle. Has Phil made the correct selection?

Question 29

Phil has been notified that yet another of his finger sticks has been rejected by the lab. The lab tech tells him, "Dude, quit milking so much!" Phil is not sure what that means. Can you tell Phil what is causing rejection of his capillary collections from finger puncture?

A)Phil, you are squeezing too hard and pulling the fingers toward the fingertip. It causes hemolysis and tissue fluid to be squeezed into the blood.
B)Phil, you are scooping the blood with the capillary collection device, instead of letting it fill on its own. It's causing hemolysis.
C)Phil my man, don't pester the lab techs so much; lay low and they will quit picking on your specimens.

Question 30

Which of the following POCT devices is the only test that requires NOT wiping the first drop of blood away, before collecting the capillary specimen?

A)Blood glucose monitor.
B)Blood gas analyzer.
C)Blood coagulation monitor.
D)Hemoglobin system.

Question 31

Which of the following is not a method of blood collection?

A)Syringe draw.
B)Intravenous infusion.
C)Vacutainer draws.
D)Butterfly syringe draw.

Question 32

A 22-gauge needle would be appropriately used for which group of the following patients?

A)Infants.
B)Children.
C)Senior adults.
D)A and C.

Question 33

What is an automatic incision device used for?

A)For surgical purposes.
B)For bleeding time punctures.
C)For arterial punctures.
D)For difficult venous punctures.

Question 34

What is the disadvantage of using the radial artery for arterial puncture?

A)There is not a disadvantage; it is the first choice for arterial puncture.
B)It lies close to the medial nerve.
C)It is small.
D)It is not easily palpable.