Take Home Quiz Chapter 8

133 Questions  I  By Phbmuststudy
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  • 1. 
    When properly anchoring a vein, the:
    • A. 

      Index and middle finger are pulling the skin parallel to the arm just below the site.

    • B. 

      Index finger is pulling the skin above the site and thumb is pulling toward the wrist.

    • C. 

      Thumb is 1 to 2 in. Below the intended site and is pulling the skin toward the wrist.

    • D. 

      Thumb is next to the intended vein and pressing heavily downward into the tissue.


  • 2. 
    Which of the following actions is unlikely to help a phlebotomist gain a patient's trust?
    • A. 

      Acting confident and assured in beside manner

    • B. 

      Being professional in dress and personal appearance

    • C. 

      Collecting a specimen before the requested time

    • D. 

      Remaining at ease while interacting with the patient


  • 3. 
    It is unlikely that a misidentifying a paitent specimen would result in:
    • A. 

      A civil action malpractice lawsuit.

    • B. 

      Being dismissed from the facility.

    • C. 

      No reprimand if no one was hurt.

    • D. 

      Temporary suspension of duties.


  • 4. 
    Needle phobia is defined as a/an:
    • A. 

      Anxiety about admission to the hospital.

    • B. 

      Inability to watch while others are drawn.

    • C. 

      Intense fear of needles and being stuck.

    • D. 

      Personal preference for smaller needles.


  • 5. 
    Symptoms of needle phobia can include:
    • A. 

      Arrhythmia.

    • B. 

      Fainting.

    • C. 

      Light-headedness.

    • D. 

      All of the above.


  • 6. 
    A basic step that can be taken to minimize any trauma assoicated with a venipuncture is to:
    • A. 

      Allow the paitent to sit in the waiting room for half an hour before collection.

    • B. 

      Choose the most skilled phlebotomist available to perform the venipuncture.

    • C. 

      Have the patient wear an eye mask or close his or her eyes during the procedure.

    • D. 

      Thoroughly explain every detail of the draw before doing the venipuncture.


  • 7. 
    Proper use of a hand sanitizer includes:
    • A. 

      Allowing the alcohol to evaporate completely.

    • B. 

      Rubbing it in between and around the fingers.

    • C. 

      Using a very generous amount of the sanitizer.

    • D. 

      All of the above.


  • 8. 
    To examine by touch or feel is to:
    • A. 

      Ambulate.

    • B. 

      Anchor.

    • C. 

      Palpate.

    • D. 

      Pronate.


  • 9. 
    In most cases, needle insertion should be performed:
    • A. 

      At a 45-degree angle to the surface of the arm.

    • B. 

      Using a smooth, steady motion forward,

    • C. 

      With a deliberate and rapid forward jab.

    • D. 

      With the bevel of the needle face down.


  • 10. 
    To "seat" the needle in the vein means to:
    • A. 

      Anchor the vein while inserting the needle.

    • B. 

      Increase the angle needed to enter the vein.

    • C. 

      Redirect the needle to gain entry to the vein.

    • D. 

      Thread part of the needle with the lumen.


  • 11. 
    Going without food or drink except for water for 8 to 12 hours is defined as:
    • A. 

      Fasting.

    • B. 

      NPO.

    • C. 

      Routine.

    • D. 

      TDM.


  • 12. 
    The reason a test is ordered "timed" is to:
    • A. 

      Assess a patient's condition after surgery.

    • B. 

      Determine patient suitability for surgery.

    • C. 

      Draw it at the best time for accurate results.

    • D. 

      Establish a clinical diagnosis or prognosis.


  • 13. 
    Examples of timed tests include:
    • A. 

      Basic metabolic panel, potassium, and glucose.

    • B. 

      Blood cultures, cardiac enzymes, and cortisol.

    • C. 

      Calcium, ferritin, and complete blood count.

    • D. 

      Creatinine, lactic acid, and reticulocyte count.


  • 14. 
    A test is ordered "fasting" to:
    • A. 

      Assess a patient after outpatient surgery.

    • B. 

      Eliminate the effects of diet on test results.

    • C. 

      Determine patient eligibility for surgery.

    • D. 

      Standardize test results on critical patients.


  • 15. 
    Bending the arm up to apply pressure to the site after venipuncture has not been shown to:
    • A. 

      Disrupt the platelet plug when the arm is eventually lowered

    • B. 

      Enable the site to quickly stop bleeding after needle removal.

    • C. 

      Increase the possibility of bruising and hematoma formation.

    • D. 

      Keep the wound open, especially if it is at the side of the arm.


  • 16. 
    The unique number assigned to a specimen request is called the:
    • A. 

      Accession number.

    • B. 

      Health facility number.

    • C. 

      Patient date of birth.

    • D. 

      Patient ID number.


  • 17. 
    Failure of the paitent to follow required diet restrictions before specimen collection could lead to:
    • A. 

      Compromised patient care and treatment.

    • B. 

      Erroneous and meaningless test results.

    • C. 

      Misinterpreted test results by the physician.

    • D. 

      All of the above.


  • 18. 
    Which of the following individuals has legal authority to authorize paitent testing?
    • A. 

      Laboratory director

    • B. 

      Patient's nurse

    • C. 

      Patient's physician

    • D. 

      Phlebotomist


  • 19. 
    Test requisition information must include the:
    • A. 

      Ordering physician.

    • B. 

      Patient's diagnosis.

    • C. 

      Patient's location

    • D. 

      Prior draw times.


  • 20. 
    Which type of requisition often serves as a test request, report, and billing form?
    • A. 

      Bar code

    • B. 

      Computer

    • C. 

      Manual

    • D. 

      Verbal


  • 21. 
    Information represented by a patient ID bar code typically includes the patient's:
    • A. 

      Credit information and employer

    • B. 

      DNA information and next of kin,

    • C. 

      Health status and lab test results

    • D. 

      Medical record number and name.


  • 22. 
    Outpaitent requisitions are typically of this type:
    • A. 

      Computer

    • B. 

      E-mail

    • C. 

      Manual

    • D. 

      Verbal


  • 23. 
    When reveived by the laboratory, inpaitent requisitions are typically sorted according to:
    • A. 

      Alphabetical order by name and then by test requested.

    • B. 

      Collection priority, date and time, and patient location.

    • C. 

      Difficulty of draw and type of equipment needed.

    • D. 

      Proximity of the patient's room to the laboratory.


  • 24. 
    Steps taken to unmistakeably connect a specimen and the accompanying paperwork to a specific individual are called:
    • A. 

      Accessioning the specimen.

    • B. 

      Bar-coding specimen labels.

    • C. 

      Collection verification.

    • D. 

      Patient identification.


  • 25. 
    Which priority does a timed test typically have?
    • A. 

      First

    • B. 

      Second

    • C. 

      Third

    • D. 

      Fourth


  • 26. 
    A test that is ordered stat should be collected:
    • A. 

      As soon as it is possible to do so.

    • B. 

      Immediately, without any hesitation.

    • C. 

      On the next closest scheduled sweep.

    • D. 

      Within 1 hour of the test request.


  • 27. 
    Which of the following tests is commonly ordered stat?
    • A. 

      Creat

    • B. 

      Diff

    • C. 

      Lytes

    • D. 

      RAST


  • 28. 
    If a test is ordered stat, it may mean that the patient is in:
    • A. 

      Critical condition.

    • B. 

      Fragile condition.

    • C. 

      Rehabilitation.

    • D. 

      Transition status.


  • 29. 
    When a test is ordered ASAP, it means that:
    • A. 

      The patient is in critical condition and needs immediate attention.

    • B. 

      The patient requires a test in which timing of collection is critical.

    • C. 

      Results are needed soon for an appropriate response.

    • D. 

      Results from blood work are needed for medication.


  • 30. 
    A preop patient:
    • A. 

      Has been admitted to the hospital.

    • B. 

      Is an ambulatory outpatient.

    • C. 

      Is being assessed after surgery.

    • D. 

      Will soon be going to surgery.


  • 31. 
    Tests are classified as routine if they are ordered:
    • A. 

      For collection at a specific time and place.

    • B. 

      In the course of establishing a diagnosis.

    • C. 

      To assess a patient's condition after surgery.

    • D. 

      To specifically eliminate the effects of a diet.


  • 32. 
    This term means the same as stat:
    • A. 

      Fasting

    • B. 

      Med emerg

    • C. 

      Postop

    • D. 

      Timed


  • 33. 
    A paitent who is NPO:
    • A. 

      Cannot have any food or drink.

    • B. 

      Cannot have anything but water.

    • C. 

      Is in critical but stable condition.

    • D. 

      Is recovering from minor surgery.


  • 34. 
    An example of a test that is commonly ordered fasting is:
    • A. 

      BUN

    • B. 

      Cortisol.

    • C. 

      Glucose.

    • D. 

      PTT.


  • 35. 
    Which liquid is acceptable to drink when one is fasting?
    • A. 

      Black coffee

    • B. 

      Diet soda

    • C. 

      Plain water

    • D. 

      Sugarless tea


  • 36. 
    Which is a common postop test?
    • A. 

      CBC

    • B. 

      ESR

    • C. 

      H & H

    • D. 

      PTT


  • 37. 
    You arrive to draw a specimen on an inpatient. The patien's door is closed. What do you do?
    • A. 

      Knock lightly, open the door slowly, and ask whether it is all right to enter.

    • B. 

      Knock softly and wait for someone in the room to come to the door.

    • C. 

      Leave to draw another patient in the same area and come back later.

    • D. 

      Open the door, announce yourself, and quickly proceed into the room.


  • 38. 
    There is a sign above the patient's bed that reads, "No blood pressures or venipuncture, right arm," the patient has an intravenous (IV) line in the left forearm. You have a request to collect a complete blood count (CBC) on the patient. How should you proceed?
    • A. 

      Ask the patient's nurse to collect the specimen from the IV.

    • B. 

      Ask the patient's nurse what to do when the sign is posted.

    • C. 

      Collect a CBC from the right arm without using a tourniquet.

    • D. 

      Collect the specimen from the left hand by finger puncture.


  • 39. 
    A code is a way to:
    • A. 

      Convey important information without alarming the public.

    • B. 

      Transmit messages over the facility's public access system.

    • C. 

      Use numbers or words to represent important information.

    • D. 

      All of the above.


  • 40. 
    DNR means:
    • A. 

      Do not alert the nurse.

    • B. 

      Do not call 911.

    • C. 

      Do not call relatives.

    • D. 

      Do not resuscitate.


  • 41. 
    You greet your patient in the following manner: "Hello, my name is Jean and I am here to collect a blood specimen, if that is all right with you." The paitent responds by saying, "OK, but I would rather not." How would you proceed?
    • A. 

      Ask another phlebotmist to draw the specimen.

    • B. 

      Come back at a later time to collect the specimen.

    • C. 

      Determine the problem is before

    • D. 

      Go ahead and draw the specimen without comment.


  • 42. 
    Which one of the following tests is used to identify protein disorders that lead to nerve damage?
    • A. 

      ANA

    • B. 

      ESR

    • C. 

      PTT

    • D. 

      SPEP


  • 43. 
    Your inpatient is asleep when you arrive to draw blood. What do you do?
    • A. 

      Call out the patient's name softly and shake the bed gently.

    • B. 

      Cancel the test and ask the nurse to resubmit the requisition.

    • C. 

      Check back every 15 minuets until the patient has awakened.

    • D. 

      Fill out a form stating the specimen was not obtained and why.


  • 44. 
    Laboratory results can be nagatively affected if the phlebotomist:
    • A. 

      Awakens a sleeping patient and raises the head of the patient's bed.

    • B. 

      Collects a specimen in dim lighting conditions in the patient's room.

    • C. 

      Draws a specimen from an unconscious patient without assistance.

    • D. 

      While preparing to collect a specimen, startles a patient who is asleep.


  • 45. 
    In collecting a blood specimen from an unconscious patient, it is unncessary to:
    • A. 

      Have someone assist you just in case the patient moves.

    • B. 

      Identify yourself and inform the patient of your intent.

    • C. 

      Move the patient to a special phlebotomy collection area.

    • D. 

      Talk the the patient as you would to a patient who is alert.


  • 46. 
    What do you do if a physician is with the patient and the specimen is ordered stat?
    • A. 

      Ask the patient's nurse to collect the stat specimen immediately.

    • B. 

      Come back later when you know the physician is no longer there.

    • C. 

      Introduce yourself and ask for permission to draw the specimen.

    • D. 

      Say "excuse me" to both and proceed to collect the specimen.


  • 47. 
    What is hte best thing to do if family or visitors are with a patient?
    • A. 

      Ask them to wait outside of the room until you are finished.

    • B. 

      Come back later to collect the specimen when they have left.

    • C. 

      Have the patient's nurse tell everyone that they should leave.

    • D. 

      Tell them to quietly watch from the opposite side of the bed.


  • 48. 
    Your patient is not in the room when you arrive to collect a timed specimen. The patient's nurse states that the patient will be unavaiable for several hours. What should you do?
    • A. 

      Ask the nurse to have the patient brought to the lab when the patient is available.

    • B. 

      Fill out a delay slip stating you were unable to collect the specimen.

    • C. 

      Report the situation to a supervisor and tell him or her to cancel the request.

    • D. 

      Return to the lab and put the request in the stack for the next sweep.


  • 49. 
    Misidentification of a specimen for this test is most likely to have fatal consequences:
    • A. 

      Blood culture

    • B. 

      Cold agglutinin

    • C. 

      Platelet count

    • D. 

      Type and screen


  • 50. 
    You arrive to collect a specimen on a patient named John Doe in 302B. How do you verify that the patient in 302B is indeed John Doe?
    • A. 

      Ask him, Are you John Doe?" If he says yes, collect the specimen.

    • B. 

      Ask him for his name and date of birth and match it to the requisition.

    • C. 

      Check his ID band. If it matches the requisition, draw the specimen.

    • D. 

      Have the nurse verify the patient's name after you check his ID band.


  • 51. 
    Which requisition information must match information on the patient's ID band?
    • A. 

      Medical record number

    • B. 

      Name of the physician

    • C. 

      Room and bed number

    • D. 

      Test collection priority


  • 52. 
    The medical record number on the ID band matches the number on your requisition, but the patient's name is spelled differently than the one on your requisition. What should you do?
    • A. 

      Collect the specimen and report the error to the patient's nurse.

    • B. 

      Do not collect the specimen until the difference is resolved.

    • C. 

      Draw the specimen because the medical record number matches.

    • D. 

      Make the correction on the requisition and draw the specimen.


  • 53. 
    An unconscious inpatient does not have an ID band. The name is on an envelope on the patient's nightstand matches with the requisition. What should you do?
    • A. 

      Ask the nurse to verify the patient's ID and collect the specimen.

    • B. 

      Complete the required procedure and then file an incident report.

    • C. 

      Do not start any procedure until the nurse attaches an ID bracelet.

    • D. 

      Make a computer entry to will alert other phlebotmists of this issue.


  • 54. 
    What would be the system of choice to identify laboratory specimens from an unconscious woman in the ER?
    • A. 

      Assign a name to the patient, such as Jane Doe.

    • B. 

      Assign a number to the patient until she is admitted.

    • C. 

      Use a three-part identification band with special tube labels.

    • D. 

      Wait to process the specimens until the patient can be identified.


  • 55. 
    Which type of inpatient is most likely to have more than one ID band?
    • A. 

      Adult

    • B. 

      Child

    • C. 

      Newborn

    • D. 

      Outpatient


  • 56. 
    What is the most critical error a phlebotomist can make?
    • A. 

      Collect a timed specimen late

    • B. 

      Fail to obtain the desired specimen

    • C. 

      Misidentify the patient's specimen

    • D. 

      Unknowingly give a patient a bruise


  • 57. 
    Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?
    • A. 

      Ask the patient to state her name; if it matches the requisition, continue.

    • B. 

      Ask the patient's nurse to attach an ID band and proceed when it is attached.

    • C. 

      Go to the nurses' station, get an ID bracelet, attach it, and then proceed.

    • D. 

      Tell the nurse that you will not collect the specimen and return to the lab.


  • 58. 
    Which one of the following types of patients is least likely to need his or her identity confirmed by the patient's nurse or a relative?
    • A. 

      A geriatric patient

    • B. 

      A very young child

    • C. 

      A mentally incompetent patient

    • D. 

      A non-English-speaking patient


  • 59. 
    The laboratory receptionist finishes checking a patient in and hands you the test request. The request is for a patient named Mary Smith. You call the name, and a woman who was just checked in responds. She is also the only patient in the waiting room. How do you verify that she is the correct patient?
    • A. 

      Ask the woman to state her complete name and date of birth to confirm her identity.

    • B. 

      Assume that you do not have to verify her identity because the receptionist already did.

    • C. 

      Conclude that she must be the right one because she is the only one in the waiting room.

    • D. 

      Decide that she must be the right one because she answered you when you called the name.


  • 60. 
    A cheerful, pleasant beside mannar and exchange of small talk are unlikely to:
    • A. 

      Divert attention from any discomfort associated with the draw.

    • B. 

      Increase the patient's confidence in the phlebotmist's abilities.

    • C. 

      Keep the patient from fainting during the venipuncture procedure.

    • D. 

      Redirect the patient's thoughts away from what is going to happen.


  • 61. 
    Your patient is cranky and rude to you. What do you do?
    • A. 

      Ask the patient's nurse to draw the specimen as you stand by to assist.

    • B. 

      Be as professional as you can and collect the specimen in a normal way.

    • C. 

      Do not speak to the patient; just get the necessary blood work and leave.

    • D. 

      Refuse to draw blood from the patient and leave the request for another phlebotomist.


  • 62. 
    Which of the following is part of informed consent for specimen collection?
    • A. 

      Advising the patient of his or her prognosis

    • B. 

      Explaining what disorders the test can detect

    • C. 

      Informing the patient that you are a student

    • D. 

      Notifying the patient of future venipunctures


  • 63. 
    The patient asks if the test you are about to draw is for disbetes. How do you answer?
    • A. 

      Explain that it is best to discuss the test with the physician.

    • B. 

      If the test is for glucose say, "Yes, it is" but do not elaborate.

    • C. 

      Say, "HIPAA confidentiality rules won't let me tell you."

    • D. 

      Tell the patient that it is not for a glucose test even if it is.


  • 64. 
    An inpatient vhemently refuses to allow you to collect a blood specimen. What should you do?
    • A. 

      Convince the patient to cooperate and collect the sample anyway.

    • B. 

      Have the nurse physically restrain the patient and draw the specimen.

    • C. 

      Notify the patient's nurse and document the patient's refusal,

    • D. 

      Return to the lab, cancel the test request, and inform the physician.


  • 65. 
    You arrive to draw a fasting specmen. The patient is just finishing breakfast. What do you do?
    • A. 

      Check with the patient's nurse to see if the specimen should be collected or the draw rescheduled.

    • B. 

      Collect the specimen, but write "nonfasting" on the lab slip and the specimen.

    • C. 

      Do not draw the blood, fill out an incident slip, and leave a copy for the nurse.

    • D. 

      Proceed to collect the specimen, since the patient had not quiet finished eating.


  • 66. 
    If you assemble equipment after selecting and cleaning the blood collection site, you will:
    • A. 

      Be more apt to allow sufficient time for the alcohol to dry.

    • B. 

      Have a better idea of what equipment you will need to use.

    • C. 

      Waste less equipment by knowing exactly what is needed.

    • D. 

      All of the above.


  • 67. 
    When performing a venipuncture, hand decontamination is required:
    • A. 

      After drawing your last patient.

    • B. 

      Before and after each patient.

    • C. 

      Only after drawing the patient.

    • D. 

      Only before putting on gloves.


  • 68. 
    Which of the following is the best thing to do if your hands are visibly contaminated?
    • A. 

      Clean them with a hand sanitizer.

    • B. 

      Cover them up with clean gloves.

    • C. 

      Wash them with soap and water.

    • D. 

      Wipe them with an alcohol pad.


  • 69. 
    You must colect a specimen on a 6-year-old. The child is a little fearful. What do you do?
    • A. 

      Explain what are you going to do to the child in simple terms.

    • B. 

      Restrain the child and draw the specimen without explanation.

    • C. 

      Tell the child that you will give him a treat if he does not cry.

    • D. 

      Tell the child to relax and not to worry because it will not hurt.


  • 70. 
    If the patient asks wheather the procedure will hurt, you should say that it:
    • A. 

      Could hurt if you watch, so look the other way.

    • B. 

      Is painless and will be over just before you know it.

    • C. 

      Might hurt just a little, but only for a short time.

    • D. 

      Hurts only if the phlebotmist is inexperienced.


  • 71. 
    What is the proper arm position for toutine veil-puncture?
    • A. 

      Downward in a straight line from shoulder to wrist, palm up

    • B. 

      Extended straight forward at about waist height and palm up

    • C. 

      Held out at an angle, bend at the elbow, and the palm up

    • D. 

      Straight down to the elbow, parallel elbow to wrist, palm up


  • 72. 
    Outpatients who have previously fainted during a blood draw should be:
    • A. 

      Allowed to sit up in order to carefully watch the draw.

    • B. 

      Asked to lie down, or sit in a reclining drawing chair.

    • C. 

      Drawn in a separate roam that has first-aid equipment.

    • D. 

      Permitted to sit in a chair if accompanied by an adult.


  • 73. 
    Which of the following acts can lead to liability issues?
    • A. 

      Asking visitors to leave the room while you draw a specimen.

    • B. 

      Drawing a patient who is lying in bed talking on a cell phone.

    • C. 

      Lowering a bed rail to make access to the patient's arm easier.

    • D. 

      Pulling the curtain between the bed while drawing on a specimen.


  • 74. 
    Never leave a tourniquet on for more than:
    • A. 

      30 seconds

    • B. 

      1 minute

    • C. 

      2 minutes.

    • D. 

      3 minutes.


  • 75. 
    Where is the best place to apply the tourniquet?
    • A. 

      About 3 to 4 in. Above the venipuncture site

    • B. 

      Distal to the venipuncture site on the forearm

    • C. 

      Distal to the wrist bone if drawing a hand vein

    • D. 

      Immediately above the venipuncture site.


  • 76. 
    If the tourniquet is too tight:
    • A. 

      Arterial flow below it may be stopped.

    • B. 

      Blood below it may hemoconcentrate.

    • C. 

      The pressure can cause the arm to ache.

    • D. 

      All the of above.


  • 77. 
    Which of the following actions is prohibited during the vein selection process?
    • A. 

      Having a patient pump his or her fist

    • B. 

      Lowering the arm alongside the chair

    • C. 

      Palpating the antecubital area firmly

    • D. 

      Using warmth to increase blood flow


  • 78. 
    In selecting a venipuncture site, how can you tell a vein from an artery?
    • A. 

      A vein has a lot less resilience.

    • B. 

      A vein pulses and feels larger.

    • C. 

      An artery has a distinct pulse.

    • D. 

      An artery is more superficial.


  • 79. 
    What does a sclerosed vein feel like?
    • A. 

      Bouncy and resilient

    • B. 

      Hard and cord-like

    • C. 

      Pulsating and firm

    • D. 

      Soft and pliable


  • 80. 
    It is acceptable to use an ankle vein if:
    • A. 

      Coagulation tests are requested.

    • B. 

      The patient is partially paralyzed.

    • C. 

      The physician gives permission.

    • D. 

      There are no other suitable sites.


  • 81. 
    Which of the following will help you avoid inadvertentlly puncturing an artery during venipuncture?
    • A. 

      Avoid drawing the basilic vein the the antecubital area.

    • B. 

      Do not select a site that is near where you feel a pulse.

    • C. 

      Do not select a vein that overlies or is close to an artery.

    • D. 

      All of the above.


  • 82. 
    You must collect a light-blue-top tube for a special coagulation test from a paitent who has an intravenous (IV) line in the left wrist area and dermatits all over the right arm and hand. The veins on the right arm and hand are not readily visible. What is the best way to proceed?
    • A. 

      Apply a tourniquet on the right arm over a towel and do the draw.

    • B. 

      Ask the patient's nurse to collect the specimen from the IV line.

    • C. 

      Collect from the left antecubital area without using a tourniquet.

    • D. 

      Collect the specimen by capillary puncture from the left hand.


  • 83. 
    What is the best thing to do if the vein can be felt but not seen, even with the tourniquet on?
    • A. 

      Insert the needle where you think it is and probe until you find it.

    • B. 

      Keep the tourniquet on while cleaning the sire and during the draw.

    • C. 

      Look for visual clues on the skin to remind you where the vein is.

    • D. 

      Mark the spot using a felt-tipped pen and clean it off when finished.


  • 84. 
    Release the tourniquet as soon as blood flow is established to:
    • A. 

      Allow arterial blood flow to return to normal.

    • B. 

      Decrease hemoconcentration of the specimen.

    • C. 

      Increase the venous flow to the vein selected.

    • D. 

      All of the above.


  • 85. 
    What is the CLSI-recommened way to clean a venipuncture site?
    • A. 

      Cleanse the area thoroughly with disinfectant using concentric circles.

    • B. 

      Cleanse with a circular motion from the center to the periphery.

    • C. 

      Scrub with an alcohol sponge as vigorously as you can for 1 minute.

    • D. 

      Wipe using concentric circles from the outside area to the center.


  • 86. 
    Which of the following is the least important reason to wait 30 seconds for the alcohol to dry before needle insertion?
    • A. 

      It allows the process of evaporation to help destroy any microbes.

    • B. 

      It avoids a stinging sensation when the needle penetrates the skin.

    • C. 

      It gives the phlebotomist time to prepare equipment and supplies.

    • D. 

      It prevents hemolysis of the specimen from alcohol to in the needle.


  • 87. 
    What happens if you advance the tube past the guideline on the holder before needle insertion?
    • A. 

      The ETS tube will fail to fill with blood because of loss of tube vacuum.

    • B. 

      Nothing; the line is actually a fill guideline for all evacuated tubes.

    • C. 

      The needle sleeve stops penetration of the tube until fully advanced.

    • D. 

      There will be transfer of the tube additive to the needle at that point.


  • 88. 
    Visual inspection of the needle tip before inserting it in a patient's vein would be unable to detect:
    • A. 

      The presence of external contamination.

    • B. 

      Flaws that could damage a vein.

    • C. 

      Proper positioning of the bevel.

    • D. 

      That the needle is out of date.


  • 89. 
    Which of the following steps are in the right order for the venipuncture procedure?
    • A. 

      Clean the site, prepare equipment, put on gloves, apply tourniquet

    • B. 

      Sanitize hands, select vein, release tourniquet, verify diet restrictions

    • C. 

      Select the site, apply tourniquet, prepare equipment, clean the site

    • D. 

      Select vein, clean the site, position the patient, put on your gloves


  • 90. 
    You are about to draw blood from a paitent. You touch the needle to the skin but change your mind and pull the needle away. What do you do next?
    • A. 

      Clean the site and try again using the same needle.

    • B. 

      Stop and obtain a new needle before trying again.

    • C. 

      Try it again immediately using that same needle.

    • D. 

      Wipe the needle across an alcohol pad and retry.


  • 91. 
    What is the best angle to use for the needle insertion during routine venipuncture?
    • A. 

      Less than 15 degrees

    • B. 

      30 degrees or less

    • C. 

      35 to 45 degrees

    • D. 

      45 to 60 degrees


  • 92. 
    In performing venipuncture, the needle is inserted:
    • A. 

      As you prefer.

    • B. 

      Bevel facing up.

    • C. 

      Bevel site down.

    • D. 

      Bevel sideways.


  • 93. 
    How can you  tell when the needle is in the vein as you insert it into the patient's arm?
    • A. 

      Blood will enter the ETS hub.

    • B. 

      The needle will start to vibrate.

    • C. 

      You will feel a slight "give."

    • D. 

      You will hear a hissing sound.


  • 94. 
    When is the best time to release the tourniquet during venipuncture?
    • A. 

      After the last tube has been filled completely

    • B. 

      After the needle is withdrawn and covered

    • C. 

      NsAs soon as blood begins to flow into the tube

    • D. 

      As soon as the needle penetrates the skin


  • 95. 
    Which of the following analytes is least afffected by prolonged tourniquet application?
    • A. 

      Potassium

    • B. 

      Prothrombin

    • C. 

      Red cell count

    • D. 

      Total protein


  • 96. 
    Which of the following would be considered improper specimen collection technique?
    • A. 

      Collect sterile specimens before all other specimens.

    • B. 

      Draw a "clear" tube before special coagulation tests.

    • C. 

      Fill each tube until the normal vacuum is exhausted.

    • D. 

      Position the arm so tubes fill from the stopper end first.


  • 97. 
    It is important to fill anticoagulant tubes to the proper level to ensure that:
    • A. 

      The specimen yields enough serum for the required tests.

    • B. 

      There is a proper ratio of blood to anticoagulant additive.

    • C. 

      There is an adequate amount of blood to perform the test.

    • D. 

      Tissue fluid contamination of the specimen is minimized.


  • 98. 
    It is important to mix anticoagulant tubes immediately after filling them to:
    • A. 

      Avoid microclot formation.

    • B. 

      Encourage coagulation.

    • C. 

      Inhibit hemoconcentration.

    • D. 

      Minimize hemolysis.


  • 99. 
    You are in the middle of drawing a blood specimen using the evacuated-tube method when you realize that you just filled an EDTA tube and still have a green-top tube to collect. What do you do?
    • A. 

      Do not collect the green tube until the next collection sweep.

    • B. 

      Draw several millimeters into a discard tube, then fill the green one.

    • C. 

      Draw the green one next and hope that there is no carryover.

    • D. 

      It is acceptable to draw the EDTA before the green stopper.


  • 100. 
    How many times do you mix nonadditive tubes?
    • A. 

      2 or 3

    • B. 

      5 to 10

    • C. 

      8 to 12

    • D. 

      None


  • 101. 
    What may happen if you mix tubes too vigorously?
    • A. 

      Hemolysis

    • B. 

      Jaundice

    • C. 

      Lipemia

    • D. 

      No effect


  • 102. 
    Use several layers of guaze during needle removal so that:
    • A. 

      Blood will not contaminate your gloved hand.

    • B. 

      It will not hurt when you pull out the needle.

    • C. 

      Pressure is adequate and bruising is prevented.

    • D. 

      The patient does not see you pull out the needle.


  • 103. 
    It is better to use gauze and not cotton balls for pressure over the site because cotton balls:
    • A. 

      Are not sufficiently porous to soak up all of the blood at the site.

    • B. 

      Attract more airborne contaminants and are therefore less sterile.

    • C. 

      Can irritate a patient's skin because they have loose cotton fibers.

    • D. 

      May pull the platelet plug away from the puncture site upon removal.


  • 104. 
    Applying pressure on the gauze as the needle is removed can cause the:
    • A. 

      Needle to bend.

    • B. 

      Patient to faint.

    • C. 

      Skin to be split.

    • D. 

      All of the above.


  • 105. 
    A needle safety feature, other than a blunting needle, should be activated:
    • A. 

      After some pressure has been applied to the site.

    • B. 

      As you are dropping the needle in the sharps container.

    • C. 

      Immediately after the needle is withdrawn.

    • D. 

      While the tube is still engaged in the holder.


  • 106. 
    Which of these steps are in the right venipuncture procedure order?
    • A. 

      Establish blood flow, release tourniquet, fill and mix tubes, remove needle

    • B. 

      Fill and mix all of the tubes, release tourniquet, remove needle, apply pressure

    • C. 

      Fill the tubes, remove needle, release tourniquet, mix tubes, apply pressure

    • D. 

      Release tourniquet, fill tubes, remove needle, apply pressure, mix all tubes


  • 107. 
    Proper needle disposal involves:
    • A. 

      Disposing of the needle and tube holder in the sharpes container as one unit.

    • B. 

      Ejecting the needle from the tube holder so that the holder can be reused.

    • C. 

      Removing the needle from the holder after engaging the needle safety device.

    • D. 

      Unscrewing the needle from the holder by using a slot in the sharps container.


  • 108. 
    Labeling of routine inpatient blood specimens should take place:
    • A. 

      At the bedside immediately after collection.

    • B. 

      Before the blood specimens are collected.

    • C. 

      In the lab processing area after collection.

    • D. 

      Outside the patient's room after collection.


  • 109. 
    Which of the following information on a specimen lavel would be considered optional?
    • A. 

      Patient room number and bed

    • B. 

      Patient's first and last name

    • C. 

      Phlebotomist's initials or ID

    • D. 

      The date and time of the draw


  • 110. 
    The patient's identification number is included on the specimen tube labels to:
    • A. 

      Avoid confusing multiple specimens from the same patient.

    • B. 

      Avoid confusing specimens from patients with the same name.

    • C. 

      Be used for an accession number in processing the specimen.

    • D. 

      Be used for insurance identification and payment purposes.


  • 111. 
    The following precautionary information was given to an outpatient after venipuncture. No other tests were scheduled. Which information was unnecessary?
    • A. 

      Do not carry a heavy bag or large purse on that arm.

    • B. 

      Do not drink or eat for 2 hours after collection.

    • C. 

      Do not lift any heavy objects for at least 1 hour.

    • D. 

      Leave the bandage on for minimum of 15 minutes.


  • 112. 
    Which of the following specimens requires routine (normal) handling?
    • A. 

      Ammonia

    • B. 

      Bilirubin

    • C. 

      Cholesterol

    • D. 

      Cryoglobulin


  • 113. 
    Which of the following is not a valid reason for failure to obtain a blood specimen?
    • A. 

      The patient adamantly refuses to have blood taken.

    • B. 

      The patient was unavailable at the designated time.

    • C. 

      You made an attempt but were unable to obtain the blood.

    • D. 

      You did not have the right equipment on your tray.


  • 114. 
    You have just made two unsuccessful attemps to collect a fasting blood specimen from an outpatient. The patient rotates his arm, and you note a large vein that you had not seen before. How do you proceed?
    • A. 

      Ask another phlebotomist to collect the fasting specimen.

    • B. 

      Ask the patient to come back later so that you can try again.

    • C. 

      Call the supervisor for permission to make a third attempt.

    • D. 

      Make a third attempt on the newly discovered large vein.


  • 115. 
    Where is the tourniquet applied when drawing a hand vein?
    • A. 

      A tourniquet is not required.

    • B. 

      Above the antecubital fossa.

    • C. 

      Just distal to the wrist bone.

    • D. 

      Proximal to the wrist bone.


  • 116. 
    A patient has difficult veins and you decide to use a butterfly for the draw. Butterfly is another name for a:
    • A. 

      Hypodermic needle.

    • B. 

      Muitisample needle

    • C. 

      Needle safety feature.

    • D. 

      Winged infusion set.


  • 117. 
    What is the advantage of using a butterfly?
    • A. 

      Blood flows faster than with the ETS needles.

    • B. 

      Butterflies are less expensive than other needles.

    • C. 

      Butterflies make it easier to draw difficult veins.

    • D. 

      There is greater choice in butterfly needle size.


  • 118. 
    Although the evacuated tube system (ETS) is the preferred method of blood collection, it may be necessary to use a syringe when:
    • A. 

      A large amount of blood is needed.

    • B. 

      The patient's veins are very fragile.

    • C. 

      There are no butterfly needles left.

    • D. 

      You need the blood to flow faster.


  • 119. 
    Specimen hemolysis can result from:
    • A. 

      Filling tubes with a transfer device at an angle.

    • B. 

      Leaving the tourniquet on until the last tube.

    • C. 

      Mixing anticoagulant tubes several extra times.

    • D. 

      Using a large-volume tube with a 23-gauge needle.


  • 120. 
    How can you tell that you are in a vein when you are using a syringe?
    • A. 

      A "flash" of blood will appear in the hub of the needle.

    • B. 

      Blood will automatically pump into the syringe barrel.

    • C. 

      There will be a very slight vibration in the needle.

    • D. 

      You cannot tell when you are in the vein with a syringe.


  • 121. 
    Success of pediatric blood collection is most dependent on:
    • A. 

      Aseptic technique.

    • B. 

      Correct order of draw.

    • C. 

      Patient immobilization.

    • D. 

      Tourniquet application.


  • 122. 
    Doing this before obtaining a blood specimen from a child is a bad idea:
    • A. 

      Establishing rapport which the child

    • B. 

      Greeting the parents and the child

    • C. 

      Telling the child it will not hurt

    • D. 

      Telling the child what to expect


  • 123. 
    A butterfly and 23-gauge needle 'is the best choice to use for venipuncture on a young child because:
    • A. 

      Children like the idea of using a butterfly.

    • B. 

      Children's veins are often very sclerosed.

    • C. 

      Flexible tubing allows for arm movement.

    • D. 

      It eliminates excessive bleeding.


  • 124. 
    In transferring blood from a syringe to evacuated tubes, which is the proper technique?
    • A. 

      Force blood through the needle into the tubes by pushing the syringe plunger.

    • B. 

      Hold the tube steady in your hand while the syringe needle penetrates the stopper.

    • C. 

      Place the evacuated tube in a rack before penetrating stopper with the needle.

    • D. 

      Use a specially designed engineering device called a syringe transfer device.


  • 125. 
    Which of the following is the least effective way to immoblize a pediatric patient before a blood draw?
    • A. 

      Allowing the child to sit with one arm bracing the other.

    • B. 

      Cradling the child close to the chest of the immobilizer.

    • C. 

      Grasping the child's wrist firmly in a palm-up position.

    • D. 

      Using two people: an immobilizer and a blood drawer.


  • 126. 
    In drawing blood from an older child, the most imporant consideration is:
    • A. 

      Assuring the child that it won't be painful.

    • B. 

      Explaining all of the tests being collected.

    • C. 

      Explaining the importance of holding still.

    • D. 

      Offering the child a reward for not crying.


  • 127. 
    Criteria used to decide which needle gauge t o use for venipuncture include:
    • A. 

      How deep the selected vein is.

    • B. 

      The size and condition of the vein.

    • C. 

      The type of test being collected.

    • D. 

      Your personal preference.


  • 128. 
    An additive should be mixed:
    • A. 

      After the next tube is placed in the tube holder.

    • B. 

      As soon as it is removed from the tube holder.

    • C. 

      When all of the other tubes have been collected.

    • D. 

      While the very next tube is being collected.


  • 129. 
    Tremors associated with this disease can make blood collection difficult:
    • A. 

      Alzheimer's

    • B. 

      Arthritis

    • C. 

      Diabetes

    • D. 

      Parkinson's


  • 130. 
    A diabetic outpatient has had a mastectomy on her right side and cannot straighten her left arm because of arthriris. The best place to collect a blood specimen is:
    • A. 

      An ankle or foot vein on either of her legs.

    • B. 

      The left forearm or hand, using a butterfly.

    • C. 

      The right arm below the antecubital fossa.

    • D. 

      The right hand, using a capillary puncture.


  • 131. 
    Which of the following is proper procedure when dealing with an elderly adult patient?
    • A. 

      Address all questions to a relative or attendent if the patient is hard of hearing.

    • B. 

      Apply a pressure bandage in case the patient does not hold adequate pressure.

    • C. 

      Raise the pitch of your voice sharply to make certain you are heard properly.

    • D. 

      Refrain from drawing on older patients if you have a cold, or else wear a mask.


  • 132. 
    The most common reason a patient must undergo dialysis treatment is:
    • A. 

      End stages of renal disease.

    • B. 

      Parkinson's disease effects.

    • C. 

      Problems with coagulation.

    • D. 

      Rheumatoid arthritis effects.


  • 133. 
    A type of care for patients who are terminally ill is:
    • A. 

      Elder care.

    • B. 

      Home care.

    • C. 

      Hospice care.

    • D. 

      Long-term care.


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