Chemistry Specimen Collection And Processing Quiz

Every laboratory should have an SOP (Standard Operating Procedure) manual that contains specific instructions for specimen collection. This is important to ensure consistency and accuracy in the collection process. The SOP manual provides step-by-step guidelines for laboratory personnel to follow when collecting specimens, including the proper techniques, equipment, and safety precautions to be taken. Having an SOP manual helps to standardize procedures, minimize errors, and maintain quality control in the laboratory. Therefore, it is true that every laboratory should have an SOP manual for specimen collection.

If a tourniquet is left on the arm for an extended period, it can restrict blood flow, leading to blood stasis. Blood stasis refers to the stopping or slowing down of blood flow. When blood flow is disrupted, certain blood analytes can become concentrated, a condition known as hemoconcentration. Therefore, the statement that if the tourniquet is left on the arm for too long, it can lead to blood stasis and hemoconcentration is true.

Phlebotomists have to follow the order of draw for venipuncture when using multiple colored evacuation tubes to decrease problems associated with small amounts of additives from previously drawn tubes. This is because some additives in the tubes can contaminate the blood sample if drawn in the wrong order, leading to inaccurate test results. By following the correct order, the risk of cross-contamination is minimized, ensuring accurate and reliable test results.

Leaving specimens uncapped can cause the volatile analytes in blood and urine specimens to evaporate, which can result in inaccurate readings of these analytes.

The purpose of the order of draw is to avoid cross-contamination from tube additives, which can lead to test result errors. By following a specific order when collecting blood samples, the risk of additives from one tube contaminating subsequent tubes is minimized. This ensures the accuracy and reliability of test results.

The statement is true because the Clinical and Laboratory Standards Institute (CLSI) is indeed an international nonprofit organization that develops standards and guidelines for patient testing and related healthcare issues. It was formerly known as the National Commission on Clinical Laboratory Standards (NCCLS).

Centrifuging for too long can lead to hemolysis, which is the rupture or destruction of red blood cells. This can occur due to the high centrifugal forces applied during the process, causing the fragile cell membranes to break and release their contents into the surrounding solution. Hemolysis can affect the accuracy of laboratory tests that rely on intact red blood cells, such as blood cell counts or measurements of specific blood components. Therefore, it is important to follow the recommended centrifugation time to avoid hemolysis and obtain reliable test results.

This statement is incorrect. Pipets do need to be clean in the chemistry lab regardless of whether we are testing for C&S (contamination and sterility) or not. Clean pipets are essential for accurate and reliable measurements in any laboratory setting.

Centrifuging at too high a speed can cause hemolysis, which is the rupture or destruction of red blood cells. This occurs because the high centrifugal forces exerted on the blood sample can cause the fragile cell membranes to break, leading to the release of hemoglobin and other cellular contents into the surrounding fluid. This can affect the accuracy of laboratory tests that rely on intact red blood cells, such as complete blood counts and blood chemistry analysis. Therefore, it is important to carefully select the appropriate speed and duration for centrifugation to avoid hemolysis and obtain reliable results.

Heparinized tubes are commonly used in chemistry tests that require plasma because heparin prevents blood from clotting, allowing for the collection and use of plasma. These tubes are particularly useful for STAT tests, which require rapid results, as they allow for quick separation of plasma from whole blood. Therefore, the statement that heparinized tubes are usually used for chemistry tests that require plasma, especially STAT tests, is true.

The explanation for the given correct answer is that there is indeed only one recommended order of draw for venipuncture. This recommended order of draw can be found in the most current edition of the Clinical and Laboratory Standards Institute (CLSI) Venipuncture document. This document provides guidelines and standards for the proper sequence in which different types of blood samples should be collected during venipuncture. Following this recommended order of draw helps to prevent cross-contamination and ensures accurate test results. Therefore, the statement "There is only one recommended order of draw" is true.

The picture provided suggests that there is a relationship between the gauge of a needle and the size of its internal bore or lumen. It implies that as the gauge of the needle increases, the internal bore becomes smaller. This can be inferred from the visual representation in the picture, where the larger gauges are associated with narrower openings. Therefore, the statement "the higher the gauge of a needle, the smaller the internal bore (lumen)" is likely to be true based on the given information.

Hemolysis of blood refers to the rupture or destruction of red blood cells, which can release their contents into the surrounding plasma. This can lead to contamination of the plasma with various substances such as potassium (K+), hemoglobin, enzymes, and other intracellular contents of red blood cells. Therefore, the statement is true.

When blood is not properly mixed in a PST evacuated tube, it can lead to the formation of micro-clots and fibrin strands. This can affect the accuracy of test results and cause complications in the analysis. Inverting the tube 8-10 times helps ensure that the blood is thoroughly mixed with the anticoagulant present in the tube, preventing clotting and ensuring accurate test results.

Extensive research has shown that even small amounts of additives in tubes can cause inaccurate test results. This suggests that it is indeed possible for the very small amounts of additives in tubes to cause inaccuracies in test results. Therefore, the statement is true.

Drawing a lavender top tube before a green tube could lead to a falsely elevated potassium (K) reading when electrolytes are being tested. This is because the lavender top tube contains an anticoagulant called EDTA, which can chelate calcium and magnesium ions. If the lavender tube is drawn before the green tube, the EDTA can contaminate the sample and affect the potassium levels, leading to a falsely elevated reading. Therefore, it is important to follow the correct order of draw to ensure accurate test results.

Using the same pipet tip for drawing blood at different times for the same patient is not recommended. Even though the blood samples belong to the same patient, it is important to ensure proper hygiene and prevent any potential contamination or cross-contamination. Using a fresh pipet tip for each blood draw helps maintain the integrity of the samples and reduces the risk of any errors or complications during testing or analysis.

The correct answer is clot activator and polymer gel. This is because clot activator is used to promote the clotting process in blood samples, which helps in separating the serum from the blood cells. The polymer gel, on the other hand, is used as a barrier to separate the serum from the blood cells and prevent contamination. Therefore, the combination of clot activator and polymer gel is commonly used in SST tubes for blood collection and analysis.

Serum tubes are typically drawn before tubes that contain anticoagulants, except for blood culture tubes and sodium citrate tubes. This is because serum tubes are used to collect blood samples for serum testing, which requires the blood to clot before the serum can be separated. Anticoagulant tubes, on the other hand, are used to prevent clotting in order to obtain plasma samples. Therefore, it is true that serum tubes are drawn before tubes that contain anticoagulants, with the exception of blood culture tubes and sodium citrate tubes.

Silica is an example of a clot activator because it promotes the coagulation process by initiating the formation of blood clots. When silica comes into contact with blood, it triggers a series of reactions that lead to the activation of clotting factors and the formation of a clot. This property of silica is often utilized in medical laboratories for blood tests, where clot activators are added to blood samples to facilitate the separation of serum or plasma from the rest of the blood components.

The plastic blood collection tube with a red closure top needs to be inverted after being filled with blood because it contains an anticoagulant or clot activator that needs to mix with the blood to prevent clotting or promote clotting, depending on the purpose of the test. Inverting the tube ensures thorough mixing of the blood with the additive, allowing accurate results to be obtained during laboratory analysis.

When patients have an IV line, it is necessary to collect the specimen from a different arm or a vein below the IV insertion. This is because the IV line may introduce medications or fluids into the bloodstream, which can contaminate the specimen and affect the accuracy of the test results. By collecting the specimen from a different arm or a vein below the IV insertion, the risk of contamination is minimized, ensuring reliable test results.

It is true that a blood sample can be drawn by the IV nurse before the IV is started. This is a common practice in medical settings where blood samples are often taken for diagnostic purposes. Drawing the blood sample before starting the IV allows for the collection of necessary samples without interference from the IV fluids or medications that may be administered later. It also helps in preventing contamination of the blood sample with any substances introduced through the IV line.

The correct answer is thrombin as clot activator and polymer gel. This is because thrombin is a protein that plays a crucial role in the blood clotting process. When thrombin is present in a tube, it activates the clotting cascade, leading to the formation of a blood clot. The polymer gel is used to separate the serum or plasma from the formed clot, allowing for further testing or analysis.

A tourniquet should not be left on the arm for more than 1 minute. Leaving it on for longer periods can cause damage to the tissues and restrict blood flow, leading to complications such as tissue death or nerve damage. It is important to remove the tourniquet as soon as its purpose has been served to prevent these potential risks.

Lithium heparin should not be used for blood lithium determinations because heparin can interfere with the accurate measurement of lithium levels. Heparin is an anticoagulant that can bind to lithium and alter its concentration in the blood sample, leading to inaccurate results. Therefore, other types of anticoagulants or collection tubes should be used for blood lithium determinations to ensure reliable and precise measurements.

Therapeutic phlebotomy is indeed a method of treatment performed on polycythemia patients. Polycythemia is a condition characterized by an excessive production of red blood cells, which can lead to an increased risk of blood clots, stroke, and other complications. Therapeutic phlebotomy involves the removal of a certain amount of blood from the patient's body to reduce the number of red blood cells and improve their overall health. This procedure helps in managing the symptoms and reducing the risks associated with polycythemia. Therefore, the statement "therapeutic phlebotomy is a method of treatment performed on polycythemia patients" is true.

Therapeutic phlebotomy is a treatment method commonly used for patients with hemochromatosis, a condition characterized by excessive iron buildup in the body. This procedure involves removing a specific amount of blood from the patient's body to reduce iron levels and prevent complications associated with hemochromatosis. Therefore, the statement "therapeutic phlebotomy is a method of treatment performed on hemochromatosis patients" is true.

Serum tubes should be left to clot for 30 minutes before centrifuging. This is because during this time, the blood in the tube forms a clot, which consists of a network of fibrin strands that trap the blood cells. After 30 minutes, the clot is considered stable and can be separated from the serum by centrifugation. Waiting for this duration ensures that the clot is fully formed and will not break apart during the centrifugation process, leading to accurate separation of serum from the clot.

Lithium heparin should not be used for blood lithium determinations because heparin can interfere with the accuracy of the test results. Heparin is an anticoagulant that can bind to lithium ions, leading to inaccurate measurements of lithium levels in the blood. Instead, lithium EDTA or lithium fluoride should be used as anticoagulants for blood lithium determinations to ensure reliable and accurate results.

The correct answer is "Remove needle with tourniquet on, Not enough pressure applied after needle has been removed." These causes can lead to the formation of a hematoma. Removing the needle while the tourniquet is still on can cause blood to pool and form a hematoma. Additionally, if enough pressure is not applied after the needle is removed, it can result in bleeding and the formation of a hematoma. Palpating the vein before venipuncture is not a cause of hematoma formation.

A serum tube is a type of blood collection tube that is commonly used to collect blood samples for laboratory testing. It contains a clot activator that promotes blood clotting and separates the serum from the rest of the blood components. The serum can then be used to measure various substances in the blood, including glucose levels. Since the clotting process is initiated immediately after collection, the serum tube is suitable for tests that need to be run right away, such as blood glucose level testing. Therefore, the statement is true.

Patients on heparin therapy should get blood drawn in order to determine the therapeutic level for this blood thinner. Heparin is a medication used to prevent blood clots, and its effectiveness is measured by monitoring the patient's activated partial thromboplastin time (aPTT) or anti-Xa levels. Regular blood tests are necessary to ensure that the patient is receiving the correct dosage of heparin to maintain the desired therapeutic level and prevent complications such as bleeding or clotting. Therefore, it is true that patients on heparin therapy should have their blood drawn to determine the therapeutic level of this blood thinner.

The plastic blood collection tube with red closure top needs to be inverted after being filled with blood. This is because the red closure top indicates that the tube contains an anticoagulant, which is used to prevent blood from clotting. Inverting the tube ensures that the anticoagulant mixes properly with the blood, preventing clotting and ensuring accurate test results.

The explanation for the given correct answer is that lavender top tubes are used for collecting blood samples for certain tests, including potassium levels. If a lavender top tube is collected before a red or green top tube, there is a possibility of cross-contamination, leading to falsely increased potassium levels in the lavender top tube. Therefore, the statement is true.

The correct answer is Answer option1 and Answer option2 because these two options indicate the blood collection tube closure colors that contain both heparin and gel separator.

Phlebotomists do not need to wipe the venipuncture site with a 70% isopropyl alcohol before venipuncture when Blood alcohol level is to be determined. This is because alcohol can contaminate the blood sample and affect the accuracy of the test results. Therefore, it is not necessary to use isopropyl alcohol in this situation.

The statement is false because patients on heparin therapy should get blood drawn in the morning, not in the evening, in order to determine the therapeutic level for this blood thinner. The timing of the blood draw is important as it helps to ensure accurate results and proper dosage adjustments for the medication.

During the collection of a capillary puncture specimen, it is important to avoid excessive milking of the site and not wiping away the first drop of blood. Excessive milking can cause hemolysis, which can affect the accuracy of the test results. Not wiping away the first drop of blood can contaminate the sample with tissue fluids and other substances present on the skin. Puncturing perpendicular to the fingerprint is not mentioned as something to avoid in the given options.

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The glass blood collection tube with a red closure top does not need to be inverted after being filled with blood. Inverting the tube is typically required for tubes with an anticoagulant additive, which helps prevent blood from clotting. However, the red closure top indicates that the tube does not contain an anticoagulant, so there is no need to invert it.

Freezing whole blood is not necessary when testing enzyme activity levels. The question states that some test procedures may require the plasma or serum to be frozen, not the whole blood. Freezing the whole blood may not provide accurate results as it may affect the activity levels of the enzymes being tested. Therefore, the correct answer is False.

The correct answer includes the types of samples that can be tested in the clinical chemistry department. These samples include blood, cerebrospinal fluid, pleural fluid, synovial fluid, and pericardial fluid. These samples are commonly tested in clinical chemistry to assess various parameters and diagnose diseases or conditions.

Ammonium heparin should not be used for blood ammonia level testing. Ammonium heparin is an anticoagulant used to prevent blood from clotting, but it can interfere with the accuracy of ammonia level testing. Instead, sodium heparin or EDTA should be used as anticoagulants for blood ammonia level testing.

Venipuncture is not allowed on the arm on the side of a mastectomy due to several reasons. Firstly, the presence of lymph fluid in this area can dilute the blood, leading to inaccurate test results. Additionally, the lymph fluid may cause swelling in the patient's arm, making it painful to apply a tourniquet. Furthermore, performing venipuncture on breast cancer surgery patients may increase the risk of developing a bacterial infection. Therefore, it is not encouraged to perform venipuncture on the arm on the side of a mastectomy.

The correct answer is heparin and polymer gel. Heparin is an anticoagulant that prevents blood from clotting in the tube, while polymer gel is used to separate the blood cells from the plasma. This combination allows for the collection of plasma without any clotting, making it suitable for certain laboratory tests that require a plasma sample.