why should a PST evacuated tube be inverted 8-10 times after it has been filled with blood?

insufficient mixing of blood leads to micro-clot and fibrin strand formation

insufficient mixing of blood leads to dirty blood

insufficient mixing of blood leads to changes in blood color

insufficient mixing of blood leads to foul smelling blood

choose all of the criteria that must be met for a specimen to be acceptable for testing

blood specimen must be free of hemolysis

specimen must be delivered to the laboratory within the specified amount of time after collection

anticoagulated blood must be free of clots

specimens must be stored properly until the time of testing

outer surfaces of specimen containers must have no visible contamination

Blood specimen cannot be drawn from a site above an IV line

specimen collected in anticoagulant must have the correct blood-to-anticoagulation ratio

whole blood specimen must be shook vigorously before all testing

blood specimen cannot be drawn from a site below an IV line under any circumstances

blood tubes with anticoagulants should have a bid visible clot before being spun down

The following information should be written on the blood collection tube while at patients bedside immediately after a venipuncture

time of collection in military time

time of collection using 12 hour clock

Chemistry Specimen Collection And Processing Quiz

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Chemistry Specimen Collection And Processing Quiz - Quiz

About This Quiz

This CHEMISTRY SPECIMEN COLLECTION AND PROCESSING QUIZ assesses knowledge in handling and processing chemical specimens. It covers anticoagulants, tube additives, and their relevance to tests such as DNA and genetic testing, focusing on practical skills essential for laboratory professionals.

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2.

In the clinical chemistry department, tests can be performed on the following
- Blood
- Candy sweetness
- Cerebrospinal fluid
- Pleural fluid
- Synovial fluid
- Pericardial
- Agar plates
Correct Answer(s)

A. Blood
A. Cerebrospinal fluid
A. Pleural fluid
A. Synovial fluid
A. Pericardial

Explanation

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.

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3.

10 of the following tests require chilling (ice/water mixture) of specimen
- Catecholamine
- Free fatty acids
- Ammonia
- Lactic acid
- Arterial blood gas
- Angiotensin converting enzyme
- ACTH
- Pyruvate
- Renin
- Acetone
- Cryoglobulin
- Cryofibrinogen
- Cold agglutinin
- Bilirubin
- Carotene
- Vitamin b12
- Folate (folic acid)
Correct Answer(s)

A. Catecholamine
A. Free fatty acids
A. Ammonia
A. Lactic acid
A. Arterial blood gas
A. Angiotensin converting enzyme
A. ACTH
A. Pyruvate
A. Renin
A. Acetone

Explanation

These tests require chilling of the specimen because they involve substances or compounds that are sensitive to temperature. Chilling the specimen helps to preserve the integrity of these substances and ensures accurate test results.

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4.

4 of the following tests are light sensitive and blood tubes wrapped in foil are used to transport
- Catecholamine
- Free fatty acids
- Ammonia
- Lactic acid
- Arterial blood gas
- Angiotensin converting enzyme
- ACTH
- Pyruvate
- Renin
- Acetone
- Cryoglobulin
- Cryofibrinogen
- Cold agglutinin
- Bilirubin
- Carotene
- Vitamin b12
- Folate (folic acid)
Correct Answer(s)

A. Bilirubin
A. Carotene
A. Vitamin b12
A. Folate (folic acid)

Explanation

The question states that 4 of the tests are light sensitive and blood tubes wrapped in foil are used to transport them. Among the options given, bilirubin, carotene, vitamin B12, and folate (folic acid) are all substances that can be affected by light exposure. To prevent degradation or alteration of these substances, blood tubes wrapped in foil are used during transportation. Therefore, these four options are the correct answers.

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5.

3 of the following tests require warm (37C) body temperature of specimen
- Catecholamine
- Free fatty acids
- Ammonia
- Lactic acid
- Arterial blood gas
- Angiotensin converting enzyme
- ACTH
- Pyruvate
- Renin
- Acetone
- Cryoglobulin
- Cryofibrinogen
- Cold agglutinin
- Bilirubin
- Carotene
- Vitamin b12
- Folate (folic acid)
Correct Answer(s)

A. Cryoglobulin
A. Cryofibrinogen
A. Cold agglutinin

Explanation

Cryoglobulin, cryofibrinogen, and cold agglutinin tests require warm (37C) body temperature of the specimen because these tests involve the detection and analysis of proteins or antibodies that may become insoluble or undergo precipitation at lower temperatures. Performing these tests at body temperature ensures accurate results by preventing any potential alterations or denaturation of the proteins or antibodies being tested.

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6.

Which of the following tubes is used to test for blood alcohol level?
- Answer option1
- Answer option2
- Answer option3
- Answer option4
Correct Answer

A. Answer option2
7.

Why should a PST evacuated tube be inverted 8-10 times after it has been filled with blood?
- Insufficient mixing of blood leads to micro-clot and fibrin strand formation
- Insufficient mixing of blood leads to dirty blood
- Insufficient mixing of blood leads to changes in blood color
- Insufficient mixing of blood leads to foul smelling blood
Correct Answer

A. Insufficient mixing of blood leads to micro-clot and fibrin strand formation

Explanation

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.

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8.

Choose all of the criteria that must be met for a specimen to be acceptable for testing
- Label must be complete
- Blood specimen must be free of hemolysis
- Specimen must be delivered to the laboratory within the specified amount of time after collection
- Anticoagulated blood must be free of clots
- Specimens must be stored properly until the time of testing
- Outer surfaces of specimen containers must have no visible contamination
- Blood specimen cannot be drawn from a site above an IV line
- Specimen collected in anticoagulant must have the correct blood-to-anticoagulation ratio
- Whole blood specimen must be shook vigorously before all testing
- Blood specimen cannot be drawn from a site below an IV line under any circumstances
- Blood tubes with anticoagulants should have a bid visible clot before being spun down
Correct Answer(s)

A. Label must be complete
A. Blood specimen must be free of hemolysis
A. Specimen must be delivered to the laboratory within the specified amount of time after collection
A. Anticoagulated blood must be free of clots
A. Specimens must be stored properly until the time of testing
A. Outer surfaces of specimen containers must have no visible contamination
A. Blood specimen cannot be drawn from a site above an IV line
A. Specimen collected in anticoagulant must have the correct blood-to-anticoagulation ratio

Explanation

To ensure that a specimen is acceptable for testing, several criteria must be met. The label must be complete to ensure proper identification. The blood specimen must be free of hemolysis, as this can alter test results. The specimen must be delivered to the laboratory within the specified time frame to prevent degradation. Anticoagulated blood must be free of clots to ensure accurate testing. Specimens must be stored properly to maintain their integrity until testing. The outer surfaces of specimen containers must have no visible contamination to prevent cross-contamination. Blood cannot be drawn from a site above an IV line to avoid contamination. Specimens collected in anticoagulant must have the correct blood-to-anticoagulation ratio for accurate results.

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9.

The following information should be written on the blood collection tube while at patients bedside immediately after a venipuncture
- Patient name
- Date of blood collection
- Time of collection in military time
- Time of collection using 12 hour clock
- Phlebotomist initials
- Accession number
- Specimen ID number
Correct Answer(s)

A. Patient name
A. Date of blood collection
A. Time of collection in military time
A. Phlebotomist initials

Explanation

The information that should be written on the blood collection tube immediately after a venipuncture includes the patient's name, the date of blood collection, the time of collection in military time, and the phlebotomist's initials. These details are essential for accurate identification and tracking of the specimen. The accession number and specimen ID number may not be necessary to write on the tube at the patient's bedside, as they are typically assigned later in the laboratory.

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10.

A blood sample can be drawn by the IV nurse before the IV is started
- True
- False
Correct Answer

A. True

Explanation

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.

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11.

When patients have an IV line, the specimen must be collected from a different arm or from a vein below the IV insertion
- True
- False
Correct Answer

A. True

Explanation

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.

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12.

Every laboratory should have an SOP (standard Operating Procedure) manual that contains specific instructions for specimen collection
- True
- False
Correct Answer

A. True

Explanation

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.

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13.

Choose all the blood collection tube closure colors that contains heparin and gel separator
- Answer option1
- Answer option2
- Answer option3
- Answer option4
Correct Answer(s)

A. Answer option1
A. Answer option2

Explanation

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.

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14.

The plastic blood collection tube with red closure top does not need to be inverted after being filled with blood
- True
- False
Correct Answer

A. False

Explanation

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.

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15.

The glass blood collection tube with red closure top needs to be inverted after being filled with blood
- True
- False
Correct Answer

A. False

Explanation

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.

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16.

The plastic blood collection tube with red closure top needs to be inverted after being filled with blood
- True
- False
Correct Answer

A. True

Explanation

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.

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17.

Heparin additive in blood collection tubes is made from cow or pig lungs or intestines
- True
- False
Correct Answer

A. True

Explanation

The heparin additive in blood collection tubes is indeed made from cow or pig lungs or intestines. Heparin is a naturally occurring anticoagulant that prevents blood from clotting. It is extracted from the mucous membranes of these animal organs and then purified for use in medical applications. This is a common practice in the pharmaceutical industry to obtain heparin for use in blood collection tubes. Therefore, the statement is true.

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18.

Heparin anticoagulant in blood collection tubes can be manufactured in the form of which salts
- Lithium (Li+)
- Sodium (Na+)
- Ammonium (NH4+)
- Potassium (K+)
- Magnesium (Mg2+)
Correct Answer(s)

A. Lithium (Li+)
A. Sodium (Na+)
A. Ammonium (NH4+)
19.

Lithium heparin should not be used for blood lithium determinations
- True
- False
Correct Answer

A. True

Explanation

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.

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20.

Lithium heparin should be used for blood lithium determinations
- True
- False
Correct Answer

A. False

Explanation

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.

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21.

Ammonium heparin should be used for blood ammonia level testing
- True
- False
Correct Answer

A. False

Explanation

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.

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22.

Patients on heparin therapy should get blood drawn in the in order to determine the therapeutic level for this blood thinner
- True
- False
Correct Answer

A. False

Explanation

Patients on heparin therapy should get blood drawn in the laboratory in order to determine the therapeutic level for this blood thinner. The statement "False" implies that patients on heparin therapy do not need to get blood drawn to determine the therapeutic level, which is incorrect. Therefore, the correct answer is "False".

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23.

Patients on heparin therapy should get blood drawn in the in order to determine level therapeutic level for this blood thinner
- True
- False
Correct Answer

A. False

Explanation

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.

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24.

Patients on heparin therapy should get blood drawn in the in order to determine level therapeutic level for this blood thinner
- True
- False
Correct Answer

A. True

Explanation

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.

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25.

Drawing a lavender top tube before a green tube could lead to a falsely elevated potassium (K) reading when electrolytes are being tested
- True
- False
Correct Answer

A. True

Explanation

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.

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26.

Choose all tests that can be performed on a green top tubes
- Electrolytes
- Arterial blood gases
- Ammonia
- C&S
- Heparin therapy
- Coumadin therapy
- Hemophilia
Correct Answer(s)

A. Electrolytes
A. Arterial blood gases
A. Ammonia

Explanation

Green top tubes are commonly used for collecting blood samples for various tests. Electrolytes, arterial blood gases, and ammonia are all tests that can be performed on blood samples collected in green top tubes. These tests help measure the levels of different substances in the blood, such as electrolytes, gases, and ammonia, which can provide important information about a person's health. Other tests mentioned in the options, such as C&S (culture and sensitivity), heparin therapy, Coumadin therapy, and hemophilia, are not typically performed on blood samples collected in green top tubes.

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27.

Snow white's blood was drawn at 1100 as well as at 1630. It is ok for me to use the same pipet tip for both specimen since they belong to the same patient.
- True
- False
Correct Answer

A. False

Explanation

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.

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1
28.

Leaving specimens uncapped will lead to evaporation of volatile analytes (that rapidly evaporate) in blood and urine specimen leading to inaccurate reading of such analytes
- True
- False
Correct Answer

A. True

Explanation

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

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29.

Pipets do not have to be clean in the chemistry lab since we are not testing for C&S
- True
- False
Correct Answer

A. False

Explanation

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.

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30.

Tourniquet should not be left on the arm for more than _____________ minute(s)
- 1
- 0.5
- 3
- 4
Correct Answer

A. 1

Explanation

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.

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31.

If the tourniquet is left on the arm for too long, this can lead to blood stasis (stopping of blood flow). Blood stasis can result in hemoconcentration (some blood analytes becoming concentrated)
- True
- False
Correct Answer

A. True

Explanation

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.

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1
32.

Centrifuging at too high a speed can lead to hemolysis
- True
- False
Correct Answer

A. True

Explanation

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.

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33.

Centrifuging for too long can lead to hemolysis
- True
- False
Correct Answer

A. True

Explanation

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.

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34.

With the exception of blood culture tubes and sodium citrate tubes, serum tubes are drawn before tubes that contain anticoagulants
- True
- False
Correct Answer

A. True

Explanation

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.

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35.

For lead testing the following tubes can be used for testing
- Tan
- Royal blue
- Pink
- Gray
Correct Answer(s)

A. Tan
A. Royal blue

Explanation

The correct answer is tan and royal blue. These two tubes can be used for lead testing. The tan tube is commonly used for trace element testing, including lead. It contains an additive that helps preserve the sample and prevent contamination. The royal blue tube is used for heavy metal testing, including lead. It contains an anticoagulant and a preservative that stabilizes the sample and prevents metal contamination. Using these two tubes ensures accurate and reliable lead testing results.

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36.

Choose all procedures that can result in hemolysis
- Excessive shaking or turbulence of the sample
- Centrifuging at a speed to high
- Centrifuging for too long
- Freezing whole blood
- Using a needle with internal bore diameter too small (narrow)
- Slow blood flow
- Drawing from a hematoma
- Not allowing the alcohol to dry before venipuncture
- Pulling back forcibly on the plunger draws blood too quickly through the needle during syringe collection
- Removing the needle from the vin with the tube intact: remaining vacuum in the tube can cause air to be drawn forcefully into the tube, causing frothing,
- Blood flowing into tube too slowly
- Underfilling tubes with additives
- Not removing serum or plasma from red blood cells as soon as possible
- Drawing with a 21 gauge needle
- Palpating the vein before blood draw
- Needle that has gauge number too big
Correct Answer(s)

A. Excessive shaking or turbulence of the sample
A. Centrifuging at a speed to high
A. Centrifuging for too long
A. Freezing whole blood
A. Using a needle with internal bore diameter too small (narrow)
A. Slow blood flow
A. Drawing from a hematoma
A. Not allowing the alcohol to dry before venipuncture
A. Pulling back forcibly on the plunger draws blood too quickly through the needle during syringe collection
A. Removing the needle from the vin with the tube intact: remaining vacuum in the tube can cause air to be drawn forcefully into the tube, causing frothing,
A. Blood flowing into tube too slowly
A. Underfilling tubes with additives
A. Not removing serum or plasma from red blood cells as soon as possible
A. Needle that has gauge number too big

Explanation

The procedures listed can result in hemolysis, which is the destruction of red blood cells and release of hemoglobin into the surrounding fluid. Excessive shaking or turbulence of the sample can cause the fragile red blood cells to rupture. Centrifuging at a speed that is too high or for too long can also cause the cells to break. Freezing whole blood can cause ice crystals to form, which can damage the cells. Using a needle with a narrow internal bore diameter can cause shearing forces that lead to cell damage. Slow blood flow, drawing from a hematoma, not allowing the alcohol to dry before venipuncture, pulling back forcibly on the plunger during syringe collection, removing the needle from the vein with the tube intact, blood flowing into the tube too slowly, underfilling tubes with additives, not removing serum or plasma from red blood cells promptly, and using a needle with a gauge number too big can all cause hemolysis as well.

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37.

Phlebotomists have to wipe the venipuncture site with a 70% isopropyl alcohol before venipuncture when Blood alcohol level is to be determined
- True
- False
Correct Answer

A. False

Explanation

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.

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38.

Therapeutic phlebotomy is a method of treatment performed on polycythemia patients
- True
- False
Correct Answer

A. True

Explanation

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.

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39.

Hemolysis of blood can lead to plasma contamination with K+, hemoglobin, enzymes and other intracellular contents of red blood cells
- True
- False
Correct Answer

A. True

Explanation

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.

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40.

When testing enzyme activity levels, some test procedures will require the plasma or serum to be frozen. In such cases freeze the whole blood
- True
- False
Correct Answer

A. False

Explanation

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.

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41.

How long should a serum tube be left to clot before centrifuging?
- 10 mi
- 20 min
- 30 min
- 40 min
Correct Answer

A. 30 min

Explanation

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.

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42.

Check the following causes of hematoma
- Remove needle with tourniquet on
- Not enough pressure applied after needle has been removed
- Palpating vein before venipuncture
Correct Answer(s)

A. Remove needle with tourniquet on
A. Not enough pressure applied after needle has been removed

Explanation

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.

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43.

Check all things to avoid during collection of capillary puncture specimen
- Excessive milking of site
- Not wiping away the first drop of blood
- Puncture perpendicular to fingerprint
Correct Answer(s)

A. Excessive milking of site
A. Not wiping away the first drop of blood

Explanation

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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44.

Do not draw from the following sites
- Edematous limb
- Burn site
- Hematoma
- Mastectomy
- Above an IV site
- Small veins
- Rolling veins
Correct Answer(s)

A. Edematous limb
A. Burn site
A. Hematoma
A. Mastectomy
A. Above an IV site

Explanation

This answer suggests that the sites mentioned (edematous limb, burn site, hematoma, mastectomy, above an IV site) should not be used for drawing from. The reasons for this could be that these sites may have compromised blood flow or may be prone to infection, making them unsuitable for drawing blood. Additionally, drawing from these sites may cause discomfort or pain to the patient.

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45.

Why do 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
- So that all phlebotomists are uniform
Correct Answer

A. To decrease problems associated with small amounts of additives from previously drawn tubes

Explanation

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.

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46.

Dilantin is an anti-epileptic drug. digoxin is used to treat congestive heart failure. Both of these drugs have to monitored because they have a narrow therapeutic range, above which the drugs are toxic. below the therapeutic range the drug is not effective. what tube is used to draw the blood for this therapeutic drug monitoring
- Serum tubes
- Heparinized tubes
- Citrated tubes
- EDTA tubes
Correct Answer

A. Serum tubes

Explanation

Serum tubes are used to draw blood for therapeutic drug monitoring of Dilantin and digoxin because these drugs have a narrow therapeutic range. Serum tubes allow for the separation of blood cells from the liquid portion of the blood, which is the serum. The serum is then used to measure the concentration of the drugs in the blood, ensuring that they are within the desired therapeutic range. Heparinized tubes contain anticoagulant and are not suitable for drug monitoring. Citrated tubes are used for coagulation studies, and EDTA tubes are used for complete blood count (CBC) and other hematological tests.

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47.

From the picture it is safe to assume that the higher the gauge of a needle, the smaller the internal bore (lumen)
- True
- False
Correct Answer

A. True

Explanation

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.

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48.

Choose all of the following that can lead to a hematoma
- Puncturing into and through the vein
- Insufficient time applying pressure to a venipuncture site
- patient on blood thinners and anticoagulants who do not apply pressure long enough to stop bleeding
- Reapplication of tourniquet on the same arm immediately after unsuccessful venipuncture
- Leaving the tourniquet on for 5 sec
- Palpating without gloves
Correct Answer(s)

A. Puncturing into and through the vein
A. Insufficient time applying pressure to a venipuncture site
A. patient on blood thinners and anticoagulants who do not apply pressure long enough to stop bleeding
A. Reapplication of tourniquet on the same arm immediately after unsuccessful venipuncture

Explanation

A hematoma is a localized collection of blood outside the blood vessels, usually caused by an injury to the blood vessels. Puncturing into and through the vein can cause bleeding into the surrounding tissues, leading to the formation of a hematoma. Insufficient time applying pressure to a venipuncture site can result in prolonged bleeding and the accumulation of blood in the tissues. Patients on blood thinners and anticoagulants who do not apply enough pressure to stop bleeding are at a higher risk of developing a hematoma. Reapplication of a tourniquet on the same arm immediately after an unsuccessful venipuncture can cause blood to pool and result in a hematoma.

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49.

. Venipuncture is not allowed on the arm on the side of a mastectomy. choose all of the reasons why this is not encouraged
- The presence of lymph fluid dilutes the blood in this area, giving erroneous patient test results
- The lymph fluid may also make the patient’s arm swollen thus making tourniquet application painful
- On breast cancer surgery patients may lead to the development of a bacterial infection
- Any cancer remaining might infect the phlebotomist
Correct Answer(s)

A. The presence of lymph fluid dilutes the blood in this area, giving erroneous patient test results
A. The lymph fluid may also make the patient’s arm swollen thus making tourniquet application painful
A. On breast cancer surgery patients may lead to the development of a bacterial infection

Explanation

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.

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Feb 11, 2013

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Chemistry Specimen Collection And Processing Quiz

Quiz Preview

In the clinical chemistry department, tests can be performed on the following

10 of the following tests require chilling (ice/water mixture) of specimen

4 of the following tests are light sensitive and blood tubes wrapped in foil are used to transport

3 of the following tests require warm (37C) body temperature of specimen

Which of the following tubes is used to test for blood alcohol level?

Why should a PST evacuated tube be inverted 8-10 times after it has been filled with blood?

Choose all of the criteria that must be met for a specimen to be acceptable for testing

The following information should be written on the blood collection tube while at patients bedside immediately after a venipuncture

A blood sample can be drawn by the IV nurse before the IV is started

When patients have an IV line, the specimen must be collected from a different arm or from a vein below the IV insertion

Every laboratory should have an SOP (standard Operating Procedure) manual that contains specific instructions for specimen collection

Choose all the blood collection tube closure colors that contains heparin and gel separator

The plastic blood collection tube with red closure top does not need to be inverted after being filled with blood

The glass blood collection tube with red closure top needs to be inverted after being filled with blood

The plastic blood collection tube with red closure top needs to be inverted after being filled with blood

Heparin additive in blood collection tubes is made from cow or pig lungs or intestines

Heparin anticoagulant in blood collection tubes can be manufactured in the form of which salts

Lithium heparin should not be used for blood lithium determinations

Lithium heparin should be used for blood lithium determinations

Ammonium heparin should be used for blood ammonia level testing

Patients on heparin therapy should get blood drawn in the in order to determine the therapeutic level for this blood thinner

Patients on heparin therapy should get blood drawn in the in order to determine level therapeutic level for this blood thinner

Patients on heparin therapy should get blood drawn in the in order to determine level therapeutic level for this blood thinner

Drawing a lavender top tube before a green tube could lead to a falsely elevated potassium (K) reading when electrolytes are being tested

Choose all tests that can be performed on a green top tubes

Snow white's blood was drawn at 1100 as well as at 1630. It is ok for me to use the same pipet tip for both specimen since they belong to the same patient.

Leaving specimens uncapped will lead to evaporation of volatile analytes (that rapidly evaporate) in blood and urine specimen leading to inaccurate reading of such analytes

Pipets do not have to be clean in the chemistry lab since we are not testing for C&S

Tourniquet should not be left on the arm for more than _____________ minute(s)

If the tourniquet is left on the arm for too long, this can lead to blood stasis (stopping of blood flow). Blood stasis can result in hemoconcentration (some blood analytes becoming concentrated)

Centrifuging at too high a speed can lead to hemolysis

Centrifuging for too long can lead to hemolysis

With the exception of blood culture tubes and sodium citrate tubes, serum tubes are drawn before tubes that contain anticoagulants

For lead testing the following tubes can be used for testing

Choose all procedures that can result in hemolysis

Phlebotomists have to wipe the venipuncture site with a 70% isopropyl alcohol before venipuncture when Blood alcohol level is to be determined

Therapeutic phlebotomy is a method of treatment performed on polycythemia patients

Hemolysis of blood can lead to plasma contamination with K+, hemoglobin, enzymes and other intracellular contents of red blood cells

When testing enzyme activity levels, some test procedures will require the plasma or serum to be frozen. In such cases freeze the whole blood

How long should a serum tube be left to clot before centrifuging?

Check the following causes of hematoma

Check all things to avoid during collection of capillary puncture specimen

Do not draw from the following sites

Why do phlebotomists have to follow the order of draw for venipuncture when using multiple colored evacuation tubes?

From the picture it is safe to assume that the higher the gauge of a needle, the smaller the internal bore (lumen)

Choose all of the following that can lead to a hematoma

. Venipuncture is not allowed on the arm on the side of a mastectomy. choose all of the reasons why this is not encouraged