NCCT Exam: Medical Procedures (Phlebotomy) Practice Test

The venipuncture site should be cleansed with an alcohol prep. This is because alcohol has antiseptic properties and can effectively kill bacteria on the skin. Cleansing the site with an alcohol prep helps to reduce the risk of infection during the venipuncture procedure. Using a damp solution, paper towel, or the back of the hand may not provide the same level of cleanliness and disinfection as an alcohol prep.

When performing a venipuncture, making a fist can cause the veins to become more prominent. This is because making a fist helps to increase blood flow and pressure in the veins, making them easier to locate and access for the procedure. By making a fist, the muscles in the hand and forearm contract, which pushes blood into the veins and causes them to bulge and become more visible. This can make it easier for the healthcare professional to find a suitable vein and perform the venipuncture successfully.

A centrifuge is an instrument commonly used in laboratories to separate the cellular and liquid portions of the blood. It achieves this by spinning the blood sample at high speeds, causing the heavier cellular components to settle at the bottom of the tube while the lighter liquid portion remains on top. This separation allows for further analysis or testing of specific components in the blood, such as red and white blood cells or plasma.

The evacuated glass tubes in the blood collection system come in different sizes, and the stoppers are color coded to denote the type of additive or lack of one. This means that each color represents a specific type of additive or lack thereof, making it easier for healthcare professionals to identify and select the appropriate tube for blood collection.

The correct answer is CLOSED. When using a centrifuge, it is important to keep the lid closed to ensure safety and prevent any accidents. Closing the lid creates a sealed environment, allowing the centrifuge to operate efficiently and securely. Keeping the lid open, ajar, or lifted can lead to the release of potentially harmful substances, disrupt the balance of the centrifuge, or cause injury to the user. Therefore, it is crucial to keep the lid closed when the centrifuge is in use.

The most important step in the performance of a venipuncture is positively identifying the patient. This is crucial to ensure that the procedure is being performed on the correct individual, preventing any potential harm or errors. Positive identification helps to avoid situations such as misdiagnosis, incorrect treatment, or transfusion reactions. It ensures patient safety and promotes accurate and effective healthcare delivery. Selecting the correct needle gauge, selecting the appropriate cleansing agent, and selecting the appropriate tourniquet are also important steps in the procedure, but positively identifying the patient takes precedence as it directly impacts patient care and outcomes.

When looking for a vein, it is important to use the index finger to palpate. Palpation involves using touch to feel for the vein's location and characteristics, such as size and depth. By using the index finger, which is more sensitive and precise than other fingers, healthcare professionals can accurately locate the vein and determine the best spot for injection or other procedures.

When cleansing the venipuncture site, it is good practice to cleanse the site from the inside out and allow it to air dry. This method ensures that the site is thoroughly cleaned and reduces the risk of introducing any contaminants into the puncture site. Allowing the site to air dry also prevents any potential irritation or discomfort that may occur if the alcohol is not completely dry before the needle is inserted.

The higher the gauge number, the smaller the needle. This is because the gauge number refers to the thickness of the needle. So, a higher gauge number indicates a thinner needle, making it smaller in size.

Wiping away the first drop of blood is important when performing a capillary stick because it helps to remove any potential contaminants or excess tissue fluid from the puncture site. This ensures that the blood sample obtained is clean and accurate for testing purposes.

A lancet is a small, sterile, needle-like piece of metal used to make small punctures in the dermis. It is commonly used in medical procedures such as blood glucose testing or obtaining a small blood sample for diagnostic purposes. The sharp tip of the lancet allows for precise and controlled punctures, minimizing pain and tissue damage.

The maximum time a tourniquet should be tied on the upper arm while drawing blood is 1 minute. Tying a tourniquet for longer periods can lead to venous congestion, which can affect the accuracy of blood test results. Keeping the tourniquet on for a shorter duration helps to minimize discomfort and potential complications for the patient.

When feeling for a vein, it is recommended to wrap the tourniquet around the arm approximately 3-4 inches above the area. This allows for proper constriction of the blood vessels, making it easier to locate and access the vein for medical procedures such as drawing blood or administering intravenous medications. Wrapping the tourniquet too high or too low may not provide adequate venous engorgement, making it difficult to find a suitable vein.

If a patient has a syncopal episode during a venipuncture, the best course of action would be to remove the needle and tourniquet and lower the patient's head and arms. This is because a syncopal episode, also known as fainting, is often caused by a temporary decrease in blood flow to the brain. Lowering the patient's head and arms can help increase blood flow to the brain, while removing the needle and tourniquet ensures that the patient is not at risk of further injury. Continuing the draw or restraining the patient may exacerbate the situation, and beginning CPR and activating 911 would not be necessary unless the patient shows signs of cardiac arrest.

To cleanse the typical venipuncture site, it is recommended to work in a circle to the periphery. This means starting at the intended site of the draw and moving in a circular motion towards the outer edges of the site. This technique helps to ensure that the entire area is thoroughly cleansed and reduces the risk of contamination.

The blood lancet is used for the collection of blood specimens by skin puncture. Skin puncture involves pricking the skin to obtain a small blood sample for testing purposes. This method is commonly used for glucose monitoring, especially in diabetic patients, as well as for other blood tests such as hemoglobin levels or blood typing. Skin puncture is a less invasive and less painful method compared to venipuncture, which involves drawing blood from a vein. The blood lancet is a small, sharp instrument designed specifically for this purpose, allowing for a controlled and precise puncture of the skin to obtain the necessary blood sample.

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When performing a venipuncture, the tourniquet should be wrapped around the arm about 3-4 inches from where you are going to feel for a vein. This positioning allows for adequate blood flow restriction, making it easier to locate and access the vein. By wrapping the tourniquet at this distance, healthcare professionals can ensure a successful venipuncture procedure.

Capillary puncture, also known as a fingerstick, is a common method used to collect small amounts of blood for testing. The fingers are the most appropriate site for performing a capillary puncture in a healthy adult because they have an abundant supply of capillaries close to the surface of the skin. This makes it easier to obtain an adequate blood sample for testing. The great toe, earlobes, and forearms are not typically used for capillary punctures in healthy adults as they may not provide a sufficient blood sample or may cause more discomfort to the individual.

Arterioles are the smallest type of arteries. Arteries are blood vessels that carry oxygenated blood away from the heart to the rest of the body. Arterioles are responsible for regulating blood flow and controlling blood pressure by constricting or dilating. They connect the larger arteries to the capillaries, which are the smallest blood vessels in the body.

When using a centrifuge, it is important to make sure that equal weights are placed opposite each other. This is because the centrifugal force generated by the spinning motion of the centrifuge causes objects of equal weight to move in opposite directions, creating a balanced force. Placing the weights opposite each other ensures that the centrifuge operates smoothly and avoids any imbalance that could potentially damage the equipment or affect the accuracy of the results.

When collecting blood by skin puncture on an infant, a lancet should be used. A lancet is a small, sharp instrument specifically designed for skin punctures. It is safer and more suitable for infants compared to larger needles or scalpels. The lancet provides a quick and precise incision, minimizing pain and the risk of injury.

The most commonly used needle gauges for venipuncture are 21-22. These gauges are ideal for drawing blood as they are large enough to allow for a smooth flow of blood, but not so large that they cause excessive pain or damage to the vein. The 21-22 gauge needles strike a balance between being effective and comfortable for the patient.

During a venipuncture, a holder is needed to secure the needle during insertion into the tube stopper. A holder is a device that holds the needle in place and provides stability while the healthcare professional performs the venipuncture. It ensures that the needle does not move or dislodge during the procedure, reducing the risk of injury or complications. A holder is specifically designed for this purpose and is an essential tool in venipuncture procedures.

The color coding for a stopper of a tube with no additives is red. This is because the red stopper indicates that the tube is used for the collection of serum. Serum is the liquid portion of blood that is obtained after the blood has clotted and the clot has been removed. The red stopper is specifically used for the collection of serum samples, as it helps to differentiate it from other types of tubes used for different purposes.

When anticoagulated blood is centrifuged, plasma goes to the top of the tube. This is because plasma is the liquid component of blood that contains various proteins, electrolytes, hormones, and waste products. During centrifugation, the heavier components of blood, such as red blood cells and white blood cells, settle at the bottom of the tube due to their higher density. Plasma, being the lighter component, rises to the top.

A glucose tolerance test requires the patient to be fasting and then blood is taken every hour for a predetermined time. This test is used to measure how well the body is able to process glucose and is commonly used to diagnose diabetes or gestational diabetes. During the test, the patient drinks a glucose solution and their blood sugar levels are monitored to see how they change over time. This test helps to evaluate the body's ability to regulate blood sugar levels and can provide important information about insulin resistance and glucose metabolism.

The cephalic, medial cubital, and basilic veins are primarily used for venipuncture. This means that these veins are the main or most commonly used veins for the procedure. Other veins may be used in certain situations, but these three veins are the preferred choice for venipuncture.

The question is asking which one of the following evacuated tubes would be drawn first. The correct answer is "RED." However, without further context or information, it is difficult to provide a specific explanation for why the red tube would be drawn first. It is possible that the red tube is prioritized for a specific test or procedure, or it may be the standard order of drawing tubes in a particular medical setting.

When anticoagulated blood is centrifuged, red blood cells go to the bottom of the tube. This is because red blood cells are denser than both white blood cells and plasma. Centrifugation separates components based on their density, with the denser components settling at the bottom. Therefore, the red blood cells settle at the bottom of the tube while the less dense plasma remains at the top.

PT (Prothrombin Time) and PTT (Partial Thromboplastin Time) are laboratory tests that monitor anticoagulation therapy. PT measures the time it takes for blood to clot and is used to monitor the effectiveness of warfarin therapy. PTT measures the time it takes for blood to clot when certain clotting factors are activated and is used to monitor heparin therapy. These tests help healthcare providers adjust the dosage of anticoagulant medications to ensure that blood is not too thin or too thick, reducing the risk of bleeding or clotting disorders.

The patient should not eat, smoke, drink coffee or alcohol for 10 hours before or during the glucose tolerance test. This is because these activities can affect the results of the test and give inaccurate readings. Fasting for a certain period of time ensures that the body's glucose levels are not influenced by external factors, allowing for an accurate assessment of the patient's glucose tolerance.

When doing a venipuncture, the syringe or tube should be below the venipuncture site to prevent back-flow. This is because gravity helps in the flow of blood into the syringe or tube when it is positioned below the site. Placing the syringe or tube above the site may cause blood to flow back into the patient's vein, leading to potential complications. Therefore, positioning it below the venipuncture site ensures proper blood collection without any back-flow.

The tube used to collect a blood sample for a complete blood count (CBC) is a lavender top tube with ethylenediaminetetraacetic acid (EDTA) additive. EDTA is an anticoagulant that prevents the blood from clotting by binding to calcium ions. This allows for accurate measurement of blood cell counts and other parameters in the CBC. The lavender top tube is specifically used for hematological tests and is commonly used in laboratories for CBC analysis.

The correct answer is a lavender-top evacuated tube. A hematocrit test measures the percentage of red blood cells in a person's blood. Lavender-top tubes are typically used for hematology tests, including hematocrit tests, because they contain an anticoagulant called ethylenediaminetetraacetic acid (EDTA) which prevents the blood from clotting. This allows for accurate measurement of the red blood cell percentage. Red-top tubes are commonly used for other types of blood tests that do not require anticoagulants. Blue-top and yellow-top tubes are used for different types of tests, such as coagulation studies and blood cultures, respectively.

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Erythrocyte sedimentation rates (ESR) are increased in infections and inflammatory diseases. ESR measures the rate at which red blood cells settle in a tube over a certain period of time. In infections and inflammatory diseases, there is an increase in the production of certain proteins called acute phase reactants, which cause red blood cells to clump together and settle faster. Therefore, an elevated ESR indicates the presence of inflammation or infection in the body.

Veins do not pulsate like arteries do. Arteries have a thicker muscular wall that helps to propel blood forward with each heartbeat, causing a pulsating sensation. Veins, on the other hand, have thinner walls and rely on one-way valves to prevent blood from flowing backward. They do not have the same pulsating sensation as arteries.

Rubber sleeves on an evacuated tube system make it possible for multiple use. The rubber sleeves act as a barrier between the blood and the tube, preventing any contamination or mixing of samples. This allows the tube to be used for multiple patients without the risk of cross-contamination. The rubber sleeves also provide a secure seal, ensuring that the blood remains in the tube during transportation and testing. Overall, the rubber sleeves enhance the efficiency and safety of the evacuated tube system, enabling it to be used multiple times.

In order to determine the hematocrit level of a patient, two hematocrit tubes should be collected. This is because the hematocrit test requires a small amount of blood to be drawn and placed into the tubes. The tubes are then centrifuged to separate the blood components, allowing for measurement of the percentage of red blood cells in the sample. Collecting two tubes ensures that there is enough blood for an accurate measurement and allows for any potential errors or discrepancies to be identified.

To perform a hemoglobin test, a blood sample with EDTA added is needed. EDTA, or ethylenediaminetetraacetic acid, is an anticoagulant that prevents the blood from clotting. This is important for the hemoglobin test as it allows for accurate measurement of the hemoglobin levels in the blood. Serum only or white blood cells would not be suitable for this test, and the option "no correct answer" is incorrect as EDTA added is the correct answer.

When performing a PKU test, a capillary blood sample is needed. This is because PKU testing requires a small amount of blood, and capillary blood can be easily obtained by pricking the fingertip. Venipuncture, on the other hand, involves drawing blood from a vein and is typically used for larger blood samples. Therefore, capillary blood is the appropriate type of blood sample for performing a PKU test.

In drug testing, the chain of custody refers to the process of documenting the handling and movement of evidence, specifically in this case, the collection and handling of drug test samples. It ensures that there is a clear and unbroken trail of custody from the moment the sample is collected to when it is analyzed, preventing tampering or contamination. This is crucial in maintaining the integrity and reliability of the evidence, as well as ensuring legal compliance and accuracy in drug testing procedures.

The correct answer is the RED-TOP TUBE. When using an evacuated tube for the collection of electrolytes, a red-top tube is used. This is because red-top tubes typically contain a clot activator and a gel separator, which helps to separate the serum from the blood cells. This is important for electrolyte testing as it allows for accurate measurement of the electrolyte levels in the serum. Blue-top tubes are typically used for coagulation testing, black-top tubes are used for special tests, and lavender-top tubes are used for hematological testing.

Making sure that a tube is correctly labeled with the patient's complete name and identification number is part of the facilities quality control plan. This plan ensures that all processes and procedures are carried out correctly to maintain high standards of quality and accuracy in patient care. By properly labeling tubes, the facility can prevent mix-ups and ensure that each patient's samples are accurately identified and processed. This is an important aspect of quality control in healthcare settings.

When collecting blood for cholesterol tests, it is recommended to use a RED top evacuated tube. This is because the red top tube contains no additives, allowing for the collection of a serum sample. Serum is the liquid portion of blood that is obtained after the blood has clotted and the clot has been removed. Cholesterol testing requires a serum sample as it provides accurate results for measuring cholesterol levels in the blood.

The tube to collect whole blood with an additive in it has a lavender stopper. The color of the stopper indicates the type of additive present in the tube. Lavender stoppers are typically used for tubes containing the anticoagulant ethylenediaminetetraacetic acid (EDTA), which is commonly used for hematology tests. The EDTA helps prevent blood from clotting by binding to calcium ions, allowing for accurate analysis of blood cell counts and morphology.

Performing a hematocrit as part of a complete count determines the ratio of the volume of packed red blood cells to that of whole blood. Hematocrit is a measure of the percentage of red blood cells in the total blood volume. It is used to evaluate the overall health and oxygen-carrying capacity of the blood. By measuring the hematocrit, healthcare professionals can assess if there is an imbalance in the red blood cell count, which can indicate conditions such as anemia or polycythemia.

Sodium citrate is an anticoagulant of choice for coagulation studies because it protects certain amounts of the pro-coagulants.

EDTA is a primary anticoagulant additive that removes calcium by forming insoluble or un-ionized calcium salts. This property of EDTA prevents platelet clumping and the formation of artifacts. Blood films are prepared by spreading a thin layer of blood on a glass slide for microscopic examination. The use of EDTA in the preparation of blood films is advantageous as it prevents clotting and ensures that the blood sample remains in a liquid state, allowing for easier spreading and staining of the blood on the slide. Therefore, EDTA is good for the preparation of blood films.