1.
Capillary blood gases are less desirable than arterial blood gases (ABGs) for what following 3 reasons?
Correct Answer
D. All of the above are correct
Explanation
Capillary blood gases are less desirable than arterial blood gases (ABGs) for the following three reasons. Firstly, skin puncture blood is only partial arterial, meaning it does not fully represent the oxygen and carbon dioxide levels in the arterial blood. Secondly, skin puncture blood contains tissue fluid, which can dilute the blood sample and affect the accuracy of the results. Lastly, during collection, the blood is exposed to air, which can alter the gas levels and lead to inaccurate readings. Therefore, all of the above reasons contribute to why capillary blood gases are less desirable than ABGs.
2.
The Clinical and Laboratory Standards Institute (CLSI) recommends the maximum depth of a heel puncture is?
Correct Answer
A. 2.0mm
Explanation
The CLSI recommends a maximum depth of 2.0mm for a heel puncture. This depth is considered safe and appropriate for obtaining a blood sample from an infant's heel. It ensures that enough blood can be collected for testing purposes without causing excessive pain or injury to the baby.
3.
EDTA specimens are obtained before other specimens when collected by skin puncture, why?
Correct Answer
C. To minimize platelet clumping
Explanation
Drawing EDTA specimens first helps to minimize platelet clumping. EDTA (ethylenediaminetetraacetic acid) is an anticoagulant commonly used in blood collection tubes. It works by binding calcium ions, which are necessary for the activation of platelets and the clotting process. By collecting EDTA specimens before other specimens, the anticoagulant can quickly mix with the blood, preventing platelet clumping and ensuring accurate test results. This order of draw is recommended to maintain the integrity of the samples and avoid any interference with subsequent tests.
4.
What is the safest area for an infant heel puncture?
Correct Answer
B. Lateral planter heel surface
Explanation
The safest area for an infant heel puncture is the lateral planter heel surface. This area is less sensitive and has a thicker layer of tissue, making it less likely to cause pain or injury to the infant. Puncturing the central area of the heel or the medial area of the arch can be more painful and may increase the risk of hitting a bone or nerve. The posterior curvature of the heel is also not recommended as it can cause discomfort and increase the risk of injury. Therefore, the lateral planter heel surface is the safest option for an infant heel puncture.
5.
What is the purpose of wiping away the first drop of blood during skin puncture?
Correct Answer
D. To eliminate tissue fluid contamination
Explanation
The purpose of wiping away the first drop of blood during skin puncture is to eliminate tissue fluid contamination. When a puncture is made, the first drop of blood that appears may contain tissue fluid, which can interfere with accurate testing. By wiping away the first drop, any potential contaminants are removed, ensuring that the subsequent blood samples collected are free from tissue fluid and providing more accurate test results.
6.
A capillary puncture should be done rather than a venipuncture except in what following situation?
Correct Answer
A. When the blue top tube is needed
Explanation
A capillary puncture should be done rather than a venipuncture except when the blue top tube is needed. This is because the blue top tube is specifically designed for coagulation tests, which require a larger volume of blood than can be obtained through a capillary puncture. In all other situations, a capillary puncture is preferred over a venipuncture due to its advantages such as being less invasive, causing minimal discomfort, and being easier to perform, especially in pediatric or geriatric patients.
7.
A purple top microcollection container would be used to collect a specimen for what test?
Correct Answer
B. CBC
Explanation
A purple top microcollection container is used to collect a specimen for a Complete Blood Count (CBC) test. The CBC test is a common blood test that provides information about the different components of blood, such as red blood cells, white blood cells, and platelets. By using a purple top microcollection container, the laboratory can ensure that the blood sample remains stable and suitable for accurate analysis of the CBC parameters.
8.
A hereditary inability to metabolize phenylalanine is called?
Correct Answer
C. pHenylketonuria
Explanation
Phenylketonuria is a hereditary condition where the body is unable to metabolize phenylalanine, an amino acid found in many foods. This inability leads to a buildup of phenylalanine in the blood, which can cause intellectual disability, developmental delays, and other health problems if left untreated. Galactosemia is a different condition that affects the body's ability to metabolize galactose, a sugar found in milk. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. Cystic fibrosis is a genetic disorder that affects the lungs and other organs.
9.
The purpose of warming the site before skin puncture is to?
Correct Answer
C. It increases blood flow up to 7 times
Explanation
Warming the site before skin puncture increases blood flow up to 7 times. This is beneficial because increased blood flow allows for easier and quicker access to the veins, making it easier to locate and puncture them. It also helps in obtaining an adequate blood sample for testing purposes. Additionally, increased blood flow can help minimize discomfort for the patient during the procedure.
10.
To make a thick blood smear you should take a large drop of blood and spread it to the size of a
Correct Answer
C. Dime
Explanation
To make a thick blood smear, a large drop of blood should be taken and spread to the size of a dime. This size ensures that there is enough blood to create a thick smear on the slide, allowing for better visualization and analysis of the blood cells under a microscope. A smaller size, such as a finger or thumb top, may not provide enough blood for an accurate smear.
11.
Fluid that comes from between tissue cells is known as
Correct Answer
D. Interstitial fluid
Explanation
Interstitial fluid is the fluid that is found between the cells of tissues. It is derived from blood plasma and contains nutrients, oxygen, hormones, and waste products. Interstitial fluid plays a crucial role in maintaining the balance of substances between the blood and the cells, allowing for the exchange of nutrients and waste products. It also helps to cushion and protect cells and tissues. Therefore, interstitial fluid is the correct term for the fluid that comes from between tissue cells.
12.
A capillary puncture site should not appear
Correct Answer
C. Cyanotic
Explanation
Cyanotic refers to a bluish discoloration of the skin or mucous membranes due to a lack of oxygen in the blood. In the context of a capillary puncture site, cyanosis would indicate poor blood flow or inadequate oxygenation. This is not desirable as it may indicate a problem with the puncture site or the overall health of the individual. Therefore, a capillary puncture site should not appear cyanotic.
13.
A good blood smear should exhibit a ________ edge.
Correct Answer
C. Feathered
Explanation
A good blood smear should exhibit a feathered edge. This means that the edge of the smear should be smooth and gradually thinning out, resembling the shape of a feather. A feathered edge indicates that the blood sample was properly prepared and spread evenly on the slide. It allows for better visualization of individual blood cells and ensures accurate analysis under a microscope.
14.
Capillary bilirubin specimens should be protected from
Correct Answer
B. Light
Explanation
Capillary bilirubin specimens should be protected from light because exposure to light can cause the breakdown of bilirubin, leading to inaccurate test results. Bilirubin is a sensitive molecule that is easily oxidized by light, resulting in the formation of biliverdin, which can interfere with the measurement of bilirubin levels. Therefore, it is important to store and handle capillary bilirubin specimens in a way that prevents exposure to light to ensure accurate test results.
15.
A microhemocrite tube is not primarily used for what type of specimen.
Correct Answer
C. Blood Culture
Explanation
A microhemocrite tube is primarily used for collecting and measuring capillary blood samples. It is not used for blood culture specimens, which require larger volumes of blood to be collected in specialized culture bottles. Blood culture specimens are used to detect and identify microorganisms causing bloodstream infections.
16.
If a baby has a huge, fleshy big toe, is it acceptable to collect a bilirubin specimen from it?
Correct Answer
B. False
Explanation
It is not acceptable to collect a bilirubin specimen from a baby's big toe, regardless of its size or fleshy nature. Bilirubin specimens are typically collected from the baby's heel, as it is a common site for blood collection in infants. The big toe is not a recommended site for this procedure.
17.
A patient who has just awakened at 0600 after fasting all night is an instance that most closely resembles a
Correct Answer
A. Basel state
Explanation
The term "basel state" refers to the body's state when it is at rest and has been fasting for an extended period, such as overnight. In this state, the body's metabolism is at its lowest, and there is minimal activity or digestion occurring. Therefore, a patient who has just awakened at 0600 after fasting all night closely resembles the basel state because their body has been at rest and without food for a significant period.
18.
When you are ordered to draw a protime specimen from a patient with an IV in both arms, where is it best to draw the specimen?
Correct Answer
B. Below or distal from the I.V. site
Explanation
When a patient has an IV in both arms, it is best to draw a protime specimen below or distal from the IV site. This is because drawing the specimen above the IV site may result in contamination of the sample with IV fluids or medications. Drawing the specimen below or distal from the IV site helps to ensure that the sample is not affected by the IV fluids and provides accurate test results.
19.
It is not a good idea to collect a CBC specimen from a screaming infant because?
Correct Answer
A. Will show elevated white blood cell counted
Explanation
Collecting a CBC specimen from a screaming infant is not a good idea because the stress and agitation caused by the screaming can lead to an increase in the number of white blood cells in the sample. This can result in an inaccurate reading of the white blood cell count, potentially leading to a misdiagnosis or unnecessary treatment.
20.
Prolonged tourniquet application may cause a change in blood composition primarily because of?
Correct Answer
B. Hemoconcentration
Explanation
Prolonged tourniquet application can cause hemoconcentration, which refers to an increase in the concentration of red blood cells and other blood components due to a decrease in plasma volume. This occurs because the tourniquet restricts blood flow, leading to the accumulation of cellular components in the affected area. As a result, the blood composition is altered, with a higher concentration of red blood cells and other components. This can have implications for the patient's health, potentially leading to complications such as blood clots or tissue damage.
21.
A __________ is a vascular access device that is placed in a peripheral vein for the purpose of blood collection and administration of medication.
Correct Answer
D. Heparin line or saline line
Explanation
A heparin line or saline line is a vascular access device that is placed in a peripheral vein for the purpose of blood collection and administration of medication. This type of line is used to deliver heparin or saline solution into the bloodstream. It is commonly used in medical settings to provide temporary access for medication administration or blood draws.
22.
If a phlebotomist has attempted twice to draw a partial thromboplastin time (PTT) specimen from a patient with difficult veins, and both times has been able to draw only a partial tube what should they do?
Correct Answer
C. Get a more experienced pHlebotomist to do the draw
Explanation
If a phlebotomist has attempted twice to draw a partial thromboplastin time (PTT) specimen from a patient with difficult veins and has only been able to draw a partial tube, they should get a more experienced phlebotomist to do the draw. This is because a more experienced phlebotomist will likely have better techniques and skills to successfully draw the specimen from a patient with difficult veins. Attempting to draw from the other arm or telling the patient to come back later may not necessarily solve the issue if the phlebotomist lacks the necessary experience.
23.
Levels of Cortisol (an analyte) can differ by____ % or more between morning and late afternoon.
Correct Answer
D. 50
Explanation
Levels of cortisol, a hormone produced by the adrenal glands, can vary significantly throughout the day. Cortisol levels are typically highest in the morning and gradually decrease as the day progresses. This diurnal variation can result in a difference of 50% or more between morning and late afternoon levels of cortisol. This fluctuation is a normal part of the body's circadian rhythm and helps regulate various physiological processes, including metabolism, immune function, and stress response.
24.
If blood pulses in to the tube this is an instance in which may lead you to suspect that you have accidentally punctured an
Correct Answer
C. Artery
Explanation
If blood pulses into the tube, it indicates a strong, rhythmic flow of blood. This suggests that the puncture was made in an artery rather than a vein. Arteries have a higher pressure and thicker walls compared to veins, which explains the pulsation. Therefore, the correct answer is artery.
25.
If blood is drawn too quickly from a small vein, the vein will have a tendency to
Correct Answer
B. Collapse
Explanation
When blood is drawn too quickly from a small vein, the high suction force created can cause the vein to collapse. This happens because the pressure inside the vein decreases, leading to a collapse of the vein walls. As a result, blood flow is impeded, and the vein may become temporarily or permanently blocked. This can make it difficult to draw blood or administer medications through that vein in the future.
26.
A fistula is a permanent fusion of an Artery and a Vein.
Correct Answer
A. True
Explanation
A fistula is indeed a permanent fusion of an artery and a vein. It is a surgically created connection between an artery and a vein, usually in the arm, to allow for better access for hemodialysis treatment in patients with kidney failure. This connection allows arterial blood to flow directly into the vein, making it easier to remove and return blood during dialysis.
27.
A clue that the patient was not fasting for a test that requires a fasting specimen is that the serum would appear
Correct Answer
D. Lipemic
Explanation
The correct answer is "lipemic" because lipemia refers to the presence of excessive lipids or fats in the blood, which can cause the serum to appear cloudy or milky. This can occur when a patient has not fasted before a test that requires a fasting specimen, as the intake of food can lead to an increase in lipid levels in the blood. A clear or yellow serum would be expected in a fasting specimen.
28.
Removing blood on a regular basis or in large amounts can lead to
Correct Answer
B. Iatrogenic anemia
Explanation
Removing blood on a regular basis or in large amounts can lead to iatrogenic anemia. Iatrogenic anemia refers to anemia that is caused by medical intervention, such as blood removal through procedures like phlebotomy or blood donation. When blood is removed regularly or in large amounts, it can result in a decrease in the overall number of red blood cells in the body, leading to anemia.
29.
Obstruction or complete stoppage of lymph flow is called
Correct Answer
B. LympHostatsis
Explanation
Lymphostasis refers to the obstruction or complete stoppage of lymph flow. This condition can occur due to various reasons, such as blockage of lymphatic vessels or lymph nodes, inflammation, or infection. When lymphostasis occurs, the normal flow of lymph fluid is disrupted, leading to a buildup of lymph in the affected area. This can result in swelling, pain, and impaired immune function. Treatment for lymphostasis typically involves addressing the underlying cause and may include compression therapy, manual lymph drainage, or surgical intervention.
30.
A condition in which blood components that cannot easily leave the blood stream become concentrated in the smaller plasma volume is known as
Correct Answer
B. Hemoconcentration
Explanation
Hemoconcentration is a condition where blood components that cannot easily leave the blood stream become concentrated in the smaller plasma volume. This means that the concentration of red blood cells, white blood cells, and platelets increases in relation to the plasma. It can occur due to various reasons such as dehydration, prolonged physical exercise, or certain medical conditions.
31.
If blood is filling the tube very slowly and a hematoma is beginning to form, the needle may not be?
Correct Answer
A. Not far enough in
Explanation
If blood is filling the tube very slowly and a hematoma is beginning to form, it suggests that the needle may not be far enough in. This is because when the needle is not inserted deep enough into the vein, it can cause a slow flow of blood into the tube and lead to the formation of a hematoma, which is a localized collection of blood outside the blood vessels.
32.
Blood cultures are a test that requires strict ______ procedures before specimen collection.
Correct Answer
B. Antisepsis
Explanation
Blood cultures are a test that requires strict antisepsis procedures before specimen collection. Antisepsis refers to the practice of using substances or techniques to prevent the growth or spread of microorganisms on living tissue. In the context of blood cultures, it is important to ensure that the skin is thoroughly cleaned and disinfected to minimize the risk of introducing any contaminants into the blood sample. This helps to maintain the integrity and accuracy of the test results.
33.
Documentation is carefully maintained from proctor to courier, what kind of test does not agree with NIDA patient collection requirements
Correct Answer
A. Urine drug screen
Explanation
The correct answer is urine drug screen. Documentation is carefully maintained from proctor to courier, indicating that the test in question requires proper documentation throughout the process. NIDA patient collection requirements do not specifically mention the need for careful documentation, but rather focus on the collection and handling of urine samples for drug testing purposes. Therefore, the urine drug screen does not agree with NIDA patient collection requirements.
34.
What type of additive is recommended for collecting an ethanol test specimen?
Correct Answer
C. Sodium Fluoride
Explanation
Sodium fluoride is recommended as an additive for collecting an ethanol test specimen. This is because sodium fluoride acts as a preservative and prevents the breakdown of ethanol in the specimen over time. By inhibiting the enzyme that breaks down ethanol, sodium fluoride ensures that the ethanol concentration remains stable and accurate for testing purposes.
35.
When should timing begin when performing a GTT?
Correct Answer
A. After finishing glucose drink
Explanation
Timing should begin after finishing the glucose drink during a GTT (Glucose Tolerance Test) because this is when the patient has completed consuming the required amount of glucose. The purpose of the GTT is to measure how the body metabolizes glucose, so it is essential to start timing after the glucose has been ingested to accurately assess the body's response to the sugar load. Starting timing before finishing the drink or at any other point would not provide an accurate measurement of glucose metabolism.
36.
What test is used to monitor heparin therapy?
Correct Answer
C. ACT
Explanation
The test used to monitor heparin therapy is ACT (Activated Clotting Time). This test measures the time it takes for a blood sample to clot after adding an activator. Heparin is an anticoagulant medication that is used to prevent blood clots. Monitoring heparin therapy is important to ensure that the patient is receiving the appropriate dosage and that their blood is not too thin or too thick. ACT is a commonly used test to assess the effectiveness of heparin therapy and adjust the dosage accordingly.
37.
At what intervals is blood blotted during a bleeding time test?
Correct Answer
B. 30 seconds
Explanation
During a bleeding time test, blood is blotted at 30-second intervals. This interval allows for the assessment of how long it takes for bleeding to stop after a small incision is made on the skin. By blotting the blood at regular intervals, healthcare professionals can monitor the clotting ability of the blood and determine if there are any abnormalities or disorders present. A 30-second interval is sufficient to track changes in bleeding time and provide accurate results for diagnosis and treatment.
38.
To prevent introducing a contaminating substance into a trace-element collection tube, it is suggested that the phlebotomist do what?
Correct Answer
B. Draw by itself using a syringe or evacuated tube system
Explanation
To prevent introducing a contaminating substance into a trace-element collection tube, it is suggested that the phlebotomist draw by itself using a syringe or evacuated tube system. This method ensures that there is no cross-contamination from other substances or additives present in different tubes or needles. By using a separate syringe or evacuated tube for the collection of trace elements, the risk of contamination is minimized, ensuring accurate and reliable test results.
39.
All POC glucose analyzers approved for hospital use, have 3 things in common, list them.
Correct Answer
D. All of the above are correct
Explanation
The correct answer is "all of the above are correct". This means that all three statements mentioned in the question are true for POC glucose analyzers approved for hospital use. These analyzers can use various sample types such as venous, arterial, or capillary blood. They also have the capability to download data from the glucose meter to a data management program. Additionally, they require quality control and either patient or authorized operator identification numbers.
40.
1. When collecting a blood culture specimen directly from a butterfly into blood culture bottles, the ______ should be collected first.
Correct Answer
A. Aerobic
Explanation
When collecting a blood culture specimen directly from a butterfly into blood culture bottles, the aerobic bottle should be collected first. This is because aerobic bacteria require oxygen to grow and the aerobic bottle provides the necessary oxygen-rich environment for their growth. Collecting the aerobic bottle first ensures that any aerobic bacteria present in the specimen will have the optimal conditions for growth and can be accurately detected in the culture.
41.
A ________ is a test that may require special “chain of custody” documentation when collected
Correct Answer
D. Drug screen
Explanation
A drug screen is a test that may require special "chain of custody" documentation when collected. This documentation ensures that the sample is properly handled and tracked throughout the testing process to maintain its integrity and prevent tampering. This is particularly important for drug screens as they are often used in legal and employment settings where accurate and reliable results are crucial. Alcohol tests, blood tests, and urine tests may also be subject to chain of custody documentation in certain situations, but the question specifically mentions drug screens as requiring this documentation.
42.
1. A condition called ________ when a unit of blood is withdrawn from a patient as treatment.
Correct Answer
B. Hemochromatosis
Explanation
Hemochromatosis is a condition where there is an excessive accumulation of iron in the body. In this context, it is being referred to as a condition that occurs when a unit of blood is withdrawn from a patient as treatment. This suggests that the patient has hemochromatosis and the blood is being removed to help reduce their iron levels.
43.
A______ color topped tube can be used to collect blood for a type and crossmatch
Correct Answer
B. Pink
Explanation
A pink color topped tube can be used to collect blood for a type and crossmatch. This is because pink top tubes usually contain an anticoagulant called EDTA, which helps prevent clotting and preserve the blood sample for further testing. Type and crossmatch is a procedure performed before blood transfusion to determine the compatibility between the donor and recipient blood types, ensuring a safe and successful transfusion.
44.
A _______ is the test that requires a specimen with a 9:1 ratio of blood to anticoagulant
Correct Answer
A. PT
Explanation
A PT (Prothrombin Time) test is the one that requires a specimen with a 9:1 ratio of blood to anticoagulant.
45.
Tests that can be performed using special POCT instruments or test kits include
Correct Answer
B. INR,ACT,APT,Platelet Function
Explanation
The correct answer includes tests that can be performed using special POCT (Point-of-Care Testing) instruments or test kits. INR (International Normalized Ratio) is a test used to monitor the effectiveness of blood-thinning medication. ACT (Activated Clotting Time) is a test used to measure the time it takes for blood to clot. APT (Activated Partial Thromboplastin Time) is a test used to evaluate the blood's ability to clot. Platelet Function tests assess the function of platelets in blood clotting. These tests can be performed using special POCT instruments or test kits, allowing for quick and convenient testing at the point of care.
46.
TDM is used by physicians to determine what?
Correct Answer
C. DRUG DOSAGE
Explanation
TDM, or Therapeutic Drug Monitoring, is a process used by physicians to determine the appropriate dosage of a drug for a patient. This involves monitoring the concentration of the drug in the patient's blood or other bodily fluids to ensure that it is within the therapeutic range. By doing so, physicians can adjust the dosage as needed to achieve optimal therapeutic effects while minimizing the risk of toxicity. Therefore, the correct answer is "DRUG DOSAGE".
47.
Everyone who performs POCT in a clinical setting must meet the requirements of the _____ for testing and the guidelines of the ______ for specimen handling.
Correct Answer
C. CLIA, OSHA
Explanation
CLIA (Clinical Laboratory Improvement Amendments) sets the standards for laboratory testing in the United States, including point-of-care testing. OSHA (Occupational Safety and Health Administration) sets guidelines for workplace safety, including handling of specimens. Therefore, everyone who performs point-of-care testing in a clinical setting must meet the requirements of CLIA for testing and the guidelines of OSHA for specimen handling.
48.
What type of curve will a patient who is lactose intolerant have after ingesting a dose of lactose?
Correct Answer
A. GLUCOSE
Explanation
A patient who is lactose intolerant will have a flat or minimal increase in glucose levels after ingesting lactose. This is because lactose intolerant individuals lack the enzyme lactase, which is necessary to break down lactose into glucose and galactose. As a result, the lactose remains undigested and unabsorbed in the small intestine, leading to minimal or no increase in blood glucose levels.
49.
A patient who is suspected of having lead poisoning should have his or her lead test specimen drawn in __________ tube. What color? _______
Correct Answer
C. TRACE ELEMENT FREE, ROYAL BLUE
Explanation
The correct answer is TRACE ELEMENT FREE, ROYAL BLUE. This is because a patient who is suspected of having lead poisoning should have their lead test specimen drawn in a trace element-free tube to prevent contamination from other elements that could interfere with the test results. The royal blue color of the tube indicates that it is trace element-free.
50.
In what instance would a specimen still most likely be accepted for testing despite this problem?
Correct Answer
B. MISSING pHLEBOTOMIST INTIALS
Explanation
If the specimen is missing the phlebotomist initials, it may still be accepted for testing because this is a procedural error rather than a problem with the specimen itself. The missing initials can be seen as a minor oversight that does not affect the quality or integrity of the specimen. The other options, such as inadequate blood, missing patient date of birth, and misspelling patient's name, are more significant issues that could potentially impact the accuracy and reliability of the test results.