Phlebotomy Test - 100

A urine C & S (culture and sensitivity) is typically ordered to diagnose urinary tract infection. This test helps identify the presence of bacteria in the urine and determines which antibiotics are effective in treating the infection. By analyzing the urine sample, healthcare providers can confirm the diagnosis of a urinary tract infection and provide appropriate treatment.

Gastric analysis is a test that measures the acid and enzyme levels in the stomach. It is used to diagnose conditions such as peptic ulcers, gastritis, and gastric cancer. The test requires the administration of histamine or pentagastrin through intravenous (IV) injection. These substances stimulate the production of stomach acid, allowing for accurate measurement. Therefore, the given correct answer suggests that gastric analysis requires the IV administration of histamine or pentagastrin.

CK and LDH are abbreviations for cardiac enzyme tests. These tests measure the levels of specific enzymes in the blood that are released when there is damage to the heart muscle. CK, or creatine kinase, is an enzyme found in the heart, brain, and skeletal muscles. LDH, or lactate dehydrogenase, is an enzyme found in many tissues, including the heart. Elevated levels of these enzymes can indicate a heart attack or other heart-related conditions. Therefore, CK and LDH are commonly used abbreviations for cardiac enzyme tests.

The tunica adventitia refers to the external layer of a blood vessel. This layer is composed of connective tissue and provides support and protection to the blood vessel. It helps to anchor the vessel to surrounding tissues and organs. The tunica adventitia is thicker in larger blood vessels, such as arteries, compared to smaller vessels like capillaries.

The test that would be most affected by carryover of K2 EDTA is potassium. K2 EDTA is an anticoagulant commonly used in blood collection tubes. It works by binding to calcium ions, preventing blood clotting. However, K2 EDTA can also bind to other ions, such as potassium. If there is carryover of K2 EDTA into the test sample, it can falsely lower the measured potassium levels. This is because the K2 EDTA will bind to the potassium ions in the sample, preventing them from being detected accurately by the test. Therefore, the potassium test would be most affected by carryover of K2 EDTA.

The right to know law primarily deals with hazard communication. This means that the law focuses on ensuring that individuals are informed about the potential hazards associated with certain substances or materials. It requires employers to provide information about the hazardous chemicals present in the workplace, including labels, safety data sheets, and employee training. This helps to protect workers and allows them to take appropriate safety measures to prevent accidents or health risks.

The word parts "iso," "neo," and "tachy" are prefixes. A prefix is a word part that is added to the beginning of a word to modify its meaning. In this case, "iso-" means equal, "neo-" means new, and "tachy-" means fast. These word parts are added to other words to create new words with different meanings. For example, "isothermal" means having equal temperature, "neonatal" means relating to newborn babies, and "tachycardia" means a fast heart rate.

Ammonia needs to be transported on ice because it is a highly volatile and hazardous chemical compound. It easily evaporates at room temperature and can release toxic fumes. Transporting it on ice helps to keep it stable and prevent any leaks or spills that could be dangerous. Additionally, keeping it cold helps to reduce the risk of any reactions or chemical changes that could occur during transportation.

When collecting a specimen from an arm with a hematoma, it is best to collect the specimen distal to the hematoma. This means collecting the specimen below or after the hematoma, closer to the hand or fingers. Collecting the specimen above or before the hematoma may result in contamination of the specimen with blood from the hematoma. Collecting the specimen beside or through the hematoma may also result in contamination or difficulty in obtaining a proper sample. Therefore, collecting the specimen distal to the hematoma is the most appropriate choice in this situation.

The correct answer is ventricular contraction. The pulse is created when the heart's ventricles contract, forcing blood into the arteries and creating a wave of pressure. This wave of pressure can be felt as a pulse in various parts of the body, such as the wrist or neck. Atrial contraction and relaxation also play a role in the heartbeat, but the main force behind the pulse is the ventricular contraction.

Coagulation tests are most affected by tissue thromboplastin contamination. Tissue thromboplastin is a substance released from damaged tissues that initiates the clotting process. If there is contamination of the sample with tissue thromboplastin, it can falsely activate the clotting process and lead to incorrect results in coagulation tests. This can affect the measurement of clotting factors, such as prothrombin time (PT) and activated partial thromboplastin time (aPTT), which are important in assessing blood clotting function. Therefore, coagulation tests are particularly sensitive to tissue thromboplastin contamination.

Phenylketonuria (PKU) is a genetic disorder involving phenylalanine metabolism. It is not contagious, nor is it caused by excessive phenylalanine ingestion or a temporary lack of phenylalanine. In PKU, the body is unable to break down phenylalanine, an amino acid found in many foods. This leads to a buildup of phenylalanine in the blood, which can cause intellectual disability, behavioral problems, and other health issues if not managed through a special diet low in phenylalanine.

Ammonia does not require protection from light because it is not light-sensitive. Unlike bilirubin, vitamin B12, and vitamin C, ammonia is not affected by exposure to light and does not degrade or undergo any chemical changes when exposed to light. Therefore, it does not require any special precautions or protection from light during storage or analysis.

Blood specimens may require cooling to slow down metabolic processes. Cooling the specimen can help to reduce the activity of enzymes and slow down the breakdown of substances within the blood. This can be important for certain tests that require stable conditions, as it helps to preserve the integrity of the sample and prevent any changes in the composition of the blood. By slowing down metabolic processes, the blood specimen can be kept in a more stable state for longer periods of time, allowing for accurate and reliable testing.

CLIA 88 stands for Clinical Laboratory Improvement Amendments of 1988. These federal regulations were established to ensure that all clinical laboratories, regardless of their size, type, or location, adhere to quality standards that guarantee accurate, reliable, and timely patient test results. CLIA 88 plays a crucial role in maintaining the quality and safety of laboratory testing, ultimately benefiting patient care.

Enzymes are proteins that catalyze biochemical reactions in the body. Exercise can lead to an increase in enzyme activity as the body requires more energy. During exercise, enzymes involved in energy production, such as lactate dehydrogenase and creatine kinase, are released into the bloodstream. Therefore, exercise prior to specimen collection can significantly affect enzyme levels in the blood, making enzymes the analyte most affected by exercise. Bilirubin is a product of red blood cell breakdown, calcium is involved in bone health, and uric acid is a waste product of purine metabolism. While exercise can have some impact on these analytes, it is not as significant as its effect on enzymes.

The ratio of blood to anticoagulant is most critical for the prothrombin time test. This test measures the time it takes for blood to clot. If the ratio of blood to anticoagulant is incorrect, it can affect the accuracy of the test results. Too much anticoagulant can lead to prolonged clotting time, while too little anticoagulant can cause premature clotting. Therefore, maintaining the correct ratio is crucial for accurate prothrombin time measurements.

A positive modified Allen test refers to the hand color returning to normal within 15 seconds. This indicates that the ulnar artery is able to adequately supply blood to the hand when the radial artery is occluded. It is an important test performed before procedures such as radial artery cannulation or harvest, to ensure that there is sufficient collateral circulation to the hand.

Sodium citrate, EDTA, and oxalate are all anticoagulants that remove calcium from the specimen by forming insoluble calcium salts. This prevents coagulation by inhibiting the clotting factors that rely on calcium for their function. Sodium citrate is commonly used for coagulation tests, EDTA is used for hematology tests, and oxalate is used for blood glucose testing.

The initials CDC and HICPAC stand for the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). These two organizations are responsible for providing guidelines and recommendations for isolation precautions in hospitals. The CDC is a federal agency that aims to protect public health and safety, while HICPAC is a committee that provides evidence-based guidance on infection control practices. Together, they collaborate to develop and update guidelines to prevent the spread of infections in healthcare settings.

The blood vessels of the skin are found in the corium and subcutaneous layers. The corium, also known as the dermis, is the middle layer of the skin and contains a network of blood vessels that supply oxygen and nutrients to the skin cells. The subcutaneous layer, also called the hypodermis, is the deepest layer of the skin and contains larger blood vessels that help regulate body temperature. Together, these layers provide the necessary blood supply to the skin for its proper functioning.

Calcium is essential to the coagulation process because it plays a key role in the activation of several blood clotting factors. It is required for the conversion of prothrombin to thrombin, which is necessary for the formation of a stable blood clot. Calcium also helps in the activation of factor XIII, which strengthens the clot and prevents bleeding. Without sufficient calcium, the coagulation process would be impaired, leading to difficulties in clot formation and increased risk of bleeding.

Partially filling a liquid EDTA tube will compromise the quality of the specimen. EDTA is an anticoagulant used to preserve blood samples for testing. If the tube is not completely filled, the blood-to-anticoagulant ratio will be incorrect, leading to improper preservation of the sample. This can affect the accuracy of test results, especially for tests that require specific blood-to-anticoagulant ratios. Therefore, it is important to fully fill the EDTA tube to maintain the quality of the specimen.

The proper technique for collecting specimen tubes when using the evacuated tube method includes collecting sterile specimens before all other specimens, drawing a clear tube before special coagulation tests, and filling each tube until the normal vacuum is exhausted. However, positioning the arm so that tubes fill from the stopper end first is not part of the proper technique. This may lead to incorrect specimen collection and potential contamination.

According to CLSI (Clinical and Laboratory Standards Institute), the maximum time limit for separating serum or plasma from cells is 30 minutes from the time of collection. This means that after the blood sample is collected, it should be processed within 30 minutes to separate the serum or plasma from the cells. This time limit is important to ensure accurate and reliable test results, as delays in separation can lead to changes in the sample composition and potentially affect the test outcomes.

Serum is the liquid portion of a clotted specimen. When blood clots, it forms a solid mass called a clot, and the liquid that separates from the clot is known as serum. Serum does not contain fibrinogen, which is a protein involved in the clotting process. It is also different from plasma, which is the liquid component of blood that contains fibrinogen and other clotting factors. Saline, on the other hand, is a solution of salt in water and is not related to the liquid portion of a clotted specimen.

Capillary specimens are collected from capillaries, which are the smallest blood vessels in the body. These specimens are primarily used for measuring glucose levels. Arterial blood, tissue fluids, and venous blood can all be collected from capillaries. However, serous fluids are not typically collected from capillaries. Serous fluids refer to the clear, watery fluids that are found in body cavities, such as the pleural and peritoneal cavities. Therefore, serous fluids are not included in capillary specimens.

Alpha-fetoprotein (AFP) is sometimes performed on amniotic fluid. AFP is a protein produced by the fetus and found in the amniotic fluid. It is used as a screening test for certain fetal abnormalities, such as neural tube defects and chromosomal abnormalities. High levels of AFP in the amniotic fluid may indicate a potential problem with the developing fetus. Therefore, performing an AFP test on amniotic fluid can provide valuable information about the health and development of the fetus.

An arterial blood gas requisition is a form used to request a test that measures the levels of oxygen and carbon dioxide in a patient's blood. It is used to assess the patient's respiratory function and determine if there is an imbalance in their blood gases. The requisition typically includes information such as the patient's identification, method of ventilation or delivery, patient activity and body position, and temperature and respiration rate. However, the age at onset of respiratory disease is not typically included in this requisition as it is not directly relevant to the blood gas analysis.

The cephlic vein is commonly used for venipuncture when the arm is thin. This is because it is usually more visible and easier to access in thin individuals. Therefore, staying away from the cephlic vein when the arm is thin would not help avoid inadvertently puncturing an artery during venipuncture.

The best way to proceed is to apply a tourniquet on the right arm over a towel and do the draw. This is because the patient has dermatitis all over the right arm and hand, making the veins not readily visible. By applying a tourniquet, it helps to constrict the blood vessels and make the veins more visible and accessible for the collection of the light blue top specimen. Using a towel underneath the tourniquet can provide additional comfort and protection for the patient's skin.

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An aliquot refers to a portion of a specimen that is taken for testing. It is a representative sample that is used to perform various laboratory analyses. By taking an aliquot, the laboratory can ensure that the results obtained are accurate and reflective of the entire specimen. This helps in minimizing errors and obtaining reliable test results.

An abnormally large buffy coat in a whole blood specimen indicates that the patient has an elevated leukocyte or platelet count. The buffy coat is the thin layer of white blood cells and platelets that separates from the red blood cells when the blood is centrifuged. If this layer is larger than usual, it suggests an increased number of white blood cells and platelets, which are components of the buffy coat. This can be a sign of infection, inflammation, or other medical conditions that cause an elevated leukocyte or platelet count.

When a tourniquet is too tight, it can cause several effects. Arterial flow below it may be stopped, meaning that blood cannot flow properly to the tissues. Blood below it may hemoconcentrate, which means that the concentration of blood cells and other components increases due to decreased fluid volume. The pressure can cause the arm to ache due to restricted blood flow and compression of nerves. However, venous flow does not increase as veins expand when the tourniquet is too tight. In fact, the constriction caused by the tourniquet can impede venous flow as well.

Specimen handling is very important because it can affect the quality of results and many lab errors occur in the preanalytical phase. Additionally, the effects of mishandling are not always obvious, which emphasizes the importance of proper handling to ensure accurate and reliable results. However, the statement that mishandling effects can be corrected if identified is not a reason why specimen handling is important. While identifying and correcting mishandling effects is important, it does not explain why proper handling is crucial in the first place.

The correct answer is "normal fluctuations throughout the day." Diurnal variations refer to the natural changes that occur in certain blood components over the course of a day. These fluctuations are considered normal and are influenced by factors such as sleep-wake cycles, physical activity, and meal times. It is important to understand these variations when interpreting blood test results, as they can help differentiate between normal and abnormal levels of certain components.

Puncturing the radial artery is considered a disadvantage because it is small and difficult to feel. This makes it challenging for healthcare professionals to accurately locate and puncture the artery, increasing the risk of errors and potential complications. Additionally, the small size of the artery can make it more prone to damage and bleeding, leading to hematoma formation.

The correct answer is "withdraw the specimen through the stopper by syringe." This is because withdrawing the specimen through the stopper by syringe does not prevent exposure to aerosol generated when the stopper is removed from a specimen tube. The other options, such as covering the stopper with a 4x4 gauze, removing the stopper with the tube held behind a shield, and using a specially designed safety stopper removal device, are all measures that can be taken to prevent exposure to aerosol generated when the stopper is removed.

The correct answer is "certify laboratory professionals." The AMT, NCA, and ASCP are agencies that provide certification to individuals working in the field of laboratory professions. Certification is a process by which professionals can demonstrate their knowledge, skills, and competence in their respective fields. It ensures that laboratory professionals meet certain standards and have the necessary qualifications to perform their job effectively. The certification provided by these agencies is recognized and respected in the industry, making it an important credential for laboratory professionals.

Accessioning the specimen refers to the process of assigning a unique identifier or accession number to a specimen and its accompanying paperwork. This helps in ensuring that the specimen can be easily identified and tracked throughout the testing or research process. Barcoding specimen labels can be a part of this accessioning process, as it provides a quick and efficient way to link the specimen to its relevant information. Collection verification involves confirming the accuracy and completeness of the specimen and its associated documentation. Patient identification is a separate step that involves verifying the identity of the individual from whom the specimen was collected.

Thrombin is a protein that plays a role in blood clotting. It is not typically present in urine, as it is primarily found in the blood. Therefore, it cannot be detected in urine using a reagent strip that is designed to test for substances commonly found in urine such as bilirubin, glucose, and leukocytes.

The correct answer is CLSI. CLSI stands for Clinical and Laboratory Standards Institute. It is an organization that develops and publishes guidelines and standards for laboratory testing and phlebotomy practices. These guidelines are widely recognized and used as a reference in phlebotomy malpractice cases to determine the standard of care that should have been followed by healthcare professionals.

The correct answer is 4 hours because ESR (erythrocyte sedimentation rate) is a measure of how quickly red blood cells settle in a tube of blood. It is an indicator of inflammation or infection in the body. After blood is collected, it needs to be tested within a certain time frame to obtain accurate results. The ESR determination on specimens held at room temperature should be made within 4 hours to ensure the reliability of the test. After 4 hours, the sedimentation rate may change, leading to inaccurate results.

The question is asking which organization's guidelines do not need to be followed when transporting specimens by courier or other mail systems. The DOT (Department of Transportation), FAA (Federal Aviation Administration), and OSHA (Occupational Safety and Health Administration) all have regulations and guidelines regarding the transportation of specimens. However, the FDA (Food and Drug Administration) does not have specific guidelines for specimen transportation, making it the exception in this case.

Chilling can cause erroneous results for potassium because it can lead to the precipitation of potassium salts or interfere with the ion-selective electrodes used for its measurement. Cold temperatures can cause potassium to precipitate out of solution, leading to falsely low results. Additionally, chilling can affect the performance of ion-selective electrodes, which are commonly used to measure potassium levels, resulting in inaccurate readings. Therefore, it is important to handle and store samples properly to prevent chilling-induced errors in potassium measurements.

An example of a QA indicator is "blood culture contamination rates will not exceed 3 percent." This statement represents a measurable and specific goal that can be used to assess the quality of the phlebotomy process. By setting a maximum contamination rate of 3 percent, it provides a benchmark for evaluating the effectiveness of infection control measures and identifying areas for improvement. This indicator helps ensure the accuracy and reliability of blood culture results, which is crucial for proper diagnosis and treatment of patients.

Transporting tubes with the stopper up does not maintain the sterility of the sample. The correct way to maintain sterility is by keeping the stopper tightly closed to prevent any contamination from entering the tube. However, transporting tubes with the stopper up does have other benefits such as encouraging complete clot formation, minimizing stopper caused aerosols, and reducing agitation caused hemolysis.

The presence of an area of induration and erythema that measures 7mm in diameter suggests a possible reaction to the TB test. However, this size of reaction is considered borderline and falls within the range of uncertainty. Therefore, the test results are considered doubtful as it is unclear whether the patient is truly positive or negative for TB. Further evaluation or testing may be required to confirm the diagnosis.

Drawing a patient's blood without their permission can be considered a violation of medical ethics and legal requirements. This action can be seen as a breach of the duty of care that healthcare professionals owe to their patients. Malpractice refers to the failure of a professional to provide the standard of care expected in their field, which can include performing medical procedures without proper consent. Therefore, drawing a patient's blood without their permission can be considered an act of malpractice, potentially leading to legal consequences for the healthcare professional involved.