Take Home Quiz Chapter 8

1. The laboratory receptionist finishes checking a patient in and hands you the test request. The request is for a patient named Mary Smith. You call the name, and a woman who was just checked in responds. She is also the only patient in the waiting room. How do you verify that she is the correct patient?

Ask the woman to state her complete name and date of birth to confirm her identity.

Assume that you do not have to verify her identity because the receptionist already did.

Conclude that she must be the right one because she is the only one in the waiting room.

Decide that she must be the right one because she answered you when you called the name.

The best way to verify that the woman is the correct patient is by asking her to state her complete name and date of birth. This ensures that she is providing accurate information about her identity, which can be cross-checked with the test request. Assuming that the receptionist already verified her identity may not be sufficient, as there could have been a mistake or miscommunication. Concluding that she is the right patient because she is the only one in the waiting room is not a reliable method, as there could be other factors at play. Similarly, deciding that she is the right patient because she responded to her name being called is not a foolproof method, as someone else could have coincidentally responded.

Explanation

The best way to verify that the woman is the correct patient is by asking her to state her complete name and date of birth. This ensures that she is providing accurate information about her identity, which can be cross-checked with the test request. Assuming that the receptionist already verified her identity may not be sufficient, as there could have been a mistake or miscommunication. Concluding that she is the right patient because she is the only one in the waiting room is not a reliable method, as there could be other factors at play. Similarly, deciding that she is the right patient because she responded to her name being called is not a foolproof method, as someone else could have coincidentally responded.

2. Where is the best place to apply the tourniquet?

About 3 to 4 in. Above the venipuncture site

Distal to the venipuncture site on the forearm

Distal to the wrist bone if drawing a hand vein

Immediately above the venipuncture site.

The best place to apply the tourniquet is about 3 to 4 inches above the venipuncture site. This is because applying the tourniquet above the venipuncture site helps to occlude the veins and increase blood flow, making it easier to locate and access the veins for the procedure. Placing the tourniquet too close to the venipuncture site may cause discomfort or restrict blood flow too much, while placing it too far away may not provide enough occlusion for successful venipuncture.

Explanation

The best place to apply the tourniquet is about 3 to 4 inches above the venipuncture site. This is because applying the tourniquet above the venipuncture site helps to occlude the veins and increase blood flow, making it easier to locate and access the veins for the procedure. Placing the tourniquet too close to the venipuncture site may cause discomfort or restrict blood flow too much, while placing it too far away may not provide enough occlusion for successful venipuncture.

3. Which liquid is acceptable to drink when one is fasting?

Black coffee

Diet soda

Plain water

Sugarless tea

Plain water is acceptable to drink when one is fasting because it does not contain any calories, sugars, or additives that could break the fast. It is a pure and natural liquid that keeps the body hydrated without interfering with the fasting process. Other options like black coffee, diet soda, and sugarless tea may contain caffeine, artificial sweeteners, or other substances that could potentially disrupt the fasting state. Therefore, plain water is the best choice to stay hydrated while fasting.

Explanation

Plain water is acceptable to drink when one is fasting because it does not contain any calories, sugars, or additives that could break the fast. It is a pure and natural liquid that keeps the body hydrated without interfering with the fasting process. Other options like black coffee, diet soda, and sugarless tea may contain caffeine, artificial sweeteners, or other substances that could potentially disrupt the fasting state. Therefore, plain water is the best choice to stay hydrated while fasting.

4. If the patient asks wheather the procedure will hurt, you should say that it:

Could hurt if you watch, so look the other way.

Is painless and will be over just before you know it.

Might hurt just a little, but only for a short time.

Hurts only if the phlebotmist is inexperienced.

The correct answer suggests that the procedure might cause a little pain but it will only last for a short duration. This response acknowledges the possibility of discomfort but reassures the patient that it will be temporary.

Explanation

The correct answer suggests that the procedure might cause a little pain but it will only last for a short duration. This response acknowledges the possibility of discomfort but reassures the patient that it will be temporary.

5. Never leave a tourniquet on for more than:

30 seconds

1 minute

2 minutes.

3 minutes.

Leaving a tourniquet on for more than 1 minute can cause damage to the underlying tissues due to restricted blood flow. Tourniquets are typically used in emergency situations to control severe bleeding, but they should only be left in place for a short period of time to prevent complications such as nerve or muscle damage.

Explanation

Leaving a tourniquet on for more than 1 minute can cause damage to the underlying tissues due to restricted blood flow. Tourniquets are typically used in emergency situations to control severe bleeding, but they should only be left in place for a short period of time to prevent complications such as nerve or muscle damage.

6. In performing venipuncture, the needle is inserted:

As you prefer.

Bevel facing up.

Bevel site down.

Bevel sideways.

When performing venipuncture, the needle should be inserted with the bevel facing up. This is because the bevel is the slanted opening at the tip of the needle, and inserting it in this position allows for smoother entry into the vein. It also helps to minimize the risk of damaging the vein walls and reduces the likelihood of hemolysis, which is the rupture of red blood cells. Placing the bevel facing up ensures that the needle is properly aligned with the vein, allowing for a more successful and efficient venipuncture procedure.

Explanation

When performing venipuncture, the needle should be inserted with the bevel facing up. This is because the bevel is the slanted opening at the tip of the needle, and inserting it in this position allows for smoother entry into the vein. It also helps to minimize the risk of damaging the vein walls and reduces the likelihood of hemolysis, which is the rupture of red blood cells. Placing the bevel facing up ensures that the needle is properly aligned with the vein, allowing for a more successful and efficient venipuncture procedure.

7. Labeling of routine inpatient blood specimens should take place:

At the bedside immediately after collection.

Before the blood specimens are collected.

In the lab processing area after collection.

Outside the patient's room after collection.

Labeling of routine inpatient blood specimens should take place at the bedside immediately after collection. This is because labeling the specimens at the bedside ensures accuracy and reduces the risk of misidentification or mix-ups. By labeling the specimens immediately after collection, healthcare professionals can verify the patient's identity and ensure that the correct labels are attached to the corresponding specimens. This helps in maintaining patient safety and preventing errors in the laboratory processing and testing of the blood specimens.

Explanation

Labeling of routine inpatient blood specimens should take place at the bedside immediately after collection. This is because labeling the specimens at the bedside ensures accuracy and reduces the risk of misidentification or mix-ups. By labeling the specimens immediately after collection, healthcare professionals can verify the patient's identity and ensure that the correct labels are attached to the corresponding specimens. This helps in maintaining patient safety and preventing errors in the laboratory processing and testing of the blood specimens.

8. Needle phobia is defined as a/an:

Anxiety about admission to the hospital.

Inability to watch while others are drawn.

Intense fear of needles and being stuck.

Personal preference for smaller needles.

The correct answer is "Intense fear of needles and being stuck." Needle phobia refers to an extreme fear or anxiety specifically related to needles and being stuck by them. This phobia can cause significant distress and avoidance behaviors when it comes to medical procedures involving needles, such as vaccinations or blood tests. It is not related to anxiety about admission to the hospital, inability to watch while others are drawn, or personal preference for smaller needles.

Explanation

The correct answer is "Intense fear of needles and being stuck." Needle phobia refers to an extreme fear or anxiety specifically related to needles and being stuck by them. This phobia can cause significant distress and avoidance behaviors when it comes to medical procedures involving needles, such as vaccinations or blood tests. It is not related to anxiety about admission to the hospital, inability to watch while others are drawn, or personal preference for smaller needles.

9. To examine by touch or feel is to:

Ambulate.

Anchor.

Palpate.

Pronate.

To examine by touch or feel is known as palpation. This involves using the hands or fingers to feel for abnormalities or changes in texture, temperature, or shape in the body. Ambulate refers to walking or moving about. Anchor means to secure or stabilize. Pronate refers to the rotation of the forearm so that the palm faces downwards.

Explanation

To examine by touch or feel is known as palpation. This involves using the hands or fingers to feel for abnormalities or changes in texture, temperature, or shape in the body. Ambulate refers to walking or moving about. Anchor means to secure or stabilize. Pronate refers to the rotation of the forearm so that the palm faces downwards.

10. If a test is ordered stat, it may mean that the patient is in:

Critical condition.

Fragile condition.

Rehabilitation.

Transition status.

If a test is ordered stat, it suggests that the patient is in a critical condition. "Stat" is a medical term that stands for "immediately" or "urgently." Therefore, when a test is ordered stat, it indicates that the patient's condition is severe and requires immediate attention and intervention. This could be due to a life-threatening situation or a medical emergency where prompt diagnosis and treatment are crucial.

Explanation

If a test is ordered stat, it suggests that the patient is in a critical condition. "Stat" is a medical term that stands for "immediately" or "urgently." Therefore, when a test is ordered stat, it indicates that the patient's condition is severe and requires immediate attention and intervention. This could be due to a life-threatening situation or a medical emergency where prompt diagnosis and treatment are crucial.

11. DNR means:

Do not alert the nurse.

Do not call 911.

Do not call relatives.

Do not resuscitate.

DNR stands for "Do not resuscitate," which means that medical professionals should not attempt to revive or resuscitate a patient if their heart stops or they stop breathing. This decision is usually made in advance by the patient or their legal representative, and it is based on the patient's wishes and quality of life considerations. It is important for healthcare providers to be aware of a patient's DNR status to ensure that their wishes are respected in emergency situations.

Explanation

DNR stands for "Do not resuscitate," which means that medical professionals should not attempt to revive or resuscitate a patient if their heart stops or they stop breathing. This decision is usually made in advance by the patient or their legal representative, and it is based on the patient's wishes and quality of life considerations. It is important for healthcare providers to be aware of a patient's DNR status to ensure that their wishes are respected in emergency situations.

12. You arrive to draw a specimen on an inpatient. The patien's door is closed. What do you do?

Knock lightly, open the door slowly, and ask whether it is all right to enter.

Knock softly and wait for someone in the room to come to the door.

Leave to draw another patient in the same area and come back later.

Open the door, announce yourself, and quickly proceed into the room.

When arriving to draw a specimen on an inpatient, it is important to respect the patient's privacy and obtain their permission before entering the room. Knocking lightly and opening the door slowly shows courtesy and allows the patient time to respond. Asking whether it is all right to enter ensures that the patient is comfortable with your presence. This approach promotes patient-centered care and maintains the patient's dignity and autonomy.

Explanation

When arriving to draw a specimen on an inpatient, it is important to respect the patient's privacy and obtain their permission before entering the room. Knocking lightly and opening the door slowly shows courtesy and allows the patient time to respond. Asking whether it is all right to enter ensures that the patient is comfortable with your presence. This approach promotes patient-centered care and maintains the patient's dignity and autonomy.

13. A patient has difficult veins and you decide to use a butterfly for the draw. Butterfly is another name for a:

Hypodermic needle.

Muitisample needle

Needle safety feature.

Winged infusion set.

A butterfly is another name for a winged infusion set. This type of needle has small plastic wings on either side of the needle, which provide stability and control during the procedure. It is commonly used when a patient has difficult veins, as the wings can be easily held and maneuvered, allowing for a more accurate and successful blood draw.

Explanation

A butterfly is another name for a winged infusion set. This type of needle has small plastic wings on either side of the needle, which provide stability and control during the procedure. It is commonly used when a patient has difficult veins, as the wings can be easily held and maneuvered, allowing for a more accurate and successful blood draw.

14. Going without food or drink except for water for 8 to 12 hours is defined as:

Fasting.

NPO.

Routine.

TDM.

Going without food or drink except for water for 8 to 12 hours is commonly known as fasting. During fasting, individuals abstain from consuming any food or beverages, except for water, for a specific period of time. This practice is often done for religious, spiritual, or health reasons. Fasting allows the body to rest and cleanse itself, and it has been associated with various health benefits such as improved insulin sensitivity, weight loss, and reduced inflammation.

Explanation

Going without food or drink except for water for 8 to 12 hours is commonly known as fasting. During fasting, individuals abstain from consuming any food or beverages, except for water, for a specific period of time. This practice is often done for religious, spiritual, or health reasons. Fasting allows the body to rest and cleanse itself, and it has been associated with various health benefits such as improved insulin sensitivity, weight loss, and reduced inflammation.

15. Which of the following individuals has legal authority to authorize paitent testing?

Laboratory director

Patient's nurse

Patient's physician

Phlebotomist

The patient's physician has legal authority to authorize patient testing because they are responsible for diagnosing and treating the patient's medical condition. They have the knowledge and expertise to determine what tests are necessary for proper diagnosis and treatment. The laboratory director, nurse, and phlebotomist do not have the same level of medical knowledge and authority to make these decisions.

Explanation

The patient's physician has legal authority to authorize patient testing because they are responsible for diagnosing and treating the patient's medical condition. They have the knowledge and expertise to determine what tests are necessary for proper diagnosis and treatment. The laboratory director, nurse, and phlebotomist do not have the same level of medical knowledge and authority to make these decisions.

16. Information represented by a patient ID bar code typically includes the patient's:

Credit information and employer

DNA information and next of kin,

Health status and lab test results

Medical record number and name.

A patient ID bar code typically includes the patient's medical record number and name. This allows healthcare professionals to accurately identify and access the patient's medical information, ensuring proper treatment and care. Including credit information and employer would be a privacy violation, while DNA information and next of kin, as well as health status and lab test results, are not typically encoded in a patient ID bar code.

Explanation

A patient ID bar code typically includes the patient's medical record number and name. This allows healthcare professionals to accurately identify and access the patient's medical information, ensuring proper treatment and care. Including credit information and employer would be a privacy violation, while DNA information and next of kin, as well as health status and lab test results, are not typically encoded in a patient ID bar code.

17. Your patient is cranky and rude to you. What do you do?

Ask the patient's nurse to draw the specimen as you stand by to assist.

Be as professional as you can and collect the specimen in a normal way.

Do not speak to the patient; just get the necessary blood work and leave.

Refuse to draw blood from the patient and leave the request for another phlebotomist.

The correct answer is to be as professional as you can and collect the specimen in a normal way. This is the most appropriate response because it emphasizes maintaining professionalism and providing care despite the patient's behavior. It is important to not let the patient's rudeness affect the quality of care provided.

Explanation

The correct answer is to be as professional as you can and collect the specimen in a normal way. This is the most appropriate response because it emphasizes maintaining professionalism and providing care despite the patient's behavior. It is important to not let the patient's rudeness affect the quality of care provided.

18. When performing a venipuncture, hand decontamination is required:

After drawing your last patient.

Before and after each patient.

Only after drawing the patient.

Only before putting on gloves.

Hand decontamination is required before and after each patient when performing a venipuncture. This is important to prevent the spread of infection and maintain a sterile environment. Before each patient, hand decontamination ensures that any potential pathogens on the hands are removed, reducing the risk of contamination. After each patient, hand decontamination helps to eliminate any potential pathogens that may have been encountered during the procedure. By following this practice, healthcare professionals can minimize the risk of infection transmission and ensure the safety of both themselves and their patients.

Explanation

Hand decontamination is required before and after each patient when performing a venipuncture. This is important to prevent the spread of infection and maintain a sterile environment. Before each patient, hand decontamination ensures that any potential pathogens on the hands are removed, reducing the risk of contamination. After each patient, hand decontamination helps to eliminate any potential pathogens that may have been encountered during the procedure. By following this practice, healthcare professionals can minimize the risk of infection transmission and ensure the safety of both themselves and their patients.

19. You must colect a specimen on a 6-year-old. The child is a little fearful. What do you do?

Explain what are you going to do to the child in simple terms.

Restrain the child and draw the specimen without explanation.

Tell the child that you will give him a treat if he does not cry.

Tell the child to relax and not to worry because it will not hurt.

The best approach in this situation is to explain to the child in simple terms what you are going to do. This helps to alleviate their fear and anxiety by providing them with a clear understanding of the procedure. By explaining it in a way that they can understand, the child is more likely to cooperate and feel more comfortable during the specimen collection process. This approach promotes trust and ensures that the child's emotional well-being is taken into consideration.

Explanation

The best approach in this situation is to explain to the child in simple terms what you are going to do. This helps to alleviate their fear and anxiety by providing them with a clear understanding of the procedure. By explaining it in a way that they can understand, the child is more likely to cooperate and feel more comfortable during the specimen collection process. This approach promotes trust and ensures that the child's emotional well-being is taken into consideration.

20. Symptoms of needle phobia can include:

Arrhythmia.

Fainting.

Light-headedness.

All of the above.

The correct answer is "All of the above." This is because needle phobia can cause various symptoms, including arrhythmia (irregular heartbeat), fainting, and light-headedness.

Explanation

The correct answer is "All of the above." This is because needle phobia can cause various symptoms, including arrhythmia (irregular heartbeat), fainting, and light-headedness.

21. An inpatient vhemently refuses to allow you to collect a blood specimen. What should you do?

Convince the patient to cooperate and collect the sample anyway.

Have the nurse physically restrain the patient and draw the specimen.

Notify the patient's nurse and document the patient's refusal,

Return to the lab, cancel the test request, and inform the physician.

If a patient refuses to allow the collection of a blood specimen, the appropriate action is to notify the patient's nurse and document the patient's refusal. This is important for maintaining accurate medical records and ensuring proper communication between healthcare providers. It is not ethical or legal to physically restrain the patient or collect the sample against their will. Returning to the lab, canceling the test request, and informing the physician may not be necessary at this point, as the nurse can assess the situation and determine the best course of action.

Explanation

If a patient refuses to allow the collection of a blood specimen, the appropriate action is to notify the patient's nurse and document the patient's refusal. This is important for maintaining accurate medical records and ensuring proper communication between healthcare providers. It is not ethical or legal to physically restrain the patient or collect the sample against their will. Returning to the lab, canceling the test request, and informing the physician may not be necessary at this point, as the nurse can assess the situation and determine the best course of action.

22. You are about to draw blood from a paitent. You touch the needle to the skin but change your mind and pull the needle away. What do you do next?

Clean the site and try again using the same needle.

Stop and obtain a new needle before trying again.

Try it again immediately using that same needle.

Wipe the needle across an alcohol pad and retry.

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Explanation

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23. When reveived by the laboratory, inpaitent requisitions are typically sorted according to:

Alphabetical order by name and then by test requested.

Collection priority, date and time, and patient location.

Difficulty of draw and type of equipment needed.

Proximity of the patient's room to the laboratory.

Inpatient requisitions are sorted by collection priority, date and time, and patient location. This means that the laboratory prioritizes the collection of samples based on the urgency of the test, the date and time the requisition was received, and the location of the patient. This sorting method ensures that tests are conducted in a timely manner and that patients who require urgent testing are given priority. Sorting alphabetically by name and test requested, difficulty of draw and type of equipment needed, or proximity to the laboratory are not mentioned as criteria for sorting inpatient requisitions.

Explanation

Inpatient requisitions are sorted by collection priority, date and time, and patient location. This means that the laboratory prioritizes the collection of samples based on the urgency of the test, the date and time the requisition was received, and the location of the patient. This sorting method ensures that tests are conducted in a timely manner and that patients who require urgent testing are given priority. Sorting alphabetically by name and test requested, difficulty of draw and type of equipment needed, or proximity to the laboratory are not mentioned as criteria for sorting inpatient requisitions.

24. An example of a test that is commonly ordered fasting is:

BUN

Cortisol.

Glucose.

PTT.

Glucose is commonly ordered fasting because the levels of glucose in the blood can be affected by recent food intake. Fasting ensures that the results are accurate and not influenced by recent meals. BUN, cortisol, and PTT tests do not require fasting as they are not affected by food intake.

Explanation

Glucose is commonly ordered fasting because the levels of glucose in the blood can be affected by recent food intake. Fasting ensures that the results are accurate and not influenced by recent meals. BUN, cortisol, and PTT tests do not require fasting as they are not affected by food intake.

25. What is hte best thing to do if family or visitors are with a patient?

Ask them to wait outside of the room until you are finished.

Come back later to collect the specimen when they have left.

Have the patient's nurse tell everyone that they should leave.

Tell them to quietly watch from the opposite side of the bed.

When family or visitors are with a patient, the best thing to do is to ask them to wait outside of the room until you are finished. This ensures the patient's privacy and allows for uninterrupted care. It also helps to create a calm and quiet environment, which is important for the patient's well-being and recovery. By asking them to wait outside, you can focus on providing the necessary care without any distractions or interruptions.

Explanation

When family or visitors are with a patient, the best thing to do is to ask them to wait outside of the room until you are finished. This ensures the patient's privacy and allows for uninterrupted care. It also helps to create a calm and quiet environment, which is important for the patient's well-being and recovery. By asking them to wait outside, you can focus on providing the necessary care without any distractions or interruptions.

26. What may happen if you mix tubes too vigorously?

Hemolysis

Jaundice

Lipemia

No effect

Mixing tubes too vigorously can cause hemolysis, which is the rupture or destruction of red blood cells. This can occur due to the physical stress placed on the cells during the mixing process. Hemolysis can lead to the release of hemoglobin into the surrounding fluid, causing it to appear red or pink. This can affect the accuracy of laboratory tests that rely on intact red blood cells, such as blood cell counts or certain chemical analyses.

Explanation

Mixing tubes too vigorously can cause hemolysis, which is the rupture or destruction of red blood cells. This can occur due to the physical stress placed on the cells during the mixing process. Hemolysis can lead to the release of hemoglobin into the surrounding fluid, causing it to appear red or pink. This can affect the accuracy of laboratory tests that rely on intact red blood cells, such as blood cell counts or certain chemical analyses.

27. Test requisition information must include the:

Ordering physician.

Patient's diagnosis.

Patient's location

Prior draw times.

The test requisition information must include the ordering physician because this information is crucial for the laboratory to know who has requested the test. It helps in ensuring that the test is performed for the correct patient and allows for proper communication between the laboratory and the physician regarding the test results and any necessary follow-up actions. The other mentioned information such as the patient's diagnosis, location, and prior draw times may also be important but are not essential for every test requisition.

Explanation

The test requisition information must include the ordering physician because this information is crucial for the laboratory to know who has requested the test. It helps in ensuring that the test is performed for the correct patient and allows for proper communication between the laboratory and the physician regarding the test results and any necessary follow-up actions. The other mentioned information such as the patient's diagnosis, location, and prior draw times may also be important but are not essential for every test requisition.

28. What is the advantage of using a butterfly?

Blood flows faster than with the ETS needles.

Butterflies are less expensive than other needles.

Butterflies make it easier to draw difficult veins.

There is greater choice in butterfly needle size.

The advantage of using a butterfly needle is that it makes it easier to draw difficult veins. This means that when a patient has veins that are hard to access or find, using a butterfly needle can help healthcare professionals to successfully draw blood or administer medication.

Explanation

The advantage of using a butterfly needle is that it makes it easier to draw difficult veins. This means that when a patient has veins that are hard to access or find, using a butterfly needle can help healthcare professionals to successfully draw blood or administer medication.

29. Failure of the paitent to follow required diet restrictions before specimen collection could lead to:

Compromised patient care and treatment.

Erroneous and meaningless test results.

Misinterpreted test results by the physician.

All of the above.

If a patient fails to follow the required diet restrictions before specimen collection, it can have several negative consequences. Firstly, it can compromise patient care and treatment as the test results may not accurately reflect the patient's condition. Secondly, it can lead to erroneous and meaningless test results, which can further hinder the proper diagnosis and treatment. Lastly, the physician may misinterpret the test results due to the patient's failure to adhere to the diet restrictions. Therefore, all of the above options are valid outcomes of the patient's failure to follow the required diet restrictions.

Explanation

If a patient fails to follow the required diet restrictions before specimen collection, it can have several negative consequences. Firstly, it can compromise patient care and treatment as the test results may not accurately reflect the patient's condition. Secondly, it can lead to erroneous and meaningless test results, which can further hinder the proper diagnosis and treatment. Lastly, the physician may misinterpret the test results due to the patient's failure to adhere to the diet restrictions. Therefore, all of the above options are valid outcomes of the patient's failure to follow the required diet restrictions.

30. A test that is ordered stat should be collected:

As soon as it is possible to do so.

Immediately, without any hesitation.

On the next closest scheduled sweep.

Within 1 hour of the test request.

A test that is ordered stat should be collected immediately, without any hesitation. This means that there should be no delay in collecting the sample once the test is ordered. The term "stat" stands for "immediately" or "urgent," indicating that the test is time-sensitive and requires prompt action. Collecting the sample without any hesitation ensures that the results can be obtained quickly, allowing for timely diagnosis or treatment if necessary.

Explanation

A test that is ordered stat should be collected immediately, without any hesitation. This means that there should be no delay in collecting the sample once the test is ordered. The term "stat" stands for "immediately" or "urgent," indicating that the test is time-sensitive and requires prompt action. Collecting the sample without any hesitation ensures that the results can be obtained quickly, allowing for timely diagnosis or treatment if necessary.

31. The medical record number on the ID band matches the number on your requisition, but the patient's name is spelled differently than the one on your requisition. What should you do?

Collect the specimen and report the error to the patient's nurse.

Do not collect the specimen until the difference is resolved.

Draw the specimen because the medical record number matches.

Make the correction on the requisition and draw the specimen.

It is important to ensure that the patient's information matches on both the ID band and the requisition. In this case, although the medical record number matches, the patient's name is spelled differently. This could indicate an error or discrepancy in the patient's identification. To avoid any potential mistakes or confusion, it is best to not collect the specimen until the difference in the patient's name is resolved.

Explanation

It is important to ensure that the patient's information matches on both the ID band and the requisition. In this case, although the medical record number matches, the patient's name is spelled differently. This could indicate an error or discrepancy in the patient's identification. To avoid any potential mistakes or confusion, it is best to not collect the specimen until the difference in the patient's name is resolved.

32. Which of the following is the best thing to do if your hands are visibly contaminated?

Clean them with a hand sanitizer.

Cover them up with clean gloves.

Wash them with soap and water.

Wipe them with an alcohol pad.

The best thing to do if your hands are visibly contaminated is to wash them with soap and water. This is because soap and water are effective in removing dirt, germs, and other contaminants from the hands. Hand sanitizer may not be as effective in removing visible dirt and debris. Covering the hands with clean gloves may help prevent the spread of contaminants, but it does not remove them from the hands. Wiping the hands with an alcohol pad may kill some germs, but it does not effectively remove visible dirt and contaminants.

Explanation

The best thing to do if your hands are visibly contaminated is to wash them with soap and water. This is because soap and water are effective in removing dirt, germs, and other contaminants from the hands. Hand sanitizer may not be as effective in removing visible dirt and debris. Covering the hands with clean gloves may help prevent the spread of contaminants, but it does not remove them from the hands. Wiping the hands with an alcohol pad may kill some germs, but it does not effectively remove visible dirt and contaminants.

33. Which of the following will help you avoid inadvertentlly puncturing an artery during venipuncture?

Avoid drawing the basilic vein the the antecubital area.

Do not select a site that is near where you feel a pulse.

Do not select a vein that overlies or is close to an artery.

All of the above.

To avoid inadvertently puncturing an artery during venipuncture, it is important to follow all of the mentioned guidelines. Avoiding drawing the basilic vein in the antecubital area helps because the basilic vein is located close to the brachial artery in this region. Not selecting a site near where a pulse is felt is important because arteries pulsate and selecting a site close to an artery increases the risk of accidentally puncturing it. Similarly, not selecting a vein that overlies or is close to an artery reduces the chances of puncturing an artery. Therefore, all of the above measures should be followed to avoid inadvertent puncturing of an artery during venipuncture.

Explanation

To avoid inadvertently puncturing an artery during venipuncture, it is important to follow all of the mentioned guidelines. Avoiding drawing the basilic vein in the antecubital area helps because the basilic vein is located close to the brachial artery in this region. Not selecting a site near where a pulse is felt is important because arteries pulsate and selecting a site close to an artery increases the risk of accidentally puncturing it. Similarly, not selecting a vein that overlies or is close to an artery reduces the chances of puncturing an artery. Therefore, all of the above measures should be followed to avoid inadvertent puncturing of an artery during venipuncture.

34. Proper use of a hand sanitizer includes:

Allowing the alcohol to evaporate completely.

Rubbing it in between and around the fingers.

Using a very generous amount of the sanitizer.

All of the above.

The correct answer is "All of the above" because proper use of a hand sanitizer involves allowing the alcohol to evaporate completely, rubbing it in between and around the fingers, and using a generous amount of the sanitizer. By following all of these steps, the hand sanitizer is effectively used to kill germs and prevent the spread of infections.

Explanation

The correct answer is "All of the above" because proper use of a hand sanitizer involves allowing the alcohol to evaporate completely, rubbing it in between and around the fingers, and using a generous amount of the sanitizer. By following all of these steps, the hand sanitizer is effectively used to kill germs and prevent the spread of infections.

35. Proper needle disposal involves:

Disposing of the needle and tube holder in the sharpes container as one unit.

Ejecting the needle from the tube holder so that the holder can be reused.

Removing the needle from the holder after engaging the needle safety device.

Unscrewing the needle from the holder by using a slot in the sharps container.

The correct answer is disposing of the needle and tube holder in the sharpes container as one unit. This is the proper way to dispose of needles because it ensures that the needle is safely contained and reduces the risk of accidental needlestick injuries. By disposing of the needle and tube holder together, it eliminates the need for reusing the holder or removing the needle from the holder, which could potentially cause harm. Unscrewing the needle from the holder using a slot in the sharps container is not a recommended method as it can be dangerous and increase the risk of needlestick injuries.

Explanation

The correct answer is disposing of the needle and tube holder in the sharpes container as one unit. This is the proper way to dispose of needles because it ensures that the needle is safely contained and reduces the risk of accidental needlestick injuries. By disposing of the needle and tube holder together, it eliminates the need for reusing the holder or removing the needle from the holder, which could potentially cause harm. Unscrewing the needle from the holder using a slot in the sharps container is not a recommended method as it can be dangerous and increase the risk of needlestick injuries.

36. A test is ordered "fasting" to:

Assess a patient after outpatient surgery.

Eliminate the effects of diet on test results.

Determine patient eligibility for surgery.

Standardize test results on critical patients.

The reason a test is ordered "fasting" is to eliminate the effects of diet on test results. When a person fasts, it means they abstain from eating or drinking anything except water for a certain period of time before the test. This is done because certain foods and beverages can affect the levels of certain substances in the body, which can in turn affect the results of the test. By fasting, the test results can be more accurate and reliable as they are not influenced by recent food intake.

Explanation

The reason a test is ordered "fasting" is to eliminate the effects of diet on test results. When a person fasts, it means they abstain from eating or drinking anything except water for a certain period of time before the test. This is done because certain foods and beverages can affect the levels of certain substances in the body, which can in turn affect the results of the test. By fasting, the test results can be more accurate and reliable as they are not influenced by recent food intake.

37. A paitent who is NPO:

Cannot have any food or drink.

Cannot have anything but water.

Is in critical but stable condition.

Is recovering from minor surgery.

The correct answer is "Cannot have any food or drink." When a patient is NPO, it means they are not allowed to have any food or drink. This is usually done before certain medical procedures or surgeries to ensure the patient's stomach is empty and reduce the risk of complications during the procedure. It is important for the patient to follow this restriction to ensure their safety and the success of the medical intervention.

Explanation

The correct answer is "Cannot have any food or drink." When a patient is NPO, it means they are not allowed to have any food or drink. This is usually done before certain medical procedures or surgeries to ensure the patient's stomach is empty and reduce the risk of complications during the procedure. It is important for the patient to follow this restriction to ensure their safety and the success of the medical intervention.

38. What is the most critical error a phlebotomist can make?

Collect a timed specimen late

Fail to obtain the desired specimen

Misidentify the patient's specimen

Unknowingly give a patient a bruise

Misidentifying the patient's specimen is the most critical error a phlebotomist can make. This error can lead to serious consequences such as misdiagnosis, wrong treatment, or even harm to the patient. It is essential for a phlebotomist to accurately label and identify each specimen to ensure that the correct tests are performed on the right patient. Any mistake in this process can have severe implications on the patient's health and well-being. Therefore, it is crucial for phlebotomists to exercise extreme caution and attention to detail to avoid misidentifying a patient's specimen.

Explanation

Misidentifying the patient's specimen is the most critical error a phlebotomist can make. This error can lead to serious consequences such as misdiagnosis, wrong treatment, or even harm to the patient. It is essential for a phlebotomist to accurately label and identify each specimen to ensure that the correct tests are performed on the right patient. Any mistake in this process can have severe implications on the patient's health and well-being. Therefore, it is crucial for phlebotomists to exercise extreme caution and attention to detail to avoid misidentifying a patient's specimen.

39. Criteria used to decide which needle gauge t o use for venipuncture include:

How deep the selected vein is.

The size and condition of the vein.

The type of test being collected.

Your personal preference.

The size and condition of the vein are important criteria to consider when deciding which needle gauge to use for venipuncture. The size of the vein will determine the appropriate size of the needle to ensure successful insertion and collection of blood. A larger vein may require a larger gauge needle, while a smaller vein may require a smaller gauge needle. The condition of the vein, such as its fragility or accessibility, will also influence the choice of needle gauge to minimize discomfort and potential complications during the procedure.

Explanation

The size and condition of the vein are important criteria to consider when deciding which needle gauge to use for venipuncture. The size of the vein will determine the appropriate size of the needle to ensure successful insertion and collection of blood. A larger vein may require a larger gauge needle, while a smaller vein may require a smaller gauge needle. The condition of the vein, such as its fragility or accessibility, will also influence the choice of needle gauge to minimize discomfort and potential complications during the procedure.

40. When properly anchoring a vein, the:

Index and middle finger are pulling the skin parallel to the arm just below the site.

Index finger is pulling the skin above the site and thumb is pulling toward the wrist.

Thumb is 1 to 2 in. Below the intended site and is pulling the skin toward the wrist.

Thumb is next to the intended vein and pressing heavily downward into the tissue.

When properly anchoring a vein, the thumb should be positioned 1 to 2 inches below the intended site and pulling the skin toward the wrist. This technique helps to stabilize the vein and make it easier to access for procedures such as venipuncture. Placing the thumb in this position allows for better control and minimizes movement of the vein during the procedure.

Explanation

When properly anchoring a vein, the thumb should be positioned 1 to 2 inches below the intended site and pulling the skin toward the wrist. This technique helps to stabilize the vein and make it easier to access for procedures such as venipuncture. Placing the thumb in this position allows for better control and minimizes movement of the vein during the procedure.

41. A preop patient:

Has been admitted to the hospital.

Is an ambulatory outpatient.

Is being assessed after surgery.

Will soon be going to surgery.

The correct answer is "Will soon be going to surgery." This is because the term "preop" refers to the period before a surgical procedure, indicating that the patient is in the preparation stage and will undergo surgery in the near future. The other options do not accurately describe the state of the patient before surgery.

Explanation

The correct answer is "Will soon be going to surgery." This is because the term "preop" refers to the period before a surgical procedure, indicating that the patient is in the preparation stage and will undergo surgery in the near future. The other options do not accurately describe the state of the patient before surgery.

42. Your inpatient is asleep when you arrive to draw blood. What do you do?

Call out the patient's name softly and shake the bed gently.

Cancel the test and ask the nurse to resubmit the requisition.

Check back every 15 minuets until the patient has awakened.

Fill out a form stating the specimen was not obtained and why.

When the patient is asleep, it is important to first try to gently wake them up by calling out their name softly and shaking the bed gently. This is a non-invasive approach to try and wake the patient without causing any harm or discomfort. It allows the patient to wake up naturally and be aware of the blood draw procedure. This approach ensures patient safety and cooperation during the procedure.

Explanation

When the patient is asleep, it is important to first try to gently wake them up by calling out their name softly and shaking the bed gently. This is a non-invasive approach to try and wake the patient without causing any harm or discomfort. It allows the patient to wake up naturally and be aware of the blood draw procedure. This approach ensures patient safety and cooperation during the procedure.

43. Outpatients who have previously fainted during a blood draw should be:

Allowed to sit up in order to carefully watch the draw.

Asked to lie down, or sit in a reclining drawing chair.

Drawn in a separate roam that has first-aid equipment.

Permitted to sit in a chair if accompanied by an adult.

Patients who have previously fainted during a blood draw should be asked to lie down or sit in a reclining drawing chair. This is because lying down or reclining helps to prevent fainting episodes by improving blood flow to the brain. It allows the patient to be in a more comfortable and relaxed position, reducing the likelihood of fainting during the procedure. Sitting up or being in a regular chair may not provide the same level of support and could increase the risk of fainting.

Explanation

Patients who have previously fainted during a blood draw should be asked to lie down or sit in a reclining drawing chair. This is because lying down or reclining helps to prevent fainting episodes by improving blood flow to the brain. It allows the patient to be in a more comfortable and relaxed position, reducing the likelihood of fainting during the procedure. Sitting up or being in a regular chair may not provide the same level of support and could increase the risk of fainting.

44. When is the best time to release the tourniquet during venipuncture?

After the last tube has been filled completely

After the needle is withdrawn and covered

NsAs soon as blood begins to flow into the tube

As soon as the needle penetrates the skin

The best time to release the tourniquet during venipuncture is as soon as blood begins to flow into the tube. Releasing the tourniquet at this point ensures that the blood flow is not obstructed and allows for a smooth and continuous collection of the sample. Releasing it too early, such as after the needle is withdrawn or covered, may result in inadequate blood flow and an incomplete sample. Similarly, releasing it after the last tube is filled completely may cause unnecessary discomfort to the patient. Releasing it as soon as the needle penetrates the skin is also not ideal as it may lead to excess bleeding before the collection process begins.

Explanation

The best time to release the tourniquet during venipuncture is as soon as blood begins to flow into the tube. Releasing the tourniquet at this point ensures that the blood flow is not obstructed and allows for a smooth and continuous collection of the sample. Releasing it too early, such as after the needle is withdrawn or covered, may result in inadequate blood flow and an incomplete sample. Similarly, releasing it after the last tube is filled completely may cause unnecessary discomfort to the patient. Releasing it as soon as the needle penetrates the skin is also not ideal as it may lead to excess bleeding before the collection process begins.

45. Doing this before obtaining a blood specimen from a child is a bad idea:

Establishing rapport which the child

Greeting the parents and the child

Telling the child it will not hurt

Telling the child what to expect

Telling the child that the blood specimen will not hurt before obtaining it is a bad idea because it can create false expectations and lead to a loss of trust. If the child experiences pain during the procedure, they may feel betrayed and become fearful of future medical procedures. It is better to prepare the child for the possibility of discomfort while reassuring them that the healthcare professional will do their best to minimize any pain or discomfort.

Explanation

Telling the child that the blood specimen will not hurt before obtaining it is a bad idea because it can create false expectations and lead to a loss of trust. If the child experiences pain during the procedure, they may feel betrayed and become fearful of future medical procedures. It is better to prepare the child for the possibility of discomfort while reassuring them that the healthcare professional will do their best to minimize any pain or discomfort.

46. In most cases, needle insertion should be performed:

At a 45-degree angle to the surface of the arm.

Using a smooth, steady motion forward,

With a deliberate and rapid forward jab.

With the bevel of the needle face down.

When performing needle insertion, it is important to do it using a smooth, steady motion forward. This ensures that the needle is inserted properly and reduces the risk of pain or discomfort for the patient. It also helps to ensure that the needle goes in at the correct angle and depth, minimizing the chances of complications or injury. A smooth, steady motion forward allows for better control and precision during the insertion process.

Explanation

When performing needle insertion, it is important to do it using a smooth, steady motion forward. This ensures that the needle is inserted properly and reduces the risk of pain or discomfort for the patient. It also helps to ensure that the needle goes in at the correct angle and depth, minimizing the chances of complications or injury. A smooth, steady motion forward allows for better control and precision during the insertion process.

47. There is a sign above the patient's bed that reads, "No blood pressures or venipuncture, right arm," the patient has an intravenous (IV) line in the left forearm. You have a request to collect a complete blood count (CBC) on the patient. How should you proceed?

Ask the patient's nurse to collect the specimen from the IV.

Ask the patient's nurse what to do when the sign is posted.

Collect a CBC from the right arm without using a tourniquet.

Collect the specimen from the left hand by finger puncture.

The correct answer is to collect the specimen from the left hand by finger puncture. This is because the sign above the patient's bed specifically states that no blood pressures or venipuncture should be done on the right arm. Therefore, using a tourniquet and collecting a CBC from the right arm would go against this instruction. Asking the patient's nurse what to do when the sign is posted is not necessary as the sign already provides clear instructions. Collecting the specimen from the left hand by finger puncture is a safe and appropriate method to obtain the CBC without violating the instructions on the sign.

Explanation

The correct answer is to collect the specimen from the left hand by finger puncture. This is because the sign above the patient's bed specifically states that no blood pressures or venipuncture should be done on the right arm. Therefore, using a tourniquet and collecting a CBC from the right arm would go against this instruction. Asking the patient's nurse what to do when the sign is posted is not necessary as the sign already provides clear instructions. Collecting the specimen from the left hand by finger puncture is a safe and appropriate method to obtain the CBC without violating the instructions on the sign.

48. This term means the same as stat:

Fasting

Med emerg

Postop

Timed

The term "med emerg" is an abbreviation for "medical emergency." It is used to describe a situation or condition that requires immediate medical attention. This term is synonymous with "stat," which is also used to indicate urgency in medical settings.

Explanation

The term "med emerg" is an abbreviation for "medical emergency." It is used to describe a situation or condition that requires immediate medical attention. This term is synonymous with "stat," which is also used to indicate urgency in medical settings.

49. Your patient is not in the room when you arrive to collect a timed specimen. The patient's nurse states that the patient will be unavaiable for several hours. What should you do?

Ask the nurse to have the patient brought to the lab when the patient is available.

Fill out a delay slip stating you were unable to collect the specimen.

Report the situation to a supervisor and tell him or her to cancel the request.

Return to the lab and put the request in the stack for the next sweep.

If the patient is not available and will not be available for several hours, the best course of action would be to fill out a delay slip stating that the specimen collection was not possible. This ensures that the situation is properly documented and communicated to the relevant parties. Asking the nurse to bring the patient to the lab when available may not be feasible due to the extended unavailability of the patient. Reporting the situation to a supervisor and canceling the request may not be necessary if a delay slip can adequately address the issue. Returning to the lab and putting the request in the stack for the next sweep would not be appropriate as the specimen cannot be collected at that time.

Explanation

If the patient is not available and will not be available for several hours, the best course of action would be to fill out a delay slip stating that the specimen collection was not possible. This ensures that the situation is properly documented and communicated to the relevant parties. Asking the nurse to bring the patient to the lab when available may not be feasible due to the extended unavailability of the patient. Reporting the situation to a supervisor and canceling the request may not be necessary if a delay slip can adequately address the issue. Returning to the lab and putting the request in the stack for the next sweep would not be appropriate as the specimen cannot be collected at that time.

50. Which type of inpatient is most likely to have more than one ID band?

Adult

Child

Newborn

Outpatient

Newborns are the type of inpatient who are most likely to have more than one ID band. This is because newborns often receive multiple identification bands for various purposes, such as matching the baby with the mother, ensuring accurate medication administration, and preventing mix-ups in the hospital. These ID bands help to maintain the safety and security of newborns during their hospital stay.

Explanation

Newborns are the type of inpatient who are most likely to have more than one ID band. This is because newborns often receive multiple identification bands for various purposes, such as matching the baby with the mother, ensuring accurate medication administration, and preventing mix-ups in the hospital. These ID bands help to maintain the safety and security of newborns during their hospital stay.

51. Which requisition information must match information on the patient's ID band?

Medical record number

Name of the physician

Room and bed number

Test collection priority

The medical record number on the patient's ID band must match the requisition information. This is important for accurate identification and tracking of the patient's medical history and test results. The medical record number serves as a unique identifier for the patient and ensures that the correct information is associated with the right individual.

Explanation

The medical record number on the patient's ID band must match the requisition information. This is important for accurate identification and tracking of the patient's medical history and test results. The medical record number serves as a unique identifier for the patient and ensures that the correct information is associated with the right individual.

52. The patient asks if the test you are about to draw is for disbetes. How do you answer?

Explain that it is best to discuss the test with the physician.

If the test is for glucose say, "Yes, it is" but do not elaborate.

Say, "HIPAA confidentiality rules won't let me tell you."

Tell the patient that it is not for a glucose test even if it is.

The correct answer suggests that it is best to discuss the test with the physician. This is the appropriate response because as a healthcare professional, it is important to ensure that patients have accurate information and understand their medical tests. By advising the patient to discuss the test with the physician, it allows for a proper explanation of the purpose of the test and any necessary precautions or preparations that need to be taken. It also respects the patient's right to receive information directly from their healthcare provider.

Explanation

The correct answer suggests that it is best to discuss the test with the physician. This is the appropriate response because as a healthcare professional, it is important to ensure that patients have accurate information and understand their medical tests. By advising the patient to discuss the test with the physician, it allows for a proper explanation of the purpose of the test and any necessary precautions or preparations that need to be taken. It also respects the patient's right to receive information directly from their healthcare provider.

53. What does a sclerosed vein feel like?

Bouncy and resilient

Hard and cord-like

Pulsating and firm

Soft and pliable

A sclerosed vein feels hard and cord-like because sclerosis refers to the hardening and thickening of the vein walls. This condition is often caused by the buildup of plaque or scar tissue in the veins, leading to a loss of elasticity and a rigid texture. The cord-like feeling is due to the increased thickness and stiffness of the vein, which can be easily palpated.

Explanation

A sclerosed vein feels hard and cord-like because sclerosis refers to the hardening and thickening of the vein walls. This condition is often caused by the buildup of plaque or scar tissue in the veins, leading to a loss of elasticity and a rigid texture. The cord-like feeling is due to the increased thickness and stiffness of the vein, which can be easily palpated.

54. Which of the following is not a valid reason for failure to obtain a blood specimen?

The patient adamantly refuses to have blood taken.

The patient was unavailable at the designated time.

You made an attempt but were unable to obtain the blood.

You did not have the right equipment on your tray.

The given answer states that "You did not have the right equipment on your tray" is not a valid reason for failure to obtain a blood specimen. This means that having the right equipment on the tray is a valid reason for obtaining a blood specimen. Therefore, if the healthcare professional does not have the necessary equipment, they may not be able to collect the blood sample successfully.

Explanation

The given answer states that "You did not have the right equipment on your tray" is not a valid reason for failure to obtain a blood specimen. This means that having the right equipment on the tray is a valid reason for obtaining a blood specimen. Therefore, if the healthcare professional does not have the necessary equipment, they may not be able to collect the blood sample successfully.

55. The most common reason a patient must undergo dialysis treatment is:

End stages of renal disease.

Parkinson's disease effects.

Problems with coagulation.

Rheumatoid arthritis effects.

The most common reason a patient must undergo dialysis treatment is end stages of renal disease. In end-stage renal disease, the kidneys are no longer able to effectively filter waste and excess fluid from the blood. Dialysis helps to artificially perform this function by removing waste products and excess fluid from the body. Parkinson's disease, problems with coagulation, and rheumatoid arthritis do not typically require dialysis treatment.

Explanation

The most common reason a patient must undergo dialysis treatment is end stages of renal disease. In end-stage renal disease, the kidneys are no longer able to effectively filter waste and excess fluid from the blood. Dialysis helps to artificially perform this function by removing waste products and excess fluid from the body. Parkinson's disease, problems with coagulation, and rheumatoid arthritis do not typically require dialysis treatment.

56. What do you do if a physician is with the patient and the specimen is ordered stat?

Ask the patient's nurse to collect the stat specimen immediately.

Come back later when you know the physician is no longer there.

Introduce yourself and ask for permission to draw the specimen.

Say "excuse me" to both and proceed to collect the specimen.

When a physician is with the patient and a specimen is ordered stat, it is important to introduce yourself and ask for permission to draw the specimen. This is the most appropriate and professional approach in this situation. It ensures that you communicate with both the physician and the patient, showing respect for their presence and consent. By introducing yourself and seeking permission, you establish a clear and respectful line of communication, ensuring that the procedure is conducted with the necessary consent and cooperation.

Explanation

When a physician is with the patient and a specimen is ordered stat, it is important to introduce yourself and ask for permission to draw the specimen. This is the most appropriate and professional approach in this situation. It ensures that you communicate with both the physician and the patient, showing respect for their presence and consent. By introducing yourself and seeking permission, you establish a clear and respectful line of communication, ensuring that the procedure is conducted with the necessary consent and cooperation.

57. It is important to fill anticoagulant tubes to the proper level to ensure that:

The specimen yields enough serum for the required tests.

There is a proper ratio of blood to anticoagulant additive.

There is an adequate amount of blood to perform the test.

Tissue fluid contamination of the specimen is minimized.

Filling anticoagulant tubes to the proper level ensures that there is a proper ratio of blood to anticoagulant additive. This is important because the anticoagulant additive prevents the blood from clotting, allowing for accurate testing. If the tube is not filled to the proper level, there may be an insufficient amount of anticoagulant additive, leading to improper clotting and inaccurate test results. Additionally, filling the tube to the proper level ensures that there is enough blood for the required tests and minimizes tissue fluid contamination of the specimen.

Explanation

Filling anticoagulant tubes to the proper level ensures that there is a proper ratio of blood to anticoagulant additive. This is important because the anticoagulant additive prevents the blood from clotting, allowing for accurate testing. If the tube is not filled to the proper level, there may be an insufficient amount of anticoagulant additive, leading to improper clotting and inaccurate test results. Additionally, filling the tube to the proper level ensures that there is enough blood for the required tests and minimizes tissue fluid contamination of the specimen.

58. You have just made two unsuccessful attemps to collect a fasting blood specimen from an outpatient. The patient rotates his arm, and you note a large vein that you had not seen before. How do you proceed?

Ask another phlebotomist to collect the fasting specimen.

Ask the patient to come back later so that you can try again.

Call the supervisor for permission to make a third attempt.

Make a third attempt on the newly discovered large vein.

Asking another phlebotomist to collect the fasting specimen would be the best course of action in this situation. Since the phlebotomist has made two unsuccessful attempts, it would be wise to bring in another professional who may have more experience or expertise in drawing blood. This would increase the chances of successfully collecting the fasting specimen from the patient.

Explanation

Asking another phlebotomist to collect the fasting specimen would be the best course of action in this situation. Since the phlebotomist has made two unsuccessful attempts, it would be wise to bring in another professional who may have more experience or expertise in drawing blood. This would increase the chances of successfully collecting the fasting specimen from the patient.

59. Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?

Ask the patient to state her name; if it matches the requisition, continue.

Ask the patient's nurse to attach an ID band and proceed when it is attached.

Go to the nurses' station, get an ID bracelet, attach it, and then proceed.

Tell the nurse that you will not collect the specimen and return to the lab.

If the patient is not wearing an ID band but the information on the requisition matches, the appropriate action would be to ask the patient's nurse to attach an ID band and proceed when it is attached. This ensures that the patient is properly identified before any procedures or specimen collection takes place, maintaining patient safety and preventing any potential mix-ups or errors.

Explanation

If the patient is not wearing an ID band but the information on the requisition matches, the appropriate action would be to ask the patient's nurse to attach an ID band and proceed when it is attached. This ensures that the patient is properly identified before any procedures or specimen collection takes place, maintaining patient safety and preventing any potential mix-ups or errors.

60. Which of the following actions is prohibited during the vein selection process?

Having a patient pump his or her fist

Lowering the arm alongside the chair

Palpating the antecubital area firmly

Using warmth to increase blood flow

Having a patient pump his or her fist is prohibited during the vein selection process because it can cause the veins to collapse or move, making it difficult to locate and access a suitable vein for the procedure. Pumping the fist can also increase the risk of injury to the patient and may result in inaccurate vein selection or unsuccessful venipuncture.

Explanation

Having a patient pump his or her fist is prohibited during the vein selection process because it can cause the veins to collapse or move, making it difficult to locate and access a suitable vein for the procedure. Pumping the fist can also increase the risk of injury to the patient and may result in inaccurate vein selection or unsuccessful venipuncture.

61. Tremors associated with this disease can make blood collection difficult:

Alzheimer's

Arthritis

Diabetes

Parkinson's

Parkinson's disease is a neurodegenerative disorder that affects the nervous system, specifically the part that controls movement. One of the main symptoms of Parkinson's is tremors, which can make it challenging to perform tasks that require fine motor skills, such as blood collection. The tremors can cause the person's hand to shake uncontrollably, making it difficult to hold a needle steady and accurately collect blood. Therefore, Parkinson's disease can make blood collection difficult due to the associated tremors.

Explanation

Parkinson's disease is a neurodegenerative disorder that affects the nervous system, specifically the part that controls movement. One of the main symptoms of Parkinson's is tremors, which can make it challenging to perform tasks that require fine motor skills, such as blood collection. The tremors can cause the person's hand to shake uncontrollably, making it difficult to hold a needle steady and accurately collect blood. Therefore, Parkinson's disease can make blood collection difficult due to the associated tremors.

62. Which of the following actions is unlikely to help a phlebotomist gain a patient's trust?

Acting confident and assured in beside manner

Being professional in dress and personal appearance

Collecting a specimen before the requested time

Remaining at ease while interacting with the patient

Collecting a specimen before the requested time is unlikely to help a phlebotomist gain a patient's trust because it shows a lack of respect for the patient's needs and preferences. By not following the requested time, the phlebotomist may cause inconvenience or discomfort to the patient, which can lead to a breakdown in trust. It is important for a phlebotomist to prioritize the patient's comfort and preferences in order to establish trust and build a positive rapport.

Explanation

Collecting a specimen before the requested time is unlikely to help a phlebotomist gain a patient's trust because it shows a lack of respect for the patient's needs and preferences. By not following the requested time, the phlebotomist may cause inconvenience or discomfort to the patient, which can lead to a breakdown in trust. It is important for a phlebotomist to prioritize the patient's comfort and preferences in order to establish trust and build a positive rapport.

63. The reason a test is ordered "timed" is to:

Assess a patient's condition after surgery.

Determine patient suitability for surgery.

Draw it at the best time for accurate results.

Establish a clinical diagnosis or prognosis.

The reason a test is ordered "timed" is to draw it at the best time for accurate results. Timing is crucial for certain tests as it can affect the validity and reliability of the results. Some tests need to be performed at specific times to capture the highest or lowest levels of certain substances in the body. This ensures that the results accurately reflect the patient's condition and help in making an accurate diagnosis or prognosis.

Explanation

The reason a test is ordered "timed" is to draw it at the best time for accurate results. Timing is crucial for certain tests as it can affect the validity and reliability of the results. Some tests need to be performed at specific times to capture the highest or lowest levels of certain substances in the body. This ensures that the results accurately reflect the patient's condition and help in making an accurate diagnosis or prognosis.

64. The unique number assigned to a specimen request is called the:

Accession number.

Health facility number.

Patient date of birth.

Patient ID number.

The unique number assigned to a specimen request is called the accession number. This number is used to track and identify the specimen throughout the entire testing process. It helps ensure that the correct specimen is matched with the correct patient and that the results are accurately reported. The accession number is typically generated by the laboratory or healthcare facility and is an important component in maintaining the integrity and traceability of specimens in the healthcare system.

Explanation

The unique number assigned to a specimen request is called the accession number. This number is used to track and identify the specimen throughout the entire testing process. It helps ensure that the correct specimen is matched with the correct patient and that the results are accurately reported. The accession number is typically generated by the laboratory or healthcare facility and is an important component in maintaining the integrity and traceability of specimens in the healthcare system.

65. You arrive to collect a specimen on a patient named John Doe in 302B. How do you verify that the patient in 302B is indeed John Doe?

Ask him, Are you John Doe?" If he says yes, collect the specimen.

Ask him for his name and date of birth and match it to the requisition.

Check his ID band. If it matches the requisition, draw the specimen.

Have the nurse verify the patient's name after you check his ID band.

To verify that the patient in room 302B is indeed John Doe, it is important to ask him for his name and date of birth and match it to the requisition. This method ensures that the patient's identity is confirmed and matches the information provided in the requisition. It is a reliable way to ensure that the correct patient is being attended to and that the specimen collection is being done on the right individual.

Explanation

To verify that the patient in room 302B is indeed John Doe, it is important to ask him for his name and date of birth and match it to the requisition. This method ensures that the patient's identity is confirmed and matches the information provided in the requisition. It is a reliable way to ensure that the correct patient is being attended to and that the specimen collection is being done on the right individual.

66. A needle safety feature, other than a blunting needle, should be activated:

After some pressure has been applied to the site.

As you are dropping the needle in the sharps container.

Immediately after the needle is withdrawn.

While the tube is still engaged in the holder.

The correct answer is "Immediately after the needle is withdrawn." This means that the needle safety feature should be activated right after the needle is taken out of the patient's body. Activating the safety feature at this point helps to prevent accidental needlestick injuries by ensuring that the needle is safely secured and cannot cause harm. It is important to activate the safety feature promptly to minimize the risk of any potential accidents or injuries.

Explanation

The correct answer is "Immediately after the needle is withdrawn." This means that the needle safety feature should be activated right after the needle is taken out of the patient's body. Activating the safety feature at this point helps to prevent accidental needlestick injuries by ensuring that the needle is safely secured and cannot cause harm. It is important to activate the safety feature promptly to minimize the risk of any potential accidents or injuries.

67. Although the evacuated tube system (ETS) is the preferred method of blood collection, it may be necessary to use a syringe when:

A large amount of blood is needed.

The patient's veins are very fragile.

There are no butterfly needles left.

You need the blood to flow faster.

When the patient's veins are very fragile, it may be necessary to use a syringe instead of the evacuated tube system (ETS) for blood collection. Fragile veins can easily collapse or be damaged during the process of drawing blood, making it difficult to collect a sample using the ETS. In such cases, a syringe can be a safer and more effective alternative for blood collection.

Explanation

When the patient's veins are very fragile, it may be necessary to use a syringe instead of the evacuated tube system (ETS) for blood collection. Fragile veins can easily collapse or be damaged during the process of drawing blood, making it difficult to collect a sample using the ETS. In such cases, a syringe can be a safer and more effective alternative for blood collection.

68. How can you tell that you are in a vein when you are using a syringe?

A "flash" of blood will appear in the hub of the needle.

Blood will automatically pump into the syringe barrel.

There will be a very slight vibration in the needle.

You cannot tell when you are in the vein with a syringe.

When using a syringe, a "flash" of blood appearing in the hub of the needle indicates that the needle has successfully entered a vein. This happens because the needle has punctured the vein wall, allowing blood to flow into the needle and be visible in the hub. This is a common method used by healthcare professionals to ensure that the syringe is correctly placed in a vein for procedures such as blood draws or administering medications.

Explanation

When using a syringe, a "flash" of blood appearing in the hub of the needle indicates that the needle has successfully entered a vein. This happens because the needle has punctured the vein wall, allowing blood to flow into the needle and be visible in the hub. This is a common method used by healthcare professionals to ensure that the syringe is correctly placed in a vein for procedures such as blood draws or administering medications.

69. Which one of the following types of patients is least likely to need his or her identity confirmed by the patient's nurse or a relative?

A geriatric patient

A very young child

A mentally incompetent patient

A non-English-speaking patient

A geriatric patient is least likely to need his or her identity confirmed by the patient's nurse or a relative because geriatric patients are typically older individuals who are more likely to have stable identities and be able to communicate their personal information accurately. Unlike very young children or mentally incompetent patients who may have difficulty providing accurate information, geriatric patients are more likely to have a clear understanding of their identity and be able to confirm it themselves. Additionally, non-English-speaking patients may require assistance in confirming their identity due to language barriers.

Explanation

A geriatric patient is least likely to need his or her identity confirmed by the patient's nurse or a relative because geriatric patients are typically older individuals who are more likely to have stable identities and be able to communicate their personal information accurately. Unlike very young children or mentally incompetent patients who may have difficulty providing accurate information, geriatric patients are more likely to have a clear understanding of their identity and be able to confirm it themselves. Additionally, non-English-speaking patients may require assistance in confirming their identity due to language barriers.

70. What is the best thing to do if the vein can be felt but not seen, even with the tourniquet on?

Insert the needle where you think it is and probe until you find it.

Keep the tourniquet on while cleaning the sire and during the draw.

Look for visual clues on the skin to remind you where the vein is.

Mark the spot using a felt-tipped pen and clean it off when finished.

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Explanation

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71. In drawing blood from an older child, the most imporant consideration is:

Assuring the child that it won't be painful.

Explaining all of the tests being collected.

Explaining the importance of holding still.

Offering the child a reward for not crying.

When drawing blood from an older child, the most important consideration is explaining the importance of holding still. This is because older children have a better understanding of the procedure and can follow instructions more effectively. Holding still is crucial during blood collection to ensure accurate and safe extraction. Assuring the child that it won't be painful may be helpful, but it is not the most important consideration. Explaining all of the tests being collected and offering a reward for not crying are not as important as ensuring the child remains still during the procedure.

Explanation

When drawing blood from an older child, the most important consideration is explaining the importance of holding still. This is because older children have a better understanding of the procedure and can follow instructions more effectively. Holding still is crucial during blood collection to ensure accurate and safe extraction. Assuring the child that it won't be painful may be helpful, but it is not the most important consideration. Explaining all of the tests being collected and offering a reward for not crying are not as important as ensuring the child remains still during the procedure.

72. An additive should be mixed:

After the next tube is placed in the tube holder.

As soon as it is removed from the tube holder.

When all of the other tubes have been collected.

While the very next tube is being collected.

The correct answer is "As soon as it is removed from the tube holder." This means that the additive should be mixed immediately after it is taken out of the tube holder. Mixing the additive at this point ensures that it is evenly distributed throughout the sample, providing accurate and consistent results. Waiting until after the next tube is placed in the tube holder or when all other tubes have been collected may result in inadequate mixing and potentially affect the accuracy of the test.

Explanation

The correct answer is "As soon as it is removed from the tube holder." This means that the additive should be mixed immediately after it is taken out of the tube holder. Mixing the additive at this point ensures that it is evenly distributed throughout the sample, providing accurate and consistent results. Waiting until after the next tube is placed in the tube holder or when all other tubes have been collected may result in inadequate mixing and potentially affect the accuracy of the test.

73. A code is a way to:

Convey important information without alarming the public.

Transmit messages over the facility's public access system.

Use numbers or words to represent important information.

All of the above.

A code is a system or method used to convey important information without alarming the public, transmit messages over a facility's public access system, and use numbers or words to represent important information. Therefore, the correct answer is "All of the above."

Explanation

A code is a system or method used to convey important information without alarming the public, transmit messages over a facility's public access system, and use numbers or words to represent important information. Therefore, the correct answer is "All of the above."

74. If the tourniquet is too tight:

Arterial flow below it may be stopped.

Blood below it may hemoconcentrate.

The pressure can cause the arm to ache.

All the of above.

If the tourniquet is too tight, it can cause several issues. Firstly, arterial flow below it may be stopped, leading to a lack of blood supply to the tissues. Secondly, the blood below the tourniquet may hemoconcentrate, meaning that the concentration of red blood cells and other components increases due to the restricted flow. Lastly, the pressure from the tight tourniquet can cause the arm to ache. Therefore, all of the above statements are correct.

Explanation

If the tourniquet is too tight, it can cause several issues. Firstly, arterial flow below it may be stopped, leading to a lack of blood supply to the tissues. Secondly, the blood below the tourniquet may hemoconcentrate, meaning that the concentration of red blood cells and other components increases due to the restricted flow. Lastly, the pressure from the tight tourniquet can cause the arm to ache. Therefore, all of the above statements are correct.

75. What is the CLSI-recommened way to clean a venipuncture site?

Cleanse the area thoroughly with disinfectant using concentric circles.

Cleanse with a circular motion from the center to the periphery.

Scrub with an alcohol sponge as vigorously as you can for 1 minute.

Wipe using concentric circles from the outside area to the center.

The CLSI-recommended way to clean a venipuncture site is to cleanse with a circular motion from the center to the periphery. This method ensures that the area is thoroughly cleaned and reduces the risk of introducing any contaminants into the site. It is important to clean the site properly before performing a venipuncture to minimize the risk of infection and ensure accurate test results.

Explanation

The CLSI-recommended way to clean a venipuncture site is to cleanse with a circular motion from the center to the periphery. This method ensures that the area is thoroughly cleaned and reduces the risk of introducing any contaminants into the site. It is important to clean the site properly before performing a venipuncture to minimize the risk of infection and ensure accurate test results.

76. Laboratory results can be nagatively affected if the phlebotomist:

Awakens a sleeping patient and raises the head of the patient's bed.

Collects a specimen in dim lighting conditions in the patient's room.

Draws a specimen from an unconscious patient without assistance.

While preparing to collect a specimen, startles a patient who is asleep.

Startling a sleeping patient who is about to have a specimen collected can negatively affect laboratory results. This is because the sudden shock or surprise can cause the patient's body to produce stress hormones, such as adrenaline, which can alter the composition of the blood. These changes in hormone levels can affect various laboratory parameters, including blood glucose levels, electrolyte levels, and even blood cell counts. Therefore, it is important for the phlebotomist to approach the patient calmly and gently to ensure accurate and reliable laboratory results.

Explanation

Startling a sleeping patient who is about to have a specimen collected can negatively affect laboratory results. This is because the sudden shock or surprise can cause the patient's body to produce stress hormones, such as adrenaline, which can alter the composition of the blood. These changes in hormone levels can affect various laboratory parameters, including blood glucose levels, electrolyte levels, and even blood cell counts. Therefore, it is important for the phlebotomist to approach the patient calmly and gently to ensure accurate and reliable laboratory results.

77. What is the best angle to use for the needle insertion during routine venipuncture?

Less than 15 degrees

30 degrees or less

35 to 45 degrees

45 to 60 degrees

The best angle to use for needle insertion during routine venipuncture is 30 degrees or less. This angle allows for proper visualization of the vein and minimizes the risk of puncturing through the vein or causing unnecessary pain to the patient. It also helps to ensure that the needle is inserted at the correct depth and allows for proper blood flow during the procedure.

Explanation

The best angle to use for needle insertion during routine venipuncture is 30 degrees or less. This angle allows for proper visualization of the vein and minimizes the risk of puncturing through the vein or causing unnecessary pain to the patient. It also helps to ensure that the needle is inserted at the correct depth and allows for proper blood flow during the procedure.

78. Which of the following information on a specimen lavel would be considered optional?

Patient room number and bed

Patient's first and last name

Phlebotomist's initials or ID

The date and time of the draw

The patient room number and bed information on a specimen label would be considered optional because it is not directly relevant to the identification and processing of the specimen. The patient's first and last name is crucial for accurate identification, while the phlebotomist's initials or ID help track who collected the specimen. The date and time of the draw are essential for monitoring the freshness and validity of the specimen. However, the patient's room number and bed are not necessary for these purposes and can be omitted if not required for specific organizational or administrative reasons.

Explanation

The patient room number and bed information on a specimen label would be considered optional because it is not directly relevant to the identification and processing of the specimen. The patient's first and last name is crucial for accurate identification, while the phlebotomist's initials or ID help track who collected the specimen. The date and time of the draw are essential for monitoring the freshness and validity of the specimen. However, the patient's room number and bed are not necessary for these purposes and can be omitted if not required for specific organizational or administrative reasons.

79. Which of the following tests is commonly ordered stat?

Creat

Diff

Lytes

RAST

Lytes, short for electrolytes, are commonly ordered stat. Electrolytes are essential minerals in the body that help maintain proper fluid balance, nerve and muscle function, and other important bodily functions. When there is an imbalance or disruption in electrolyte levels, it can lead to serious health complications. Therefore, it is crucial to quickly assess and monitor electrolyte levels in certain situations, such as in cases of dehydration, kidney dysfunction, or cardiac abnormalities. Ordering lytes as a stat test ensures that the results are obtained and acted upon promptly to prevent any potential harm to the patient.

Explanation

Lytes, short for electrolytes, are commonly ordered stat. Electrolytes are essential minerals in the body that help maintain proper fluid balance, nerve and muscle function, and other important bodily functions. When there is an imbalance or disruption in electrolyte levels, it can lead to serious health complications. Therefore, it is crucial to quickly assess and monitor electrolyte levels in certain situations, such as in cases of dehydration, kidney dysfunction, or cardiac abnormalities. Ordering lytes as a stat test ensures that the results are obtained and acted upon promptly to prevent any potential harm to the patient.

80. It is important to mix anticoagulant tubes immediately after filling them to:

Avoid microclot formation.

Encourage coagulation.

Inhibit hemoconcentration.

Minimize hemolysis.

Mixing anticoagulant tubes immediately after filling them helps to prevent microclot formation. When blood is drawn into a tube, it can sometimes form small clots due to the activation of the coagulation cascade. These microclots can interfere with accurate laboratory test results and may clog the needle or block the flow of blood in the tube. By mixing the blood and anticoagulant immediately after collection, the anticoagulant can prevent clotting and ensure that the blood remains in a liquid state, allowing for accurate testing and analysis.

Explanation

Mixing anticoagulant tubes immediately after filling them helps to prevent microclot formation. When blood is drawn into a tube, it can sometimes form small clots due to the activation of the coagulation cascade. These microclots can interfere with accurate laboratory test results and may clog the needle or block the flow of blood in the tube. By mixing the blood and anticoagulant immediately after collection, the anticoagulant can prevent clotting and ensure that the blood remains in a liquid state, allowing for accurate testing and analysis.

81. A type of care for patients who are terminally ill is:

Elder care.

Home care.

Hospice care.

Long-term care.

Hospice care is a type of care provided to patients who are terminally ill. It focuses on providing comfort and support to patients and their families during the final stages of life. Hospice care aims to improve the quality of life by managing pain and symptoms, addressing emotional and spiritual needs, and offering counseling and bereavement support. Unlike other types of care mentioned, such as elder care, home care, or long-term care, hospice care specifically caters to the needs of terminally ill patients.

Explanation

Hospice care is a type of care provided to patients who are terminally ill. It focuses on providing comfort and support to patients and their families during the final stages of life. Hospice care aims to improve the quality of life by managing pain and symptoms, addressing emotional and spiritual needs, and offering counseling and bereavement support. Unlike other types of care mentioned, such as elder care, home care, or long-term care, hospice care specifically caters to the needs of terminally ill patients.

82. It is unlikely that a misidentifying a paitent specimen would result in:

A civil action malpractice lawsuit.

Being dismissed from the facility.

No reprimand if no one was hurt.

Temporary suspension of duties.

Misidentifying a patient specimen may lead to serious consequences such as a civil action malpractice lawsuit, being dismissed from the facility, or temporary suspension of duties. However, if no one was hurt as a result of the misidentification, there may be no reprimand since there was no harm caused.

Explanation

Misidentifying a patient specimen may lead to serious consequences such as a civil action malpractice lawsuit, being dismissed from the facility, or temporary suspension of duties. However, if no one was hurt as a result of the misidentification, there may be no reprimand since there was no harm caused.

83. Bending the arm up to apply pressure to the site after venipuncture has not been shown to:

Disrupt the platelet plug when the arm is eventually lowered

Enable the site to quickly stop bleeding after needle removal.

Increase the possibility of bruising and hematoma formation.

Keep the wound open, especially if it is at the side of the arm.

Bending the arm up to apply pressure to the site after venipuncture does not enable the site to quickly stop bleeding after needle removal.

Explanation

Bending the arm up to apply pressure to the site after venipuncture does not enable the site to quickly stop bleeding after needle removal.

84. If you assemble equipment after selecting and cleaning the blood collection site, you will:

Be more apt to allow sufficient time for the alcohol to dry.

Have a better idea of what equipment you will need to use.

Waste less equipment by knowing exactly what is needed.

All of the above.

By assembling equipment after selecting and cleaning the blood collection site, you will be more likely to allow sufficient time for the alcohol to dry because you have already completed these steps beforehand. Additionally, you will have a better idea of what equipment you will need to use as you have assessed the site and its requirements. This helps in avoiding any unnecessary equipment and wastage. Therefore, all of the given options are correct explanations for why assembling equipment after selecting and cleaning the blood collection site is beneficial.

Explanation

By assembling equipment after selecting and cleaning the blood collection site, you will be more likely to allow sufficient time for the alcohol to dry because you have already completed these steps beforehand. Additionally, you will have a better idea of what equipment you will need to use as you have assessed the site and its requirements. This helps in avoiding any unnecessary equipment and wastage. Therefore, all of the given options are correct explanations for why assembling equipment after selecting and cleaning the blood collection site is beneficial.

85. The following precautionary information was given to an outpatient after venipuncture. No other tests were scheduled. Which information was unnecessary?

Do not carry a heavy bag or large purse on that arm.

Do not drink or eat for 2 hours after collection.

Do not lift any heavy objects for at least 1 hour.

Leave the bandage on for minimum of 15 minutes.

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Explanation

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86. Success of pediatric blood collection is most dependent on:

Aseptic technique.

Correct order of draw.

Patient immobilization.

Tourniquet application.

The success of pediatric blood collection is most dependent on patient immobilization. This is because children tend to move and squirm during the procedure, making it difficult to locate and access the vein. Proper immobilization ensures that the child remains still, reducing the risk of injury and improving the accuracy of the blood draw. Aseptic technique, correct order of draw, and tourniquet application are also important factors in blood collection, but patient immobilization is crucial for a successful procedure in pediatric patients.

Explanation

The success of pediatric blood collection is most dependent on patient immobilization. This is because children tend to move and squirm during the procedure, making it difficult to locate and access the vein. Proper immobilization ensures that the child remains still, reducing the risk of injury and improving the accuracy of the blood draw. Aseptic technique, correct order of draw, and tourniquet application are also important factors in blood collection, but patient immobilization is crucial for a successful procedure in pediatric patients.

87. Outpaitent requisitions are typically of this type:

Computer

E-mail

Manual

Verbal

Outpatient requisitions are typically done manually. This means that the process of making a request for outpatient services, such as medical tests or consultations, is usually done by filling out a physical form or document. This manual method allows for proper documentation and record-keeping of the requisition, ensuring that all necessary information is provided and easily accessible. It also allows for easier tracking and processing of the request by the healthcare facility.

Explanation

Outpatient requisitions are typically done manually. This means that the process of making a request for outpatient services, such as medical tests or consultations, is usually done by filling out a physical form or document. This manual method allows for proper documentation and record-keeping of the requisition, ensuring that all necessary information is provided and easily accessible. It also allows for easier tracking and processing of the request by the healthcare facility.

88. It is acceptable to use an ankle vein if:

Coagulation tests are requested.

The patient is partially paralyzed.

The physician gives permission.

There are no other suitable sites.

The given answer states that it is acceptable to use an ankle vein if the physician gives permission. This implies that the decision to use an ankle vein depends on the physician's approval. The other options mentioned in the question, such as coagulation tests being requested, the patient being partially paralyzed, or there being no other suitable sites, do not directly determine the acceptability of using an ankle vein. Therefore, the physician's permission is the most crucial factor in this scenario.

Explanation

The given answer states that it is acceptable to use an ankle vein if the physician gives permission. This implies that the decision to use an ankle vein depends on the physician's approval. The other options mentioned in the question, such as coagulation tests being requested, the patient being partially paralyzed, or there being no other suitable sites, do not directly determine the acceptability of using an ankle vein. Therefore, the physician's permission is the most crucial factor in this scenario.

89. What happens if you advance the tube past the guideline on the holder before needle insertion?

The ETS tube will fail to fill with blood because of loss of tube vacuum.

Nothing; the line is actually a fill guideline for all evacuated tubes.

The needle sleeve stops penetration of the tube until fully advanced.

There will be transfer of the tube additive to the needle at that point.

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Explanation

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90. You greet your patient in the following manner: "Hello, my name is Jean and I am here to collect a blood specimen, if that is all right with you." The paitent responds by saying, "OK, but I would rather not." How would you proceed?

Ask another phlebotmist to draw the specimen.

Come back at a later time to collect the specimen.

Determine the problem is before

Go ahead and draw the specimen without comment.

The correct answer is to determine the problem before proceeding. The patient has expressed a reluctance to have their blood drawn, so it is important to understand the reason behind their hesitation. This could be due to fear, discomfort, or other concerns. By determining the problem before proceeding, the healthcare professional can address the patient's concerns and ensure their comfort and cooperation during the procedure.

Explanation

The correct answer is to determine the problem before proceeding. The patient has expressed a reluctance to have their blood drawn, so it is important to understand the reason behind their hesitation. This could be due to fear, discomfort, or other concerns. By determining the problem before proceeding, the healthcare professional can address the patient's concerns and ensure their comfort and cooperation during the procedure.

91. An unconscious inpatient does not have an ID band. The name is on an envelope on the patient's nightstand matches with the requisition. What should you do?

Ask the nurse to verify the patient's ID and collect the specimen.

Complete the required procedure and then file an incident report.

Do not start any procedure until the nurse attaches an ID bracelet.

Make a computer entry to will alert other phlebotmists of this issue.

It is important to have proper identification of the patient before starting any procedure to ensure patient safety and prevent any potential errors. Without an ID band, there is a risk of misidentification. Therefore, it is necessary to wait for the nurse to attach an ID bracelet before proceeding with any procedure.

Explanation

It is important to have proper identification of the patient before starting any procedure to ensure patient safety and prevent any potential errors. Without an ID band, there is a risk of misidentification. Therefore, it is necessary to wait for the nurse to attach an ID bracelet before proceeding with any procedure.

92. When a test is ordered ASAP, it means that:

The patient is in critical condition and needs immediate attention.

The patient requires a test in which timing of collection is critical.

Results are needed soon for an appropriate response.

Results from blood work are needed for medication.

When a test is ordered ASAP, it means that the results are needed soon for an appropriate response. This suggests that there is a sense of urgency in obtaining the test results in order to make a timely and informed decision or take appropriate action. It does not necessarily indicate that the patient is in critical condition or that the timing of collection is critical, although these factors could be possible reasons for ordering a test ASAP. Additionally, while the need for results for medication may be a valid reason, it is not specifically mentioned in the given options.

Explanation

When a test is ordered ASAP, it means that the results are needed soon for an appropriate response. This suggests that there is a sense of urgency in obtaining the test results in order to make a timely and informed decision or take appropriate action. It does not necessarily indicate that the patient is in critical condition or that the timing of collection is critical, although these factors could be possible reasons for ordering a test ASAP. Additionally, while the need for results for medication may be a valid reason, it is not specifically mentioned in the given options.

93. Tests are classified as routine if they are ordered:

For collection at a specific time and place.

In the course of establishing a diagnosis.

To assess a patient's condition after surgery.

To specifically eliminate the effects of a diet.

Tests are classified as routine if they are ordered in the course of establishing a diagnosis. This means that these tests are commonly ordered as part of the diagnostic process to help determine the underlying cause of a patient's symptoms or condition. By conducting these routine tests, healthcare professionals can gather valuable information that aids in the diagnosis and subsequent treatment planning for the patient.

Explanation

Tests are classified as routine if they are ordered in the course of establishing a diagnosis. This means that these tests are commonly ordered as part of the diagnostic process to help determine the underlying cause of a patient's symptoms or condition. By conducting these routine tests, healthcare professionals can gather valuable information that aids in the diagnosis and subsequent treatment planning for the patient.

94. Which of the following is part of informed consent for specimen collection?

Advising the patient of his or her prognosis

Explaining what disorders the test can detect

Informing the patient that you are a student

Notifying the patient of future venipunctures

The correct answer is "Informing the patient that you are a student." This is part of informed consent for specimen collection because it is important for the patient to be aware if the person collecting their specimen is a student rather than a fully qualified medical professional. This allows the patient to make an informed decision about whether or not they are comfortable with a student performing the procedure.

Explanation

The correct answer is "Informing the patient that you are a student." This is part of informed consent for specimen collection because it is important for the patient to be aware if the person collecting their specimen is a student rather than a fully qualified medical professional. This allows the patient to make an informed decision about whether or not they are comfortable with a student performing the procedure.

95. The patient's identification number is included on the specimen tube labels to:

Avoid confusing multiple specimens from the same patient.

Avoid confusing specimens from patients with the same name.

Be used for an accession number in processing the specimen.

Be used for insurance identification and payment purposes.

The patient's identification number is included on the specimen tube labels to avoid confusing specimens from patients with the same name. This is important because multiple patients with the same name may have different medical conditions or require different treatments. By including the identification number, healthcare professionals can ensure that the correct specimen is used for diagnosis and treatment, reducing the risk of medical errors and improving patient care.

Explanation

The patient's identification number is included on the specimen tube labels to avoid confusing specimens from patients with the same name. This is important because multiple patients with the same name may have different medical conditions or require different treatments. By including the identification number, healthcare professionals can ensure that the correct specimen is used for diagnosis and treatment, reducing the risk of medical errors and improving patient care.

96. Which priority does a timed test typically have?

First

Second

Third

Fourth

A timed test typically has the second priority. This means that it is not the most important task, but it is still important and should be completed within the designated time frame. Other tasks or priorities may take precedence over the timed test, but it should still be given attention and completed in a timely manner.

Explanation

A timed test typically has the second priority. This means that it is not the most important task, but it is still important and should be completed within the designated time frame. Other tasks or priorities may take precedence over the timed test, but it should still be given attention and completed in a timely manner.

97. You are in the middle of drawing a blood specimen using the evacuated-tube method when you realize that you just filled an EDTA tube and still have a green-top tube to collect. What do you do?

Do not collect the green tube until the next collection sweep.

Draw several millimeters into a discard tube, then fill the green one.

Draw the green one next and hope that there is no carryover.

It is acceptable to draw the EDTA before the green stopper.

When using the evacuated-tube method, it is important to draw a small amount of blood into a discard tube before filling the actual collection tube. This is done to ensure that any residual anticoagulant or additive from the previous tube is not carried over into the next tube, which could potentially interfere with the test results. Therefore, in this situation, the correct action would be to draw several millimeters into a discard tube before filling the green-top tube to avoid any cross-contamination.

Explanation

When using the evacuated-tube method, it is important to draw a small amount of blood into a discard tube before filling the actual collection tube. This is done to ensure that any residual anticoagulant or additive from the previous tube is not carried over into the next tube, which could potentially interfere with the test results. Therefore, in this situation, the correct action would be to draw several millimeters into a discard tube before filling the green-top tube to avoid any cross-contamination.

98. In transferring blood from a syringe to evacuated tubes, which is the proper technique?

Force blood through the needle into the tubes by pushing the syringe plunger.

Hold the tube steady in your hand while the syringe needle penetrates the stopper.

Place the evacuated tube in a rack before penetrating stopper with the needle.

Use a specially designed engineering device called a syringe transfer device.

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Explanation

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99. Which of the following specimens requires routine (normal) handling?

Ammonia

Bilirubin

Cholesterol

Cryoglobulin

Cholesterol is the correct answer because it is a common and routine specimen that is frequently tested in medical laboratories. It does not require any special handling or precautions compared to the other specimens listed. Ammonia, bilirubin, and cryoglobulin may require specific handling instructions due to their unstable nature or potential for degradation.

Explanation

Cholesterol is the correct answer because it is a common and routine specimen that is frequently tested in medical laboratories. It does not require any special handling or precautions compared to the other specimens listed. Ammonia, bilirubin, and cryoglobulin may require specific handling instructions due to their unstable nature or potential for degradation.

100. What would be the system of choice to identify laboratory specimens from an unconscious woman in the ER?

Assign a name to the patient, such as Jane Doe.

Assign a number to the patient until she is admitted.

Use a three-part identification band with special tube labels.

Wait to process the specimens until the patient can be identified.

A three-part identification band with special tube labels would be the system of choice to identify laboratory specimens from an unconscious woman in the ER. This system ensures that the specimens are properly labeled and linked to the correct patient even if she is unconscious. The identification band includes information such as the patient's name, unique identifier, and other relevant details. The special tube labels also aid in accurate identification and tracking of the specimens. This system allows for efficient and reliable specimen identification, which is crucial for providing appropriate medical care to the patient.

Explanation

A three-part identification band with special tube labels would be the system of choice to identify laboratory specimens from an unconscious woman in the ER. This system ensures that the specimens are properly labeled and linked to the correct patient even if she is unconscious. The identification band includes information such as the patient's name, unique identifier, and other relevant details. The special tube labels also aid in accurate identification and tracking of the specimens. This system allows for efficient and reliable specimen identification, which is crucial for providing appropriate medical care to the patient.

101. In selecting a venipuncture site, how can you tell a vein from an artery?

A vein has a lot less resilience.

A vein pulses and feels larger.

An artery has a distinct pulse.

An artery is more superficial.

The correct answer is "An artery has a distinct pulse." This is because arteries carry oxygenated blood away from the heart and have a stronger pulse due to the forceful contraction of the heart. Veins, on the other hand, carry deoxygenated blood back to the heart and have a weaker or no pulse. Therefore, feeling a distinct pulse can help distinguish an artery from a vein when selecting a venipuncture site.

Explanation

The correct answer is "An artery has a distinct pulse." This is because arteries carry oxygenated blood away from the heart and have a stronger pulse due to the forceful contraction of the heart. Veins, on the other hand, carry deoxygenated blood back to the heart and have a weaker or no pulse. Therefore, feeling a distinct pulse can help distinguish an artery from a vein when selecting a venipuncture site.

102. How many times do you mix nonadditive tubes?

2 or 3

5 to 10

8 to 12

None

The question is asking about the number of times nonadditive tubes are mixed. The answer "None" indicates that nonadditive tubes are not mixed at all.

Explanation

The question is asking about the number of times nonadditive tubes are mixed. The answer "None" indicates that nonadditive tubes are not mixed at all.

103. Which of these steps are in the right venipuncture procedure order?

Establish blood flow, release tourniquet, fill and mix tubes, remove needle

Fill and mix all of the tubes, release tourniquet, remove needle, apply pressure

Fill the tubes, remove needle, release tourniquet, mix tubes, apply pressure

Release tourniquet, fill tubes, remove needle, apply pressure, mix all tubes

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Explanation

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104. A basic step that can be taken to minimize any trauma assoicated with a venipuncture is to:

Allow the paitent to sit in the waiting room for half an hour before collection.

Choose the most skilled phlebotomist available to perform the venipuncture.

Have the patient wear an eye mask or close his or her eyes during the procedure.

Thoroughly explain every detail of the draw before doing the venipuncture.

To minimize trauma associated with a venipuncture, it is important to choose the most skilled phlebotomist available to perform the procedure. This is because a skilled phlebotomist will have the expertise to perform the venipuncture accurately and efficiently, reducing the chances of any complications or additional trauma. A skilled phlebotomist will also be able to handle any unexpected situations that may arise during the procedure, ensuring a smoother and less traumatic experience for the patient.

Explanation

To minimize trauma associated with a venipuncture, it is important to choose the most skilled phlebotomist available to perform the procedure. This is because a skilled phlebotomist will have the expertise to perform the venipuncture accurately and efficiently, reducing the chances of any complications or additional trauma. A skilled phlebotomist will also be able to handle any unexpected situations that may arise during the procedure, ensuring a smoother and less traumatic experience for the patient.

105. You arrive to draw a fasting specmen. The patient is just finishing breakfast. What do you do?

Check with the patient's nurse to see if the specimen should be collected or the draw rescheduled.

Collect the specimen, but write "nonfasting" on the lab slip and the specimen.

Do not draw the blood, fill out an incident slip, and leave a copy for the nurse.

Proceed to collect the specimen, since the patient had not quiet finished eating.

If the patient is just finishing breakfast, it is likely that they have not fasted for the required amount of time before the specimen is collected. Checking with the patient's nurse is the appropriate course of action to determine if the specimen should still be collected or if the draw should be rescheduled.

Explanation

If the patient is just finishing breakfast, it is likely that they have not fasted for the required amount of time before the specimen is collected. Checking with the patient's nurse is the appropriate course of action to determine if the specimen should still be collected or if the draw should be rescheduled.

106. Which of the following acts can lead to liability issues?

Asking visitors to leave the room while you draw a specimen.

Drawing a patient who is lying in bed talking on a cell phone.

Lowering a bed rail to make access to the patient's arm easier.

Pulling the curtain between the bed while drawing on a specimen.

Lowering a bed rail to make access to the patient's arm easier can lead to liability issues because it compromises the safety and security of the patient. Lowering the bed rail without proper precautions can increase the risk of falls or injuries to the patient. It is important to ensure that the bed rail is used appropriately and in accordance with the patient's needs and safety guidelines to avoid any potential liability issues.

Explanation

Lowering a bed rail to make access to the patient's arm easier can lead to liability issues because it compromises the safety and security of the patient. Lowering the bed rail without proper precautions can increase the risk of falls or injuries to the patient. It is important to ensure that the bed rail is used appropriately and in accordance with the patient's needs and safety guidelines to avoid any potential liability issues.

107. A diabetic outpatient has had a mastectomy on her right side and cannot straighten her left arm because of arthriris. The best place to collect a blood specimen is:

An ankle or foot vein on either of her legs.

The left forearm or hand, using a butterfly.

The right arm below the antecubital fossa.

The right hand, using a capillary puncture.

The left forearm or hand would be the best place to collect a blood specimen for the diabetic outpatient who has had a mastectomy on her right side and cannot straighten her left arm due to arthritis. Using a butterfly for the collection would allow for easier access to the veins in the left forearm or hand, ensuring a successful blood draw. Collecting from the right arm or using a capillary puncture on the right hand may not be feasible due to the patient's condition.

Explanation

The left forearm or hand would be the best place to collect a blood specimen for the diabetic outpatient who has had a mastectomy on her right side and cannot straighten her left arm due to arthritis. Using a butterfly for the collection would allow for easier access to the veins in the left forearm or hand, ensuring a successful blood draw. Collecting from the right arm or using a capillary puncture on the right hand may not be feasible due to the patient's condition.

108. Examples of timed tests include:

Basic metabolic panel, potassium, and glucose.

Blood cultures, cardiac enzymes, and cortisol.

Calcium, ferritin, and complete blood count.

Creatinine, lactic acid, and reticulocyte count.

This answer is correct because blood cultures, cardiac enzymes, and cortisol are examples of timed tests. Timed tests refer to laboratory tests that need to be performed at specific times to obtain accurate results. These tests may require specific timing for sample collection or may need to be done within a certain time frame after a specific event or medication administration. In the case of blood cultures, cardiac enzymes, and cortisol, these tests often require samples to be collected at specific intervals or during specific time periods to accurately diagnose and monitor certain conditions.

Explanation

This answer is correct because blood cultures, cardiac enzymes, and cortisol are examples of timed tests. Timed tests refer to laboratory tests that need to be performed at specific times to obtain accurate results. These tests may require specific timing for sample collection or may need to be done within a certain time frame after a specific event or medication administration. In the case of blood cultures, cardiac enzymes, and cortisol, these tests often require samples to be collected at specific intervals or during specific time periods to accurately diagnose and monitor certain conditions.

109. A cheerful, pleasant beside mannar and exchange of small talk are unlikely to:

Divert attention from any discomfort associated with the draw.

Increase the patient's confidence in the phlebotmist's abilities.

Keep the patient from fainting during the venipuncture procedure.

Redirect the patient's thoughts away from what is going to happen.

A cheerful, pleasant bedside manner and exchange of small talk may help to divert attention from any discomfort associated with the draw, increase the patient's confidence in the phlebotomist's abilities, and redirect the patient's thoughts away from what is going to happen. However, it is unlikely to keep the patient from fainting during the venipuncture procedure.

Explanation

A cheerful, pleasant bedside manner and exchange of small talk may help to divert attention from any discomfort associated with the draw, increase the patient's confidence in the phlebotomist's abilities, and redirect the patient's thoughts away from what is going to happen. However, it is unlikely to keep the patient from fainting during the venipuncture procedure.

110. Which type of requisition often serves as a test request, report, and billing form?

Bar code

Computer

Manual

Verbal

A manual requisition often serves as a test request, report, and billing form. This means that it can be used to request a test, provide a report on the results of the test, and also serve as a billing form for the services provided. Manual requisitions are typically filled out by hand and may require signatures or other forms of manual authorization. They are often used in situations where a physical form is needed for documentation purposes.

Explanation

A manual requisition often serves as a test request, report, and billing form. This means that it can be used to request a test, provide a report on the results of the test, and also serve as a billing form for the services provided. Manual requisitions are typically filled out by hand and may require signatures or other forms of manual authorization. They are often used in situations where a physical form is needed for documentation purposes.

111. What is the proper arm position for toutine veil-puncture?

Downward in a straight line from shoulder to wrist, palm up

Extended straight forward at about waist height and palm up

Held out at an angle, bend at the elbow, and the palm up

Straight down to the elbow, parallel elbow to wrist, palm up

The proper arm position for toutine veil-puncture is downward in a straight line from shoulder to wrist, palm up. This position ensures stability and control while performing the puncture. It allows for a straight and accurate insertion of the needle, minimizing the risk of injury or complications. The palm being up helps in maintaining a steady grip on the needle and provides better visibility of the puncture site.

Explanation

The proper arm position for toutine veil-puncture is downward in a straight line from shoulder to wrist, palm up. This position ensures stability and control while performing the puncture. It allows for a straight and accurate insertion of the needle, minimizing the risk of injury or complications. The palm being up helps in maintaining a steady grip on the needle and provides better visibility of the puncture site.

112. Misidentification of a specimen for this test is most likely to have fatal consequences:

Blood culture

Cold agglutinin

Platelet count

Type and screen

Misidentification of a specimen for the Type and screen test is most likely to have fatal consequences because this test is performed before a blood transfusion to determine the patient's blood type and screen for any antibodies that may cause a transfusion reaction. If the specimen is misidentified, the patient could be given the wrong blood type, leading to a severe transfusion reaction, which can be life-threatening. It is crucial to ensure accurate identification and labeling of the specimen to prevent such fatal consequences.

Explanation

Misidentification of a specimen for the Type and screen test is most likely to have fatal consequences because this test is performed before a blood transfusion to determine the patient's blood type and screen for any antibodies that may cause a transfusion reaction. If the specimen is misidentified, the patient could be given the wrong blood type, leading to a severe transfusion reaction, which can be life-threatening. It is crucial to ensure accurate identification and labeling of the specimen to prevent such fatal consequences.

113. Which of the following steps are in the right order for the venipuncture procedure?

Clean the site, prepare equipment, put on gloves, apply tourniquet

Sanitize hands, select vein, release tourniquet, verify diet restrictions

Select the site, apply tourniquet, prepare equipment, clean the site

Select vein, clean the site, position the patient, put on your gloves

The correct order for the venipuncture procedure is to first clean the site to ensure it is free from any contaminants, then prepare the necessary equipment for the procedure, put on gloves to maintain a sterile environment, and finally apply the tourniquet to help locate and access the vein. This order ensures that the procedure is performed in a safe and hygienic manner.

Explanation

The correct order for the venipuncture procedure is to first clean the site to ensure it is free from any contaminants, then prepare the necessary equipment for the procedure, put on gloves to maintain a sterile environment, and finally apply the tourniquet to help locate and access the vein. This order ensures that the procedure is performed in a safe and hygienic manner.

114. How can you tell when the needle is in the vein as you insert it into the patient's arm?

Blood will enter the ETS hub.

The needle will start to vibrate.

You will feel a slight "give."

You will hear a hissing sound.

When inserting a needle into a patient's arm, feeling a slight "give" is an indication that the needle has entered the vein. This "give" refers to a subtle resistance or change in the texture of the tissue, suggesting that the needle has successfully punctured the vein wall. This physical sensation is commonly used by healthcare professionals to ensure accurate needle placement and to avoid complications such as infiltration or puncturing through the vein.

Explanation

When inserting a needle into a patient's arm, feeling a slight "give" is an indication that the needle has entered the vein. This "give" refers to a subtle resistance or change in the texture of the tissue, suggesting that the needle has successfully punctured the vein wall. This physical sensation is commonly used by healthcare professionals to ensure accurate needle placement and to avoid complications such as infiltration or puncturing through the vein.

115. To "seat" the needle in the vein means to:

Anchor the vein while inserting the needle.

Increase the angle needed to enter the vein.

Redirect the needle to gain entry to the vein.

Thread part of the needle with the lumen.

To "seat" the needle in the vein means to thread part of the needle with the lumen. This refers to the process of properly inserting the needle into the vein so that the needle tip is positioned correctly within the vein's lumen. It ensures that the needle is securely in place and allows for the successful administration of fluids or medication through the vein.

Explanation

To "seat" the needle in the vein means to thread part of the needle with the lumen. This refers to the process of properly inserting the needle into the vein so that the needle tip is positioned correctly within the vein's lumen. It ensures that the needle is securely in place and allows for the successful administration of fluids or medication through the vein.

116. It is better to use gauze and not cotton balls for pressure over the site because cotton balls:

Are not sufficiently porous to soak up all of the blood at the site.

Attract more airborne contaminants and are therefore less sterile.

Can irritate a patient's skin because they have loose cotton fibers.

May pull the platelet plug away from the puncture site upon removal.

Cotton balls may pull the platelet plug away from the puncture site upon removal. This is because cotton balls have loose cotton fibers that can get stuck to the platelet plug and disrupt the clotting process. Gauze, on the other hand, has a smoother surface and is less likely to disturb the clot when being removed. Using gauze instead of cotton balls helps to maintain the integrity of the clot and promote proper wound healing.

Explanation

Cotton balls may pull the platelet plug away from the puncture site upon removal. This is because cotton balls have loose cotton fibers that can get stuck to the platelet plug and disrupt the clotting process. Gauze, on the other hand, has a smoother surface and is less likely to disturb the clot when being removed. Using gauze instead of cotton balls helps to maintain the integrity of the clot and promote proper wound healing.

117. Steps taken to unmistakeably connect a specimen and the accompanying paperwork to a specific individual are called:

Accessioning the specimen.

Bar-coding specimen labels.

Collection verification.

Patient identification.

Accessioning the specimen refers to the process of assigning a unique identifier or accession number to a specimen and its accompanying paperwork. This ensures that the specimen and all relevant information are linked to a specific individual, allowing for accurate tracking and identification. Bar-coding specimen labels and collection verification may be part of the accessioning process, but the term "accessioning" encompasses the broader concept of connecting the specimen and paperwork to an individual. Patient identification, while important, is not specifically related to the steps taken to connect the specimen and paperwork.

Explanation

Accessioning the specimen refers to the process of assigning a unique identifier or accession number to a specimen and its accompanying paperwork. This ensures that the specimen and all relevant information are linked to a specific individual, allowing for accurate tracking and identification. Bar-coding specimen labels and collection verification may be part of the accessioning process, but the term "accessioning" encompasses the broader concept of connecting the specimen and paperwork to an individual. Patient identification, while important, is not specifically related to the steps taken to connect the specimen and paperwork.

118. Which of the following is the least important reason to wait 30 seconds for the alcohol to dry before needle insertion?

It allows the process of evaporation to help destroy any microbes.

It avoids a stinging sensation when the needle penetrates the skin.

It gives the phlebotomist time to prepare equipment and supplies.

It prevents hemolysis of the specimen from alcohol to in the needle.

Waiting 30 seconds for the alcohol to dry before needle insertion is important for several reasons. It allows the process of evaporation to help destroy any microbes, reducing the risk of infection. It also prevents hemolysis of the specimen, as alcohol in the needle can cause the breakdown of red blood cells. Additionally, waiting helps to avoid a stinging sensation when the needle penetrates the skin. However, giving the phlebotomist time to prepare equipment and supplies is the least important reason because it does not directly impact patient safety or the quality of the specimen.

Explanation

Waiting 30 seconds for the alcohol to dry before needle insertion is important for several reasons. It allows the process of evaporation to help destroy any microbes, reducing the risk of infection. It also prevents hemolysis of the specimen, as alcohol in the needle can cause the breakdown of red blood cells. Additionally, waiting helps to avoid a stinging sensation when the needle penetrates the skin. However, giving the phlebotomist time to prepare equipment and supplies is the least important reason because it does not directly impact patient safety or the quality of the specimen.

119. Which is a common postop test?

CBC

ESR

H & H

PTT

H & H, which stands for hemoglobin and hematocrit, is a common postoperative test. This test measures the levels of red blood cells and hemoglobin in the blood, providing information about the patient's blood volume and oxygen-carrying capacity. Postoperative patients often undergo this test to monitor their blood loss, assess their overall health, and determine if they require any blood transfusions. The CBC (complete blood count) is a broader test that includes H & H, as well as other blood cell counts and indices. ESR (erythrocyte sedimentation rate) and PTT (partial thromboplastin time) are not typically performed as routine postoperative tests.

Explanation

H & H, which stands for hemoglobin and hematocrit, is a common postoperative test. This test measures the levels of red blood cells and hemoglobin in the blood, providing information about the patient's blood volume and oxygen-carrying capacity. Postoperative patients often undergo this test to monitor their blood loss, assess their overall health, and determine if they require any blood transfusions. The CBC (complete blood count) is a broader test that includes H & H, as well as other blood cell counts and indices. ESR (erythrocyte sedimentation rate) and PTT (partial thromboplastin time) are not typically performed as routine postoperative tests.

120. Which one of the following tests is used to identify protein disorders that lead to nerve damage?

ANA

ESR

PTT

SPEP

SPEP stands for Serum Protein Electrophoresis, which is a test used to identify protein disorders that can lead to nerve damage. This test separates proteins in the blood based on their size and charge, allowing for the detection of abnormal protein patterns that may indicate underlying conditions such as multiple myeloma or amyloidosis. By identifying these protein disorders, appropriate treatment and management strategies can be implemented to prevent or minimize nerve damage.

Explanation

SPEP stands for Serum Protein Electrophoresis, which is a test used to identify protein disorders that can lead to nerve damage. This test separates proteins in the blood based on their size and charge, allowing for the detection of abnormal protein patterns that may indicate underlying conditions such as multiple myeloma or amyloidosis. By identifying these protein disorders, appropriate treatment and management strategies can be implemented to prevent or minimize nerve damage.

121. In collecting a blood specimen from an unconscious patient, it is unncessary to:

Have someone assist you just in case the patient moves.

Identify yourself and inform the patient of your intent.

Move the patient to a special phlebotomy collection area.

Talk the the patient as you would to a patient who is alert.

Moving the patient to a special phlebotomy collection area is unnecessary because the location where the blood specimen is collected does not affect the procedure or the patient's unconsciousness. The other options are necessary for the safety and comfort of the patient and to ensure proper communication and consent during the blood collection process.

Explanation

Moving the patient to a special phlebotomy collection area is unnecessary because the location where the blood specimen is collected does not affect the procedure or the patient's unconsciousness. The other options are necessary for the safety and comfort of the patient and to ensure proper communication and consent during the blood collection process.

122. Which of the following would be considered improper specimen collection technique?

Collect sterile specimens before all other specimens.

Draw a "clear" tube before special coagulation tests.

Fill each tube until the normal vacuum is exhausted.

Position the arm so tubes fill from the stopper end first.

Positioning the arm so that the tubes fill from the stopper end first would be considered an improper specimen collection technique. This is because it can lead to the introduction of air bubbles into the tubes, which can interfere with accurate test results. It is important to fill each tube until the normal vacuum is exhausted to ensure proper specimen collection. Collecting sterile specimens before all other specimens and drawing a "clear" tube before special coagulation tests are both appropriate techniques in specimen collection.

Explanation

Positioning the arm so that the tubes fill from the stopper end first would be considered an improper specimen collection technique. This is because it can lead to the introduction of air bubbles into the tubes, which can interfere with accurate test results. It is important to fill each tube until the normal vacuum is exhausted to ensure proper specimen collection. Collecting sterile specimens before all other specimens and drawing a "clear" tube before special coagulation tests are both appropriate techniques in specimen collection.

123. You must collect a light-blue-top tube for a special coagulation test from a paitent who has an intravenous (IV) line in the left wrist area and dermatits all over the right arm and hand. The veins on the right arm and hand are not readily visible. What is the best way to proceed?

Apply a tourniquet on the right arm over a towel and do the draw.

Ask the patient's nurse to collect the specimen from the IV line.

Collect from the left antecubital area without using a tourniquet.

Collect the specimen by capillary puncture from the left hand.

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Explanation

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124. Use several layers of guaze during needle removal so that:

Blood will not contaminate your gloved hand.

It will not hurt when you pull out the needle.

Pressure is adequate and bruising is prevented.

The patient does not see you pull out the needle.

Using several layers of gauze during needle removal helps to prevent blood from contaminating the gloved hand. This is important for infection control and to maintain a sterile environment. By having multiple layers of gauze, any blood that may be present on the needle or around the injection site can be absorbed, reducing the risk of exposure to bloodborne pathogens. It also helps to maintain a clean and safe working environment for both the healthcare provider and the patient.

Explanation

Using several layers of gauze during needle removal helps to prevent blood from contaminating the gloved hand. This is important for infection control and to maintain a sterile environment. By having multiple layers of gauze, any blood that may be present on the needle or around the injection site can be absorbed, reducing the risk of exposure to bloodborne pathogens. It also helps to maintain a clean and safe working environment for both the healthcare provider and the patient.

125. Where is the tourniquet applied when drawing a hand vein?

A tourniquet is not required.

Above the antecubital fossa.

Just distal to the wrist bone.

Proximal to the wrist bone.

When drawing a hand vein, a tourniquet is not required. However, if a tourniquet is used, it should be applied proximal to the wrist bone. This is because applying the tourniquet above the antecubital fossa or just distal to the wrist bone may not provide enough pressure to occlude the vein and make it easier to locate and access for drawing blood. Therefore, applying the tourniquet proximal to the wrist bone ensures a better chance of successful vein identification and blood collection.

Explanation

When drawing a hand vein, a tourniquet is not required. However, if a tourniquet is used, it should be applied proximal to the wrist bone. This is because applying the tourniquet above the antecubital fossa or just distal to the wrist bone may not provide enough pressure to occlude the vein and make it easier to locate and access for drawing blood. Therefore, applying the tourniquet proximal to the wrist bone ensures a better chance of successful vein identification and blood collection.

126. Specimen hemolysis can result from:

Filling tubes with a transfer device at an angle.

Leaving the tourniquet on until the last tube.

Mixing anticoagulant tubes several extra times.

Using a large-volume tube with a 23-gauge needle.

Using a large-volume tube with a 23-gauge needle can result in specimen hemolysis. A 23-gauge needle has a larger diameter compared to smaller gauge needles, which can cause more trauma to the red blood cells during the collection process. Additionally, using a large-volume tube means that there is a greater amount of blood flowing through the needle, increasing the likelihood of hemolysis. Hemolysis occurs when the red blood cells rupture, releasing their contents into the plasma or serum, which can affect the accuracy of test results.

Explanation

Using a large-volume tube with a 23-gauge needle can result in specimen hemolysis. A 23-gauge needle has a larger diameter compared to smaller gauge needles, which can cause more trauma to the red blood cells during the collection process. Additionally, using a large-volume tube means that there is a greater amount of blood flowing through the needle, increasing the likelihood of hemolysis. Hemolysis occurs when the red blood cells rupture, releasing their contents into the plasma or serum, which can affect the accuracy of test results.

127. A butterfly and 23-gauge needle 'is the best choice to use for venipuncture on a young child because:

Children like the idea of using a butterfly.

Children's veins are often very sclerosed.

Flexible tubing allows for arm movement.

It eliminates excessive bleeding.

Flexible tubing allows for arm movement during venipuncture on a young child. This is important because children may be more likely to fidget or move their arm during the procedure. The flexible tubing allows for some movement without causing damage to the needle or the child's arm. This can help ensure a successful and safe venipuncture procedure.

Explanation

Flexible tubing allows for arm movement during venipuncture on a young child. This is important because children may be more likely to fidget or move their arm during the procedure. The flexible tubing allows for some movement without causing damage to the needle or the child's arm. This can help ensure a successful and safe venipuncture procedure.

128. Visual inspection of the needle tip before inserting it in a patient's vein would be unable to detect:

The presence of external contamination.

Flaws that could damage a vein.

Proper positioning of the bevel.

That the needle is out of date.

Visual inspection of the needle tip before insertion cannot detect whether the needle is out of date. This is because the expiration date of the needle is not visible on its surface and requires checking the packaging or labeling. Visual inspection can, however, help identify external contamination, flaws that could damage a vein, and ensure the proper positioning of the bevel.

Explanation

Visual inspection of the needle tip before insertion cannot detect whether the needle is out of date. This is because the expiration date of the needle is not visible on its surface and requires checking the packaging or labeling. Visual inspection can, however, help identify external contamination, flaws that could damage a vein, and ensure the proper positioning of the bevel.

129. Applying pressure on the gauze as the needle is removed can cause the:

Needle to bend.

Patient to faint.

Skin to be split.

All of the above.

Applying pressure on the gauze as the needle is removed can cause the skin to be split. This is because when pressure is applied, it can cause the skin to stretch and tear, resulting in a split. This can be particularly true if the needle is being removed quickly or forcefully, as it increases the likelihood of the skin being split.

Explanation

Applying pressure on the gauze as the needle is removed can cause the skin to be split. This is because when pressure is applied, it can cause the skin to stretch and tear, resulting in a split. This can be particularly true if the needle is being removed quickly or forcefully, as it increases the likelihood of the skin being split.

130. Which of the following is the least effective way to immoblize a pediatric patient before a blood draw?

Allowing the child to sit with one arm bracing the other.

Cradling the child close to the chest of the immobilizer.

Grasping the child's wrist firmly in a palm-up position.

Using two people: an immobilizer and a blood drawer.

Allowing the child to sit with one arm bracing the other is the least effective way to immobilize a pediatric patient before a blood draw because it does not provide adequate restriction of movement. This position still allows the child to move their arms freely, which increases the risk of accidental movement during the procedure. Proper immobilization is essential to ensure the safety and success of the blood draw.

Explanation

Allowing the child to sit with one arm bracing the other is the least effective way to immobilize a pediatric patient before a blood draw because it does not provide adequate restriction of movement. This position still allows the child to move their arms freely, which increases the risk of accidental movement during the procedure. Proper immobilization is essential to ensure the safety and success of the blood draw.

131. Which of the following analytes is least afffected by prolonged tourniquet application?

Potassium

Prothrombin

Red cell count

Total protein

Prolonged tourniquet application can lead to changes in blood composition and analyte levels. Red cell count is least affected by this application because tourniquet mainly affects the plasma components of blood, such as proteins and electrolytes, while the red blood cells remain relatively stable. Therefore, red cell count is the least affected analyte in this scenario.

Explanation

Prolonged tourniquet application can lead to changes in blood composition and analyte levels. Red cell count is least affected by this application because tourniquet mainly affects the plasma components of blood, such as proteins and electrolytes, while the red blood cells remain relatively stable. Therefore, red cell count is the least affected analyte in this scenario.

132. Which of the following is proper procedure when dealing with an elderly adult patient?

Address all questions to a relative or attendent if the patient is hard of hearing.

Apply a pressure bandage in case the patient does not hold adequate pressure.

Raise the pitch of your voice sharply to make certain you are heard properly.

Refrain from drawing on older patients if you have a cold, or else wear a mask.

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Explanation

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133. Release the tourniquet as soon as blood flow is established to:

Allow arterial blood flow to return to normal.

Decrease hemoconcentration of the specimen.

Increase the venous flow to the vein selected.

All of the above.

Releasing the tourniquet as soon as blood flow is established helps decrease hemoconcentration of the specimen. Hemoconcentration refers to an increase in blood concentration due to the accumulation of cellular and protein components. By releasing the tourniquet, blood flow returns to normal, preventing the buildup of these components and ensuring a more accurate representation of the patient's blood composition. Allowing arterial blood flow to return to normal or increasing venous flow to the selected vein are not directly related to decreasing hemoconcentration.

Explanation

Releasing the tourniquet as soon as blood flow is established helps decrease hemoconcentration of the specimen. Hemoconcentration refers to an increase in blood concentration due to the accumulation of cellular and protein components. By releasing the tourniquet, blood flow returns to normal, preventing the buildup of these components and ensuring a more accurate representation of the patient's blood composition. Allowing arterial blood flow to return to normal or increasing venous flow to the selected vein are not directly related to decreasing hemoconcentration.

Take Home Quiz Chapter 8

2.

What first name or nickname would you like us to use?

2. Where is the best place to apply the tourniquet?

3. Which liquid is acceptable to drink when one is fasting?

4. If the patient asks wheather the procedure will hurt, you should say that it:

5. Never leave a tourniquet on for more than:

6. In performing venipuncture, the needle is inserted:

7. Labeling of routine inpatient blood specimens should take place:

8. Needle phobia is defined as a/an:

9. To examine by touch or feel is to:

10. If a test is ordered stat, it may mean that the patient is in:

11. DNR means:

12. You arrive to draw a specimen on an inpatient. The patien's door is closed. What do you do?

13. A patient has difficult veins and you decide to use a butterfly for the draw. Butterfly is another name for a:

14. Going without food or drink except for water for 8 to 12 hours is defined as:

15. Which of the following individuals has legal authority to authorize paitent testing?

16. Information represented by a patient ID bar code typically includes the patient's:

17. Your patient is cranky and rude to you. What do you do?

18. When performing a venipuncture, hand decontamination is required:

19. You must colect a specimen on a 6-year-old. The child is a little fearful. What do you do?

20. Symptoms of needle phobia can include:

21. An inpatient vhemently refuses to allow you to collect a blood specimen. What should you do?

22. You are about to draw blood from a paitent. You touch the needle to the skin but change your mind and pull the needle away. What do you do next?

23. When reveived by the laboratory, inpaitent requisitions are typically sorted according to:

24. An example of a test that is commonly ordered fasting is:

25. What is hte best thing to do if family or visitors are with a patient?

26. What may happen if you mix tubes too vigorously?

27. Test requisition information must include the:

28. What is the advantage of using a butterfly?

29. Failure of the paitent to follow required diet restrictions before specimen collection could lead to:

30. A test that is ordered stat should be collected:

31. The medical record number on the ID band matches the number on your requisition, but the patient's name is spelled differently than the one on your requisition. What should you do?

32. Which of the following is the best thing to do if your hands are visibly contaminated?

33. Which of the following will help you avoid inadvertentlly puncturing an artery during venipuncture?

34. Proper use of a hand sanitizer includes:

35. Proper needle disposal involves:

36. A test is ordered "fasting" to:

37. A paitent who is NPO:

38. What is the most critical error a phlebotomist can make?

39. Criteria used to decide which needle gauge t o use for venipuncture include:

40. When properly anchoring a vein, the:

41. A preop patient:

42. Your inpatient is asleep when you arrive to draw blood. What do you do?

43. Outpatients who have previously fainted during a blood draw should be:

44. When is the best time to release the tourniquet during venipuncture?

45. Doing this before obtaining a blood specimen from a child is a bad idea:

46. In most cases, needle insertion should be performed:

47. There is a sign above the patient's bed that reads, "No blood pressures or venipuncture, right arm," the patient has an intravenous (IV) line in the left forearm. You have a request to collect a complete blood count (CBC) on the patient. How should you proceed?

48. This term means the same as stat:

49. Your patient is not in the room when you arrive to collect a timed specimen. The patient's nurse states that the patient will be unavaiable for several hours. What should you do?

50. Which type of inpatient is most likely to have more than one ID band?

51. Which requisition information must match information on the patient's ID band?

52. The patient asks if the test you are about to draw is for disbetes. How do you answer?

53. What does a sclerosed vein feel like?

54. Which of the following is not a valid reason for failure to obtain a blood specimen?

55. The most common reason a patient must undergo dialysis treatment is:

56. What do you do if a physician is with the patient and the specimen is ordered stat?

57. It is important to fill anticoagulant tubes to the proper level to ensure that:

58. You have just made two unsuccessful attemps to collect a fasting blood specimen from an outpatient. The patient rotates his arm, and you note a large vein that you had not seen before. How do you proceed?

59. Your patient is not wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?

60. Which of the following actions is prohibited during the vein selection process?

61. Tremors associated with this disease can make blood collection difficult:

62. Which of the following actions is unlikely to help a phlebotomist gain a patient's trust?

63. The reason a test is ordered "timed" is to:

64. The unique number assigned to a specimen request is called the:

65. You arrive to collect a specimen on a patient named John Doe in 302B. How do you verify that the patient in 302B is indeed John Doe?

66. A needle safety feature, other than a blunting needle, should be activated:

67. Although the evacuated tube system (ETS) is the preferred method of blood collection, it may be necessary to use a syringe when:

68. How can you tell that you are in a vein when you are using a syringe?

69. Which one of the following types of patients is least likely to need his or her identity confirmed by the patient's nurse or a relative?

70. What is the best thing to do if the vein can be felt but not seen, even with the tourniquet on?

71. In drawing blood from an older child, the most imporant consideration is:

72. An additive should be mixed:

73. A code is a way to:

74. If the tourniquet is too tight:

75. What is the CLSI-recommened way to clean a venipuncture site?

76. Laboratory results can be nagatively affected if the phlebotomist:

77. What is the best angle to use for the needle insertion during routine venipuncture?

78. Which of the following information on a specimen lavel would be considered optional?