Take Home Quiz Chapter 9

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Questions and Answers
  • 1. 

    The preanalytical phase of the testing process begin for the laborataory when a:

    • A.

      Blood or body fluid specimen is collected.

    • B.

      Patient is admitted to a healthcare facility.

    • C.

      Specimen is submitted for processing.

    • D.

      Test is ordered by a patient's physician.

    Correct Answer
    D. Test is ordered by a patient's physician.
    Explanation
    The preanalytical phase of the testing process begins for the laboratory when a test is ordered by a patient's physician. This is because the preanalytical phase refers to all the activities that occur before the actual testing of the specimen takes place. In this phase, the laboratory receives the test order, verifies the patient's information, and prepares the necessary supplies and equipment for specimen collection. Therefore, the ordering of the test by the physician initiates the preanalytical phase.

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  • 2. 

    Most reference ranges are based on normal laboratory test valyes for:

    • A.

      Fasting patients.

    • B.

      Healthy people.

    • C.

      I11 individuals.

    • D.

      Treated patients.

    Correct Answer
    B. Healthy people.
    Explanation
    The correct answer is "Healthy people." Reference ranges for laboratory tests are typically based on values obtained from healthy individuals. These ranges represent the normal values for specific tests and are used as a comparison to determine if a patient's results fall within the expected range. Fasting patients, treated patients, and individuals with illnesses or diseases may have different test values that deviate from the normal range, making it less suitable for establishing reference ranges.

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  • 3. 

    Diurnal variation associated with some blood components are:

    • A.

      Abnormal changes that occur once a day.

    • B.

      Changes that follow a monthly cycle.

    • C.

      Normal fluctuations throughout the day.

    • D.

      Variations that occur on an hourly basis

    Correct Answer
    C. Normal fluctuations throughout the day.
    Explanation
    The correct answer is "Normal fluctuations throughout the day." Diurnal variation refers to the natural changes in certain blood components that occur over a 24-hour period. These fluctuations are considered normal and can be influenced by factors such as sleep-wake cycles, physical activity, and hormone levels. It is important to understand these variations when interpreting blood test results, as they can help differentiate between normal and abnormal values.

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  • 4. 

    A patient;s arm is swollen. The term used to describe this condition is:

    • A.

      Cyanotic.

    • B.

      Edematous.

    • C.

      Sclerosed.

    • D.

      Thrombosed.

    Correct Answer
    B. Edematous.
    Explanation
    Edematous is the correct term to describe a swollen arm. Edema refers to the accumulation of excess fluid in the tissues, leading to swelling. In this case, the patient's arm is swollen, indicating the presence of edema. Cyanotic refers to a bluish discoloration of the skin due to inadequate oxygenation, sclerosed refers to the hardening or thickening of tissues, and thrombosed refers to the formation of a blood clot in a blood vessel. None of these terms accurately describe the condition of a swollen arm.

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  • 5. 

    Lipemia results from:

    • A.

      High fat content of the blood.

    • B.

      Improper specimen handling.

    • C.

      Increased number of platelets.

    • D.

      Specimen hemoconcentration.

    Correct Answer
    A. High fat content of the blood.
    Explanation
    Lipemia results from a high fat content in the blood. Lipids, such as triglycerides, can cause the blood to appear turbid or milky, leading to lipemia. This can occur due to various factors, including a high-fat diet, certain medical conditions like hyperlipidemia, or genetic factors. When a blood sample is collected, the presence of lipemia can interfere with laboratory tests and affect the accuracy of the results. It is important to properly handle and process the specimen to minimize the occurrence of lipemia.

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  • 6. 

    A patient with a high degree of jaundice typically has:

    • A.

      Bruising and petechiae.

    • B.

      Edematous extremities.

    • C.

      Hemolyzed specimens.

    • D.

      Yellow skin and sclerae.

    Correct Answer
    D. Yellow skin and sclerae.
    Explanation
    A patient with a high degree of jaundice typically has yellow skin and sclerae. Jaundice is a condition characterized by the yellowing of the skin and the whites of the eyes (sclerae) due to an excess of bilirubin in the blood. Bilirubin is a yellow pigment produced during the breakdown of red blood cells. When the liver is unable to properly process and excrete bilirubin, it builds up in the body, leading to the characteristic yellow discoloration. Bruising and petechiae are not typically associated with jaundice, while edematous extremities may be seen in certain conditions but are not specific to jaundice. Hemolyzed specimens are not directly related to jaundice.

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  • 7. 

    Lymphostasis is:

    • A.

      Impaired secretion of lymph fluid,

    • B.

      Obstruction of the flow of lymph.

    • C.

      Reduced lymphocyte production.

    • D.

      Stoppage of lymphoid functions.

    Correct Answer
    B. Obstruction of the flow of lymph.
    Explanation
    Lymphostasis refers to the obstruction of the flow of lymph. This condition occurs when there is a blockage or impairment in the lymphatic system, which is responsible for draining excess fluid from tissues and transporting immune cells. When the flow of lymph is obstructed, it can lead to swelling, fluid retention, and impaired immune function. Therefore, the correct answer is obstruction of the flow of lymph.

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  • 8. 

    This is the medical term for a nervious system response to abrupt pain, stress, or trauma:

    • A.

      Circadian response

    • B.

      Latrogenic reflux

    • C.

      Vasovagal syncope

    • D.

      Venous stagnation

    Correct Answer
    C. Vasovagal syncope
    Explanation
    Vasovagal syncope is the correct answer because it refers to a medical term that describes a nervous system response to sudden pain, stress, or trauma. This response involves a temporary drop in blood pressure and heart rate, leading to fainting or loss of consciousness. It is a common reaction to triggers such as seeing blood, experiencing extreme pain, or feeling intense emotions.

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  • 9. 

    Small non-rasied red spots appear on the patient's skin below where the tourniquet has been tied. What are they and what causes them?

    • A.

      A rash from tying the tourniquet too tightly

    • B.

      Bilirubin spots as a result of a diseased liver

    • C.

      Dermatitis from an allergy to the tourniquet

    • D.

      Petechiae due to capillary or platelet defects

    Correct Answer
    D. Petechiae due to capillary or platelet defects
    Explanation
    The small non-raised red spots that appear on the patient's skin below where the tourniquet has been tied are called petechiae. These petechiae are caused by capillary or platelet defects. Capillary defects can occur due to increased pressure on the blood vessels caused by the tightness of the tourniquet, leading to the leakage of blood into the surrounding tissues. Platelet defects can result in inadequate clotting, leading to the formation of petechiae.

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  • 10. 

    Venous stasis is:

    • A.

      Backflow of tissue fluid into a vein.

    • B.

      Part of the normal coagulation process.

    • C.

      Stoppage of the normal venous blood flow.

    • D.

      Vein collapse from excess pressure.

    Correct Answer
    C. Stoppage of the normal venous blood flow.
    Explanation
    Venous stasis refers to the stoppage or slowing down of normal blood flow in the veins. This can occur due to various factors such as blood clots, weak or damaged vein valves, or immobility. When blood flow is hindered, it can lead to pooling of blood in the veins, causing swelling, pain, and potentially leading to complications such as deep vein thrombosis. Therefore, the correct answer is "Stoppage of the normal venous blood flow."

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  • 11. 

    A hematoma is a:

    • A.

      Blood clot inside a vein.

    • B.

      Pool of fluid from an iv.

    • C.

      Swelling or mass of blood.

    • D.

      Symptom of nerve injury.

    Correct Answer
    C. Swelling or mass of blood.
    Explanation
    A hematoma refers to a swelling or mass of blood. It occurs when blood vessels rupture or leak, leading to the accumulation of blood in the surrounding tissues. This swelling or mass of blood can cause pain, tenderness, and discoloration in the affected area. It is different from a blood clot inside a vein, which is known as a thrombus. A hematoma can occur due to various reasons such as trauma, surgery, or underlying medical conditions.

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  • 12. 

    Mastectomy is the medical term for breast:

    • A.

      Biopsy.

    • B.

      Reduction.

    • C.

      Removal.

    • D.

      Surgery.

    Correct Answer
    C. Removal.
    Explanation
    The term "mastectomy" refers to the surgical procedure of removing the breast. It is commonly performed to treat breast cancer or as a preventive measure for individuals at high risk of developing breast cancer. The other options listed - biopsy, reduction, and surgery - do not specifically refer to the complete removal of the breast tissue, making "removal" the correct answer.

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  • 13. 

    Exsanguination is:

    • A.

      Autologous donation of blood.

    • B.

      Iatrogenic depletion of blood.

    • C.

      Life-threatening loss of blood.

    • D.

      Therapeutic removal of blood.

    Correct Answer
    C. Life-threatening loss of blood.
    Explanation
    Exsanguination refers to life-threatening loss of blood. This term is used to describe a condition where a person loses a significant amount of blood, which can lead to severe hemorrhage, shock, and ultimately death if not treated promptly. It is not related to autologous blood donation, iatrogenic blood depletion, or therapeutic removal of blood.

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  • 14. 

    Which of the following is a product of the breakdown of red blood cells (RBCs)?

    • A.

      Bilirubin

    • B.

      Creatinine

    • C.

      Glucagon

    • D.

      Lipid (fat_

    Correct Answer
    A. Bilirubin
    Explanation
    Bilirubin is a product of the breakdown of red blood cells (RBCs). When RBCs reach the end of their lifespan, they are broken down in the liver and spleen. Bilirubin is a yellow pigment that is produced during this breakdown process. It is then transported to the liver where it is processed and eventually excreted in bile. Elevated levels of bilirubin in the blood can indicate liver or gallbladder dysfunction.

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  • 15. 

    A vein that is thrombosed is:

    • A.

      Clotted.

    • B.

      Patent.

    • C.

      Scarred.

    • D.

      Swollen.

    Correct Answer
    A. Clotted.
    Explanation
    A vein that is thrombosed means that it has a blood clot formed within it. Therefore, the correct answer is "Clotted."

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  • 16. 

    A patient goes into convulsion while you are drawing his blood. The last tube has just started to fill. Which of the following is the wrong thing to do?

    • A.

      Complete the draw as quickly as you can.

    • B.

      Immediately discontinue the blood draw.

    • C.

      Prevent the patient from injuring himself.

    • D.

      Notify the appropriate first-aid personnel.

    Correct Answer
    C. Prevent the patient from injuring himself.
    Explanation
    Preventing the patient from injuring himself is the wrong thing to do in this situation. When a patient goes into convulsion, it is important to immediately discontinue the blood draw to ensure their safety. Continuing the draw could potentially worsen the convulsion or cause further harm to the patient. Once the blood draw is stopped, the next step should be to notify the appropriate first-aid personnel who can provide immediate assistance and medical attention to the patient.

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  • 17. 

    The patient has in IV in the left foreawm and a large hematoma in the antecubital area of the right arm. The best place to collect a specimen by venipuncture is the:

    • A.

      Left arm above the IV entry point.

    • B.

      Left arm below the IV entry point.

    • C.

      Right arm distal to the hematoma.

    • D.

      Right arm in the antecubital area.

    Correct Answer
    C. Right arm distal to the hematoma.
    Explanation
    The best place to collect a specimen by venipuncture would be the right arm distal to the hematoma. This is because the hematoma in the antecubital area of the right arm may interfere with the collection process and potentially contaminate the specimen. Therefore, it is recommended to choose a location in the right arm that is away from the hematoma to ensure a clean and accurate sample.

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  • 18. 

    Which of the following is not true of Hematomas?

    • A.

      It is a swelling or mass of blood

    • B.

      It can lead to inaccurate test results

    • C.

      It can causes an obstruction of blood flow

    • D.

      All of the above are correct

    Correct Answer
    D. All of the above are correct
    Explanation
    Hematomas are swellings or masses of blood that can occur due to injury or trauma. They can lead to inaccurate test results because they can interfere with the normal flow and composition of blood. Additionally, hematomas can cause an obstruction of blood flow in the affected area, leading to further complications. Therefore, all of the given statements about hematomas are true.

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  • 19. 

    Hemoconcentration from prolonged tourniquet application increases:

    • A.

      Blood plasma volume.

    • B.

      Non-filterable analytes.

    • C.

      PH and oxygen levels.

    • D.

      Specimen hemolysis.

    Correct Answer
    B. Non-filterable analytes.
    Explanation
    Prolonged tourniquet application can lead to hemoconcentration, which means an increase in the concentration of blood components due to a decrease in plasma volume. This can cause an increase in the concentration of non-filterable analytes, such as proteins, electrolytes, and other substances that are normally found in the plasma. These analytes cannot be filtered out by the kidneys and therefore their concentration increases in the blood.

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  • 20. 

    Which of the following is the medical term for fainting?

    • A.

      Sclerosis

    • B.

      Stasis

    • C.

      Supine

    • D.

      Syncope

    Correct Answer
    D. Syncope
    Explanation
    Syncope is the correct answer because it is the medical term for fainting. Syncope refers to a temporary loss of consciousness caused by a lack of blood flow to the brain. It is often a result of low blood pressure or a sudden drop in heart rate.

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  • 21. 

    In which instance if the patient closest to the basal state? The patient who:

    • A.

      Arrived at the lab at 0800 and had not eaten since dinner the prior night.

    • B.

      Came straight to the lab after working all night but was fasting at work.

    • C.

      Has been awake but lying down quietly resting for the last several hours.

    • D.

      Is awakened for a blood draw at 0600 after fasting since 0800 last night.

    Correct Answer
    D. Is awakened for a blood draw at 0600 after fasting since 0800 last night.
    Explanation
    The patient who is awakened for a blood draw at 0600 after fasting since 0800 last night is closest to the basal state. This is because the patient has been fasting for a long period of time and has not engaged in any physical activity or eaten anything that could affect their metabolic state. The other options involve factors such as eating dinner, working all night, or resting, which can all have an impact on the patient's metabolic state and therefore are not as close to the basal state.

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  • 22. 

    The best specimens to use for establishing inpatient reference ranges for blood tests are:

    • A.

      Basal-state specimens.

    • B.

      Fasting specimens.

    • C.

      Postprandial specimens.

    • D.

      Steady-state specimens.

    Correct Answer
    A. Basal-state specimens.
    Explanation
    Basal-state specimens are the best specimens to use for establishing inpatient reference ranges for blood tests. Basal-state refers to the body being in a resting state, typically in the morning after an overnight fast and without any recent physical activity or stress. Using basal-state specimens ensures that the results are not influenced by recent food intake or physical exertion, providing a more accurate baseline for establishing reference ranges. Fasting specimens are also commonly used, but they may not be as reliable as basal-state specimens since fasting can vary in duration and individuals may have different metabolic responses. Postprandial specimens, taken after a meal, and steady-state specimens, taken during a stable condition, are not ideal for establishing reference ranges as they can introduce additional variables and fluctuations in blood test results.

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  • 23. 

    Which test requires the parient's age in calculating results?

    • A.

      Cold agglutinin titer

    • B.

      C-reactive protein

    • C.

      Creatine kinase mb

    • D.

      Creatinine clearance

    Correct Answer
    D. Creatinine clearance
    Explanation
    Creatinine clearance is a test that measures how well the kidneys are functioning. It requires the patient's age because the results are adjusted based on age. As people age, their kidney function naturally declines, so it is important to take age into account when interpreting the results. This helps to provide a more accurate assessment of the patient's kidney function and overall health.

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  • 24. 

    Which of the following tests is most affected by altitude?

    • A.

      Cholesterol

    • B.

      Electrolytes

    • C.

      Magnesium

    • D.

      RBC count

    Correct Answer
    D. RBC count
    Explanation
    The RBC count is most affected by altitude. This is because at higher altitudes, there is a decrease in the partial pressure of oxygen, which can lead to an increase in the production of red blood cells in order to compensate for the lower oxygen levels. This is known as altitude-induced polycythemia. Therefore, the RBC count is directly influenced by the altitude at which the test is conducted.

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  • 25. 

    Persistent diarrhea in the absence of fluid replacement may cause:

    • A.

      Hemoconcentration.

    • B.

      Iatrogenic anemia.

    • C.

      Petechiae formation.

    • D.

      Red cell destruction.

    Correct Answer
    A. Hemoconcentration.
    Explanation
    Persistent diarrhea can lead to hemoconcentration because the continuous loss of fluid and electrolytes in the stool can result in dehydration. Dehydration causes a decrease in blood volume, leading to an increased concentration of red blood cells and other blood components in the bloodstream. This hemoconcentration can be measured by an increased hematocrit level.

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  • 26. 

    The serum or plasma of a lipemic specimen appears:

    • A.

      Cloudy White.

    • B.

      Dark Yellow.

    • C.

      Foamy pink.

    • D.

      Pink to red.

    Correct Answer
    A. Cloudy White.
    Explanation
    The correct answer is Cloudy White. When a specimen is lipemic, it means that it contains a high concentration of lipids (fats). This can occur due to several reasons, such as recent food intake or a metabolic disorder. The lipids cause the serum or plasma to appear cloudy and white. It can interfere with the accuracy of laboratory tests, as it may affect the measurement of certain analytes. Therefore, lipemic specimens are often rejected or additional steps are taken to remove the lipids before testing.

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  • 27. 

    A lipemic specimen is a clue that the patient was probably:

    • A.

      In basal state.

    • B.

      Dehydrated.

    • C.

      Jaundiced.

    • D.

      Not fasting.

    Correct Answer
    D. Not fasting.
    Explanation
    A lipemic specimen refers to a blood sample that appears cloudy or milky due to the presence of high levels of lipids (fats). This can occur when a patient has not fasted before the blood test, as the ingestion of fatty foods can temporarily increase lipid levels in the blood. Lipemic specimens are commonly seen in non-fasting patients, and it is an indication that the patient was not fasting prior to the blood draw.

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  • 28. 

    A 12-hour fast is normally required in testing for this analyte:

    • A.

      Bilirubin

    • B.

      Calcium

    • C.

      Electrolytes

    • D.

      Triglycerides

    Correct Answer
    D. Triglycerides
    Explanation
    Triglycerides are a type of fat found in the blood. Testing for triglyceride levels usually requires a 12-hour fast because eating can temporarily increase triglyceride levels in the blood. By fasting for 12 hours, the test results will provide a more accurate reflection of a person's baseline triglyceride levels. This fasting requirement helps to ensure the reliability and accuracy of the test results.

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  • 29. 

    This blood component exhibits diurnal varisation, with peak levels occurring in the morning:

    • A.

      Cortisol

    • B.

      Creatinine

    • C.

      Glucose

    • D.

      Phosphate

    Correct Answer
    A. Cortisol
    Explanation
    Cortisol is a hormone that exhibits diurnal variation, meaning its levels fluctuate throughout the day. The peak levels of cortisol occur in the morning, typically within the first few hours after waking up. This is known as the cortisol awakening response, which helps to prepare the body for the day ahead. Cortisol plays a role in regulating various physiological processes, including metabolism, immune function, and stress response.

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  • 30. 

    Test influenced by diurnal variation are typically ordered:

    • A.

      Fasting.

    • B.

      Preop.

    • C.

      Slat.

    • D.

      Timed.

    Correct Answer
    D. Timed.
    Explanation
    The correct answer is "Timed." This means that the test influenced by diurnal variation is typically ordered at a specific time of the day. Diurnal variation refers to the natural fluctuations that occur in various biological processes over a 24-hour period. By ordering the test at a specific time, healthcare professionals can account for these fluctuations and obtain more accurate results. This is particularly important for tests that are affected by factors such as hormone levels, blood pressure, or body temperature, which can vary throughout the day.

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  • 31. 

    A drug known to interfere with a blood test should be discontinuted for this many hours before the test ranges for RBC counts?

    • A.

      1-3

    • B.

      4-24

    • C.

      25-30

    • D.

      48-72

    Correct Answer
    B. 4-24
    Explanation
    The drug should be discontinued for 4-24 hours before the blood test for RBC counts because it is known to interfere with the test results. This time frame allows for the drug to be cleared from the system and ensures more accurate and reliable test results.

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  • 32. 

    A test result can be fasely decreased if:

    • A.

      A drug competes with the test reagents for the test analyte.

    • B.

      An analyte-detecting color reaction is enhanced by a drug.

    • C.

      Anticoagulant reflux occurred during specimen collection.

    • D.

      Serum used for the test came partially filled SST.

    Correct Answer
    A. A drug competes with the test reagents for the test analyte.
    Explanation
    If a drug competes with the test reagents for the test analyte, it can lead to a falsely decreased test result. This means that the drug interferes with the accuracy of the test by competing with the reagents that are supposed to detect the analyte being tested. As a result, the test may underestimate the actual levels of the analyte in the specimen, leading to a false decrease in the test result.

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  • 33. 

    Which of the following analytes can remain elevated for 24 hours or more after exercise?

    • A.

      Ck

    • B.

      Co2

    • C.

      K+

    • D.

      Ph

    Correct Answer
    A. Ck
    Explanation
    CK (creatine kinase) can remain elevated for 24 hours or more after exercise. CK is an enzyme found in various tissues, including skeletal muscle. During intense exercise, muscle damage occurs, leading to the release of CK into the bloodstream. Elevated levels of CK indicate muscle damage and can persist for a significant period after exercise. Therefore, CK is the analyte that can remain elevated for 24 hours or more after exercise.

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  • 34. 

    Which hormone is most affected by the presence of a fever?

    • A.

      Insulin

    • B.

      Melatonin

    • C.

      Testosterone

    • D.

      Thyroxine

    Correct Answer
    A. Insulin
    Explanation
    A fever is a temporary increase in body temperature, usually caused by an infection. During a fever, the body's metabolic rate increases, leading to an increased demand for energy. Insulin is a hormone that regulates blood sugar levels and helps cells take in glucose for energy. When the body temperature rises during a fever, insulin sensitivity decreases, leading to a decrease in insulin production and an increase in blood sugar levels. Therefore, insulin is the hormone most affected by the presence of a fever.

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  • 35. 

    Which analyte has a higher reference range for males than for females?

    • A.

      Cholesterol

    • B.

      Hematocrit

    • C.

      Magnesium

    • D.

      Potassium

    Correct Answer
    B. Hematocrit
    Explanation
    Hematocrit is a measure of the proportion of red blood cells in the blood. In general, males tend to have higher hematocrit levels than females. This is because testosterone, a male sex hormone, stimulates the production of red blood cells. Therefore, the reference range for hematocrit is typically higher for males compared to females.

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  • 36. 

    An icteric blood specimen indicates that:

    • A.

      Bilirubin test results could be elevated.

    • B.

      It probably was not a fasting specimen.

    • C.

      The collection procedure was incorrect.

    • D.

      The blood could be hemoconcentrated.

    Correct Answer
    A. Bilirubin test results could be elevated.
    Explanation
    An icteric blood specimen refers to a sample of blood that appears yellowish due to elevated levels of bilirubin. Bilirubin is a yellow pigment produced when red blood cells break down. Therefore, an icteric blood specimen indicates that the bilirubin test results could be elevated, suggesting potential liver or gallbladder dysfunction. The other options, such as fasting status, collection procedure, or hemoconcentration, do not directly relate to the presence of icteric blood.

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  • 37. 

    What changes occur in the bloodstream when a patient goes from supine to standing?

    • A.

      Non-filterable elements increase.

    • B.

      Red blood cell counts decrease.

    • C.

      The level of calcium decreases.

    • D.

      The volume of plasma is increased.

    Correct Answer
    A. Non-filterable elements increase.
    Explanation
    When a patient goes from a supine to a standing position, there is an increase in hydrostatic pressure in the lower extremities. This causes fluid to shift from the blood vessels into the interstitial spaces, leading to an increase in non-filterable elements in the bloodstream. Red blood cell counts may decrease due to the pooling of blood in the lower extremities, but this is not the primary change that occurs. The level of calcium and the volume of plasma do not directly change as a result of the change in body position.

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  • 38. 

    Why do pregnant patients have lower reference ranges for RBC counts?

    • A.

      Frequent bouts of nausea lead to hemoconcentration.

    • B.

      Increased body fluids result in the dilution of the RBC's

    • C.

      Poor appetite results in a temporary form of anemia.

    • D.

      The growing fetus uses up the mother's iron reserves.

    Correct Answer
    B. Increased body fluids result in the dilution of the RBC's
    Explanation
    During pregnancy, the body produces a higher volume of blood and increases the total amount of body fluids. This increased fluid volume can lead to the dilution of red blood cells (RBCs), resulting in lower reference ranges for RBC counts. The dilution effect occurs because the same number of RBCs is distributed in a larger volume of fluid, causing the concentration of RBCs to decrease. This is a normal physiological adaptation to support the needs of the growing fetus and ensure an adequate blood supply to both the mother and the baby.

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  • 39. 

    Which of the following analytes is typically increased in chronic smokers?

    • A.

      Bicarbonate

    • B.

      Hemoglobin

    • C.

      O2 saturation

    • D.

      Vitamin b12

    Correct Answer
    B. Hemoglobin
    Explanation
    Chronic smokers often have increased levels of hemoglobin. Smoking causes damage to the lungs and reduces the amount of oxygen that can be carried in the blood. In response, the body produces more hemoglobin to compensate for the decreased oxygen levels. This increased hemoglobin level is a common finding in chronic smokers and can be detected through blood tests.

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  • 40. 

    It is not a good idea to collect a cbc from a screaming infant because the:

    • A.

      Chance of hemolysis is increased.

    • B.

      Platelets are more likely to clump.

    • C.

      Specimen may be hemoconcentrated.

    • D.

      WBCs may be temporarily elevated.

    Correct Answer
    D. WBCs may be temporarily elevated.
    Explanation
    Collecting a CBC from a screaming infant is not a good idea because the WBCs may be temporarily elevated. When an infant is screaming, it can cause stress and agitation, leading to an increase in the production and release of white blood cells. This temporary elevation in WBC count can affect the accuracy of the CBC results, making it difficult to interpret the true WBC count. Therefore, it is recommended to collect a CBC from an infant when they are calm and not in a distressed state.

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  • 41. 

    Of the following factors known to affect basal state, which is automatically accounted for when reference ranges are established?

    • A.

      Diurnal variation

    • B.

      Drug interferences

    • C.

      Effect of exercise

    • D.

      Geographic locale

    Correct Answer
    D. Geographic locale
    Explanation
    Geographic locale is automatically accounted for when reference ranges are established because different regions can have variations in factors such as altitude, temperature, and environmental conditions, which can affect basal state. Therefore, reference ranges are established based on the specific geographic locale to ensure accurate interpretation of laboratory test results for individuals in that particular region.

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  • 42. 

    Temperature and humidity control in a laboratory is important because it:

    • A.

      Ensures that the test results will be normal.

    • B.

      Maintains the integrity of specimens.

    • C.

      Prevents hemolysis of the specimens.

    • D.

      Reduces any interference from drug.

    Correct Answer
    B. Maintains the integrity of specimens.
    Explanation
    Temperature and humidity control in a laboratory is important because it maintains the integrity of specimens. Fluctuations in temperature and humidity can cause changes in the physical and chemical properties of specimens, leading to inaccurate results. By controlling these factors, the laboratory ensures that the specimens remain stable and unaffected, allowing for reliable and consistent test results.

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  • 43. 

    Scarred or burned areas should be avoided as blood collection sites because:

    • A.

      Analytes are diluted in such areas.

    • B.

      Circulation is typically impaired.

    • C.

      Specimens tend to be hemolyzed.

    • D.

      Veins are most likely thrombosed.

    Correct Answer
    B. Circulation is typically impaired.
    Explanation
    Scarred or burned areas should be avoided as blood collection sites because circulation is typically impaired. Scar tissue and burn injuries can cause damage to blood vessels, leading to reduced blood flow in the area. This impaired circulation can make it difficult to obtain an adequate blood sample and may result in a lower quantity or quality of analytes in the specimen. Additionally, impaired circulation can increase the risk of complications during the blood collection process, such as hematoma formation or prolonged bleeding. Therefore, it is best to avoid scarred or burned areas when selecting a blood collection site.

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  • 44. 

    A vein that feels hard, cord-like, and lakcs resiliency is most likely:

    • A.

      An artery.

    • B.

      Collapsed.

    • C.

      Sclerosed.

    • D.

      Superficial.

    Correct Answer
    C. Sclerosed.
    Explanation
    If a vein feels hard, cord-like, and lacks resiliency, it is most likely sclerosed. Sclerosis refers to the hardening and thickening of the walls of blood vessels, which can occur due to various factors such as aging, inflammation, or the buildup of plaque. This can cause the vein to lose its normal elasticity and become rigid, resulting in a hard, cord-like texture.

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  • 45. 

    Drawing blood from an edmatous extermity may cause:

    • A.

      Erroneous specimen results.

    • B.

      Hemolysis of the specimen.

    • C.

      Premature specimen clotting.

    • D.

      Rapid formation of petechiae.

    Correct Answer
    A. Erroneous specimen results.
    Explanation
    Drawing blood from an edematous extremity may cause erroneous specimen results because the excess fluid in the tissue can dilute the blood sample, leading to inaccurate test results. The edema can also affect the composition of the blood, potentially affecting the levels of various substances being measured. It is important to draw blood from a non-edematous area to ensure accurate and reliable test results.

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  • 46. 

    If you have no choice but to collect a specimen from an arm with a hematoma, collect the specimen:

    • A.

      Above it.

    • B.

      Beside it.

    • C.

      Distal to it.

    • D.

      Through it.

    Correct Answer
    C. Distal to it.
    Explanation
    When collecting a specimen from an arm with a hematoma, it is best to collect the specimen distal to it. This means collecting the specimen below or after the hematoma, towards the end of the arm. This is because a hematoma is a localized collection of blood outside the blood vessels, which can interfere with the accuracy of the specimen. Collecting the specimen distal to the hematoma helps to ensure that the collected sample is not contaminated by the hematoma and provides a more accurate representation of the patient's condition.

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  • 47. 

    One reason collecting blood specimens from an arm on the same side as a mastectomy without permission from the patient's physician is prohibited is because:

    • A.

      Results on that arm will be elevated.

    • B.

      That arm will have much less feeling.

    • C.

      Tourniquet application may injure it

    • D.

      Veins in that arm will collapse easily.

    Correct Answer
    C. Tourniquet application may injure it
    Explanation
    Collecting blood specimens from an arm on the same side as a mastectomy without permission from the patient's physician is prohibited because tourniquet application may injure it. After a mastectomy, the arm on the affected side may have compromised lymphatic and circulatory systems, making it more susceptible to injury. Applying a tourniquet to this arm can cause further damage and complications. Therefore, it is necessary to obtain permission from the patient's physician before collecting blood specimens from that arm to ensure the safety and well-being of the patient.

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  • 48. 

    Which of the following veins is often the easiest to feel on obese patients?

    • A.

      Basilic

    • B.

      Brachial

    • C.

      Cephalic

    • D.

      Median

    Correct Answer
    D. Median
    Explanation
    The median vein is often the easiest to feel on obese patients because it is located in the middle of the forearm, close to the surface of the skin. This makes it more accessible and easier to palpate compared to other veins such as the basilic, brachial, or cephalic veins, which may be deeper or harder to locate.

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  • 49. 

    You must collect a protime specimen from a patient with IV's in both arms. The best place to collect the specimen is:

    • A.

      Above one of the IV's.

    • B.

      Below one of the IV's.

    • C.

      From an ankle vein.

    • D.

      From one of the IV's.

    Correct Answer
    B. Below one of the IV's.
    Explanation
    When a patient has IVs in both arms, it is best to collect a protime specimen from below one of the IVs. This is because collecting the specimen above the IV may cause contamination of the sample with fluids from the IV line. Collecting from an ankle vein may not be practical or necessary in this situation. Collecting from one of the IVs may also lead to contamination or difficulty in obtaining an accurate sample. Therefore, collecting the specimen below one of the IVs is the most appropriate option.

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  • 50. 

    A phlebotomist must collect a hemoglobin specimen from a patient in the ICU. There is an IV in the patient's left wrist. There is no suitable antecubital vein or hand vein in the right arm. What should the phlebotomist do?

    • A.

      Ask another phlebotomist to collect it.

    • B.

      Collect it from a leg, ankle, or foot vein.

    • C.

      Draw it from a hand vein below the IV.

    • D.

      Perform a fingerstick on the right hand.

    Correct Answer
    D. Perform a fingerstick on the right hand.
    Explanation
    In this scenario, the phlebotomist is unable to collect a hemoglobin specimen from the patient's left arm due to the IV. Since there are no suitable veins in the right arm, the phlebotomist should consider alternative options. Performing a fingerstick on the right hand allows for the collection of a small amount of blood, which is sufficient for a hemoglobin test. This method is less invasive and can be easily done without interfering with the IV or causing discomfort to the patient.

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