Phlebotomy Essentials 5th Edition Ch 7

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Which blood specimen additive can inhibit the metabolism of glucose by the cells?

NaF

Which item is unnecessary when performing a routine venipuncture?

Skin disinfectant

If a serum specimen is requested, what is an evacuated tube that can be used to collect it?

SST

What are all anticoagulants that remove calcium from the specimen by forming insoluble calcium salts and therefore preventing coagulation?

Sodium citrate, EDTA, oxalate

In a successful venipuncture, evacuated tubes fill automatically as soon as the stopper is pierced because of what?

Pre-measured vacuum in each tube

Lavender-stopper tubes are most commonly used to collect?

Hematology Tubes

What is one reason that the ETS is the preferred blood collection system?

Exposure of the blood to contaminants is avoided

Lithium heparin is a suitable anticoagulant for which test?

Lytes

What additive can be found in a royal blue-stopped collection tube?

EDTA

Measurement of copper, a trace element, requires blood collection in a tube with a?

Royal-blue top

The blood-to-additive ratio is most critical for a specimen collected in what tube?

Light-blue top

If phlebotomists have dermatitis, they should?

Wear a barrier hand cream or lotion

Decontamination of the hands after glove removal is essential because?

Hand contamination might not be visible to the naked eye

Which of the following is a disinfectant?

Household bleach

What is a disinfectant is preferred by the HICPAC for use on surfaces and instruments?

EPA-registered sodium hypochlorite product

After a blood spill, a disinfectant is applied and must have at least how many minutes of contact time for cleanup to be effective?

10 Minutes

If hands are heavily contaminated with organic material and a sink is not available, the phlebotomist should clean them with?

Detergent-containing wipes followed by sanitizer

The purpose of a transiliumination device is to?

Locate veins for venipuncture

Which statement is incorrect? A properly applied tourniquet should: Distend or inflate the veins of choice, Make veins larger and easier to find, Restrict venous and arterial blood flow, Stretch vein walls so that they are thinner.

Restrict venous and arterial blood flow

What gauge needle is used primarily for infant or child veins, & difficult or hard veins of adults?

23

Needle safety features work by?

All of the above...Covering or shielding the needle, retracting the needle after the use, using a device to blunt the needle

OSHA regulations require that after use:

Tube holders with needles attached be disposed of as a unit.

The head space in an evacuated tube is:

A consistent amount of airspace left when a tube is filled properly

Tubes designed by the manufacturer to be "short draw" are:

Made to fill only partially

Types of ETS tube additives include

All of the following: Anticoagulants, Clot activators, Separator gels

Plastic red-top tubes used to collect blood specimens usually contain:

Clot activators

Improper handling or storage of evacuated tubes can affect:

All of the above: Additive integrity, the shape of the tube, the vacuum of a tube

Which test can be affected by cross-contamination from a light blue top tube?

Calcium

Which of the following tests could be affected by carryover from an EDTA tube?

Creatine kinase

Which of the following additives is least likely to affect an alkaline phosphatase test?

Heparin

Carryover of this additive is unlikely to affect a partial thromboplastin time:

Naf

This antiseptic has been traditionally used to obtain the high degree of skin antisepsis required when blood cultures are being collected:

Povidone-iodine

Which of the following is the preferred solution to use to clean up blood spills?

An EPA-approved bleach product

Antiseptics are:

Safe for use on human skin

A solution used to clean the site before routine venipuncture is?

70% isopropyl alcohol

Why are gauze pads a better choice than cotton balls for covering the site and holding pressure following venipuncture?

Cotton ball fibers can stick to the site

CLSI standards advise against using these on infants and children under 2 years old:

Adhesive bandages

It is best if tourniquets are:

Used once and then discarded

Wearing gloves during phlebotomy procedures is mandated by the following agency:

OSHA

What criterion is used to decide which needle gauge to use for venipuncture?

Size and condition of the vein

To what does the "gauge" of a needle relate?

Diameter

Which needle gauge has the largest bore or lumen

18

Multi-sample needles are typically available in these gauges:

20-22

The slanted tip of a needle is called the:

Bevel

The purpose of the rubber sleeve that covers the tube end of a multiple-sample needle is to:

Prevent leakage of blood during tube changes

A phlebotomy needle that does not have a safety feature:

Must be used with a holder that has a safety feature

Which of the following plays no role in deciding what size tubes to use for ETS blood collection?

Patient's allergy to antisptics

Mixing additive tubes properly involves:

Turning the wrist 180 degrees and back

Which of the following stopper colors identifies a tube used for coagulation testing?

Light blue

Which of the following tubes will yield a serum sample?

Red top

The cleaning agent in hand sanitizers used in healthcare is?

Alcohol-based

Which of the following tube stopper colors indicates something other than the presence (or absence) and type of additive in the tube?

Royal blue

Heparin prevents blood from clotting by:

Inhibiting thrombin

Which department would most likely perform the test on a specimen collected in an SPS tube?

Microbiology

A tube with a royal-blue top with lavender color coding on the label contains:

EDTA

Which one of the following substances is anticoagulant?

Oxalate

It's important to fill oxalate tubes to the stated fill capacity because excess oxalate:

Causes hemolysis of blood specimens

Which of the following substances is contained in a serum separator tube?

Thixotropic gel

What is the purpose of an antiglycolytic agent?

It preserves glucose

Glass particles present in serum separator tubes:

Activate clotting

Which is the best tube for collecting an ETOH (ethanol) specimen?

Gray Top

Identify the tubes needed to collect a CBC, PTT, & STAT potassium by color and in the proper order of collection for a multi-tube draw:

Light-blue top, green top, lavender top

During venipuncture the tourniquet should not be left on longer than:

1 Minute

This test is collected in a tube with a light-blue top:

Blood culture tube

This test is collected in a tube with a light-blue top:

Prothrombin time

Which of the following STAT tests is typically collected in a lithium heparin tube?

Electrolyte panel

This tube stopper color indicates that the tube contains EDTA:

Lavender

What anticoagulant is contained in a plasma separator tube (PST)

Heparin

The purpose of sodium citrate in a specimen collection is to:

Protect coagulation factors

The part of a syringe that shows measurements in cc or ml is called the:

Barrel

This part of the evacuated tube holder is meant to aid in smooth tube removal:

Flange

The best choice of equipment for drawing difficult veins is a:

Butterfly and ETS holder

Mixing equipment from different manufacturers can result in:

Improper fit of the needle

You are most likely to increase the chance of hemolyzing a specimen if you use a:

25 gauge butterfly needle to collect a specimen from a small child

The purpose of a tourniquet in the venipuncture procedure is to:

Enlarge veins so they are easier to find and enter

If a blood pressure cuff is used for venipuncture in place of a tourniquet, the pressure used must be:

Below the patient's diastolic pressure

In general, an anticoagulant is unable to:

Inhibit the metabolism of glucose

Needle safety devices must:

Create a barrier between a user's hand and the needle after use.

This gel separator tube contains EDTA:

PPT

Which additive contains a substance that inhibits phagocytosis of bacteria by white blood cells?

Sodium polyanethol sulfonate

Which type of test is most affected by tissue thromboplastin contamination?

Coagulation

Which of the following tests would be most affected by carryover of K2EDTA?

Potassium

What is the fewest number of tubes needed to collect a CBC and protime when using a butterfly on a patient who is a difficult draw?

3

A trace elements specimen tube should be collected:

Separately or by syringe

A pink-top tube containing EDTA is primarily used for:

Blood bank tests

Identify the tubes needed to collect a PT, STAT, Lytes, and BC in the proper order of collection:

Yellow, light blue, PST

Which one of the following tubes is additive-free

Red glass

A tube with this stopper color could contain either of two different forms of an anticoagulant salt?

Green

Which additive can be found in four separate tubes with different stopper colors?

EDTA

Which stopper color is the same for two completely different types of additives used by two different departments?

Yellow

How many tubes with different-colored stoppers can sometimes go to the chemistry department?

12

Which of the following additives is most commonly used for chemistry tests?

Heparin

An ETS holder and a syringe transfer device look very similar. What is the difference between the two?

There is a permanently attached needle with a sleeve inside the transfer device

A prothrombin time (PT) & platelet count are ordered on an 80-year-old female patient. Deciding to use a butterfly and "short draw" evacuated tubes on a tiny cephalic vein on the side of her right arm, the phlebotomist collects one light blue-top tube and then a lavender-top tube. Why would you suspect that the PT test results might be incorrect and the platelet count unaffected?

No tube was drawn to remove air in the butterfly tubing

A home care phlebotomist had a requisition to collect a complete blood count (CBC), plasma K, partial thromboplastin time (PTT), and prothrombin time (PT). He collected the tubes from the client, who was lying on the sofa with her arm elevated above her shoulder on a table next to the sofa. As he collected the tests in the following order-CBC, K, & finally the PT & PTT-he was careful to invert the tubes as required. Later that day, the lab called the phlebotomist to say that three of the tests would have to be redrawn. Which three test most likely had questionable results and needed to redrawn?

Potassium, PTT, and PT

While collecting a stat blood culture and electrolytes on a child in the emergency room, the phlebotomist was asked by the physician to get an extra tube of blood to check for metal poisoning. Which one of the following tubes would the phlebotmist add to the ones already being collected?

Royal Blue

Which one of the following tubes/additives is sometimes used to collect DNA tests?

Yellow/ACD

Electrolytes should never be collected in a:

Gray-top tube

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