260 terms

Phlebotomy final

an inert synthetic substance that forms a physical barrier between the cells and serum or plasma of a specimen is known as....
the tests performed in the following department are typically collected in a tube with a light blue stopper
the head space in an evacuated tube is:
a consistent amount of airspace left when a tube is filled properly
What additive is usally present in a tube with a lavender stopper?
Which of the following 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 tube stopper is pierced because of
premeasured vacuum in each tube
What substance is contained in a serum separator tube?
Thixotropic gel
the type of needle used to collect blood from small or difficult veins is known as a
winged infusion set or butterfly
identify the tubes needed to collect a CBC, PTT, and STAT potassium by color and in the proper order of collection for a multitube draw
light-blue top, green top, lavender top
substances that provide increased surface for platelet activation are known as
clot activators
which is the best tube for collecting an ethanol speciment
sodium fluoride
what is the most important factor in choosing which gauge needle to use for venipuncture?
size and condition of the vein
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
heparin prevents blood from clotting by
inhibiting thrombin
if the blood pressure cuff is used for venipuncture in place of a tourniquet, the pressure used must be:
below the patient's diastolic pressure
you are most likely to increase the chance of hemolyzing a specimen if you use a
25 guage butterfly needle to collect a speciman from a small child
an antiglycholytic agent
prevents the breakdown of glucose
evacuated tubes fill with blood automatically because a ______ exists in the tube
which blood speciman additive can inhibit the metabolism of glucose by the cells
a pink top tube containing EDTA is primarily used for:
blood bank tests
measurement of copper, a trace element, requires blood collection in a tube with :
royal-blue top
a tube with a green stopper usually contains
plastic red-top tubes used to collect blood specimens usually contain
clot activators
lithium heparin is a suitable anticoaglulant for which test?
Which of the following basic tissue types covers and lines organs, vessels, and cavities..
Which of the following are basic structural components found inside cells?
-All of the above
The glomerulus is a tuft of capillaries located in the kidney. It filters the blood for the urinary system.
The transvers plane divides the body
horizontally into upper and lower portions
during internal respiration
oxygen enters the cells in the tissue
The exchange of O2 and CO2 in the lungs takes place in the ?
Which body plane divides the body into equal portions
Which of the following is a function of the urinary system?
-to maintain electrolyte balance
-to return tissue fluid to the blood
-to receive environmental stimuli
-to remove CO2 from the body
-to maintain electrolyte balance
hematopoiesis is a function of the _______ system
there are no hormones produced by the organs of the reproductive system
Which of the following is normally a urinary system disorder
Which of the following is a test of the urinary system?
-creatinine clearance
-creatine kinase
-creatinine clearance
T/F the pituitary gland is often called the "master gland" of the endocrine
another name for the blood bank is
The ability of the body to repair and maintain itself to achieve a "steady state" defines what term?
The transverse plane divides the body
a nearest to the point of attachment
Which of the following is a test of the respiratory system?
T/F the peripheral nervous system is composed of the brain and spinal cord
Hepatitis is a disorder that primarily affects the
Which of the following structures in the skin give rise to fingerprints
pancreatitis is a disorder of the ______ system
Growth hormone (GH) levels test the function of the?
Diagnostic test of the digestive system include
amylase and lipase
The spinal cord and brain are covered by protective membranes called
Which of the following is a nervous system disorder
-acute nephritis
-multiple sclerosis
-chronic hepatitis
-rheumatoid arthritis
-multiple sclerosis
The medical term for elevated blood sugar is:
sudoriferous glands are:
referred to as sweat glands
the term that describes a person having difficulty breathing
The layers of the skin containing blood vessels are
dermis and subcutaneous
T/F the pancreas is considered an accessory organ in the digestive system as well as an endocrine organ
The gland produces "figh or flight" hormones
adrenal gland
evaluation of the endocrine system involves
hormone determinations
a major cause of respiratory distress in infants and young children is
respiratory and syncytial virus
when you are facing someone in normal anatomic position, at which body plane are you looking
Which of the following are respiratory system structures
-bronchioles, epiglottis, pleura
-neurons, meniges, myelin sheath
-calcaneus, mandible, phalanges
-corium, corneum, adipose cells
-bronchioles, epiglottis, pleura
most gas exchange between blood and tissue takes place in the
what kind of muscle is under voluntary control
the avascular layer of the skin is the
the term distal means:
farthest from the point of attachment
which of the following of an accessory organ of the digestive system
The singular form of alveoli is
What word means "hardening of the artery?
a prefix
-modifies the meaning of a term
-precedes the word root
-adds information about a term
-all of the above are correct
-all of the above are correct
which of the following are abbreviations for lab tests
Which of the following abbreviations identifies a type of blood cell
Which of the following word parts is a prefix
what does the suffix -algia mean
which part of cardiomyopathy means "disease"
What is the medical term for red blood cell
the combining form erythro means
what is the suffix in the term "lipase"
what is the term for muscle pain?
cystitis means
inflammation of the bladder
all of the following are included on the Joint commission "do not use" list except
if a suffix is added to a word root that ends in "x", the "x" changes to a/an
g or c
What word is used to describe the breadown of red blood cells
what word part means recording or writing
The Joint commission "do not use" list applies to all of the following except?
-handwritten medication orders
-writing on preprinted forms
-electronic laboratory reports
-handwritten laboratory reports
-electronic laboratory reports
which part of gastr/o/enter/o/logy is the suffix?
what is the meaning of the word root in the term hyperglycemia
The abbreviation NPO means
nothing by mouth
what word means "large cell"
the word elements of the term "polycythemia" mean
blood condition of many cells
what is the word root in the word "electrocardiogram"
The "c" sounds like an "s" in which of the following terms
what part of the term "osteochondritis" is the suffix
what is the medical term from white blood cell
only the second vowel of the ending is pronounced in the word
to what part of the body does the word root hepat refer?
what term means kidney inflammation
The balance or "steady state" of the body is called?
the letter "g" is pronounced like a "j" in
The abbreviation "ESR" means
erythrocyte sedimentation rate
which of the follwing abbreviations is on the current Joint Commission "Do Not use" list?
what does the suffix of the term "glycolysis" mean
what is the word root for vessel
what word means "controlling blood flow"
according to the meanings of its word parts, phlebotomy means
cutting a vien
what word part means "blood condition"?
What word means "condition of clotting"?
The study of a persons concept and use of space is known as
Another name for blood bank is
T/F A phlebotomist who gets the specimen for the doctor even if he or she must take shortcuts and save time is exhibiting integrity.
Which of the following is an example of a confirming response to a patient?
I understand how you must be feeling
T/F Acknowledging a patients beliefs, customs, knowledge, and attitudes exemplifies diversity awareness
The term "phlebotomy" is derived from Greek words that, literally translated, mean
vein incision
Promoting good public relations is a part of the phlebotomist's role because
-good public relations promotes a harmonious relationship with the staff
-a phlebotomist is a representative of the laboratory throughout the facility
-patients often equate venipuncture experiences with the overall hospital care
What is referred to as a medical laboratory scientist?
Medical technologist
Which duty is not performed by local public health agencies
-immunization and vaccination
-venereal disease screening
-licensure of healthcare personnel
-diabetes screening
-licensure of healthcare personnel
The term used to describe sophisticated and highly complex medical care is
tertiary care
proof of participation in workshops to upgrade skills required by some agencies to renew certification is called
Outpatient phlebotomy, such as in a physiciann's office or patient care service center, will be assigned a code for reimbursement using which national coding system
What are the crednetials for an ASCP-certified phlebotomist
Which of the following is an example of a barrier to effective communication with a patient? the patient....
-is emotionally upset
-does not speak English
-is a very young child
-all of the answers are correct
-all of the answers are correct
Which of the following communicates unprofessionalism
-short, clean fingernails
-clean laboratory coat
-long hair pulled back
-intense odor of cologne
-intense odor of cologne
T/F the area of the lab where testing involving infectious diseases and the immune process is performed is called immunohematology
Patients who can get to the lab or doctor's office on their own are called _______.
Which of the following is an example of negative kinesics.
-eye contact
It is improper telephone protocol to:
hang up on angry callers
Electrolyte testing includes
sodium, potassium
Which department is responsible for administering oxygen therapy
Respiratory therapy
with with other hospital department would the laboratory coordinate therapeutic drug monitory
The term used when blood is withdrawn to a dangerous or deadly limit is _______
The federal law that defines the responsibilities of medical laboratory personnel is the______
Which of the following is NOT a phlebotomists duty?
-collecting blood specimens
-transporting specimens to the laboratory
-starting intravenous (IV) lines
-Performing laboratory computer operations
-starting intravenous (IV) lines
A clinical laboratory "path of workflow" is all of the following EXCEPT
-monitored throughout the process by quality indicators
-made up of preanalytical, analytical, and postanalytical processes
-overseen by the hospital administrator through periodic reports
-defined as the steps necessary to deliver a product or services
-overseen by the hospital administrator through periodic reports
T/F As healthcare providers go about their daily activities, there are many activities that , if performed without reasonable care and skill, could result in a lawsuit.
Which action will compromise the quality of a specimen?
- mixing a serum separator tube five times
- partially filling a liquid EDTA tube
-placing a cold agglutinin in a heat block
-drawing electrolytes in an amber tube
- partially filling a liquid EDTA tube
The only phlebotomist in an outpatient drawing center is not familiar with the test that a physician has ordered. What is the most appropriate action to take?
refer to the collection manual for instruction
T/F a good way to avoid lawsuits is to consistently perform venipunctures as rapidly as possible so as to get the results to the physician quickly
A national organization that sets standards for phlebotomy procedures is the
Three of the following conditions are reasons a specimen could be rejected for analysis EXCEPT
-a bilirubin specimen is icteric
- a CBC specimen contains clots
-an electrolyte specimen is hemolyzed
-a fasting glucose specimen is lipemic
-a bilirubin specimen is icteric
The purpose of the Joint Commission's Office of Quality Monitoring is to:
-inspect helathcare facilities for accreditation
-evaluate and track complaints related to care
-implememnt immediate response to safety issues
-set specific patient safety goals to improve care
-evaluate and track complaints related to care
A specimen was mislabeled on the floor. The phlebotomist is required to fill out an incident report form. What information is NOT part of the report?
-explanation of the problem
-details of the corrective action taken
-suggestion for new guidelines
-description of the consequence
-suggestion for new guidelines
Malpractice is a claim of
-invasion of privacy
-improper treatment
-assault and battery
-breach of confidentiality
-improper treatment
________ emphasize quality assurance in collecting and performing blood work using waived testing kits.
T/F labeling of a specimen must be exact
An example of a QA indicator is
The blood culture contamination rate will not exceed the national rate
Two phlebotomists are discussing a patient's condition in the elevator. They are overheard by the patient's daughter. This is an example of:
invasion of privacy
Some test specimens require immediate cooling in ice and water slurry to
slow down metabolic processes
If a phlebotomist ______, he or she is negligent
fails to put the needle and holder in the sharps container
When the threshold value of a clinical indicator of QA is exceeded and a problem is identified
a corrective action plan is implemented
Which one of the following examples is unrelated to quality control
employees filling out their time sheets daily
one of the key players in bringing quality assessment review techniques to healthcare is the ______
Joint Commission
chilling will adversely affect the quality of test results for which analyte?
Which one of the following is NOT included in the various phases of malpractice litigation
-a healthcare institution is informed of an injury to a patient
-depositions are given while a court reporter records every word
-appeal of the jury decision is begun by the losing party
- a complaint against the defendant is filed by the plaintiff
-a healthcare institution is informed of an injury to a patient
Drawing a patient's blood without his or her permission can result in a charge of
assault and battery
The "standard of care" in the practice of phlebotomy is influenced by which of the following organizations?
-the Environmental Protection Agency
-the health insurance privacy agency
-the U.S. Food and Drug Administration
-The Joint Commission
-The Joint Commission
Which of the following would NOT violate a patient's right to confidentiality
-listing all HIV+ patients in the laboratory computer
-Sharing collection site information on a difficult patient
-indicating the nature of a patients diseas on the door
-tracking a patient's laboratory results on the bulletin board
-Sharing collection site information on a difficult patient
The joint commissions Sentinel Event QI program policy is designed to do all of the following EXCEPT
-improve the safety of patients in healthcare institutions
-identify unfavorable events for immediate investigation
-prevent unfavorable events from happening again
-demonstrate flexibility in setting QC measures
-demonstrate flexibility in setting QC measures
A global nonprofit, standards-developing organization with representatives from the profession, industry, and government who use a consensus process to develop voluntary guidelines and standards for all areas of the laboratory is _______
The abbreviation for the Centers for Disease Control and Prevention is _______.
Occupational exposure to bloodborne pathogens can occur if which of the following happens while the healthcare worker is performing his or her duties
-body fluids splash into the mouth
-blood comes in contact with a cut
-a human bite breaks the skin
-all of the above
all of the above
The needlestick safety and prevention act directed OSHA to revise the BBP standard in all of the following areas except
-availability of vaccination against HBV for all employees
-modification of definitions relating to engineering controls
-new requirements for record-keeping for all needle sticks
-obtaining employee input in selecting engineering controls
-availability of vaccination against HBV for all employees
T/F a class A fire occurs when flammable liquids are involved
In what instance might a patient be placed in protective isolation
the patient has severe burns
What is the proper order for putting on protective clothing
Gown first, then mask, gloves last
Which type of contact infection transmission involves transer of an infective microbe to the mucous membranes of a susceptible individual by means of a cough or sneeze?
Which of the following is an example of a work practice control that reduces risk of exposure to bloodborne pathogens?
Hand decontamination
Which of the following is NOT one of the code words in the NFPA order of action in the event of fire?
Examples of nosocomial infections include
when a catheter site of a patient in ICU becomes infected
T/F Sterile gloves must be used when collecting and handling blood specimens
Which of the following is an example of a means of transmission that differs from parental transmission
-drinking water from a contaminated glass
-touching infectious material with chapped hands
-rubbing an eye with a contaminated hand
-getting stuck by a needle used on an AIDS patient
-drinking water from a contaminated glass
According to standard first aid procedures, severe external bleeding is best controlled by
applying direct pressure
The most important means of breaking the chain of infections is
hand washing
vaccination against HBV involves
a dose of vaccine, another 1 month later, and a final dose 6 months later
Federal law requires that hepatitis B vaccination be made available to employees assigned to duties with occupation exposure risk
within 10 working days of initial assignment
the purpose of "protective" isolation is to
protect susceptible patients from outside contamination
T/F applying lip-balm in the lab is acceptable when an employee has chapped lips
The main principles involved in radiation exposure are
exposure time, distance, and shielding
T/F eating fresh vegetables and whole grains can help a person stay healthy
Class C fires
involve electrical equipment
What is the first thing the phlebotomist should do in the event of an accidental needlestick
decontaminate the site and fill out an incident report
The abbreviation PPE stands for
personal protective equipment
The OSHA HAZCOM Standard is also commonly called the
Righ to know law
An example of employee screening for infection control is
PPD testing
The most common needle size for routine radial ABG specimen collection is
22 gauge
The artery of choice for ABG collection
When performing the Allen test which artery is released first
Which of the following is the most common arterial puncture complication even when proper technique is used?
Which of the following patients would be considered to be in a "steady state" ABG specimen collection
a patient who has been asleep for 30 minutes while breathing room air
T/F ABG syringes are usually pretreated with EDTA to prevent clotting
A fistula is
a permanent fusion of an artery and vein
If you have no choice but to collect a specimen from an arm with hematoma, collect the specimen
distal to it
When a blood speciman es collected from a heparin lock, it is important to draw:
a 5-ml discard tube before the specimen tubes are filled
How long before obtaining blood for testing should drugs known to interfere with blood tests be discontinues
4-24 hours
Levels of this analyte can differ by 50% or more between morning and later afternoon
Lipemia results from
high fat content of the blood
which of the following veins is often the easiest to feel on obese patients?
small nonraised red spots appear on the patient's skin below where the tourniquet has just been tied. What are they and what causes them?
petechiae, due to capillary or platelet defects
the preanalytical phase of the testing process begins for the laboratory when a:
test is ordered by a patients physician
venous stasis is
stoppage of the normal venous blood flow
when a test requires a fasting specimen, but the serum is ______, it is a clue that the patient was not fasting
which instance most cloesly resembles basal state? a patients who has
-worked all nigh but did not eat at work
-just arrived for a fasting blood test
-just awakened at 0600 after fasting all night
-been lying down for an hour
-just awakened at 0600 after fasting all night
what vascular access device is placed in a peripheral vein for the purpose of blood collection and administration of medication?
heparin lock
why do pregnant patients have lower reference ranges for red blood cell counts
body fluid increases in pregnancy, dilute red blood cells
how many times do you mix non-aditive tubes
there is a request to draw a specimen from an inpatient by the name of John Doe. Which of the following is an acceptable way to confirm the patients identity
match the ID band and requisition with his verbal statement of ID
where is the tourniquet applied when drawing a hand vein
proximal to the wrist bone
tests are classified as routine if they are ordered
in the course of establishing a diagnosis
bending the arm up to apply pressure to the site after venipuncture has been shown to:
increase the possibility of bruising and hematoma formation
when is the best time to release the tourniquet during venipuncture
as soon as blood begins to flow into the tube
what is the proper arm position for routine venipunture
downward in a straight line from shoulder to wrist, palm up
it is important to mix anticoagulant tubes immediately after filling them to:
avoid microclot formation
according to CLSI, the maximum time limit for separating serum or plasma from cells is
2 hours
this is a source of preanalytical error that occurs before specimen collection
misidentified patient
applications software called "middleware"
accepts data downloaded from POC instruments
Transferring specimens into aliquot tubs has inherent risks. Which of the following involves the least risk?
-aerosols created during transfer
-aliquot tubes that are pre-labeled
-serum and plama's similar color
-specimens that are biohazardous
-aliquot tubes that are pre-labeled
which of the following specimens are least likely to require special handling
-bilirubin and serum folate
-cholesterol and uric acid
-gastrin and lactic acid
-homocystenine and renin
-cholesterol and uric acid
T/F Glycolysis by erythrocytes and leukocytes in blood specimans can lower glucose values at a rate of up to 20 mg/dL per hour
Which of the follwing collection circumstances is least likely to result in delayed clotting of serum sample
-collection was difficult, hemolyzing red cells
-patient has an elevated white blood cell count
-patient is taking an anticoagulant medication
-specimen is chilled soon after being collected
-collection was difficult, hemolyzing red cells
transporting blood specimens with the stopper up has nothing to do with
maintaining the sterility of the sample
to avoid airborne infection while processing specimens
cover the tube stoppers with guaze to remove them
ESR determinations on specimens held at room temperature must be made within:
4 hours
Which of the following specimens needs to be chilled?
-cold agglutinin
-serum protein
which one of the following describes proper aliquot preparation?
-immediately covering aliquot tubes after transferring the specimen
-lableling tubes after pipetting the sample into the aliquot tube
-pouring plasma from different additive tubes into one aliquot tube
-pouring samples into aliquot tubes instad of using transfer pipettes
-immediately covering aliquot tubes after transferring the specimen
which of the following should never be used to prevent exposure to airosols generated when the stopper is removed from a specimen tube?
covering the stopper with a 4x4 inch gauze while removing it
-removing the stopper with the tube held behind a shield
using a specially designed safety stopper removal devices
-withdrawing the specimen through the stopper by syringe
-withdrawing the specimen through the stopper by syringe
which one of the following represents improper aliquot preparation
-removing the stopper behind a splash shield
-carefully pouring the contents into the aliquot tube
-covering or capping the aliquot tube immediately
-none of the above
-carefully pouring the contents into the aliquot tube
which specimen can be centrifuged immediately upon arrival in specimen processing
calcium in a green top tube
a pneumatic tube is a
pressurized air transportation system
when performing a GTT, the timing should begin
as soon as the patient finishes the drink
which of the following tests may require special "chain of custody" documentation when collected?
-blood culture
-drug screen
drug screen
to prevent introducing a contaminating substance into a trace-element collection tube, it is suggested that the phlebotomist
draw it by itself using a syringe or evacuated tube system
the point of care testing instrument has recently been recognized as an accurate predictor of developing diabetic complications
DCA Vantage
at what intevals is the blood blotted during a bleeding time test
30 seconds
the correct order in collecting a blood culture is
select equipment, perform friction scrub, cleanse bottle tops, perform venipuncture
what coagulation tests can be monitored using a POC instrument
why would blood cultures be collected with an antimicrobial absorbing resis
the patient has fever spikes for more than a week
What is the recommended disinfectant for blood culture sites in infants 2 months and older
chlorhexidine gluconate
what test requires strict skin antisepsis procedures before specimen collection
Blood culture
what type of additive is recommended for collecting an ethanol test specimen
sodium fluoride
all POC glucose analyzers approved for hospital use have which of the following in common?
-the ability to use capillary, venous, or arterial blood samples
-data can be downloaded to a data management program
-they require the use of an authorized operator ID number
-all of the answers are correct
-all of the answers are correct
TDM is used by physicians to
determine a beneficial drug dosage for a patient
In using a cell-salvaging procedure during surger, what analyte must be evaluated before the patient's blood can be reinfusted
free hemoglobulin
which type of speciman may require collection of a discard tube before the test specimen is collected
what type of additive is best for collecting an ethanol specimen
sodium fluoride
which test is used to monitor heparin therapy
an antibiotic susceptibility test determines which antibiotics
are effective against a particular microbe
what test requires a 24-hour urine specimen
creatinine clearance
what type of specimen must be protected from light
amniotic fluid
a first morning specimen is preferred for hCG testing because it is
typically more concentrated
a test that identifies bacteria and the antibiotics that can be used against them is the
C&S test
what additional information is typically required when lasbeling a nonblood specimen
specimen type and source
which fluid is aspirated from the peritoneal cavity
which microcollection container would be used to collect a speciman for a CBC
purple top
which of the following patient conditions would make capillary puncture a good choice for specimen collection
iatrogenic anemia
you need to collect blood cultures, and green, light blue, and purple top tubes on an adult with difficult veins. Which of these can be collected by skin puncture.
green top and purple top
why are EDTA specimens obtained before other specimens when collected by skin puncture
to minimize effects of platelet clumping
what is the safest area of an infants foot to puncture during a capillary puncture
medial plantar heel
for accurate results, the heel must be warmed before collecting a cappillary specimen for this test
Definition for Pulmonary function test
which statement concerning microhematocrit tubes is INCORRECT
-they are coated with lithium heparin
-they are filled using capillary action
-they are narrow-bore capillary tubes
-they are used for PCV determination
-they are coated with lithium heparin
Hemolysis of a capillary specimen can erroneously elevate results for what test
if collected by capillary puncture, which of the following specimens should be collected in an amber microtube
which test MUST be collected by venipuncture
blood culture
Capillary puncture blood reference ranges are higher for what analyte