PROCEDURE 1
It is not a good idea to collect a CBC specimen from a screaming infanct beacuse the
a) spexcimen will be more likely to hemolyze
b) specimen will be hemoconcentrated
c) white blood count may be falsely elevated
d) platelets are more likely to clump
C- White blood count may be falsely elevated.
Indicies, MCV and MCHC are all processed in which department and in which additve is used to obtain?
a) EDTA (Pink) and Blood bank
b) EDTA (Lavender) and Hematology
c) Thixotropic Gel (SST) and Chemistry
d) Plain Tube (Red) and Serology
B- EDTA (Lavender) and Hematology
Kandace has attempted twice to draw a partial thromboplastin (PTT) time specimen from Naomi Green, who has difficult veins. Both times Kandace has been able to draw only a partial tube. What should the Kandace do?
a) pour the two tubes together and mix well
b) submit the fullest tube for testing
c) have another phlebtomist attempt to draw the specimen
d) Collect the specimen by skin puncture
C- have another phlebotomist attempt to draw the specimen
You must draw a Protime specimen from a pt with IVs in both arms. Which of the following is the best thing to do?
a) Draw the specimen above an IV
b) Draw the specimen from an IV
c) Draw the specimen from an ankle vein
d) Draw the specimen below an IV
D- Draw the specimen below an IV
Tattooed areas should be avoided as venipuncture sites because:
a- there could be an undetected infection in the area
b- fresh tattoo sites may be more prone to infection
c- tattoos can mask an adverse reactoin to the draw
d- All of the above
e- none of the above
D- all of the question is correct
2- part Question:
1) Which instance most closely resembles basal state?
a) A pt who has been lying down for an hour
b) A pt who has worked all night but did not eat at work
c) A pt who has just awakened at 0600 after fasting all night
d) A pt who has just arrivedfor a fasting blood test
2) You have no choice but to draw a specimen from a site with a hematoma. Where should you obtain the specimen?
a) None of the options is correct
b) Proximal to the hematoma
c) Distal to the hematoma
d) In the area of the hematoma
1) -C- A pt who has just awakened at 0600 after fasting all night
2) C- Distal to the hematoma
2- part question:
1) Which test below is drawn in a lavender-top, however, it is processed in chemistry department?
a) MCH
b) Hgb A1c
c) Hct
d) PLT
2) Which test below is used to check for allergies. What test and department will process.
a) Diff and hematology
b) Eos and hematology
c) CBC and hematology
d) ESR and hematology
1)-B- Hgb A1c ( pg. 524)
2)- B- Eos and hematology
2-part question:
1) If a pt is complaining of sharp radiating pain from the needle insertion site, the phlebotomist should:
a) immediately terminate the venipuncture
b) tell the pt the pain will stop soon
c) apologize to the pt and and continue
d) give the pt an ice pack after the draw
2) A tube fails to fill with blood during a venipuncture. Which of the following might lead you to think that the vein has collapsed?
a) the vein disappears when you engage the tube
b) there is a hissing sound as the tube is engaged
a hematoma quickly starts to form at the site
you sense a slight needle vibration or quiver
1) A- immediaely stop the venipuncture
2) A- there is a hissing sound as the tube is engaged
2-Part Question:
1) Which instance most closely resembles basal state?
a) A pt who has been lying down for an hour
b) A pt who has worked all night but did not eat at work
c) A pt who has just awakened at 0600 after fasting all night
d) A pt who has just arrived for a fasting blood test
2) When a test requires a fasting specimen, but the serum is ___, it is a clue that the pt was not fasting.
a) lipemic
b) hemoconcentrated
c) jaundice
d) hemolyzed
1) C- A pt who has just awakened at 0600 after fasting all night
2)- A- lipemic
2- part Question:
1- An arm that is paralyzed has:
a) no ability to fee pan
b) loss muscle function
c) damage to the nerves
d) all of the options are correct
2) Hand or fist pumping can increase blood potassium by___%.
a) 5
b) 10
c) 15
d) 20
1- B- Loss muscle function
2- D 20%
3- Part Question:
1)-Prolonged tourniquet application may cause a change in blood composition primarily becuasae of
a) hemoglobin
b) hemeostasis
c) hemolysis
d) hemoconcentration
2)-Which situation is the best way to tell that you may have accidentlly punctured an artery?
a) a hematoma starts to form
b) the blood obtained is dark red
c) there is no way to tell
d) the blood pulses into the tube
3) Some drugs have an affect on physiologic functions as well as blood analytes. Which of the following below is most affected due to oral contraceptives?
a) elevated ESR
b) decrease levels of B12
c) elevated calcium
d) A & B
e) B & C
a)
2) D- the blood pulses into the tube
3)- D- elevated ESR and decrease levels of B12
3 part Question:
1) Gonorrhea screen is done in which department:
a) Chemistry
b) Microbiology
c) Coagulation
d) Serology
2) TIBC, Fe is processed in which department:
a) Microbiology
b) Chemistry
c) Serology
d) Immunology
3) Which test below is a kidney function test and what department process the specimen.
a) SPEP and Coagualation
b) BUN and Chemistry
c) Renin and Chemistry
d) Phosporus and Serology
1) B- Microbiology
2) B- Chemistry (pg. 525)
3) B- BUN and Chemistry
3- part questions:
1) Petechiae appear on a pt.'s arm when the tourniquet is applied. This is an indication that the:
a) venipuncture site may bleed excessively
b) pt. is extremely anemic
c) arm should not be used for venipuncture
d) tourniquet is tied too tightly
2) Blood analytes show significant variation at higher elevations. Which of one test below is not affected by the higher elevation:
a) Hct
b) Hgb
c) Glucose
d) RBCs
3) True or False: Newborns' WBC and RBCs are lower than that of adults.
1) D- tourniquet is tied too tightly
2) C-Glucose
3) False (pg. 318)
3- Part Question:
1) Which of the following vascular access devices is placed in a peripheral vein for the purpose of blood collection and administration of medication?
a) PICC line
b) fistula
c) heparin lock
d) implanted port
2) Hemolysis can erroneously elevate:
a) ammonia
b) magnesium
c) all of the options are correct
d) potassium
3) Stress can affect many test results. However which test below is not affected by stress.
a) WBC
b) Catecholamines
c) Cortisol
d) RBC
1) C- heparin lock
2) C- all of the options are correct
3) D- RBC
3-part Question:
1)- There are ways to prevent hemoconcentration during venipuncture
a) Choose an appropriate pt vein
b) do not exxessively massage the area in locating a vein
c) Do not allow pt to pump the first
d) nonly of these are ttrue
e) all are true
2) True or False: One of the most common procedural errors that can cause hemolysis is drawing blood through an IV valve.
3) Which organization developed guidelines and sets standard for lab procedures:
a) CAP
b) CLSI
c) CLIAC
CDc
1- E all are true
2- True pg. 340
3- B- SLCI
4-Part Questions:
1) If blood is drawn too quickly from a small vein, the vein, the vein will have a tendency to:
a) collapse
b) bruise
c) disintegrate
d) roll
2) Exercise affects a number of blood components, raising levels of some blood componenets, which one of the test below would be affected?
a) Pancreatic enzymes
b) ESR
c) Arterial pH
d) WBCs
3) Which abnormality can cause Petechiae___
a) Thrombocytopenia
b) basal state
c) emesis
d) Iatrogenic
4)Sudden faintness or loss of consciousness caused by a nervous system response to abrupt pain, stress or trauma is a type of reflex syncope?
a) Latex Allergy
b) Excessive bleeding
c) Vasovagal
d) Antiseptic Allergy
2) Arterial pH
3) A- Thrombocytopenia
4) C- Vasovagal
3- part question:
1) True or false. All EDTA tubes are processed in Hematology Department
2) Which test below is not drawn with a Trace- element free tube:
a) Zinc
b) Chromium
c) Mercury
d) CBC
3) Which of the following tubes contains EDTA and thixotropic gel and what departments processes this tube?
a) RST and chemistry
b) PPT and chemistry
c) SST and Chemistry
d) PTT and Chemistry
1 False only lavender tubes are processed in hematology
2) D- CBC
3) B- PPT and Chemistry
4-part question:
1) Kebriya encounters problems during a draw and redirects the needle several times before obtaining blood. Which of the following tests will be most affected by this complication?
a) platelet count
b) prothrombin
c) total protein
d) hemoglobin
2) What additive is used to draw the specimen in question #1 and what department will process the specimen?
3) Eaven is processing an ova and parasites specimen, what department is Eaven working in today?
4) Arianna is working on the floor today, she is ordered to collect a DAT. What does DAT stand for and what department will process the specimen?
1) B- Prothrombin
2) Sodium Citrate and Coagulation department
3) Microbiology Department (pg. 37)
4) Direct antiglobulin test (pg. 38) and Blood bank & immunohematolgy test
4- Part Question:
1) Why do pregnant pts have lower reference ranges for RBCC?
a) the growing fetus uses up the mothers iron
b) Body fluid increases in pregnancy, diluting RBCs
c) Poor appetite leads to transient anemia
d) Constant nausea leads to hemoconcentration of the blood
2) Levels of which analyte can differ by 50% or more between morning and late afternoon?
a) Sodium
b) BUN
c) CBC
d) Cortisol
3) Tests influenced by diurnal variation are often ordered as ____ tests and it is important to collect them as close as possible to the time ordered.
a) postprandial
b) timed
c) fasting
d) STAT
4) There are many situation that can trigger hematoma formation. Which one below is not one of them.
a) The needle penetrates all the way through the vein
b) The vein is fragile or too small for the needle size
c) Pressure is not adequately applied following venipuncture
d) Ask the pt to release the fist upon blood flow
1)- B- Body fluid increases in pregnancy, diluting RBCs
2) D- Cortisol
3) A- postprandial
4) D- Ask the pt to release the first upon blood flow
3-part question:
1) The creatinine clearance rate decreases in elderly pts due to a normal decline in:
a) physical activity
b) hormone levels
c) kidney function
d) red blood cells
2) A perspn with liver disease may develop blood clotting problems because the liver:
a) filters toxins from the blood
b) produces coagulation factors
c) stores and secretes antibodies
d) remove fragmented RBCs
3) Which of the following are set up to monitor all areas of care that tend to cause problems?
a) Internal report forms
b) Quality indicators
c) Sentinel events
d) Threshold values
1) C-Kidney function
2) B- Produces coagulation factors
3) B- Quality Indicators
4- part Question:
1) A fistula is a
a) special winged infusion set left in a pt's arm
b) temporary fusion of an artery and a capillary
c) implanted port attached to an indwelling line
d) permanent fusion of an arterty and a vein
2) Blood loss to a point at which life cannot be sustained is called____.
a) Claw Hand
b) Exsanguination
c) Iatrogenic
d) Occluded
3) An arterial line is a catheter that is placed in an artery. It is commonly placed in the ____ artery.
a) Brachial
b) Radial
c) Carotid
d) femoral
4) Cholesterol level can increase up to ____% after 2 minutes of the tourniquet application and up to ___% after 5 minutes.
a) 2 and 15
b) 3 and 10
c) 5 and 15
d) 7 and 20
1) D- permanent fusion of an artery and a vein
2) B- Exsanguination
3) B- Radial (pg. 328)
4) c- 5% AND 15% 9
3- Part Question:
1)- TRUE or FALSE: According to the CLSI, trace elements in blood collection equipment may contaminate specimens for trace element test. However, syringes must be used to collected speciments with Colbalt and Chromium
2) Hematolgy processes _____ blood specimen
a) clotted
b) whole
c) plasmic
d) serology
3) Creatinine is drawn with what color tube___ and is processed in which depatment
1-False pg. 247
2- B-whole
3- Gold and Chemistry 521
4- part question:
1) What is the best way to prevent reflux of tube contents during a blood draw?
a) mix the tubes while they fill with blood
b) allow the tubes to fill from bottom up
c)collect tubes in the proper order of draw
d) keep the tourniquet on until the last tube
2) Cynthia is processing a urine specimen. What 3 areas of evaluation, will Cynthia be analyzing?
3) There are several common test ordered on geriatric patients. however, below there is one test that is not ordered.
a) PT/PTT
b) Electrolyte
c) IPEP
d) GC
4) There are several physiologic variables that can affect blood results. Which one below is not a variable that will affect the blood result?
a) Pregnancy
b) Smoking
c) Cold weather
d) Position
1) -B) allow the tubes to fill from bottom up
2) Physical, chemical and Microscopic evaluation (pg. 39)
3) D-GC (Gonorrhea culture) pg. 306
4) C- cold weather (pg. 324)
4- Part Questions:
1) How long before obtaining blood for testing should drugs known to interfere with blood tests be discontinued?
a) 1-4 hours
b) 4-24 hours
c) 24-36 hours
d) 48-72 hours
2) Which of the following blood components is influenced by diurnal rhythms, with results typically highest in the morning?
a) eosiniphils
b) cortisol
c) glucose
d) creatinine
3) Which of the following 3 tests are most affected by hemolysis?
a) digoxin, creatinine, theophylline
b) glucose, sodium, chloride
c) potassium, magnesium, CPK
d) carbon dioxide, calcium, BUN
4) Hemolyzed specimens can result from pt conditions such as____ but which test below is not affected.
a) liver disease
b) stomach ulcers
c) hemolytic anemia
d) transfusion reaction
1) B- 4-24 hours
2) B- Cortisol
3) C- Potassium, magnesium, CPK
4) B- Stomach ulcers
3- Part Questions:
1) An example of possible percutaneous infection transmission is:
a) rubbing your eyes with hands that are contaminated
b) splashing blood on ungloved, badly chapped hands
c) cutting yourself on glass from a broken blood tube
d) eating your lunch without first washing your hands
2) The waiting room is crowded and an outpatient had been standing for a prolonged period bedore being called into the drawing room. Of the following tests that are being collected, which will be least affected as a result?
a) potassium
b) Rh type
c) RBC count
d) cholesterol
3) True or False: Melatonin levels are affected by the night and increases in the day time
4)Blood components that exhibit diurnal variation with highest levels occuring in the morning, include all but____.
a) Aldosterone
b) Bilirubin
c) Hemoglobin
d) WBCs
1) C- cutting yourself on glass from a broken blood tube
2) B- Rh type
3) False: Melantonin levels ae affected by light, they increase at night when it is dark and decrease during the daylight (pg. 319)
4) D- WBCs (pgs. 319