Pre-examination Pre-analytic
Prolonged tourniquet application may cause a change in blood composition primarily because of:
A) hemoconcentration.
B) hemoglobin.
C) hemolysis.
D) homeostasis.
A) hemoconcentration.
What is the Clinical and Laboratory Standards Institute (CLSI) recommended maximum depth of heel puncture?
A) 1.0 mm
B) 1.4 mm
C) 2.0 mm
D) 2.4 mm
C) 2.0 mm
Capillary bilirubin specimens require protection from ____________ so they are typically collected in amber microtubes.
light
Which of the following tests requires strict skin antisepsis procedures before specimen collection?
A) Blood culture
B) Blood urea nitrogen
C) Complete blood count
D) Type and crossmatch
A) Blood culture
Removing blood on a regular basis or in large amounts can lead to ________________ anemia.
iatrogenic
Which of the following tubes can be used to collect blood for a type and crossmatch?
A) ETS gray top
B) Pink top
C) Royal blue top
D) Gel barrier
B) Pink top
You have no choice but to draw a specimen from an antecubital area with a hematoma. Where should you obtain the specimen?
A) Distal to the hematoma
B) In the area of the hematoma
C) Proximal to the hematoma
D) None of these is correct.
A) Distal to the hematoma
Why are EDTA specimens obtained before other specimens when collected by skin puncture?
A) To minimize effects of platelet clumping
B) To minimize tissue fluid contamination
C) To prevent contamination from carryover
D) To reduce negative effects of hemolysis
A) To minimize effects of platelet clumping
What does the term “calcaneus” mean?
A) Bone infection
B) Contains calcium
C) Heel bone
D) Osteomyelitis
C) Heel bone
What type of additive is recommended for collecting an ethanol test specimen?
A) EDTA
B) No additive
C) Sodium citrate
D) Sodium fluoride
D) Sodium fluoride
Hemolysis can erroneously elevate:
A) ammonia.
B) magnesium.
C) potassium.
D) All of these are correct.
C) potassium.
. An autologous blood transfusion is a transfusion of blood:
A) directly from the donor to the patient.
B) donated by the patient for the patient.
C) donated by a compatible relative.
D) given by an anonymous donor.
B) donated by the patient for the patient.
You must draw a specimen from a patient 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 below an IV.
C) Draw the specimen from an ankle vein.
D) Draw the specimen from an IV.
B) Draw the specimen below an IV.
Which of the following is the safest area for infant heel puncture?
A) The area of the arch
B) The central area
C) The lateral plantar surface
D) The posterior curvature
C) The lateral plantar surface
______________ can result from heel punctures that are too deep.
Osteochondritis, osteomyelitis, bone damage
Of the following tests, which is most likely to result in fatal consequences if the patient is misidentified?
A) Blood cultures
B) Drug screen
C) Postprandial glucose
D) Type and crossmatch
D) Type and crossmatch
A fistula is a(n) :
A) implanted port attached to an indwelling line.
B) permanent fusion of an artery and a vein.
C) special winged infusion set left in a patient's arm.
D) temporary fusion of an artery and a vein.
Ans: B
B) permanent fusion of an artery and a vei
The most critical aspect of blood culture collection is:
A) the amount of specimen.
B) skin antisepsis.
C) specimen handling.
D) the needle gauge.
B) skin antisepsis.
Which of the following most closely resembles basal state?
A) A patient who has been lying down for an hour
B) A patient who has just arrived for a fasting blood test
C) A patient who has just awakened at 0600 after fasting all night
D) A patient who has worked all night but did not eat at work
C) A patient who has just awakened at 0600 after fasting all night
A blood smear from an EDTA specimen should be made:
A) any time after collection.
B) within 1 hour of collection.
C) within 4 hours of collection.
D) within 12 hours of collection.
B) within 1 hour of collection.
Fluid that comes from between tissue cells is called ___________________ fluid.
interstitial
5. When performing a GTT, the timing should begin:
A) as soon as the patient finishes the drink.
B) 30 minutes after the drink is finished.
C) right after the patient arrives in the lab.
D) when the fasting specimen is collected.
A) as soon as the patient finishes the drink.
Which of the following vascular access devices is placed in a peripheral vein for the purpose of blood collection and administration of medication?
A) Fistula
B) Heparin lock
C) Implanted port
D) PICC
B) Heparin lock
TDM is used by physicians to:
A) determine a beneficial drug dosage for a patient.
B) maintain “peak” levels of a drug in a patient's system.
C) maintain “trough” levels of a drug in a patient's system.
D) screen inpatients for abuse of prescriptive drugs.
A) determine a beneficial drug dosage for a patient.
Which of the following is the best way to tell that you may have accidentally punctured an artery?
A) A hematoma starts to form.
B) The blood obtained is dark red.
C) The blood pulses into the tube.
D) There is no way to tell.
C) The blood pulses into the tube.
Why should a venous blood sample placed in a microtube be labeled as venous blood?
A) Because test results can vary depending on the method of collection
B) So that subsequent specimens will be collected by venipuncture
C) So that the patient's nurse can check the site for signs of infection
D) To satisfy liability insurance requirements and for billing purposes
A) Because test results can vary depending on the method of collection
Which of the following scenarios represents correct capillary puncture technique in adults and older children?
A) Puncturing perpendicular to the fingerprint whorls
B) Scooping up blood that is running down the finger
C) Using the pinky finger for the puncture site
D) Wiping the alcohol dry so the puncture doesn't sting
A) Puncturing perpendicular to the fingerprint whorls
According to CLSI, _______________ is the recommended blood culture site skin disinfectant for infants 2 months and older.
A) povidone-iodine
B) benzalkonium chloride
C) chlorhexidine gluconate
D) 70% isopropyl alcohol
C) chlorhexidine gluconate
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) fasting
B) postprandial
C) STAT
D) timed
D) timed
A 2-hour postprandial specimen should be drawn:
A) 2 hours after the patient comes out of surgery.
B) 2 hours after the patient arrives for the test.
C) 2 hours after the patient wakes up in the morning.
D) 2 hours after the patient finishes eating a meal.
D) 2 hours after the patient finishes eating a meal.
A phlebotomist has attempted twice to draw a coagulation specimen from a patient with difficult veins. Both times the phlebotomist has been able to draw only a partial tube. What should the phlebotomist do?
A) Collect the specimen by skin puncture.
B) Have another phlebotomist attempt to draw the specimen.
C) Pour the two tubes together and mix well.
D) Submit the fullest tube for testing, noting the draw was difficult.
B) Have another phlebotomist attempt to draw the specimen.
A capillary puncture should be done rather than a venipuncture in all of the following situations, except when:
A) the patient is a child younger than 1 year.
B) a light-blue-top tube is needed.
C) the patient has difficult veins.
D) the test uses very little blood.
B) a light-blue-top tube is needed.
. What is PKU?
A) A contagious condition caused by a lack of phenylalanine
B) A hereditary inability to metabolize phenylalanine
C) An acquired condition caused by a lack of phenylalanine
D) An inherited condition caused by a lack of thyroid hormone
B) A hereditary inability to metabolize phenylalanine
. When collecting a blood culture specimen directly from a butterfly into blood culture bottles, which should be filled first?
A) Aerobic
B) Anaerobic
C) Either aerobic or anaerobic, it does not matter
D) Neither; a discard tube must be drawn first.
A) Aerobic
Which of the following is the best way to avoid reflux when drawing a blood specimen?
A) Fill tubes from the bottom up.
B) Do not overfill additive tubes.
C) Use the correct order of draw.
D) All of these are correct.
A) Fill tubes from the bottom up.
Which of the following tests helps physicians differentiate between chronic obstructive pulmonary disease and congestive heart failure?
A) B-type natriuretic peptide
B) C-reactive protein
C) Low-density lipoprotein
D) Troponins T and I
A) B-type natriuretic peptide
When a test requires a fasting specimen, but the serum is __________, it is a clue that the patient was not fasting.
A) hemoconcentrated
B) hemolyzed
C) jaundiced
D) lipemic
D) lipemic
A metal bar and a(n) __________________are used to mix a CBG specimen.
magnet (flea)
Which of the following lists the correct order of draw for capillary puncture?
A) Gray top, green top, red top
B) Green top, red top, gray top
C) Lavender top green top, red top
D) Red top, green top, lavender top
C) Lavender top green top, red top
Which of the following is used by the laboratory to identify a specimen throughout the testing process?
A) Accession number
B) Hospital number
C) Mnemonic code
D) Password ID
A) Accession number
If a patient is complaining of sharp radiating pain from the needle insertion site, the phlebotomist should:
A) ask the patient if it is OK to continue.
B) complete the draw and put ice on the site
C) immediately terminate the venipuncture.
D) tell the patient the pain will stop soon.
C) immediately terminate the venipuncture.
Which of the following is the recommended procedure for collecting a 24-hour urine sample?
A) Collect all of the urine voided in any 24-hour period.
B) Collect the first morning specimen and all other specimens, except the next morning specimen.
C) Start the timing, then collect the first morning specimen and all other specimens, including the next morning specimen.
D) Void the first morning specimen, start the timing, and collect all other specimens, including the next morning's specimen.
D) Void the first morning specimen, start the timing, and collect all other specimens, including the next morning's specimen.