Capillary Technique #1
What is the CLSI recommended maximum depth of heel puncture?
2.0mm
Which microtube would be used to collect a specimen for a CBC?
a) Gray top
b) Red Top
c) Purple Top
c) Purple top
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
c_ The lateral plantar surface
1- What is the correct angel used for a blood smear?
a) 20 degree
b) 30 degree
c) 15 degree
B- 30 degree
A fingerstick should not be performed on an edematous finger because:
a) Hemolysis of the specimen may result
b) Petechiae may develop
c) Tissue fluid may dilute the specimen
C- Tissue fluid my dilute the specimen
1- It is necessary to control depth of lancet insertion during capillary puncture to avoid?
a) Bacterial contamination
b) Injuring the heel bone
c) Puncturing the artery
2- Capillary puncture blood most closely resembles__.
a) Arterial blood
b) Tissue fluid
c) Venous blood
1- B- Injuring the heel bone
2- A- Arterial blood
1- When collecting all of the following specimens from a newborn's heel is collected first?
a) Bilirubin
b) CBC
c) PKU
2- True or False: Light-blue- microtubes are collected first, which is in the same order as the ETS.
1- B- CBC
2- False (pg. 358)
1- A phlebotomist should not draw more than ____% of the infant's blood volume.
2- Large quantities removed rapidly can cause _____.
1- 10%
2- Cardiac Arrest (pg. 358)
1- The phlebotomist has made a blood smear from an EDTA specimen. There are holes in the sear. The most likely reason for the holes in the smear is:
a) Angle of the pusher slide was too steep
b) Slide had dirt or fingerprints on it.
c) Pt. has a very low hemoglobin
2- If the alcohol is still wet when a capillary puncture is made it can:
a) Cause hereditary disorders
b) Prevent round drops from forming
c) Capillary blood is preferred for some tests
1- B- Slide had dirt or fingerprints on it.
2- B-Prevent round drops from forming
1- Why are EDTA specimens obtained before other specimens when collected by skin puncture?
a) To minimize tissue fluid contamination
b) To minimize effects of platelet clumping
c) To prevent contamination from carryover
2-Which of the following tests would reference values be higher for capillary specimens than for venous specimens?
a) Glucose
b) Total Protein
c) Bilirubin
1-B- To minimize effects of platelet clumping.
2- A- Glucose
1- Why are capillary blood gases less desirable than arterial blood gases (ABGs)?
a) Skin puncture blood contain tissues fluid
b) Skin puncture blood is only partly arterial
c) The blood is exposed to air during collection
d) None of these are correct
e) All are correct
2-What is PKU?
a) A contagious condition caused by a lack of phenylalanine
b) An acquired condition caused by lack of phenylalanine
c) A hereditary inability to metabolize phenylalanine
1- E- All are correct.
2- C- A Hereditary condition
1- True or False: The phlebotomist must draw a capillary stick from a pt. that is dehydrated.
2- Puncturing the skin releases tissue _____ which activates the coagulation process in the blood drops.
1- True pg. 358
2- Thromboplastin (pg. 358)
1- Performing a finger stick on an infant has been prohibited on infants younger than ____. There are lancets that penetrate ____mm to use on this sector or infants.
2-Lancets specifically designed for heel puncture reduce the risk of___.
a) Inadvertent puncture of an artery
b) Excess tissue fluid in the specimen
c) Bacterial infection
1- 1 year of age. 1mm (pg. 361)
2- B- Excess tissue fluid in the specimen
The phlebotomist's responsibility concerning CSF, synovial fluid, or amniotic fluid specimens does not include:
a) deliver the specimen to the lab
b) Prepare the collection site
c) Check for proper identification
B- Prepare the collection site
1- Ivy was out of alcohol and used povidone iodine to clean the site before collecting hemoglobin, electrolytes an bilirubin specimens from the heel of an infant. Ivy, also failed to wipe away the first drop of blood before collecting the specimens. Which of the following could result because of the collection procedure?
a) Bilirubin results may be falsely decreased
b) Potassium results may be falsely increased
c) Electrolytes results may be falsely decreased.
2- Drawing blood on the same side as a recent mastectomy is to be avoided because:
a) Effects a lymphostasis make the site more prone to infection
b) Veins on that side must be saved for chemotherapy procedures
c) Antecubital veins are often removed as part of the procedure.
1- B- Potassium results my be falsely increased
2- A- Effects of lymphostasis make the site more prone to infection
1-Capillary puncture is the preferred method of obtaining blood from infants because?
a) Capillary blood is preferred for some tests
b) removing tubes of blood can lead to anemia
c) To minimize effects of platelet clumping
d) A & B only
e) None of these
2-Why is it important to notify the lab that the specimen is a capillary specimen? Give an example of a specimen that can vary.
1- D
2- Because test results can vary depending on the method of collection and Glucose readings are different when drawn from the finger and or via the tube
1- What does the term "calcaneus " mean?
a) Bone infection
b) heel bone
c) Osteomyelitis
2-A new unit clerk relays an order for a CBC, platelet count, Hbg and HCT on the same pt. for collection at the same time. How many tubes will the phlebotomist use and which department will the specimen go to?
a) 1
b) 2
c) 4
1- B- Heel bone
2- A- 1 tube & Hematology
When performing blood spot collection for a newborn screening test, which of the following would be incorrect technique?
a) Apply successive drops of blood to each circle
b) Avoid touching the filter paper or blood spots
c) Allow the spots to dry before stacking slips
2- Newborn screening tests primarily detect:
a) Elevated levels of bilirubin
b) Disorders that are inherited.
c) Only performed on male newborns
1- A Apply successive drops of blood to each circle
2- Disorders that are inherited
1-The purpose of wiping away the first drop of blood during skin puncture is to:
a) Avoid bacteria infection
b) Minimize platelet aggregation
c) Eliminate tissue fluid contamination
2-Capillary puncture blood reference ranges are higher for which of the following analytes?
a) Calcium
b) Glucose
c) Total Protein
1- C Eliminate tissue fluid contamination
2- B- Glucose
1- An arterial puncture site may take longer to stop bleeding than a venipuncture site because:
a) Arteries tend to be much less elastic than veins
b) Blood pressure is higher in arteries than in veins
c) there are a lot fewer platelets in arterial blood.
1- B- Blood pressure is higher in arteries than in veins
1- Which of the following scenarios represents correct capillary puncture technique?
a) Puncturing perpendicular to the fingerprint whorls
b) Scooping up blood that is running down the finger
c) Wiping the alcohol dry so the puncture doesn't sting
2-The general site selection criteria include selecting a site that is ____, _____, _____ and ____.
1- A Puncturing perpendicular to the fingerprint whorls
2- warm, normal color, free of scars, bruises or rashes. pg. 359
1- Which of the following tests is performed on newborns to detect inability to metabolize an amino acid?
a) TSH
b) WBC
c) PKU
d) Bilirubin
2-What is the purpose of warming the site before skin puncture?
a) It is comforting to the pt.
b) It makes the veins more visible
c) It increases blood flow up to 7 times
1) C- PKU
2- C- It increases blood flow up to 7 times
1- The purpose of warming the heel before capillary blood gas collection is to :
a) Help arterialize the specimen.
b) Calm the crying infant
c) Reduce effects of platelet clumping
2- When performing a capillary stick on a toddler, unlike the adult, how is the toddlers specimen obtained
1- A -Help arterialize the specimen
2- Key point (pg. 364)- It is best to grasp 3-4 fingers with toddlers when performing a capillary stick, while one fingers for the adults.
1- If several blood specimens are being collected by capillary puncture and a slide is also needed, it should be made:
a) last to avoid the effects of tissue thromboplastin
b) After EDTA containers but before serum ones.
c) First to avoid the effects of platelets clumping.
2- Ja'La is asked to recollect a finger stick specimen because it was hemolyzed. Which of he following is least likely to have caused the hemolysis?
a) Scraping blood from the finger during collection
b) Collecting the specimen before the alcohol was dry
1- C- First to avoid the effects of platelets clumping
2- A Scraping blood from the finger during collection
Which specimen would most likely be rejected for testing?
a) 0800 specimen drawn at 0815
b) hemolyzed potassium specimen
c) Bilirubin specimen that is icteric
2- The order of draw for capillary is different from ETS. The following tests are done: What are the order of draw and what departments does these specimens are analyzed: Ammonia, X-match, CMP, ABG and FBS
1- B- Hemolyzed potassium specimen
2- ABG, X-match, Ammonia, FBS and CMP ( Chemistry, Blood bank or Immunohematology