PROCEDURE 1
The purpose of warming the heel before capillary blood gas collection is to:
a) help arterialize the specimen
b) comfort and calm the infant
c) reduce effects of platelet clumping
d) minimize tissue damage
A- help arterialize the specimen
Capillary action is a term used to describe how:
a) arterial blood arteries the capillaries
b) cells spread across a blood smear
c) warming can increase blood flow
d) blood fills a microhematocrit tube
1) D- blood fills a microhematocrit tube
Eaven's responsibility concerning the CSF, synovial fluid or amniotic fluid specimens does not include:
a) deliver specimen to the lab
b) accession the specimen
c) prepare the collection site
d) check for proper identification
C- Prepare the collection site
I am Treponema Pallidum; I am the antibody used to detect a rapid _____.
a) MMR
b) TB
c) Syphilis
d) Mononucleosis
C- Syphilis
Which disease causes microcephaly?
a) Zika Virus
b) Mpox
c) Ebola
d) Malaria
A- Zika Virus
2- part question:
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) an anticoagulant is used to collect the specimen
d) there are a lot fewer platelets in arterial blood
2) Why are EDTA specimens obtained before other specimens when collected by skin puncture?
a) To minimize effects of platelet clumping
b) To minimize effects of RBCs clumping
c) To prevent contamination from carryover
d) To reduce negative effects of hemolysis
1) B
2) A
2- part question:
1) Capillary puncture blood reference ranges are higher for which of the following analytes?
a) Calcium
b) glucose
c) phosphorous
d) total protein
2) What is the purpose of warming the site before skin puncture?
a) it increases blood flow up to seven times
b) it decreases blood flow up to five times
c) it makes the veins more visible
d) it comforts the infant
1) B
2) A- it increases blood flow up to seven times
2-part question:
1) When performing blood spot collection for a newborn screening test, which of the following would be incorrect technique?
a) allow the spots to dry before stacking sips
b) avoid touching the filter paper or blood spots
c) apply successive drops of blood to each circle
d) fill blood spots from only one side of the paper
2) Why are capillary blood gases less desirable than arterial blood gases (ABGs)
a) skin puncture blood contains tissue fluid
b) skin puncture blood is only partly arterial
c) the blood is exposed to air during collection
d) all of the option above are correct
1) C
2) D
2-Part questionnaire:
1) Correct newborn screening test collection or handling includes:
a) applying blood drops to both sides of the filter paper
b) hanging a specimen slip to dry in a vertical position
c) layering successive blood drops in a collection circle
d) using one large drop entirely fill a collection circle
2) Of the following test below, which specimen is collected first:
a) electrolyte
b) CBC
c) Phosphorus
d) Glucose
1) D- using one large drop entirely fill a collection circle
2) B- CBC
2- part question:
1) What is the best time to obtain a CBC from an infant?
a) right after a bowel movement
b) before the infant falls asleep
c) after the infant has been awake and quiet for 15 minutes
d) after the infant has been sleeping and resting for at least 30 minutes.
2) Plasma aldosterone and renin change more slowly but can double within ___. Consequently, pts are typically required to be recumbent for at least ____ minutes.
a) 2 hour and 30 min.
b) 1 hour and 45 min.
c) 1 hour and 15 min.
d) 1 hour and 30 min.
1) D- after the infant has been sleeping and resting for at least 30 minutes (pg. 323)
2) D- 1 hour and 30 min.
3- part question:
1) For which of the following tests would reference values be higher for capillary specimens than for venous specimens?
a) glucose
b) total protein
c) bilirubin
d) cholesterol
2) Capillary puncture is the preferred method of obtaining blood from infants because:
a) capillary blood is preferred for some tests
b) removing rubes of blood can lead to anemia
c) venipuncture in infants may damage veins
d) all of the above
e) none of the above
3) The maximum depth a lancet should penetrate during heel puncture is:
a) 1.5mm
b) 2.0mm
c) 4.0mm
d) 2.4mm
1) A
2) D
3) B
3-part questionnaire
1) Iyanna was out of alcohol and used povidone iodine to clean the site before collecting hemoglobin, electrolytes, and bilirubin specimens from the heel of baby Washington. Iyanna also failed to wipe away the first drop of blood before collecting the specimens. Which of the following test result can be affect due to the collection procedure?
a) Bilirubin results may be falsely decreased
b) Potassium results may be falsely increased
c) Potassium results may be falsely decreased
d) Hemoglobin values may be falsely decreased
2) Which of the following scenarios represents correct capillary puncture technique?
a) Puncturing the perpendicular to the fingerprint whorls
b) Scooping up blood that is running down the finger
c) Wiping away the alcohol so that the capillary puncture will not hurt
d) Using povidone-iodine to clean the heel of an infant
3) Newborn screening tests primarily detect:
a) elevated levels of bilirubin
b) diseases that are contagious
c) disorders that are inherited
d) glucose metabolism issues
1) B- Potassium results may be falsely increased
2) A- Puncturing the perpendicular to the fingerprint whorls
3) C- Disorders that are inherited
3-Part Questionnaire
1) Which of the following tests is performed on newborns to detect inability to metabolize amino acid?
a) PKU
b) bilirubin
c) TSH
d) WBC
2) The purpose of wiping away the first drops of blood during skin puncture is to:
a) avoic bacterial contamination
b) eliminate tissue fluid contamination
c) minimize platelet aggregation
d) reduce effects of hemoconcentration
3) Cythnia has made a blood smear from an EDTA specimen. There are holes in the smear. The most likely reason for this is that the
a) angle of the pusher slide was too steep
b) slide had dirt or fingerprints on it
c) pt. has a very low hemoglobin
d) pt. has a very high hemoglobin
1) A- PKU
2) B- eliminate tissue fluid contamination
3) B- Slide had dirt or fingerprints on it
3-part question:
1) Which test below is not collected by capillary puncture:
a) Bili
b) aPTT
c) Lead
d) Hgb
2) When making a routine blood smear, the "pusher slide" is normally used at an angle of ____ degree
a) 30
b) 15
c) 60
d) 90
3) Capillary action is a term used to describe how:
a) arterial blood enters the capillaries
b) blood fills a microhematocrit tube
c) cells spread across a blood smear
d) warming can increase blood flow
1) B- aPTT
2) C-60 degree
3) B- blood fills a microhematocrit tube
3- part question:
1) Thiazide diuretics are used to treat HBP. However, it the use of this medication can elevate:
a) Potassium and Hemoglobin
b) Calcium and Glucose
c) Sodium and Calcium
d) Glucose and Aldosterone
2)Jasmyne Blackston is taking Yaz OC, which blood level of hers is going to be affected due to her OC.
a) ESR increase and B12 will decrease
b) ESR decrease and B12 will increase
c) CBC increase and Biotin will decrease
d) CBC decrease and Biotin increase
3) Which capillary puncture on an infant will cause inflammation of the bone and cartilage, due to infection:
a) osteomyelitis
b) osteomalacia
c) osteochondritis
d) osteostenosis
1) B- Calcium and Glucose (pg. 320)
2) A- ESR increase and B12 will decrease
3) C- Osteochondritis
3-part question:
1) Arianna has made two unsuccessful attempts to collect a blood specimen from a pt. What should Arianna do?
a) make another attempt to collect the specimen
b) ask Darla to collect the specimen
c) have the pt.'s nurse assist her
d) return to the lab and cancel the test order
2) Clinical and Laboratory Standards Institute (CLSI) recommended maximum dept of heel puncture:
a) 1.0mm
b) 1.4mm
c) 2.0mm
d) 2.4mm
3) Which of the following is the safest area for infant heel puncture?
a) the posterior curvature
b) the area of the arch
c) central area
d) the lateral plantar surface
1) B- Ask Darla
2) C-2.0mm
3) D
3-part question:
1) If several blood specimens are being collected by capillary puncture and a slide is also needed, which one below is the correct procedure to perform when using a slide:
a) the slide is last to avoid the effects of tissue thromboplastin
b) the slide is done after the EDTA containers, but before the serum ones
c) the slide is first to avoid the effects of platelet clumping
d) none of these are correct.
2) 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
3) If the alcohol is still wet when capillary puncture is made it can
a) cause hemolysis of the specimen
b) lead to errors in the testing process
c) prevent round drops from forming
d) Only A & C
e) all of them are correct
1) C- the slide is first to avoid the effect of platelet clumping
2) B- A hereditary inability to metabolize phenylalanine
3) E- All of them are correct
3- Part question:
1) Gavin is asked to recollect a finger stick specimen, previously collected by Cynthia; the specimen was hemolyzed. Which of the following is least likely to be the cause of the hemolyzed specimen
a) collecting the specimen before the alcohol was dry
b) warming the site for 5 minutes prior to collection
c) scraping blood from the finger during collection
d) squeezing the site while collecting the specimen
2) Lancets specifically designed for heel puncture reduce the risk of:
a) bacterial contamination of the site
b) excess tissue fluid in the specimen
c) inadvertent puncture of an artery
d) none of these are correct
3) Which microtube would be used to collect a specimen for a CBC?
a) gray top
b) green top
c) purple top
d) red top
1) C- scraping blood from the finger during collection
2) C- inadvertent puncture of an artery
3) C- Purple
3- part question:
1) Cynthia is performing a capillary stick in the ED. A thick smear was also ordered. What disease may the pt encountered.
a) TB
b) Mononucleosis
c) Malaria
d) Measels
2) Referring to the above question, which microbe must be present for the DX above:
a) Plasmodia
b) Galactosemia
c) Neisseria meningitides
d) Mycobacterium
3) Which department will process the above specimen?
a) Chemistry
b) Cytology
c) Hematology
d) Microbiology
1) C- Malaria
2) A- Plasmodia
3) D- Microbiology
4- part question:
1) Which capillary puncture on an infant heel is inflammation of the bone marrow and adjacent bone?
a) osteomyelitis
b) osteomalacia
c) osteochondritis
d) osteostenosis
2) True or False: Sticking a newborn at 1.6mm would cause the infant pain due to the pain receptors are in this area.
3) When performing a fingerstick on an infant that is 11 months old, the lancet should be ___ mm.
a) 0.6mm
b) 1mm
c) 2mm
d) 3mm
4) True or False: With very young children it is best to grab the ring finger and hold it firmly.
1) A- osteomyelitis
2) False, page 362
3) C- 2mm
4) False (pg. 364)
3-part question:
1) Finger and heel puncture specimens are called capillary specimens because the blood:
a) Comes from the capillary bed
b) comes directly from capillaries
c) fills devices by capillary action
d) is collected in capillary tubes
2) Whitley, the new unit clerk ordered a CBC, platelet count, Hgb and HCT on the same pt. for collection at the same time. How many tubes will Charie collect?
a) 4
b) 1
c) 3
d) 2
3) What department(s) will process all of the tests in the above question
1) A- Comes from the capillary bed
2) 1
3) Hematology
3- Part Questionnaire:
1) Drawing blood on the sane side as a recent mastectomy is to be avoided because:
a) veins on that side must e saved for chemotherapy procedures
b) nerves in the arm are more sensitive to tourniquet pressure
c) antecubital veins are often removed as part of the procedure
d) effects of lymphostasis make the site more prone to infection
2) What does the term "calcaneus" mean?
a) bone infection
b) contains calcium
c) heel bone
d) osteo
3) Platelet clumping on a blood smear made from an EDTA specimen indicates that the__________.
a) specimen has micro clots in it
b) pt. has a clotting disorder
c) tube was incompletely filled
d) EDTA tube was contaminated
1) D- effects of lymphostasis make the site more prone to infection
2) C- heel bone
3) A- specimen has micro clots in it.
4- part question:
1) Kieanah is a specimen from a newborn's heel, which specimen will be collected first:
a) bilirubin
b) CBC
c) PKU
d) glucose
2) Capillary puncture blood most closely resembles:
a) arterial blood
b) intracellular fluid
c) tissue fluid
d) venous blood
3) A fingerstick should not be performed on an edematous finger because:
a) hemolysis of the specimen may result
b) syncope may occur
c) petechiae may develop
d) tissue fluid may dilute the specimen
4) It is necessary to control depth of lancet insertion during capillary puncture to avoid____________
a) bacterial contamination
b) excessive bleeding
c) injuring the heel bone
d) puncturing the artery
1) B- CBC
2) A- arterial blood
3) D- tissue fluid may dilute the specimen
4) C- Injuring the heel bone
4- questions:
1) Evaluates thrombin and plasmin activity and is very useful in testing for disseminated intravascular coagulation?
a) CMP
b) aPTT
c) D-dimer
d) CBC w Diff
2) This test is used to detect the presence of Helicobacter pylori.
a) ova and parasite
b) CBC
c) LH
d) CLO test
3) Which department will the above test be sent for processing?
a) UA
b) Hematology
c) Chemistry
d) Microbiology
4) Which 2 test above will be sent to Chemistry and the tube used?
1) C-D-dimer
2) D- CLO Test
3) D- Microbiology
4) CMP, LH and Gold
3- part question:
1)Most NBS test are ideally performed when an infant is ____ and ___ hours old.
a) 2 and 12
b) 24 and 72
c) 12 and 24
d) 18 and 36
2) If an infant requires a blood transfusion, NBS specimen should be collected _____
a) after blood transfusion
b) before blood transfusion
c) 2 hours after blood transfusion
d) 24 hours after blood transfusion
3) True or False: Touching the filter paper circles with gloves on can contaminated the collection filter paper
1) B- 24-72 hours old
2) B-(pg. 380)
3) True (page 380)