Safety & Compliance
Who has established regulations and guidelines to direct phlebotomists to work at the highest levels of safety possible?
OSHA
When confirming a patient's identity in an impatient setting, what is a statement that a phlebotomist could use?
Please state your full name and date of birth for me
What angle of insertion would you use when puncturing a hand vein?
What about an AC vein?
10 degrees
15 to 30 degrees
What is the most common POCT performed?
Glucose or A1C
Test: CBC
What is the additive and what type of blood do you send? (whole blood, plasma or serum)
Lavender WHOLE BLOOD EDTA
What type of precaution is required for varicella (chickenpox), tuberculosis, and rubeola (measels)?
Airborne precautions; N95 or N99 Respirator
A phlebotomist is educating a patient about a 24 hour urine collection. What instruction should the technician give to the patient?
"Start collecting at the second void of the day."
If a draw is not possible on one side of the patients body and you may choose between the opposite basilic or opposite dorsal hand, which is the best site?
What is the order of vein selection?
Dorsal hand
Median cubital, cephalic, hand, basilic
What is the chronological documentation or paper trail showing the acquisition, custody, control, transfer, analysis, and disposition of a specimen that provides evidence.
Name which tests would most likely have to have this documentation?
Chain of custody.
Paternity testing, urinary drug screenings, alcohol tests.
PT/INR
What is the additive and what type of blood do you send? (whole blood, plasma or serum)
Light Blue NaCit Plasma
What type of precaution is required for scabies, wound and skin infections, C-diff (Clostridium difficile)?
contact; gloves and gown
A phlebotomist is preparing to collect blood from a patient who has experienced syncope during previous draws. What actions should the technician take?
Place the patient in a supine position
Range of needle gauge used for routine venipunctures
21- to 23-gauge
How many pokes would you perform for a 3 hour GTT? When does the time start for the timed draws?
4 pokes: Fasting draw, 1 hour, 2 hour, 3 hour.
Time starts once the patient finishes the 100gm glucose drink and they return exactly 1 hour after that.
CMP
What is the additive and what type of blood do you send? (whole blood, plasma or serum)
What department does this go to?
SST
or
Lithium Heparin Plasma
Chemistry
What is a measure of precision or of how well an instrument is functioning to produce results that will be consistent if repeated over time?
Quality Control (QC)
A phlebotomist is performing a venipuncture on a patient who currently has an IV in both arms. What action should the technician take?
Ask the nurse to turn the IV's off for 2 minutes
The use of povidone-iodine can contaminate the site and cause falsely elevated levels of what?
Potassium
Iodine can adversely effect the results of:
Bilirubin
Uric acid
Phosphorus
Potassium
(BUPP)
A phlebotomy technician is preparing to perform a neonatal screening test. The technician should identify that which of the following is the optimal time to perform the test?
The technician should identify that the optimal time to perform a neonatal screening test to obtain accurate results is between 24 and 72 hr. after birth.
Ammonia test
What is the additive and what type of blood do you send? (whole blood, plasma or serum)
What special procedure do you have to follow?
Lithium Heparin Plasma
Place in ice slurry immediately, must be centrifuged within 15 minutes, aliquoted, and froze.
What accredits and certifies thousands of health care organizations in the U.S. and as an independent, nongovernmental, nonprofit organization, its operational standards focus on continual improvement of patient safety and quality of care?
The Joint Commision (TJC)
What types of urine specimen should a pharmacy technician instruct a patient to collect for a pregnancy test?
First-morning
What is the order of draw and additives?
Blood culture (aerobic/anaerobic or SPS yellow tube)
Light blue (sodium citrate)
Red (no additive)
Gold / Tiger (clot activator, thixotropic gel)
Green (lithium or sodium heparin)
Lavender (EDTA)
Grey (sodium fluoride potassium oxalate)
With POC and CLIA-waived testing, collect and prepare specimens to insert immediately into automated clinical analyzers for fast and accurate results. Name as many of these tests as you can.
Electrolytes (sodium, potassium, chloride, calcium, magnesium)
Hematology (WBCs, RBCs, Hct, Hgb)
Glucose, hemoglobin A1c
Cholesterol (HDL, LDL, total cholesterol, triglycerides)
Blood coagulation (PT, international normalized ratio [INR])
dipstick urinalysis, fecal occult blood, urine pregnancy tests
Lactic Acid
What is the additive and what type of blood do you send? (whole blood, plasma or serum)
What special procedure do you have to follow?
Grey (Sodium fluoride potassium oxalate) Plasma
No tourniquet, patient should be completely at rest. Centrifuge and aliquot within 15 minutes and refrigerate.