Additives
Sodium citrate is commonly found in what tube color?
Light blue
Explanation: Sodium citrate is found in light blue tubes.
Why are blood cultures taken before other tubes in a routine venipuncture?
Additives in other tubes may contaminate the blood culture samples, affecting results
Explanation: See above
You should always wear what PPE when performing different procedures?
Gloves
Explanation: Gloves should be worn to protect both the patient and phlebotomist during procedures.
You are informing a patient about the process of sputum collection. Of the following instructions, which should you relay to the patient?
A) Discard the first sputum sample collected.
B) Collect the sample just before going to sleep.
C) Do not eat at least twelve hours before collection.
D) Cough deeply into the collection cup.
D) Cough deeply into the collection cup.
Explanation: A sputum sample should be collected first thing after waking up for the day by coughing deeply into the collection cup. The patient should not eat or drink anything prior to collection. They should submit the first sample collected.
OSHA requires your employer to provide a free immunization against what blood borne pathogen?
Hepatitis B (HBV)
Explanation: OSHA requires a number of immunizations, and, as one of the most common and infective blood borne pathogens, they require your employer to provide HBV vaccination.
You should invert the majority of the tubes how many times?
8-10 inversions
Explanation: Excluding the tubes containing sodium citrate, clot activator, SST, or no additive, you should invert the tube 8-10.
Light blue; sodium citrate
Explanation: Following a routine venipuncture's order of draw, you will first take blood cultures and then you will take a light blue sodium citrate tube.
You have just completed a venipuncture on a patient with airborne and contact precautions. In what order do you remove your PPE?
1) Gloves; 2) Gown; 3) Mask, N95, or N99 respirator
Explanation: When you are drawing on a patient with airborne and contact precautions, you will be using a pair of gloves; gown; and mask, N95, or N99 respirator. The proper removal of these pieces is listed above.
A phlebotomist is drawing samples from a patient who has recently eaten a large amount of meat and cheese. You should expect the samples to be ____.
lipemic
Explanation: Meat and cheese is high in lipids, meaning you should expect a large amount in your samples.
After collecting a capillary sample, you should note the collection site because you may see skewed levels of ____.
Explanation: Capillary samples often see a higher amount of thrombin, causing clots and creating inaccurate results.
Which two tubes do not need to be inverted after a draw?
Red and royal blue tubes without additives
Explanation: Both the red and royal blue tubes may come without additives. Since there is nothing to mix, there is no reason to invert the sample.
Of the below, select the tube you would draw first in a capillary collection: green, purple, gold, red.
Purple
Explanation: Capillary punctures release a large amount of thrombin, coagulating blood quicker. To prevent inaccurate results, tubes with anticoagulants should take priority.
You are drawing from a patient with tuberculosis. What PPE should you don?
Gloves and a mask, N95, or N99 respirator
Explanation: Tuberculosis requires airborne protections, which include wearing the above.
You have just drawn a sample of blood for a CBC. What are you measuring? General answers will not be accepted.
Platelet, red blood cell, and white blood cell counts
Explanation: CBC's measure the number of cells within a patient's blood sample. This include the sample's platelets, red blood cells, and white blood cells.
You are performing a routine venipuncture on a patient. Of the patient's arm veins, the left brachiocephalic, right median cubital, and right brachiocephalic are palpable. You can palpate the patient's hand veins, though they are small and fragile. There is a tattoo on the left arm, and there is a bruise on the right arm over the median cubital. Where should you draw?
Either of the hand veins
Explanation: Because the median cubital has a bruise, you should not draw from it, for it may have altered test results. Neither brachiocephalic vein should ever be selected (unless as a last resort) because it resides over the artery. The hand veins may be used, though you should take precautions against their collapse.
When you are drawing a tube with potassium oxalate, which of the following disinfectants would you use to cleanse the site: glutaraldehyde, isopropyl alcohol, ethyl alcohol, or soap and water.
Soap and water
Explanation: Potassium oxalate, or gray tubes, are often used to take blood alcohol. Isopropyl and ethyl alcohol can create inappropriate results. Glutaraldehyde should not be used as a disinfectant for a draw.
You are performing a routine venipuncture and need to collect the following tubes: EDTA, green, SST, blood cultures, and pink. Of the tubes, which do you collect second?
SST
Explanation: Following the venipuncture order of draw, you will draw in the listed order: blood cultures, gold or tiger top (SST), green (heparin), lavender (EDTA), and pink (EDTA).
State the procedure for putting on a non-disposable gown. (Hint: There are four different steps.)
Step 1: Cleanse your hands.
Step 2: Unfold the gown and put it on. This includes putting your arms through the sleeve openings, pulling it on, and ensuring the opening of the gown is on your back.
Step 3: Tie the gown at the back of your neck.
Step 4: Overlap the gown in the back and tie the waist strips.
Explanation: In short, wash your hands, unfold and put on the gown, tie its neck bands, and tie its waist bands.
What test is routinely used for a patient with diabetes?
Glucose test
Explanation: Diabetic patients often grapple with regulating their sugar levels. The glucose test is used to check these levels, allowing them to prevent glucose-associated issues.
EDTA works by binding itself to what clotting mineral?
Calcium
Explanation: EDTA binds to Calcium, which is a blood clotting mineral.
Which tube additive is used in vials that are kept in ice slurries (for specific tests)?
Heparin
Explanation: Green tubes that contain heparin may be used in ammonia tests. These samples need to be kept in ice slurries.
Properly list the correct routine venipuncture order of draw given the following tube colors: red, orange, gold, green, light blue, royal blue, lavender, pink, and gray.
Light blue, red, gold, orange, green, lavender, pink, gray, and royal blue
Explanation: The routine venipuncture order of draw is as follows: blood cultures, light blue, red, tiger top or gold, orange, green, lavender, pink, gray, yellow (ACD tube), and royal blue.
You receive an infant patient with respiratory syncytial virus (RVS). Additionally, they have an ulcer on their heel. What PPE should you don?
Gloves; gown; and mask
Explanation: Respiratory syncytial virus (RVS) is a disease that requires both droplet and contact precautions. For contact precautions, you should don gloves and a gown. For droplet precautions, you need a mask. The ulcer, or open sore, should be handled with gloves.
What blood test is used to assess kidney functions, measuring the levels of waste products in the blood?
Explanation: BUNs, often tested using green tube samples, measure the amount of urea nitrogen, a waste product formed from protein breakdown, in your blood.
A phlebotomy technician has just obtained a blood alcohol specimen. What information should they include on the chain of custody form?
Name and identifying information of the patient; name of the person who obtained and processed the sample; date, location, and signature of person attesting the specimen is the same one within its documentation; and signature and date from every person who's had possession of the sample
Explanation: Chain of custody guidelines require all of the above information.