Phlebotomist performs a venous blood draw on a 91 year old patient. The phlebotomist should use what method?
Hand draw
What is the first thing a phlebotomist must do when performing a finger stick?
Confirm the correct identity of a patient
When performing a blood draw the phlebotomist notices red spots forming, what action should the phlebotomist do?
Release the tourniquet immediately
What is appropriate to use when collecting serum chemistry?
SST (Serum Separator Tube)
A phlebotomist collects a blood alcohol level for forensic testing and hands the specimen off to a lab tech. What represents the correct procedure?
The technologist writes both the time received and his initials on the chain of custody form
What result is affected when providone iodine is used to cleans the site for a dermal puncture?
Potassium
What can cause a hemolyzed specimen?
Shaking the tube vigorously
What is an appropriate cleanser for cleansing around the urinary meatus in a clean catch urine collection?
Benzalkonium chloride
What anti-coagulant should the phlebotomist use to collect a PT/PTT test
Sodium citrate
A phlebotomist received an order to draw an infant screening card 02 levels, bilirubin, and DNA. What should be drawn first?
O2 level
What is the correct order of draw?
Green, Lavender, and Grey
A phlebotomist is preparing a hand draw, what instrument should the phlebotomist assemble?
Winged infusion set and adapter
During a venipuncture the patient reports a sharp pain radiating down the arm. What action should the phlebotomist take?
Release the tourniquet and remove the needle
A blood specimen was rejected based on QNS, what does this mean?
Specimen quantity was insufficient
When collecting a sample for CBC, what vessel should the phlebotomist attempt to draw from first?
Medial cubital vein
A diabetic patient states that she prefers to be drawn on the inside of her wrist. What action should the phlebotomist take?
Attempt to draw from the antecubital region first
What is the best protection when drawing blood rom a patient with active tuberculosis?
N-95 respirator
According to CLSI order of draw guidelines, what sample should the phlebotomist collect first?
Blood cultures
A phlebotomist must invert anticoagulant tubes to prevent what?
Clotting of the sample
The following emergency fist aid treatment, maintaining an open airway, control bleeding, and keeping the victim warm until help arrives indicates the patient is suffering from?
Shock
What does the phlebotomist need to do first when collecting a blood culture using a winged infusion set and evacuated tube system?
Fill the aerobic bottles first
I phlebotomist is drawing five blood collection tubes. When should the tourniquet be removed?
After 1 minute (1-2 times tube)
A phlebotomist must choose the correct tube color and additive for the corresponding ....... test?
Laboratory
What is the appropriate action when labeling a specimen>
Label the specimen at the time of collection in front of the patient
Choosing to perform a capillary puncture is best determined by what?
Test ordered
What is the next step after removing the needle from a patients arm?
Engage the needle safety device
What is the first step un the blood collection procedure?
Test requisition - check that it is clear of labs needed, if not contact the appropriate person for confirmation
A 69 year old patient is brought in to the ER. Several blood tests are ordered. The phlebotomist collects blood under ........ consent?
Informed consent
A physician orders a specimen STAT, but the phlebotomist forgets to fill the out the patient ID number. What will the lab do when they receive the specimen?
The lab rejects mislabeled specimens
A patient states that this is his first blood draw. What action is appropriate?
Describe the procedure
When alcohol is used to cleanse the venipuncture site, it must be allowed to air dry prior to the venipuncture because alcohol
Requires time for the antiseptic to work
The phlebotomist needs to draw a GTT on a patient and notices an empty breakfast plate on the bedside table. What action should the phlebotomist take?
Ask the patient if they have had anything to eat or drink
While the phlebotomist is performing a venipuncture, the patient begins to seize, what action must the phlebotomist take?
Discontinue the draw immediately
During a routine phlebotomy procedure the phlebotomist is stuck with a used needle. What action should be taken next?
Flush the puncture site with running water
What statement by a phlebotomist regarding skin preparation for blood cultures is appropriate?
I will cleanse the area with providone iodine
What tube should be collected first for dermal samples?
Lavender top
What is the proper procedure after collecting an ammonia sample?
Place the specimen tube in an ice water slurry
A phlebotomist has a request to collect a routine CBC from a healthy 10 month old infant, what is the appropriate collection site?
Left heel
When performing an ETS venipuncture the phlebotomist should and the needle.......?
In the same direction as the vein and at a 30 degree angle with the bevel facing up
During a venipuncture the patient becomes pale and diaphoretic. What condition is most likely to occur in this patient?
Syncope (fainting)
A phlebotomist walks into a patients room and finds the patient bleeding profusely from the leg. What action should the phlebotomist do first?
Apply direct pressure to the wound
When preparing for transport, what specimen must be placed in a ice bath within 30 mins after collection?
Arterial Blood Gases (ABG)
What is an important question to ask the patient prior to collecting a metabolic panel?
When was the last time you ate
What additive should be used when performing a CBC?
EDTA (in a lavender tube)
What is the name for small red spots caused by the tourniquet?
Petechiae
A phlebotomist performs a urine dipstick on a pediatric inpatient and the value for blood is 4+. What is the best action for the phlebotomist to take when reporting this value?
Report the result to the patients physician
What includes all the appropriate forms of identification in the inpatient setting?
Verbal, identification band, and tube label
Serum sodium level and serum potassium level are main test for?
Electrolytes evaluations
Appropriate tubes to check coagulation factors (PTT, APTT, BT, CT, PTT, TT)?
Blue top tube
Chemical in blue top tube
Citrate (remember blue = citrate b after c)
Medical terminology for red blood cells?
Erythrocytes
Thrombocytes are what kind of cell?
Platelets
Medical terminology for ALL blood cells?
All of the above - ie, eurthro, thrombo and white
Main function of thrombocytes?
Coagulation
Main function red blood cells?
Transport O2 to cells
Life cycle of red blood cell?
120 days
What is not part of a complete blood count (Hemoglobin, Hematocrit and differential are part of the CBC?
Activate partial thromboplastin time test (APPT)
What is the most common occurring lab nosocomial infection?
HBV
Common and routinely performed test in the serology lab department?
Rapid Plasma Regain (RPR)(SST Tube)
What does CBC stand for?
Complete Blood Count (Lavender tube)
What does PTT stand for?
Prothrombin Time Test (Blue tube)
What does BUN stand for?
Blood, urea, nitrogen (SST tube)
What does BT stand for?
Bleeding time
What does GTT stand for?
Glucose Tolerance Test (SST tube)
Which lab department performs hemogram?
Hematology
Most common test for lavender top tube?
CBC - complete blood count
What is the additive present in the lavender top tube?
EDTA (E after D)
What are not included in the antecubital fossa?
Brachial veins
Vein choice order?
Ante cubital is 1st choice
Basilic is 2nd choice
Cephalic
is 3rd Choice (or 1st in obese choice)
What is the process used to wash and remove blood and tissues from contaminated medical supplies?
Sanitization
What would be the first test the lab worker would draw if the patient is suspected to have FUO (fever unknown origin)?
Blood culture
BNP is a special test used to evaluate
Cardiac enzymes and cardiac markers
........ is the process where complex substances in the food are broken down into simple substances while releasing energy
Catabolism
Homeostasis definition?
The condition where healthy body through constant changes remains the same
Hemostasis definition?
Stoppage of excessive blood
The blood which contains more oxygen and less carbon dioxide is called?
Oxygenated blood, which is also red in color
The blood contains less oxygen and more carbon dioxide is called?
Deoxygenated blood and is blue in color
Name the main organ of the human body that is closer to the heart and contains deoxygenated blood?
Superior vena cava
What is found in plasma but not in serum?
Fibrinogen
An infection acquired in a health care facility is called?
Nosocomial
Three components of the chain of infection are?
Source, mode of transmission, and susceptible host
Important PPE's in an isolation room?
Gloves, gown, and mask
A sample for fimbrin degradation product testing would be sent to which department?
Coagulation department
What precaution require special air handlings and ventilation?
Airborne diseases
What is the current CDC guidelines for infection control?
Standard precaution
Legal action in which the alleged injured party sues for monetary damages are?
Civil action
The level of care that a person of ordinary intelligence and good sense would exercise under the given circumstance's is the definition of .... care?
Due care
What test is not associated with the muscular system of the human body?
HCG
Guides used to monitor all aspects of proper patient care are called?
QA Indicators
The concentration of H20 (water) in plasma is about 90% the ..... is the concentration of remaining solution in the plasma?
Dissolved substances
If patient has a blood group B, what agglutinins are present in that blood group?
Anti-A
When performing bleeding time test the blood pressure cuff must be inflated to?
40mm Hg
Educate the patient, not allowed to eat and drink anything by mouth, is called?
NPO (Nothing by mouth)
An example of QC measures in phlebotomy is?
Checking the expiration dates in all different evacuated tubes
What, according to CLIS, order of draw guidelines would be last?
Lavender top tube
What lab documents describes in detail the steps to follow specimen collections?
Procedure manual
In order to monitor therapeutic drug level the lab worker needs to know?
Time of the last dose
What test should be collected in a royal blue top tube?
Magnesium
How many tubes are drawn for a 3 hour glucose tolerance test (GTT)?
4 tubes (1st is always random fasting specimen then 3 tests)
If a lab test requires serum, which tube is used?
Red topped tube
Alanine amino transfearas test (ALAST) is associated with which part of the body?
Liver
The principals of right and wrong, as applied to professional issues are defined as?
Ethics
What is the abbreviation for a type of antibody?
IgM
Most coagulation tests require a plasma specimen collected in a ......... top?
Light blue top
What test requires a whole blood specimen?
CBC
Patient with a low grade fever, 1 month, doctor ordered EST, what tube will be used for this test?
Lavender top tube
A SST tube is frequently used for what path lab department (Serum Separator Tube)?
Chemistry
What is the chemical substance present in a serum separator tube (SST)?
Thixotropic gel
Three main parts of a needle?
Bevel, shaft, hub
The clear colorless fluid that functions in protecting and nourishing the ...... and ...... is called the cerebrospinal fluid?
Brain and spinal cord
Identifying the tubes need to collect a PT, Stat, and BC in order?
Yellow, light blue, plain silicone tube (PST)
What is collected in a trace element tube?
Lead
Verbal expressions are not an example of?
Kinesics
Location of antecubital veins
Basilic - thumb side
Cephalic - pinkie finger
Medial
cubital is centered
Label the diagram
Bottles are culture bottles, then label as red, yellow, lavender etc. Yellow and black tube is a tiger top tube.
Sterile Blood Culture Tubes or Vials (YELLOW)
Sterile specimens are drawn first to prevent contamination that can occur during the procedure. The specimens you should draw first are blood culture bottles and SPS (yellow top) tubes.
Blue top tubes
Blue top tubes are used for coagulation studies and contain citrate additives. They have a light blue shield/stopper as well as a clear shield used over the blue stopper.
Red top tubes
These tubes may come with or without clot activator or gel separator. They may look like a red and black tiger top stopper, gold shield, or a red shield/stopper. These are used to draw samples for blood bank and HCG levels (pregnancy hormones).
Green top tubes
These tubes contain heparin as an additive and may come with or without a gel plasma separator. They may have a green and gray stopper, light green shield, as well as the green shield/stopper. These tubes are used to test ammonia and blood chemistry levels.
Purple (Lavender)top tubes
EDTA (Ethylenediaminetetraacetic Acid) tubes use a lavender stopper/shield, white (pearl) shield, pink stopper/shield, royal blue shield or tan shield. These tubes can be used to test CBC (Complete Blood Count), Hematocrit, Hemoglobin, and ESR (Erythrocyte Sedimentation Rate).
Grey top tubes
These glycolytic inhibitor tubes have a gray stopper/shield and are used for a variety of glucose studies
Order of draw:
