Phlebotomy Practice Test New Exam Update 2022 Complete Solution

Phlebotomy Practice TEST NEW EXAM Update 2022 Complete Solution Most important step in venipuncture? - Patient identification What is PPE? - Personal Protective Equipment What is the best way to let a clean site dry? - Air dry OSHA requires all phlebotomist to be trained regarding what? - Blood borne pathogens and needle saftey All specimens are considered hazardous and infectious so we must use what? Universal and or Standard precautions What organization should be contacted regarding employee safety and unsafe working conditions? - OSHA (occupational safety and health administration What does MSDS mean and what is it part of? - Material Safety Data Sheet (right to know law) What color tube, and additive is used for CBC, Hct, Hgb, Sed rate? - Lavender, EDTA Which tube has no additive? - Red What color tube and which additive is used for protime and APTT? - Lt. Blue, sodium citrate What is the ratio of blood to additive in a light blue tube? - 9 to 1 Which additive is the best choice for an ethanol specimen? - Na fluoride What color tube is an ethanol specimen drawn in? - Grey In case of a needle stick accident you should? - Cleanse the site, get patient information if able, and notify your supervisor What is the purpose of the tourniquet? - To find the vein How long can the tourniquet be in place? - 1 minute What is the first thing you must do after every finger stick? - Wipe away the first drop Why is it necessary to keep the centrifuge lid closed until it comes to a complete stop? It reduced the chance of aerosol and microbial contamination 1/17 What angle should your slider be when making blood smears? - 30 degrees What should you do if a standard size tube collapses the veins? - Use a pediatric tube Which cleansers are most common for blood culture site preparation? - povidone iodine or 2% chlorhexidine What characteristics do sharps disposal containers have? - Spill proof, tamper proof, and puncture resistant. When used for decontamination, the dilution for bleach in water should be what? - 10% bleach, 90% water Which point of care test is done to determine a platelet plug formation? - Bleeding time (also known as platelet function assay) Where in the wrist area are ABGs done and which artery? - Outer aspect of the wrist and from the radial artery Which are the smallest vessels in the body? - Capillaries Which are the smallest veins in the body? - Venules The respiratory system is responsible for? - Breathing and the exchange of oxygen and carbon dioxide Common site cleanser for a venipuncture is? - 70% isopropyl alcohol When anticoagulated blood is spun down in the centrifuge, how does it separate? Plasma (top), buffy coal = WBCs & platelets (middle), Red blood cells (bottom) MSDS is part of the? - Right to Know Law When you leave the patient's room, make sure that? - Everything is returned to where you found it including the bed rails, (up if up, down if down) What is the difference between serum and plasma? - Serum= the fluid portion of clotted blood Plasma= fluid portion of unclotted blood which contains all of its clotting factors (fibrinogen) Empathy is? - The Validation of a persons feelings QA indicators are what? - Measurable factors System that filters, eliminates wastes, regulates water balance is the? - Urinary system 2/17 If a patient has fragile skin or excessive hair, where should the tourniquet be placed? Over their clothing or a piece of coflex/coband When drawing on a burn victim? - Look for a site that is the least damaged or scarred for the draw Even if you wear gloves, your hands should be washed when? - Before and after specimen collection, toilet use, every time they could become soiled What happens if you squeeze too much during a finger stick/capillary puncture? - Errors in the results by diluting with tissue fluid If an I.V is present you much draw blood where? - Below the I.V What vein is most likely to be used for an obese patient? - The cephalic If swelling occurs or a hematoma begins to form at the venipuncture site you must? Remove the tourniquet and needle and apply pressure The most prevalent work related acquired infection in the laboratory is? - Hepatitis B Fibrin strands may be present in serum because? - It was centrifuged What should you do if the information is not correct on the patient's I.D bands/requisitions? - Do not draw the blood until the patient is properly identified/banded If a patient who is legally responsible for himself says NO to a blood draw, what should you do? - Do not draw Two forms of outpatient I.D are? - Spelling name and birthdate Bursting capillaries cause small red pin-point clusters are known as? - Petechiae Reverse or protective isolation is for the protections of? - Immuno-compromised patients What is the name of the system used for unidentified patients? - Special 3 part I.D system What is the most common complications of phlebotomy? - Hematoma What happens when the tourniquet is on to long? - Hemoconcentration How do you transport Bilirubin? - By protecting it from light 3/17 What test is ordered to determine PH and blood gas? - Arterial Blood Gases (ABGs) What test would be ordered to detect hematuria? - Urinalysis What test would be ordered if the patient is suffering from FUO? (fever of unknown origin) - Blood Cultures What tube is used for STAT electrolytes and what is the additive? - Green top and Heparin is the additive Sample mailers have a few distinctive warnings to their label. They are? - Biohazard sign, send to CDC in case of breakage, name and address of sender and receiver What is the chain of custody? - The tracking of legal samples Doctors order glucose monitoring for patients with which disorder? - Diabetes How long do Red blood cells live for? - 120 days What is a reticulocyte and how long does it live for? - An immature red cell and lives for about one day What does a glucose test monitor? - Sugar level All I.V supplies must be handled with care and kept? - Sterile What is a sphygmomanometer used for? - Blood pressure Medical ethics can identify a professional as? - Morally desirable Define negligence vs. malpractice? - Negligence is failure to exercise due care Malpractice is negligence by a professional Sedrate or ESR is drawn on what color tube? - Lavender Which PPE will keep you the safest when body substance or wounds are present? Gloves What has to be supplied by chemical manufacture according to the Right to Know Law? - MSDS (Material Safety Data Sheet) Parenteral transmission means infection can enter through everything except? - The digestive tract Does the tourniquet need to be on the entire time? - No, its the phlebotomist call 4/17 In what direction is a concentric circle? - Center to periphery What test is ordered to confirm hyper or hypoglycemia? - GTT If something is easily combustible what color and number would you expect to see? Red-4 IF a moderate health hazard would exist what color and number would you expect to see? - Blue-2 If you do not let the cleaners dry before performing a blood culture you might get what? - Contaminated specimen/false positive. Skin prep is the #1 contamination of a blood culture How many ml would be in a typical 24-hour urine container? - 2000ml or 2L How do you transport cold agglutinin after collection? - At body temperature Cardio vascular system includes? - Heart and vessels It is your job as a part of being a health professional to? - Make your patient as comfortable and at ease as possible What could happen if you carelessly remove a stopper from an evacuated tube of blood? - Could cause an aerosol (like popping the champagne bottle) What is included in the microorganism category that can exist in body fluids? - Fungus, bacterium, virus What are examples of timed tests? - GTT, Medication monitoring Selection of a preferred care giver has to do with what? - Insurance PPO/HMO. Not a patient right What does contamination mean? - It is not clean anymore Extrinsic coagulation function is evaluated by what test? - Protime, Prothrombin time, PT CLSI (Clinical Laboratory Standards Institute) is formerly known as? - NCCLS (National Committee for Clinical Laboratory Standards) Every year laboratory employees must take a test to demonstrate what? - Competence 5/17 What should you do if you get blood on a requisition or on the side of a tube? - Wipe off with disinfectant Positive body language is? - Being sure of yourself, being confident. It is not being irate or cowering. Which fingers are used for skin puncture, most often? - Third and fourth digits. Leg and foot draws can only be done? - With a doctor order If you are drawing for a CBC, and having difficulty because of vein damage or bruising, it is acceptable to get the blood by which method? - Skin puncture; "finger stick"; capillary draw What could cause "failure to obtain blood" - Missing the vein altogether, not going deep enough, or going through the vein Urinary track infection is the most common? - Nosocomial infection What is the most common size needle used for venipuncture? - 21 gauge Which is larger 18 or24? - 18 When using additive tubes, when should you start the mixing process? - Immediately What is the additive in a grey top tube? - Na fluoride and K oxalate What is the additive in additive in a green top tube? - Heparin TDM means therapeutic drug monitoring. It is important to know the? - Time of the last dose The feathered edge of a smear is how many layers thick? - One layer What is the first step in phlebotomy? - Introduction and explanation What is the difference between "inpatient" and "ambulatory patient"? - Inpatient stays overnight and the ambulatory is out patient What is a VAD? - Vascular Access Device What would you do if a patient has an I.V. In the right arm? - Look for a vein in the left arm 6/17 A patient states she/he has had a mastectomy on the left breast. What would you NOT DO? - You will not put a tourniquet or BP cuff on that arm. No blood samples from that arm. If a patient had fragile skin, what would you use for a bandage? - An alternative to adhesive/coflex is gauze all around and then taped What are the three common veins for venipuncture? - Median antecubital, cephalic, and basilic What is the requirement by the government when shipping specimens? - Container must be water tight Services and results that meet accepted standards are? - Quality Assurance Extracting too much blood especially from infants could put the patient in danger of becoming what? - Anemic What would you do if you found two or three requisitions from different doctors for the same order? - Make sure that they are not duplicates The nurse asks you to go to room 312 and draw Robert Jones. When you get to 312 the patient's arm band says Roger Jones. What would you do? - Nothing until you get the correct I.D confirmed What is Hemostasis? - The ability to stop bleeding. In order to ensure Hemostasis all of these must be in good working order/have the proper amount? - All the vessels, coagulation factors, and the platelets Q.N.S. Stands for? - Quantity non-sufficient Which part of the analytical process are phlebotomists involved in? - The preanalytical Doing the right thing when nobody is looking is? - Integrity AIDS stands for what? - Acquired Immune Deficiency Syndrome What happens if a specimen is misplaced for several days at room temp? - You must re-draw One thing the healthcare industry did to lessen the spread of infection? - They started using disposable equipment Name the 3 types of blood cell? - Erythocytes, leukocytes, thrombocytes 7/17 Parents sometimes get a prescription for a topical anesthetic for their child, which is called? - EMLA Which cell is the transport cell? - RBC transports oxygen and nutrients If a language barrier between you and the patient, what would you do? - Must have a translator As healthcare workers, it is very important to be aware of surroundings? - Do not walk by spills without reporting them. Do not rush around corners in the halls. Get out of patient's way. Which is the most prevalent blood borne pathogen among the laboratory healthcare workers? - Hepatitis B Injury could occur on an infant's foot if you used a lancet that penetrated deeper than? 2.0 mm Checking the expiration dates on collection tubes is part of? - Quality assurance or quality control Blood cultures are drawn in a set of two bottles. Name the differences between the bottles? - One is aerobic (has air in it) the other is anaerobic (no air) What five things must be on a specimen label? - Pt. name, Pt. #, date of specimen, time specimen was taken in military time, and initials of person performing the lab What might cause clotting of an anticoagulated specimen? - Insufficient mixing If red blotches appears after a tourniquet is applied of skin is in contact with gloves. What would you suspect? - The patient might have a latex allergy If you are collecting blood and the patient stops breathing, what would you do? - Stop everything and call for help TB isolation requires what? - N95 respirator, gown and gloves (all airborne isolation's require these) What would you do with expired tube? - Discard them Why would you put a stick in a centrifuged specimen? - To check for presence of Fibrin (serum only) A family member wants family records. Who regulates this matter? - The patient must give written permission for medical personnel to release information. The confidentiality law that regulates this is HIPAA 8/17 You have a trauma and a timed test. Which should you do first? - Trauma, then the timed test Why do you use a N95 for TB patients? - Because TB is an airborne mycobacteria What is another name for a "winged apparatus"? - Butterfly needle The joint commission is responsible for what? - Requires healthcare institutions to have an infection control program in place. QA, medical record protocol How many hours does the patient fast for a GTT? (Glucose Tolerance Test) - 8 to 12 hours How many draws are needed for a GTT? - TWO, plus the number of hours for the test Who is the Director of the Laboratory? - The Pathologist List the Priority of Draw? - ER/STAT, Timed, ASAP, Fasting, Routine If a phlebotomist mis-I.D.'s a patient and this action causes harm to come to the patient, it is an act of? - Negligence Which patient is most likely to have more than (1) I.D bracelet? - Newborn, patient admitted through ER, Patient getting transfusion Name the gel in a SST or PST tube? - Thixotropic gel Name the Order of Draw for non-capillary blood samples? - Yellow for BC (SPS) Lt. Blue (Na citrate) Red and/or SST Green (heparin) Lavender (EDTA) Grey (Na flouride/ K oxalate) Name the Order of Draw for capillary blood samples? - Lavender? EDTA specimens; other additive specimens; Red/serum specimens What is Hirudo Medicinalis? - A european medicinal leech What initials are used to designate a phlebotomist certified by the National Credentialing Agency? - CLPlb (NCA) Clinical Laboratory Phlebotomist What initials are used to designate a phlebotomist in CA certified by the American Certification Agency? What do the initials mean? - CPT (ACA) 9/17 Certified Phlebotomy Technician What does ETS stand for? - Evacuated Tube System What is this? - Biohazrard Symbol What is this? - Radioactive Symbol What do the colors mean? - Red is flammable Blue is health hazard Yellow is reactive White is for special issues (e.g radioactive or water reactive) What numbers can this have and what do they mean? - 0 means no hazard 1 means slight danger 2 means moderate danger 3 means severe danger 4 means extreme danger What type of controls do mechanical devices have? - Engineering controls Give two examples of engineering controls? - Sharps containers Safety needles Hazard signs Safety transfer devices Biohazard bags MSDS Give an example of a "Work Practice Control"? - Hand washing, Designated areas for activities like eating What 3 factors relate to radiation exposure? - 1. Distance- how far away 2.Shielding- how you are protected/barrier 3. Time- how long exposed What acronym is used for Fire Response? What do the letters mean? - RACE R-Rescue A-Alarm C-Confine E-Extinguish What does CAP stand for? - College of American Pathologist What does CLIA stand for? - Clinical Laboratory Improvement Amendment (of 1988) What does agglutinate mean? - Clumping or sticking together 10/17 What is the difference between STAT and ASAP? - STAT- immediately ASAP- as soon as possible/ when possible Does Ca mean the same thing as CA? - NO, Ca=calcium and CA=cancer What is Homeostasis? - The "steady state"; state of equilibrium or balance What gland is referred to as the Master Gland? What body system is it part of? Where is it? What does it regulate? - The pituitary gland; part of the Endocrine system; found in the brain; regulates body function via hormone production What body system uses chemical substances and electrical impulses to control and coordinate body activities? - The Nervous system What are the two main structural divisions in the Nervous System? - Structural= 1. Central Nervous System 2. Peripheral Nervous System What are the two main functional divisions in the Nervous system/ - Functional=1. Somatic (voluntary) 2. Autonomic (involuntary) What anatomical plane divides the body into front and back? - Frontal, also known as Coronal What anatomical plane divides the body into top and bottom? - Transverse, also known as horizontal What anatomical planes divides the body into equal/unequal right and left? - Midsagittla is equal right and left; Sagittal can be unequal right and left What anatomical terms describe the front and the back of the body? - Front= anterior or ventral Back= posterior or dorsal What anatomical terms describe the top and the bottom of the body? - Top= superior or cranial Bottom= inferior or caudal What anatomical term describe if something is near another structure, or farther away? Near= proximal Away= distal What word describes the palm of the hand? - Palmar What word describes the bottom or sole of the foot? - Plantar 11/17 What anatomical terms describe something that is either on or neat the surface of the body, or inside the body? - External is superficial or near the surface of the body Internal is deep inside the body What anatomical terms describe if something is near the middle of the body or more to the side of the body? - Medial is closer to the middle of the body Lateral is more the side/outside of the body What body organs remove erythrocytes from circulation when they are old or damaged? - The liver and the spleen What is the longest vein in the body? - The saphenous vein Name four body cavities? - 1. Cranial 2. Thoracic 3. Abdominal 4. Pelvic Where is the primary place RBCs and WBCs are made? What fraction or percent for each? - In the bone marrow 1/4 (25%) for RBCs 3/4 (75%) for WBCs What does hematocrit measure? What is the abbreviation for this test? - Hematocrit measures the VOLUME of RBCs in blood; Hct What does a differential blood count measure? Can you name 5 types of WBCs? - The number of each of the different blood cell types; The 5 kinds of WBCs are neutrophils, eosinophils, basophils, lymphocytes and monocytes What are the two different numbers in blood pressure readings called, and what do they represent? - Systolic-when the heart chambers are contracting Diastolic- when the heart chambers are resting What color vacuum tube is used for a blood culture? What is the additive? - Yellow; SPS (sodium polyanethol sulfonate) What does AFB stand for? What kind of test is it? - Acid-fast bacillus; blood or sputum test; Turberculosis What does a hemoglobin test measure? - Hemoglobin measures the iron containing pigment in RBC's that can carry oxygen and carbon dioxide; Hgb or Hb How does the additive heparin work? - Heparin prevents clotting by inhibiting thrombin formation 12/17 How does the additive EDTA work? - EDTA prevents clotting by binding (chelating) calcium(Ca) How does the additive Sodium Citrate work? - Na citrate prevents clotting by binding (chelating) calcium (Ca) What does the additive Sodium Flouride do? - Na flouride prevents glycolysis (sugar breakdown) and inhibits the growth of bacteria How does the additive Potassium Oxalate work? - K+ oxalate prevents coagulation by precipitating calcium (Ca) Which blood type is the universal recipient? - Universal recipient= AB (had both A and B antigen) Which blood type is the universal donor? - Universal donor= O (had no antigens) Where did the RH abbreviation come from? What does it stand for? - The Rhesus monkey. A protein, known as the D antigen (represented by a + sign if the protein is present) Which RH factor puts a woman at risk of having her 2nd child born with hemolytic disease of the newborn (HDN)? - RH- (negative), if her babies are both RH + What is ABORH? - The abbreviation for blood type and RH factor classification system. DO platelets aggregate or agglutinate? - Aggregate is a total mass by addition of parts Agglutination is the process of adhering Coagulation factors circulating in the blood stream are part of which coagulation pathway- Intrinsic or Extrinsic? - Intrinsic Coagulation step aided by the release of thromboplastin from injured tissue is part of which pathway- Intrinsic or Extrinsic? - Extrinsic The circulatory system can be divided into what two distinct parts? - 1. Pulmonary system (heart and lungs); and 2. Systemic system ( the rest of the blood vessels in the body) When doing therapeutic drug monitoring, the lowest blood (serum) level-just before the next does-is known as what? - Trough When a drug is circulating at the highest level in your bloodstream (serum), it is known as what? How long does it take for this affect to occur? - Peak; 30-60 minutes after the last dose 13/17 Matching blood types for transfusion occurs in which part of the clinical laboratory? Immunohematology Testing bleeding time occurs in which part of the clinical laboratory? - Hematologyspecifically coagulation testing Testing for tuberculosis occurs in which part of the clinical laboratory? - Microbiology Testing a lipid profile occurs in which part of the clinical laboratory? - Chemistry Testing for antibodies (e.g. for hepatitis, lupus, or HIV) occurs in which part of the clinical laboratory? - Serology/Immunology Testing a person's WBC occurs in which part of the clinical laboratory? - Hematology Testing for fungal infection occurs in which part of the clinical laboratory? - Microbiology When testing for blood alcohol level, what type of skin cleaner can you use? - Soap and water or Povidone iodine; benzalkonium chloride What is NAACLS? - National Accrediting Agency for Clinical Laboratory Sciences What is CLIAC? - Clinical Laboratory Improvement Advisory Committee What is COW? - Certificate of Waiver What is GLP? - Good Laboratory Practices The single, most important way to prevent the spread of infection while preforming phlebotomy is by? - washing hands After drawing the blood from a patient, the phlebotomist should dispose of the needle by? - depositing it in an approved "sharps container" Negligence by a professional person is called? - malpractice Which of the following is the single most common source of HIV and HBV in the workplace? - Blood The heart, lymphatic organs, and blood vessels are in the? - cardiovascular system The venipuncture site should be cleansed in a circular motion from the center to the? periphery Within the capillaries, blood cells? - Give away oxygen pick up carbon dioxide 14/17 pick up waste products Which is not an infection control method? - sphygomomanometers Safe working conditions for employees are regulated by? - OSHA Which of the following types of tourniquets are used in specimen collection? - Velcro Blood pressure cuff Pliable strap The color of normal serum is usually? - straw to yellow Which of the following conditions would stop a phlebotomist from drawing blood in a patient's vein? - same side mastectomy Chemicals that prevent blood from clotting are called? - anticoagulants Red and white blood cell counts are examples of what type of test? - microbiology Treating all specimens as if they are hazardous and infectious is the basis for? Universal Precautions Drugs used to destroy or kill bacteria that cause disease are called? - antibiotics When the heart is contracting, the pressure is highest. The pressure is called the? systolic pressure The process by which an object or area becomes unclean is known as? - contamination The healthcare worker is protected by law if it can be determined that he or she acted as expected when compared with fellow workers. This is called? - Respondent superior reasonable care duty of care none of the above Which of the following is not known to transmit HIV? - sweat Consent to treatment based upon full understanding of all possible risks of unpreventable results of that treatment is called? - assumption of risk Infections that can spread from person to person are called? - communicable A tube adapter that has been visibly contaminated with blood should be disposed of in? - a bio hazardous waste container 15/17 A violation of a person's right to have his or her name, photograph, or private affairs made public without giving consent is called? - invasion of privacy OSHA requires training and educational information on blood borne pathogens to be given to employees? - at no cost Characteristics of capillaries include? - a. being thin-walled in structure b. forming microscopic pathways c. connecting arterioles with venules d. all of the above Arterioles, the smallest arteries, subdivide into? - capillaries The branch of study of moral issues, questions, and problems arising in the practice of medicine and in biomedical research is called? - bioethics If a test requires serum, rather than plasma, a tube with what color top should be drawn? - red When using evacuated tubes for blood collection, it is crucial to remember to? - a. never under fill tubes that contain anticoagulant b. never use tubes past their expiration dates c. immediately invert any tubes that contain additives d. all of the above The rubber sleeve (at the end opposite the needle tip) on an evacuated tube needle makes it possible for use with? - multiple tubes Because bacteria and other micro-organisms can be found anywhere, all health care personnel should maintain sterility when handling? - a. IV supplies b. catheters c. instruments d. all of the above When entering a room marked with isolation signs? - read isolation signs to determine what PPE is appropriate What information must be included if the phlebotomist must manually label a blood collection tube from an outpatient? - a. patients full name and phlebotomist initials b. date of patient birth and or social security number c. date and time of draw d. all of the above The study of blood is called? - hematology The term asepsis literally means? - with out bacteria 16/17 The use of a chemical procedure to destroy all microbial life, including highly resistant bacterial endospores, is called? - sterilization Capillary blood sampling may be used if the laboratory test require? - very little blood The tube to collect whole blood with an EDTA additive in it, has what color stopper? lavender Diastolic pressure is? - the bottom number of blood pressure readings Do not draw blood ________ an intravenous infusion. - above Which of the following legally enforces the Blood-borne Pathogen Standard? - OSHA Common symptoms of shock include all of the following except? - temperature Which of the following causes AIDS? - HIV Eating and drinking are permissible in a laboratory setting? - only in designated clean areas In health care, when all evaluated services and results compare within acceptable standards, principles of ________ are being used? - quality assurance The tissue that covers and protects the body is? - epithelial A possible cause of tube breakage during centrifugation might be? - unbalanced centrifuge A tube containing sodium citrate as an additive is the? - blue top tube The lack of physical or mental fitness is? - incompetence The correct order of draw for a skin puncture is? - lavender, green, red What is the term for difficulty breathing? - dyspnea When using a blood pressure cuff as a tourniquet, inflate the cuff between mm hg? - 4060 mm hg (60-80 mm hg) 17/17