PHLEBOTOMY PRACTICE TEST 2023 WITH COMPLETE SOLUTION

PHLEBOTOMY PRACTICE TEST 2023 WITH COMPLETE SOLUTION Most important step in venipuncture? - answerPatient identification What is PPE? - answerPersonal Protective Equipment What is the best way to let a clean site dry? - answerAir dry OSHA requires all phlebotomist to be trained regarding what? - answerBlood borne pathogens and needle saftey All specimens are considered hazardous and infectious so we must use what? - answerUniversal and or Standard precautions What organization should be contacted regarding employee safety and unsafe working conditions? - answerOSHA (occupational safety and health administration What does MSDS mean and what is it part of? - answerMaterial Safety Data Sheet (right to know law) What color tube, and additive is used for CBC, Hct, Hgb, Sed rate? - answerLavender, EDTA Which tube has no additive? - answerRed What color tube and which additive is used for protime and APTT? - answerLt. Blue, sodium citrate What is the ratio of blood to additive in a light blue tube? - answer9 to 1 Which additive is the best choice for an ethanol specimen? - answerNa fluoride What color tube is an ethanol specimen drawn in? - answerGrey In case of a needle stick accident you should? - answerCleanse the site, get patient information if able, and notify your supervisor What is the purpose of the tourniquet? - answerTo find the vein How long can the tourniquet be in place? - answer1 minute What is the first thing you must do after every finger stick? - answerWipe away the first drop Why is it necessary to keep the centrifuge lid closed until it comes to a complete stop? - answerIt reduced the chance of aerosol and microbial contamination What angle should your slider be when making blood smears? - answer30 degrees What should you do if a standard size tube collapses the veins? - answerUse a pediatric tube Which cleansers are most common for blood culture site preparation? - answerpovidone iodine or 2% chlorhexidine What characteristics do sharps disposal containers have? - answerSpill proof, tamper proof, and puncture resistant. When used for decontamination, the dilution for bleach in water should be what? - answer10% bleach, 90% water Which point of care test is done to determine a platelet plug formation? - answerBleeding time (also known as platelet function assay) Where in the wrist area are ABGs done and which artery? - answerOuter aspect of the wrist and from the radial artery Which are the smallest vessels in the body? - answerCapillaries Which are the smallest veins in the body? - answerVenules The respiratory system is responsible for? - answerBreathing and the exchange of oxygen and carbon dioxide Common site cleanser for a venipuncture is? - answer70% isopropyl alcohol When anticoagulated blood is spun down in the centrifuge, how does it separate? - answerPlasma (top), buffy coal = WBCs & platelets (middle), Red blood cells (bottom) MSDS is part of the? - answerRight to Know Law When you leave the patient's room, make sure that? - answerEverything 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? - answerSerum= the fluid portion of clotted blood Plasma= fluid portion of unclotted blood which contains all of its clotting factors (fibrinogen) Empathy is? - answerThe Validation of a persons feelings QA indicators are what? - answerMeasurable factors System that filters, eliminates wastes, regulates water balance is the? - answerUrinary system If a patient has fragile skin or excessive hair, where should the tourniquet be placed? - answerOver their clothing or a piece of coflex/coband When drawing on a burn victim? - answerLook for a site that is the least damaged or scarred for the draw Even if you wear gloves, your hands should be washed when? - answerBefore 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? - answerErrors in the results by diluting with tissue fluid If an I.V is present you much draw blood where? - answerBelow the I.V What vein is most likely to be used for an obese patient? - answerThe cephalic If swelling occurs or a hematoma begins to form at the venipuncture site you must? - answerRemove the tourniquet and needle and apply pressure The most prevalent work related acquired infection in the laboratory is? - answerHepatitis B Fibrin strands may be present in serum because? - answerIt was centrifuged What should you do if the information is not correct on the patient's I.D bands/requisitions? - answerDo 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? - answerDo not draw Two forms of outpatient I.D are? - answerSpelling name and birthdate Bursting capillaries cause small red pin-point clusters are known as? - answerPetechiae Reverse or protective isolation is for the protections of? - answerImmuno-compromised patients What is the name of the system used for unidentified patients? - answerSpecial 3 part I.D system What is the most common complications of phlebotomy? - answerHematoma What happens when the tourniquet is on to long? - answerHemoconcentration How do you transport Bilirubin? - answerBy protecting it from light What test is ordered to determine PH and blood gas? - answerArterial Blood Gases (ABGs) What test would be ordered to detect hematuria? - answerUrinalysis What test would be ordered if the patient is suffering from FUO? (fever of unknown origin) - answerBlood Cultures What tube is used for STAT electrolytes and what is the additive? - answerGreen top and Heparin is the additive Sample mailers have a few distinctive warnings to their label. They are? - answerBiohazard sign, send to CDC in case of breakage, name and address of sender and receiver What is the chain of custody? - answerThe tracking of legal samples Doctors order glucose monitoring for patients withwhich disorder? - answerDiabetes How long do Red blood cells live for? - answer120 days What is a reticulocyte and how long does it live for? - answerAn immature red cell and lives for about one day What does a glucose test monitor? - answerSugar level All I.V supplies must be handled with care and kept? - answerSterile What is a sphygmomanometer used for? - answerBlood pressure Medical ethics can identify a professional as? - answerMorally desirable Define negligence vs. malpractice? - answerNegligence is failure to exercise due care Malpractice is negligence by a professional Sedrate or ESR is drawn on what color tube? - answerLavender Which PPE will keep you the safest when body substance or wounds are present? - answerGloves What has to be supplied by chemical manufacture according to the Right to Know Law? - answerMSDS (Material Safety Data Sheet) Parenteral transmission means infection can enter through everything except? - answerThe digestive tract Does the tourniquet need to be on the entire time? - answerNo, its the phlebotomist call In what direction is a concentric circle? - answerCenter to periphery What test is ordered to confirm hyper or hypoglycemia? - answerGTT If something is easily combustible what color and number would you expect to see? - answerRed-4 IF a moderate health hazard would exist what color and number would you expect to see? - answerBlue-2 If you do not let the cleaners dry before performing a blood culture you might get what? - answerContaminated 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? - answer2000ml or 2L How do you transport cold agglutinin after collection? - answerAt body temperature Cardio vascular system includes? - answerHeart and vessels It is your job as a part of being a health professional to? - answerMake your patient as comfortable and at ease as possible What could happen if you carelessly remove a stopper from an evacuated tube of blood? - answerCould cause an aerosol (like popping the champagne bottle) What is included in the microorganism category that can exist in body fluids? - answerFungus, bacterium, virus What are examples of timed tests? - answerGTT, Medication monitoring Selection of a preferred care giver has to do with what? - answerInsurance PPO/HMO. Not a patient right What does contamination mean? - answerIt is not clean anymore Extrinsic coagulation function is evaluated by what test? - answerProtime, Prothrombin time, PT CLSI (Clinical Laboratory Standards Institute) is formerly known as? - answerNCCLS (National Committee for Clinical Laboratory Standards) Every year laboratory employees must take a test to demonstrate what? - answerCompetence What should you do if you get blood on a requisition or on the side of a tube? - answerWipe off with disinfectant Positive body language is? - answerBeing sure of yourself, being confident. It is not being irate or cowering. Which fingers are used for skin puncture, most often? - answerThird and fourth digits. Leg and foot draws can only be done? - answerWith 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? - answerSkin puncture; "finger stick"; capillary draw What could cause "failure to obtain blood" - answerMissing the vein altogether, not going deep enough, or going through the vein Urinary track infection is the most common? - answerNosocomial infection What is the most common size needle used for venipuncture? - answer21 gauge Which is larger 18 or24? - answer18 When using additive tubes, when should you start the mixing process? - answerImmediately What is the additive in a grey top tube? - answerNa fluoride and K oxalate What is the additive in additive in a green top tube? - answerHeparin TDM means therapeutic drug monitoring. It is important to know the? - answerTime of the last dose The feathered edge of a smear is how many layers thick? - answerOne layer What is the first step in phlebotomy? - answerIntroduction and explanation What is the difference between "inpatient" and "ambulatory patient"? - answerInpatient stays overnight and the ambulatory is out patient What is a VAD? - answerVascular Access Device What would you do if a patient has an I.V. In the right arm? - answerLook for a vein in the left arm A patient states she/he has had a mastectomy on the left breast. What would you NOT DO? - answerYou 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? - answerAn alternative to adhesive/coflex is gauze all around and then taped What are the three common veins for venipuncture? - answerMedian antecubital, cephalic, and basilic What is the requirement by the government when shipping specimens? - answerContainer must be water tight Services and results that meet accepted standards are? - answerQuality Assurance Extracting too much blood especially from infants could put the patient in danger of becoming what? - answerAnemic What would you do if you found two or three requisitions from different doctors for the same order? - answerMake 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? - answerNothing until you get the correct I.D confirmed What is Hemostasis? - answerThe ability to stop bleeding. In order to ensure Hemostasis all of these must be in good working order/have the proper amount? - answerAll the vessels, coagulation factors, and the platelets Q.N.S. Stands for? - answerQuantity non-sufficient Which part of the analytical process are phlebotomists involved in? - answerThe preanalytical Doing the right thing when nobody is looking is? - answerIntegrity AIDS stands for what? - answerAcquired Immune Deficiency Syndrome What happens if a specimen is misplaced for several days at room temp? - answerYou must re-draw One thing the healthcare industry did to lessen the spread of infection? - answerThey started using disposable equipment Name the 3 types of blood cell? - answerErythocytes, leukocytes, thrombocytes Parents sometimes get a prescription for a topical anesthetic for their child, which is called? - answerEMLA Which cell is the transport cell? - answerRBC transports oxygen and nutrients If a language barrier between you and the patient, what would you do? - answerMust have a translator As healthcare workers, it is very important to be aware of surroundings? - answerDo 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? - answerHepatitis B Injury could occur on an infant's foot if you used a lancet that penetrated deeper than? - answer2.0 mm Checking the expiration dates on collection tubes is part of? - answerQuality assurance or quality control Blood cultures are drawn in a set of two bottles. Name the differences between the bottles? - answerOne is aerobic (has air in it) the other is anaerobic (no air) What five things must be on a specimen label? - answerPt. 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? - answerInsufficient mixing If red blotches appears after a tourniquet is applied of skin is in contact with gloves. What would you suspect? - answerThe patient might have a latex allergy If you are collecting blood and the patient stops breathing, what would you do? - answerStop everything and call for help TB isolation requires what? - answerN95 respirator, gown and gloves (all airborne isolation's require these) What would you do with expired tube? - answerDiscard them Why would you put a stick in a centrifuged specimen? - answerTo check for presence of Fibrin (serum only) A family member wants family records. Who regulates this matter? - answerThe patient must give written permission for medical personnel to release information. The confidentiality law that regulates this is HIPAA You have a trauma and a timed test. Which should you do first? - answerTrauma, then the timed test Why do you use a N95 for TB patients? - answerBecause TB is an airborne mycobacteria What is another name for a "winged apparatus"? - answerButterfly needle The joint commission is responsible for what? - answerRequires 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) - answer8 to 12 hours How many draws are needed for a GTT? - answerTWO, plus the number of hours for the test Who is the Director of the Laboratory? - answerThe Pathologist List the Priority of Draw? - answerER/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? - answerNegligence Which patient is most likely to have more than (1) I.D bracelet? - answerNewborn, patient admitted through ER, Patient getting transfusion Name the gel in a SST or PST tube? - answerThixotropic gel Name the Order of Draw for non-capillary blood samples? - answerYellow 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? - answerLavender? EDTA specimens; other additive specimens; Red/serum specimens What is Hirudo Medicinalis? - answerA european medicinal leech What initials are used to designate a phlebotomist certified by the National Credentialing Agency? - answerCLPlb (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? - answerCPT (ACA) Certified Phlebotomy Technician What does ETS stand for? - answerEvacuated Tube System What is this? - answerBiohazrard Symbol What is this? - answerRadioactive Symbol What do the colors mean? - answerRed 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? - answer0 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? - answerEngineering controls Give two examples of engineering controls? - answerSharps containers Safety needles Hazard signs Safety transfer devices Biohazard bags MSDS Give an example of a "Work Practice Control"? - answerHand washing, Designated areas for activities like eating What 3 factors relate to radiation exposure? - answer1. 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? - answerRACE R-Rescue A-Alarm C-Confine E-Extinguish What does CAP stand for? - answerCollege of American Pathologist What does CLIA stand for? - answerClinical Laboratory Improvement Amendment (of 1988) What does agglutinate mean? - answerClumping or sticking together What is the difference between STAT and ASAP? - answerSTAT- immediately ASAP- as soon as possible/ when possible Does Ca mean the same thing as CA? - answerNO, Ca=calcium and CA=cancer What is Homeostasis? - answerThe "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? - answerThe 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? - answerThe Nervous system What are the two main structural divisions in the Nervous System? - answerStructural= 1. Central Nervous System 2. Peripheral Nervous System What are the two main functional divisions in the Nervous system/ - answerFunctional=1. Somatic (voluntary) 2. Autonomic (involuntary) What anatomical plane divides the body into front and back? - answerFrontal, also known as Coronal What anatomical plane divides the body into top and bottom? - answerTransverse, also known as horizontal What anatomical planes divides the body into equal/unequal right and left? - answerMidsagittla is equal right and left; Sagittal can be unequal right and left What anatomical terms describe the front and the back of the body? - answerFront= anterior or ventral Back= posterior or dorsal What anatomical terms describe the top and the bottom of the body? - answerTop= superior or cranial Bottom= inferior or caudal What anatomical term describe if something is near another structure, or farther away? - answerNear= proximal Away= distal What word describes the palm of the hand? - answerPalmar What word describes the bottom or sole of the foot? - answerPlantar What anatomical terms describe something that is either on or neat the surface of the body, or inside the body? - answerExternal 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? - answerMedial 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? - answerThe liver and the spleen