Phlebotomy BOC Exam with Accurate
Solutions
How is ammonia handled after being drawn? - ANSWER-it needs to be put on ice
Arteries carry blood away from the heart via _____? - ANSWER-Aorta
What carries blood back to heart - ANSWER-veins
Baby bilirubin; amber tube, Why? - ANSWER-bilirubin breaks down in the presence of
light, amber tube protects specimen from light
best site for baby heel stick - ANSWER-medial to big toe and lateral to the line between
4th and 5th toe on the fattiest part of the heel
Best way to break the chain of infection - ANSWER-hand hygiene
Blood alcohol; What do you use to cleanse the skin - ANSWER-not isopropyl alcohol;
povidone-iodine and benzalkonium chloride
Blood cultures; What is the #1 skin antiseptic? - ANSWER--povidone-iodine,
bezalkonium chloride
-due to iodine sensitivities chlorhexidine gluconate/ isopropyl alcohol antiseptic
preparations are being used
blood cultures - ANSWER-draw two at 30-60 minutes intervals
capillary blood - ANSWER-closer to arterial blood than venous
causes of hematoma - ANSWER-probing
going through the vein
using a cotton ball instead of gauze
Centrifudges - ANSWER-check every 3 months, balance with caps on
chain of custody - ANSWER-ID, Date, time of sampling handling
clean catch midstream urine - ANSWER-best for detecting bacterial infection
cold agglutinins, cryofibrinogen, cryoglobulines - ANSWER-keep sample warm; body
temperature; 37 degrees Celsius
,What if a patient has cold hands? - ANSWER-warm them before finger stick
contact isolation - ANSWER-use gloves and gown
How often do you do quality controls? - ANSWER-usually daily but depends on the
manufacturer
crying baby - ANSWER-wait one hour to draw
evacuated tube system - ANSWER-dispose of both needle and holder
fasting - ANSWER-12 hours of no food, water okay
which fingers do you use on a finger stick? - ANSWER-3rd and 4th
how often do you change gloves? - ANSWER-in between patients
hemolysis - ANSWER---when RBC are damaged or destroyed and the hemoglobin
escapes into the fluid portion of the specimen turning it pink to red depending on extent
--unsatisfactory for electrolytes, esp. potassium, also magnesium and most enzyme
tests
What could happen if you draw too much blood from infants? - ANSWER-anemia
How long do you leave iodine on for blood cultures? - ANSWER-at least 20 seconds
What if a patient has an IV? - ANSWER-draw below IV from a different vein
When do you label tubes? - ANSWER-after blood is collected
lancet position - ANSWER-perpendicular to fingerprint
lancets - ANSWER-control length to prevent bone injury
links in chain of infection - ANSWER-
mastectomy patient - ANSWER-draw from other arm so lymph nodes don't swell
negligence - ANSWER-failure to exercise due care that any reasonable professional
would do
i.e.
not disinfecting skin
forgetting to remove tourniquet
leaving a bed rail down
, If a tube doesn't have anticoagulant what does it result in? - ANSWER-serum
Oral glucose tolerance test (OGTT) - ANSWER-evaluates the body's ability to
metabolize glucose by monitoring the patient's tolerance to high levels of glucose
without adverse effects; evaluates the insulin response to a measured dose of glucose
by recording glucose levels on specimens collected at specific time intervals
OGTT - ANSWER---collect first sample 1 hour after patient finishes drinking glucose
beverage for gestational diabetes
--3 hours after beverage for other glucose metabolism evaluations
--if patient eats something contact doctor before continuing
lactose tolerance test - ANSWER---suggested that a 2-hour GTT be performed the day
before the lactose tolerance test
--2-hour lactose test is performed the same as GTT except with lactose instead of
glucose
--if the patient is lactose intolerant the glucose levels don't rise above fasting level
order of draw - ANSWER-Stop Light Red Stay Put Green Light Go
Sterile (blood culture)
Light Blue
Red
SST (Gold)
PST (Light Green)
Green
Lavender
Gray
Patient ID - ANSWER-always ask for name and birthday
Peak and trough drug levels; When do you draw? - ANSWER---peak levels are
collected when the highest serum concentration of the drug is anticipated; 30 min after
IV , 60 min after IM, and 1-2 hours after oral intake
--trough levels are collected when the lowest serum concentration of the drug is
expected; taken prior to next dose being given
Pneumatic tube systems - ANSWER-not recommended (causes hemolysis)
Postprandial (PP) - ANSWER-means after a meal
Principles of 2-hour PP specimen collection - ANSWER--the patient is placed on a high-
carb diet for 2 to 3 days prior to test.
-the patient is NPO (food, drink besides water, or smoking) 10 hours before the test
-a fasting glucose specimen may be collected before the start of test
-the patient is instructed to intake 100 grams of glucose for breakfast
-blood glucose specimen is collected 2 hours after the patient finished eating
Solutions
How is ammonia handled after being drawn? - ANSWER-it needs to be put on ice
Arteries carry blood away from the heart via _____? - ANSWER-Aorta
What carries blood back to heart - ANSWER-veins
Baby bilirubin; amber tube, Why? - ANSWER-bilirubin breaks down in the presence of
light, amber tube protects specimen from light
best site for baby heel stick - ANSWER-medial to big toe and lateral to the line between
4th and 5th toe on the fattiest part of the heel
Best way to break the chain of infection - ANSWER-hand hygiene
Blood alcohol; What do you use to cleanse the skin - ANSWER-not isopropyl alcohol;
povidone-iodine and benzalkonium chloride
Blood cultures; What is the #1 skin antiseptic? - ANSWER--povidone-iodine,
bezalkonium chloride
-due to iodine sensitivities chlorhexidine gluconate/ isopropyl alcohol antiseptic
preparations are being used
blood cultures - ANSWER-draw two at 30-60 minutes intervals
capillary blood - ANSWER-closer to arterial blood than venous
causes of hematoma - ANSWER-probing
going through the vein
using a cotton ball instead of gauze
Centrifudges - ANSWER-check every 3 months, balance with caps on
chain of custody - ANSWER-ID, Date, time of sampling handling
clean catch midstream urine - ANSWER-best for detecting bacterial infection
cold agglutinins, cryofibrinogen, cryoglobulines - ANSWER-keep sample warm; body
temperature; 37 degrees Celsius
,What if a patient has cold hands? - ANSWER-warm them before finger stick
contact isolation - ANSWER-use gloves and gown
How often do you do quality controls? - ANSWER-usually daily but depends on the
manufacturer
crying baby - ANSWER-wait one hour to draw
evacuated tube system - ANSWER-dispose of both needle and holder
fasting - ANSWER-12 hours of no food, water okay
which fingers do you use on a finger stick? - ANSWER-3rd and 4th
how often do you change gloves? - ANSWER-in between patients
hemolysis - ANSWER---when RBC are damaged or destroyed and the hemoglobin
escapes into the fluid portion of the specimen turning it pink to red depending on extent
--unsatisfactory for electrolytes, esp. potassium, also magnesium and most enzyme
tests
What could happen if you draw too much blood from infants? - ANSWER-anemia
How long do you leave iodine on for blood cultures? - ANSWER-at least 20 seconds
What if a patient has an IV? - ANSWER-draw below IV from a different vein
When do you label tubes? - ANSWER-after blood is collected
lancet position - ANSWER-perpendicular to fingerprint
lancets - ANSWER-control length to prevent bone injury
links in chain of infection - ANSWER-
mastectomy patient - ANSWER-draw from other arm so lymph nodes don't swell
negligence - ANSWER-failure to exercise due care that any reasonable professional
would do
i.e.
not disinfecting skin
forgetting to remove tourniquet
leaving a bed rail down
, If a tube doesn't have anticoagulant what does it result in? - ANSWER-serum
Oral glucose tolerance test (OGTT) - ANSWER-evaluates the body's ability to
metabolize glucose by monitoring the patient's tolerance to high levels of glucose
without adverse effects; evaluates the insulin response to a measured dose of glucose
by recording glucose levels on specimens collected at specific time intervals
OGTT - ANSWER---collect first sample 1 hour after patient finishes drinking glucose
beverage for gestational diabetes
--3 hours after beverage for other glucose metabolism evaluations
--if patient eats something contact doctor before continuing
lactose tolerance test - ANSWER---suggested that a 2-hour GTT be performed the day
before the lactose tolerance test
--2-hour lactose test is performed the same as GTT except with lactose instead of
glucose
--if the patient is lactose intolerant the glucose levels don't rise above fasting level
order of draw - ANSWER-Stop Light Red Stay Put Green Light Go
Sterile (blood culture)
Light Blue
Red
SST (Gold)
PST (Light Green)
Green
Lavender
Gray
Patient ID - ANSWER-always ask for name and birthday
Peak and trough drug levels; When do you draw? - ANSWER---peak levels are
collected when the highest serum concentration of the drug is anticipated; 30 min after
IV , 60 min after IM, and 1-2 hours after oral intake
--trough levels are collected when the lowest serum concentration of the drug is
expected; taken prior to next dose being given
Pneumatic tube systems - ANSWER-not recommended (causes hemolysis)
Postprandial (PP) - ANSWER-means after a meal
Principles of 2-hour PP specimen collection - ANSWER--the patient is placed on a high-
carb diet for 2 to 3 days prior to test.
-the patient is NPO (food, drink besides water, or smoking) 10 hours before the test
-a fasting glucose specimen may be collected before the start of test
-the patient is instructed to intake 100 grams of glucose for breakfast
-blood glucose specimen is collected 2 hours after the patient finished eating
