QUESTIONS AND VERIFIED SOLUTIONS
GRADED A+
◉ A phlebotomist is assigned to manage an outpatient draw station.
Prioritize the following patients in the correct order.
A. 2-hour post-prandial glucose level due in 40 minutes
B. type and screen on a pre-operative patient due for surgery that
day
C.weekly PT/INR
D.STAT troponin level on a patient sent over from a doctor's office.
Answer: STAT troponin level on a patient sent over from a doctor's
office, type and screen on a pre-operative patient due for surgery
that day, 2-hour post-prandial glucose level due in 40 minutes,
weekly PT/INR
Rationale
It is important that a phlebotomist be able to prioritize blood draw
orders. This assures that patients get correct and timely medical
treatment. A STAT troponin level is used to triage the possibility of
heart attack. The type and screen for surgery the same day is needed
so the Blood Bank staff can assure blood components can be ready if
necessary. For accurate results, timed tests need to be drawn within
a certain window. The weekly PT/INR can be done anytime.
,◉ A phlebotomist performs a blood draw testing for CBC, chemistry,
and bilirubin. After the draw, the phlebotomist wraps the bilirubin
tube in aluminum foil. Which of the following was the reason for the
wrapping of the bilirubin tube?
A. To cool down the specimen.
B. To maintain the specimen at 37 degrees Celsius.
C. To protect specimen from light.
D. To prevent contamination of the specimen.. Answer: To protect
specimen from light.
Rationale
Levels of bilirubin are susceptible to deterioration if exposed to
light. Bilirubin is the most sensitive - it may drop in concentration as
much as 50% in one hour. Therefore these tests are protected from
light by either wrapping the specimen in aluminum foil or
transferring the spun serum or plasma to a brown aliquot tube. The
specimen does not have to be cooled down or maintained at body
temperature (37oC). Also, the foil wrapping does not prevent
contamination of the specimen.
◉ Which of the following correctly matches the test with the
appropriate special handling instructions?
A. vitamin A specimen kept warm using a heating pack
,B. cryoglobulin level protected from light with aluminum foil
C. ammonia level kept warm using a heating pack
D. lactic acid chilled in slurry of ice and water. Answer: lactic acid
chilled in slurry of ice and water
Rationale
Some blood specimens require special treatment and handling to
preserve the analyte while being transported to the lab for testing.
Lactic acid and ammonia are chilled in ice slurries as they
deteriorate very quickly at room temperature. Cryoglobulin must be
kept at body temperature (in a 37 degree C heat block) until analysis
can begin. Vitamin A samples need to be protected from light and
may be wrapped with aluminum foil.
◉ The phlebotomist draws blood from a patient in an isolation
room. The specimen should be properly taken to the lab in a
A. red biohazard bag
B. yellow bag
C. biohazard transport bag
D. brown paper bag. Answer: biohazard transport bag
Rationale
Biohazard transport bags are used to transfer specimens to the lab
in an effort to prevent the spread on infection. There are two
pockets. The inside one holds the specimen and the outside pocket is
for any labels or paperwork. Red biohazard bags are used for
, disposal of medical waste such as used gloves or objects
contaminated with blood or body fluids. Yellow bags are used for
containing contaminated linens or PPE. Brown paper bags are not
used for specimen transport.
◉ Which of the following samples is still acceptable when kept at
room temperature for 8 hours after collection?
A. a urine sample
B. a stool culture
C. a glucose test in a gray top tube
D. a B12 test in a red top tube. Answer: a glucose test in a gray top
tube
Rationale
Glucose levels are stable in a gray top tube at room temperature for
up to three days because they contain the glycolytic inhibitor sodium
fluoride. A urine or stool sample would need to be refrigerated to
prevent overgrowth of bacteria or deterioration of analytes. Red top
tubes for B12 levels should be centrifuged and the serum removed
from the cells within 2 hours of collection.
◉ Which of the following blood tests require special handling?
(Select the three (3) correct answers.)
A. CBC