CPT Phlebotomy Exam Study Guide Rated A+

CPT Phlebotomy Exam Study Guide Rated A+ What is phlebotomy? The process of drawing blood What is a phlebotomist? A trained professional in blood drawing Which of the following is a part of a phlebotomist's POC job related duties? Taking blood pressure, instructing patients on urine specimen collection, and performing POC testing All of the following are true about laboratory safety Protect your feet from spills, always wear required personal protection equipment As written in the Patient Care Partnership from the American Hospital Association, the patient has the right to: High quality care, protection of privacy, help with billing claims Certification is evidence that: The phlebotomist has demonstrated proficiency in the area of blood drawing Which of the is OSHA required personal protection equipment? Goggles, chin-length face shield, full-length lab coat The Clinical Laboratory Improvement Act of 1988 follows guidelines and standards set by the: CLSI Samples collected from a patient in a nursing home are sent to the: Reference laboratory Quality assurance for laboratory personnel includes all of the following Specimen collection procedures, Specimen transport processes, Specimen processing policies Personal protection equipment must be provided by the Employer Which of the following personal protection equipment must a phlebotomist use when performing a skin puncture or venipuncture? Gloves Under HIPPA, protected health is defined as: Any part of a pt's health information that is linked to information that identifies the pt. Employers must provide vaccination against what free of charge? Hep B Which of the following would be a reason for a rejection of a specimen by the lab? An ESR has been collected in a red-topped tube The quality of the test result depends on: The time between collecting the specimen and analyzing the specimen The purpose of Total Quality Management is to: Check machinery with automated procedures, ensure that proper laboratory procedures are being followed, ensure that adequate patient care is being provided. A specimen may be rejected by the lab if: The tube was not initialed, the blood is hemolyzed, the tube was not transported properly. Transport bags have a separate compartment (pouch) for the requisition to: Prevent contamination if the specimen leaks Acceptable methods of identifying a patient include: Ask the pt to give his or her name and DOB, check the pts ID band, ask the pt to present a photo ID What is the proper procedure for a phlebotomist to follow if a physician or member of the clergy is in the pts room at the time of draw? Return at another time if the specimen is not a stat request Most tubes that containing additives should be inverted: 5 to 8 times The lavender topped tube contains: EDTA The green topped tube contains: Heparin The yellow topped tube contains: SPS or ACD The glass red topped tube contains: No additive Which of the following tubes contains sodium fluoride and potassium oxalate? Grey topped tube Which of the following tubes would hold a glucose specimen for 24 hours? Grey topped tube In which tube would a phlebotomist collect an erythrocyte sedimentation rate? Lavender topped tube Cardiac enzymes are drawn in a: Red topped tube Which of the following tubes yield a serum specimen? Red topped tube Coagulation studies include all of the following: Prothrombin time, Partial thromboplastin time, and platelet function Why should a red topped tube be drawn before a green topped tube? Since there are no additives in the red topped tube, it cannot contaminate the green topped tube. Which of the following is false for blood culture collection? The culture must be collected in the red and marble topped tube and a tourniquet is not used for blood culture collection. Which is true for arterial blood gas collection? The area must be prepped with iodine before the draw. A heparinized needle and syringe are necessary in the collection of: ABG A Hemogard top: Is a plastic top that fits over the stopper, is used to reduce aerosol and splattering of blood Cold agglutinin test must be maintained at a temperature of: 32 degrees F Chilling a specimen will: Maintain the stability of the specimen during transport Specimens for the following test must be kept chilled Ammonia, Pyruvate, and Lactic Acid When labeling a tube all of the following must be placed on them Pt's name, date, time of draw, and phlebotomist initials What is not needed for a routine phlebotomy procedure? Iodine What additional equipment may be needed when drawing blood from a patient in the premature nursery? Additional PPE (because they are immunocompromised) The depth of a heel puncture cannot exceed 2mm The tourniquet is placed how many inches above the site of draw 3-4 inches When a tourniquet is left on too tight, capillaries may rupture, causing Petechiae What is true when using a tourniquet during a phlebotomy procedure? Never tie a tourniquet on open sores, tying a tourniquet too tightly can cause petechiae, leaving on too long can cause hemoconcentration Phlebotomist must inspect the needle for: burrs, expiration date, and bevel facing up The smaller the needle The larger the gauge A butterfly needle should be used on: Pts with sclerosed veins and one tube being drawn, on adults' dorsal and metacarpal veins, on pediatric and geriatric pts A tube holder is used to connect and evacuated tube to: Ensure a firm, stable connection between them The proper way to dispose of a needle is to: Put it a sharps container, without recapping, immediately withdrawing it from a patient In making a selection, the phlebotomist should consider which of the following before a venipuncture Scars or burns, edema, mastectomy What is the correct way for ending the phlebotomy procedure Remove the tourniquet, remove the tube, place the gauze, remove the needle, apply pressure, and discard the needle in the sharps container. The most commonly occurring complication in phlebotomy is: Hematoma A tourniquet that has been left on too long can cause: Petechiae, hemolysis, hemoconcentration What should a phlebotomist do first if a pt has syncope during a phlebotomy procedure? Remove the needle and tourniquet, and apply pressure What are the signs and symptom of syncope? Cold, damp, clammy skin Blood that has seeped from a vein into tissue is called: Hemotoma Which of the following my cause vein occlusion? Sphygmomanometer What complication may occur if the phlebotomist punctures a bone? Osteomyelitis Veins that are hard and cordlike are called: Sclerosed The term that means the rupturing of red blood cell is: Hemolysis High bilirubin levels can lead to: Jaundice, which can lead to brain damage Thrombosis Clot formation within blood vessel Which of the following will cause a shortened bleeding time in a bleeding time in a bleeding time test? Hair at the incision site A hematoma can be prevented if: Pressure is applied on the vein until bleeding stops completely Aspirin may affect a pts: Bleeding time In a CSF collection, the phlebotomist will: Transport the specimen to the lab Midstream clean catch urine collection are: Obtained by a phlebotomist and collected in a sterile container The process for collecting amniotic fluid is known as: An amniocentesis The amniotic fluid must be: Transferred into a sterile container, protected from light, transported immediately to the lab for analysis Prompt delivery to the lab of semen samples is necessary to determine what: Viability in fertility Fecal specimens are collected for: Ova and parasite testing, testing for digestive abnormalities, occult blood analysis What is the best sample to determine blood pH and blood gases? Arterial blood An un-iced ABG must be delivered to the lab 5-10 minutes Arterial blood gas must be processed immediately to minimize Changes in the analyte All of the following are safety equipment for arterial blood gas collection except a: Transport container If the modified Allen test is negative, Another artery must be selected for blood collection The NP culture is used to diagnose: Whooping cough, croup, and respiratory infections The SE test is used to diagnose: Cystic fibrosis Which procedure is normally collected by a nurse or respiratory therapist? Arterial blood gas Dermal punctures can be used as an alternate for all of the following except: ESR For which of the following pts should a dermal puncture be performed? Ps who require frequent blood draws, pts with burns on the arms, pts who are at risk for venous thrombosis Which of the following is the reason for cleansing the first drop of blood in a dermal puncture? To rid the specimen of fluid from tissue When collecting blood from a child, the phlebotomist should: Consider the psychological aspect of the draw, log the amount of blood collected to avoid depletion, collect dermal punctures whenever possible Which of the following should a phlebotomist not do when drawing blood from a child? Tell the child that the procedure will not hurt What does the phlebotomist look for when identifying a newborn? The hospital identification number and the last name Improper cleansing of a venipuncture site can cause: Septicemia Which of the following components is needed in order to make what is known as the chain of infection? Causative agent A health care-related infection is: An infection contracted within a health care institution When a pt has a highly contagious disease, he or she is placed: In strict isolation A pt who is known to have a blood transmissible disease is placed: On blood and body fluid precautions A pt who has diarrhea and bacterial gastroenteritis disease is placed: In enteric isolation Pts within a neonatal ICU/burn unit or the recovery room are: In a protective environment The most infectious health care-acquired disease is: HCV An infection is: The invasion and growth of a pathogen Microorganisms that cause disease Pathogenic Which of the following are causative agents? Bacteria, viruses, protozoa, and fungi Elevation of what is an indication of an infection Leukocytes The primary function of a red blood cell is to: Carry hemoglobin The most abundant white blood cell is the: Neutrophil The liquid portion of blood is: Plasma The average adult has approximately how much blood? 5L The vein most commonly used for venipuncture is: The median cubital Veins carry: Oxygenated blood away from heart Arteries carry: Deoxygenated blood away from the heart The outermost layer of the heart is the: Epicardium The contractile layer of the heart is the: Myocardium The upper receiving chamber of the heart is the: Atrium What heart chamber has the thickest myocardium The left ventricle What of the following are semilunar valves? The aortic valve and the pulmonary valve What are atrioventricular valves? The mitral or bicuspid valve and the tricuspid valve The aorta is: The major artery The pulmonary vein will carry blood: To the heart from the lung The exchange of oxygen and carbon dioxide occurs in: The capillaries A loss of pituitary gland function: Is likely to be very serious, since this gland regulate many others When a person has adequate rest and has not eaten in 12 hours, it is called: Basal state The location where bones come together is called: Joints The appendicular and the axial are two main divisions of the: Skeleton The three kinds of muscles in the body are: Skeletal, smooth, and cardiac The beginning of a muscle is attached to a bone that the muscle cannot move. This is called Origin What kind of muscle straightens a part of the body? Extensor The stomach passes food into the: small intestine Compared to arteries, veins: Have thinner walls, carry blood under lower pressure, and may be closer to the surface of the skin Tissue fluid is returned to the circulation through the: Lymphatic The correct ratio of plasma to formed elements in the blood? 55% plasma, 45% formed elements The master gland in the endocrine system is/are the: Pituitary The phlebotomist dropped a tube of blood on the floor and it broke on impact. The proper way to clean up the blood and broken glass includes all of the following: Don PPE as required by facility, pick up the glass using forceps, saturate site with bleach Mary the phlebotomist brought in ice cream bars in celebration of passing her certification exam. She put them in the freezer thinking it was alright because only test reagents, no blood or body fluids, were stored inside. She was reprimanded for all of the following: Test reagents can contain blood or vody fluids, no food or drink is allowed in the lab without permission, laboratories are designated as biohazardous, and OSHA regulations were violated. The phlebotomists prepares to draw blood on a child that refused to sit in the chair and have her blood drawn. Why can the phlebotomist proceed with the procedure? Parental consent was given in the case of the minor The phlebotomist donned gloves, gown, and goggles before performing an ABG procedure. She is still at risk for which type of exposure? Cutaneous, permucosal, and percutaneous A patient in open heart recovery has an order for an H&H, glucose, electrolytes, and ABGs. The phlebotomist tells the nurse to collect all of the specimens through the arterial line because: Blood samples will be labeled as arterial samples While in the ER performing a venipuncture, you, the pt, and the pt's family clearly overhear two nurses outside the room discussing the pt next to you. You should: Report the breach of confidentiality to your supervisor You are working quickly to complete your early AM draws when you encounter a difficult draw on a newborn. You should call down to the lab for assistance because you: Are nearing the acceptable time lapse between collection of the specimen and analysis While performing QC on a point-of-care instrument for glucose testing prior to the 10 PM patient glucose testing, the phlebotomist records a QC value for the abnormal control that is two points out of range. The appropriate course of action is to: Initiate trouble shooting protocol for out-of-range controls While processing a specimen, the phlebotomist accidently spills serum on the requisition. The phlebotomist should: Disinfect the contaminated area with 10% bleach and blot dry The phlebotomist has an order for a blood draw on his father who is in the hospital. The phlebotomist can identify his father by: Asking the pt to state his name and checking the requisition against the pt's armband As you are putting away the new order of vaccutainer tubes, you should: Position current stock so it will be used up first Why is it important that the pt see the phlebotomist wash his or her hands before and after the draw? So the pt is assured that infection control policies are being followed The ER nurse hands the phlebotomist an ID bracelet to put on a trauma pt so the phlebotomist can draw stat labs. The phlebotomist should: Inform the nurse that he or she is not allowed to do so and , request that the pt put it on The phlebotomist walks into open heat recovery to pick up the pt's specimens for transport to the lab and notices one nurse drawing from the arterial line while the other nurse transfer blood into a lavender, light blue, and heparin tube, placing each tube on the bed after filling, and then turns to help the other nurse flush the line. The proper course of action is to: Pick up all of the tubes and immediately begin inversion eight to ten times the pt was in a hurry to leave and the phlebotomist had not labeled all of the tubes. As she exits the room with the pt she takes the tubes and sets them down on the counter outside the room and walks the pt to the exit door, giving instructions for puncture wound care. Another phlebotomist comes by, picks up the tubes and the requisition, and puts them in the rack for delivery to processing. The proper course of action is to: Reject the specimen for labeling error and call the pt in for a redraw You are on your last pt for the AM draws only to find that you have almost depleted your supple of tubes. The order is for a CBC and electrolytes, and you only have lavender and red tops left on your tray. The proper course of action is to: Draw one lavender tube for Hematology and one red top tube for Chemistry You receive a specimen from a physician's office dated yesterday. The specimen is now 18 hours, but you do not reject it because it was: A glucose test drawn in a gray top When processing the specimens that the courier just dropped off, you find that there are four tests ordered but only two tubes received : one lavender and one SST tube. The requisition is marked for a CBC, RPR, BUN, and creatinine. The phlebotomist should: Make aliquots from the SST tube for the RPR and BUN/ Creatinine tests After putting a tourniquet on a pt, th phlebotomist notice the development of petechiae. She verified correct application of the tourniquet and should now: The phlebotomist removed the cap from the needle, proceeded to anchor the vein, and noticed he forgot to reapply the tourniquet. The appropriate course of action would be: Discard the vaccuatiner and needle unit and start the procedure over The phlebotomist enters a pts room and says, "Hi, John. I need to draw some blood again." The phlebotomist's identification of the pt is: Not ok because proper identification of the pt must be adhered to at all times.