Phlebotomy ASCP Test 100% Correct

What would happen to an infant if you punctured the foot or finger bone? - ANSWER osteomyelitis Why is it important to wipe the first drop away before collecting blood? - ANSWER wipe the excess, bacteria What is the correct order of draw for microtainers? - ANSWER blood gas, EDTA, other additive, serum specimens When would you do a dermal puncture on a child? Why? - ANSWER 2 years old and under because venipuncture can damage veins. A child can get injured from venipuncture. Why is it important to notate dermal puncture blood was collected? - ANSWER billing Why is it important to warm the site before a dermal puncture? - ANSWER to get the blood flowing What is the PPE's needed to perform a venipuncture? - ANSWER gloves, gown, nose, eye, mouth protection What would you do if a patient had latex sensitivity? - ANSWER use latex free gloves What would you do if you have a latex sensitivity? - ANSWER use latex free gloves What is an MSDS? - ANSWER Material Safety Data Sheet What is the MSDS used for and when? - ANSWER distribute hazardous chemical What does OSHA stand for? - ANSWER Occupational Safety and Health Administration Who is OSHA beneficial to? - ANSWER Health care employees What is contained in the MSDS? - ANSWER information about chemicals When and how do you use a fire extinguisher? - ANSWER when there is a fire and 10 feet away What is the main job for a phlebotomist? - ANSWER collect specimens What educational requirements are needed to be an MLT? - ANSWER 2 years of college What are other names for a MT? - ANSWER Medical Laboratory Scientists What educational requirements are needed to be an MT? - ANSWER 4 years of college A pathologist is a medical doctor who is the head of what? - ANSWER Everyone. A medical director What are the two separate divisions under the pathologists? - ANSWER Clinical and Anatomical What is Licensure? - ANSWER the granting or regulation of licenses, as for professionals What is a certification? - ANSWER Evidence that an individual has demonstrated proficiency in a particular area of practice. Do you have to be certified to do phlebotomy? - ANSWER For some states yes, most no Accredited applied to who or what? - ANSWER Colleges, NAACLS CAP accredits who? How often is the lab visit by CAP? - ANSWER Every 2 years SST stands for - ANSWER serum separator tube What department primarily uses an SST tube? - ANSWER chemistry What kind of specimen would you find in an SST tube? - ANSWER serum What is the anticoagulant is in the SST tube? - ANSWER No anticoagulant (red) or clot activator (gold) How long must an SST tube allowed to clot? - ANSWER 20-30 mins PST stands for - ANSWER plasma separator tube When would you use a PST tube? - ANSWER Used for plasma determinations in chemistry Used for potassium determinations. What department would use a PST tube? - ANSWER Chemistry What kind of specimen would you find in a PST tube? - ANSWER gel What is anticoagulant in the PST tube? - ANSWER lithium heparin How long must the PST tube be allowed to clot? - ANSWER 1 hour Sodium Citrate/light blue is primarily tested in what department? - ANSWER coagulation What is the most commonly ordered test for the sodium citrate/light blue tube? - ANSWER PT and PTT What is the required fill for the sodium citrate tube? - ANSWER 90% EDTA, lavender, purple tube contains what anticoagulant? - ANSWER EDTA What is the most commonly ordered test for the EDTA tube? - ANSWER CBC What department performs tests on EDTA's? - ANSWER Hematology and Blood Bank What is a ESR? - ANSWER erythrocyte sedimentation rate tested within 4 hour Sodium Fluoride tube has what color stopper? - ANSWER gray What test would you draw using a sodium fluoride tube? - ANSWER glucose, alcohol level, lactate Why would you use a sodium fluoride tube? - ANSWER Glucose and lactate What is glycolysis? - ANSWER breakdown of glucose What department would perform tests on a sodium fluoride tube? - ANSWER chemistry Royal blue tubes is for what kinds of tests? - ANSWER trace elements Why is it important to use the royal blue for these tests? - ANSWER to find trace elements Hematology - ANSWER study of blood and formed elements What are other names for a red blood cell? - ANSWER erythrocyte What is the main purpose of a RBC? - ANSWER it carries oxygen What are other names for a white blood cell? - ANSWER leukocytes What is the purpose of the white blood cell? - ANSWER immune system Microbiology - ANSWER identification of disease causing organisms What is a sensitivity test? - ANSWER an antibiotic allows physician to select the correct treatment What is a nosocomial infection? - ANSWER an infection acquired in a hospital Where would you contact a nosocomial infection? - ANSWER people, food, drugs, equipment The vessel of the heart are - ANSWER arteries, veins, capillary Which vessels carry blood away from the heart? - ANSWER arteries Which vessel carries the blood back to the heart? - ANSWER veins Where does the blood gas exchange take place? - ANSWER capillaries What is the most important step in the blood draw? - ANSWER patient identification What is the order of draw for evacuated tubes? - ANSWER light blue, red, yellow, light green, green, lavender, gray Why is it important to follow the order of draw? - ANSWER it could cross contamination What sources of identification would you ask the patient? - ANSWER ID, last, first, DOB Pertaining to inpatients, if they do not have an armband, what would you do? - ANSWER ID When doing a venipuncture, if at first you don't get blood, what would you do? - ANSWER go deeper, pull out a little, or change tubes Why do you use a tourniquet? - ANSWER to stop blood from flowing back What could happen if you left the tourniquet on too long? What test would be affected? - ANSWER cause hemoconcentration. RBC What is the proper location for tourniquet application? - ANSWER 3-4 inches above the arm What are the three main veins and in what order? - ANSWER median cephalic, basilic What needle has a larger bore? 21 or 23 - ANSWER 21 gauge When would you label the blood filled tubes? - ANSWER after drawing What would you label on the tubes? - ANSWER name, DOB, time, your initials What is the best way to sanitize your hand, yet most neglected? - ANSWER every other patients or every patients What do you use to cleanse the area for venipuncture? - ANSWER 70% alcohol with circular motions Standard precautions or universal precautions are? What do they apply to? - ANSWER Reports healthcare workers infected with HIV through needles. All individuals What does the biohazard symbol stand for? - ANSWER laboratory specimens have the potential to contain infectious agents What does HIV stand for? - ANSWER human immunodeficiency virus What does HBV stand for? - ANSWER hepatitis B virus Which of the two is more of a threat to health care workers? Why? - ANSWER Hep B because it affects your liver and there is no cure. If a patient has an IV in their arm, where would you draw them and why? - ANSWER Below the IV or on the other arm because it will give negative results. If the patient has a fistula or shunt in the right arm, where would you draw them? - ANSWER left If the patient had small, fragile veins, what would you do? - ANSWER I would draw them using a syringe If the patient has burns over both arms, what would you do? - ANSWER Draw from the hand if it is not burned or the feet but, needs a doctor approval. POCT - ANSWER Point of care testing What are examples of POCT? - ANSWER glucose testing, pregnancy testing, drug test, occult How is the billing different for regular lab testing and resulting vs POCT? - ANSWER Regular testing cost more than at home POCT test are considered what? - ANSWER At home care testing What serious miss step on a phlebotomist part could result in death of a patient? - ANSWER ID patient PT - ANSWER prothrombin time PTT - ANSWER partial thromboplastin time What tube is most often drawn for coagulation? - ANSWER Blue Bleeding time test is performed to test what? - ANSWER clotting time The blood pressure cuff is inflated to what? - ANSWER 40 mercury How often should you blot at the incision? - ANSWER every 30 seconds after cut What instrument is used to make the incision for a BT? - ANSWER lancet What questions should you ask the pt? - ANSWER if they are taking medications (aspirin within 7-10 days) What should you tell the pt regarded scarring? - ANSWER possible to scar What 4 components are in the electrolyte panel? - ANSWER Sodium (Na), Carbon dioxide (CO2), Potassium (Kt), Chloride (Cl) What test is most altered if the patient makes a fist or pumps his/ her fist? - ANSWER create more potassium and CK A CK test is for which organ? - ANSWER Heart What organ is being analyzed for a BUN, creatinine test? - ANSWER kidney What organ is being analyzed for a bilirubin test? - ANSWER liver What is the special handling for a bilirubin test? - ANSWER no exposure to light What organ is being analyzed for a glucose test? - ANSWER pancreas How long should a pt fast for a glucose test? - ANSWER 10-12 hours What tubes is recommended for drawing a GTT? Drawing this tube will avoid what? - ANSWER grey, gold glycolysis, separate RBC to serum What 2 tests would be most affected if the pt did not fast? - ANSWER glucose, triglycerides What tube is most commonly drawn for serum chemistry tests? - ANSWER red, gold What tube would you draw for a STAT chemistry and why? - ANSWER gold because it clots faster SST tubes must be allowed to clot for how long? - ANSWER 30 mins Why is centrifuging a SST tube in a timely manner important? - ANSWER RBC will start to breakdown What test would be most affected if the specimen is not centrifuged in a timely manner? - ANSWER glucose, potassium What specimen would you get from a PST? - ANSWER fibrinogen What protein is found in plasma but not in serum? - ANSWER fibrinogen Why is there no fibrinogen in serum? - ANSWER because it doesn't clot What specimen would you get form an SST? - ANSWER clot and serum activator A 3 hour GTT would require how much glucola? - ANSWER 100 grams A 1 hour GTT would require how much glucola? - ANSWER 50 grams Post-prandial means what? - ANSWER after eating If the test ordered is a 3 hour glucose and the pt is drawn at 8:00, and ingests the glucose immediately after when would the next draws be? - ANSWER 9:05, 10:05, 11:05 What is a myocardial infarction? - ANSWER heart attack What does HCG stand for? - ANSWER human chorionic gonadotropin Where is HCG produced? - ANSWER placenta that appears in both urine and serum beginning approximately 10 days after conception A test for confirmation of a pregnancy is? - ANSWER HCG If a urine is supplied for a HCG test, what is the best specimen? - ANSWER Urine, blood What test is associated with the reproductive system? - ANSWER estrogen, PAP smear Order of draw for microtainer (dermal puncture) - ANSWER lavender, gold, green, gray What is the proper storage requirements for urine dip sticks? - ANSWER dry space, out of light What color is a normal urine? - ANSWER clear yellow Explain how a 24 hour urine is collected? - ANSWER you void your first pee when you wake up then start Explain how a clean catch mid stream urine is collected - ANSWER wash hand, wipe front to back Why is a clean catch mid stream urine collection recommended? - ANSWER avoid contamination What does random urine mean? - ANSWER collected at anytime Why is it important to refrigerate urine? - ANSWER keep away bacteria How much bacteria is usually found in urine? - ANSWER Usually no bacteria. For healthy people, there's 5-7. If above 7, you could have an infection If a doctor orders a sensitivity and culture, what department would the urine go to? - ANSWER microbiology What is the purpose of a culture and sensitivity? - ANSWER UTI Normally is there bacteria in urine? - ANSWER no The specific gravity is used to measure what? - ANSWER more concentrated specimen What tube would you draw for a cross match? - ANSWER EDTA, pink What is a cross match? - ANSWER determines blood type What is the blood collected for ones own used called? - ANSWER autologous donation What are other names for Blood Bank department? - ANSWER immunohematology Agar should be labeled where? - ANSWER on the bottom on the agar Why are agar plates stored upside down? - ANSWER so the cover doesn't fall off or get lost Bacteria is allowed to grow best at what temperature? - ANSWER 37 celcius Performing a blood culture requires aseptic technique. Why? - ANSWER if contaminated, it introduces new microorganisms Why is it important to site the source of specimen for microbiology department? - ANSWER preserved microorganisms What is the special handling for occult blood collection? - ANSWER room temperature Explain how occult blood is collected? - ANSWER poop on saran wrap, stick in the poop, smear onto the card What does the term occult blood mean? - ANSWER hidden blood How many negative occult blood cards would conclusive be a reported negative? - ANSWER 2/3 Occult blood is a screaming for what? - ANSWER blood in stool, colon cancer, GI What is food or vitamins should a patient avoid during occult blood collection? - ANSWER red meat, raw fish What is another name for occult blood? - ANSWER fecal Positive occult blood card would be what color? - ANSWER blue Current instruction manuals are also known as what? - ANSWER policy and procedure Who is the policy and procedure manual written for? - ANSWER phlebotomists How often are control run? - ANSWER every 2 years Are controls documented? - ANSWER yes If there is a spill, what manual would you pull for clean up? - ANSWER policy and procedure Accuracy - ANSWER how close a measurement is to the true value Proficiency - ANSWER getting the value consistently Reliability - ANSWER combination of accuracy and precision What does the quality assurance statement tell the doctors? - ANSWER to provide adequate confidence that lab will satisfy given needs for patient care A peak collection is drawn when? - ANSWER right after administering drug A trough collection is drawn when? - ANSWER before What are common peak and trough tests? - ANSWER therapeutic drug What other department works closely with the lab for peak and trough testing? - ANSWER chemistry Who draws arterial blood gases? - ANSWER doctors What is the Allen testing for? - ANSWER noninvasive test to assess collateral before collecting from radial artery What is the special handling for arterial blood gases? - ANSWER ice bag ASAP The artery of choice for arterial blood gases is? - ANSWER radial artery Who draws arterial blood gases? - ANSWER doctors What is the special handling for an ammonia test? - ANSWER put on ice ASAP, wear mask What is the special handling for cold agglutions? - ANSWER room temperature What is the special handling for arterial blood gasses? - ANSWER put on ice ASAP, test immediately What is the special handling for a bilirubin? - ANSWER keep away from UV, foil it What would you do if an inpatient refused the blood draw? - ANSWER tell the nurse, don't forced them How would you ID a deaf or blind or mute person? - ANSWER family member, ID, ID band How would you ID a child? - ANSWER parent, ID band If the pt has an IV in her right arm where would you draw her? - ANSWER below the IV or left arm If the pt has a fistula or canula in her right arm where would you draw her? - ANSWER left If the pt has had a mastectomy on her right side, where would you draw her? - ANSWER left What are the signs for a pt fainting? - ANSWER pale, unresponsive, sweating, hot, cold What should you do if the pt faints? - ANSWER #1: reject needle head down, cold towel on the back of the neck Why are new born screenings important? - ANSWER disorder, disabilities, healthy What newborn tests would detect the inability to metabolize an amino acid? - ANSWER PKU (phenylketonuria) How many times can you attempt to draw a patient? - ANSWER 2 Failure to give the pt proper care is what? - ANSWER negligence, neglect Hemoglobin - ANSWER An iron-containing protein that enables them to transport oxygen and carbon dioxide and also gives them their red color. How long does HIV bacteria live? - ANSWER 6 hours How long does HEP B virus live? - ANSWER 2 weeks PPE (personal protective equipment) - ANSWER a barrier between a person and pathogens; includes gloves, gowns, masks, goggles, and face shields RACE - ANSWER rescue, alarm, contain, extinguish TB - ANSWER tuberculosis Phagocytosis - ANSWER a process in which a pathogen or foreign matter is surrounded, engulfed, and destroyed by the WBC Additive - ANSWER preventing clotting or preserving certain blood components Jaundice - ANSWER A yellowing of the skin and eyes Blood cultures - ANSWER aerobic first if using a butterfly because it contains air anaerobic air is not allowed Postprandial - ANSWER 2 hours after a meal Chain of custody draws - ANSWER never use alcohol wipes. use water and soap The most common infectious disease is - ANSWER UTI What percent of water is found in human cells? - ANSWER 60% RPM (remote patient monitoring) - ANSWER homecare telehealth, is a type of ambulatory healthcare that allows a patient to use a mobile medical device to perform a routine test and send the test data to a healthcare professional Amylase - ANSWER Enzyme in saliva that breaks the chemical bonds in starches. Common in pancreatitis Blood specimen for the a test does not need to be transported in a mixture of ice and water. - ANSWER Amylase What preservative used in 24 hour urine collection will interfere least with dipstick analysis? - ANSWER boric acid The action of sodium polyanethole sulfate (SPS) as an additive to blood culture containers includes: - ANSWER Complement Inhibition The best marker to insure completeness of a 24 hour urine collection, would be: - ANSWER 4-Aminobenzoic acid level Which of the following anticoagulants does not bind calcium? - ANSWER heparin Which of the following anti-glycolytic agents is preferred because it does not interfere with urease and allows the same blood sample to be tested for Blood Urea Nitrogen (BUN) as well as glucose? - ANSWER Sodium Iodoacetate Which of the following additive is a true anticoagulant, Sodium Flouride, Potassium Oxalate, Thrombin, or Sodium Citrate? - ANSWER sodium citrate Which of the following is true of capillary punctures done on the fingertips? - ANSWER insert the lancet perpendicular to the fingerprint Arterial blood leaves the heart through the - ANSWER aorta Liquid portion of the blood in the body is - ANSWER plasma Low and High controls are required for a glucose meter. These are run: - ANSWER Exactly the same time as patient samples are run Urine begins forming in the ______ where the blood is ____. - ANSWER kidney, filtered Blood culture collection sites are prepared by swabbing the venipuncture site with iodine, which is left on for at least: - ANSWER 20 seconds A tourniquet is applied to the arm above a venipuncture site to: - ANSWER Slow the flow of venous blood to the heart Arterial walls have thick layers of ______ to withstand increased blood pressure during contraction phase of the heart. - ANSWER muscles A neonatal bilirubin specimen should be collected in a - ANSWER Amber micro collection tube and protected from light Peak and trough specimens are collected for therapeutic drug monitoring. The trough specimen is typically collected: - ANSWER 30 minutes before a dose A specimen for a blood ammonia test is to be preserved from the time of collection until it is tested in the laboratory. The best course of action is to keep the tube in - ANSWER ice and water The performance and speed of centrifuges should be checked - ANSWER every 3 months What best describes the safe operation of a centrifuge? - ANSWER Tube stoppers are left on, the centrifuge is loaded by balancing similar tubes, and the lid is closed during centrifugation. Centrifuge - ANSWER device to separate substances by spinning them at high speed The preferred depth of incision for a skin puncture of a premature infant is: - ANSWER 0.85 mm The arteries used for arterial puncture, in order of preference are: - ANSWER Radial, Brachial, Femoral The transportation of blood and body fluid specimens by pneumatic tube system: - ANSWER not recommended You're asked to assemble equipment for an arterial puncture. Which of the following would be inappropriate? - ANSWER tourniquet When collecting blood samples from a patient with a Venous access device (VAD): - ANSWER Discard the first 5 mL of blood to flush the device After centrifuging a green stoppered tube containing blood to be tested for a electrolyte panel, the phlebotomist notes that the serum is pink, indicating: - ANSWER Hemolysis and an unacceptable specimen When a lipid panel is ordered, the patient should be: - ANSWER fasting for 10-12 hours A patient is given urine collection materials and told to collect a urine sample by cleaning the urethral meatus, starting to void without collection, and collecting the remainder of the voided urine in a specimen cup. This urine sample is: - ANSWER a clean-catch, midstream urine When collecting blood with a syringe, pulling back quickly and hard on the plunger can: - ANSWER collapse the vein and hemolyze the blood A skin puncture for a complete blood cell (CBC) count is ordered on a newborn. The phlebotomist finds the infant is crying violently. The phlebotomist should: - ANSWER If possible, wait until the infant has stopped crying for 1 hour. Proper placement of the needle within a vein is indicated by all the following, except: - ANSWER Swelling around the venipuncture site All the following terms indicate the patient has had nothing to eat, except: - ANSWER postprandial The term for identifying the means of transmission of a contagious disease from its host is: - ANSWER Chain of infection The laboratory receives a request to collect 450 mL of blood from a patient with polycythemia. This blood collection would be called a: - ANSWER Therapeutic phlebotomy Care in centrifuging, such as eliminating splashing or splattering and not "popping" off tube stoppers, are designed to prevent the formation of: - ANSWER Aerosols A phlebotomist performs a venipuncture without disinfecting the venipuncture site and leaving the tourniquet on longer than indicated. This would be considered: - ANSWER negligence The outer layer of the heart is the: - ANSWER Epicardium A platelet count of 650,000 per cubic millimeter is termed: - ANSWER Thrombocytosis A phlebotomist with 6 collection orders for patients in the hospital receives a handwritten lab order for a STAT glucose after only completing the fourth draw. What should they do next? - ANSWER Collect the STAT glucose, deliver it to the lab, then return to perform the last 2. A body fluid that should be protected from light before analysis for bilirubin is: - ANSWER Amniotic fluid Veins carry - ANSWER deoxygenated blood to the heart When collecting blood from an artery for arterial blood gases (ABG's), it is not necessary to pull back on the plunger of the syringe because: - ANSWER Arterial blood is under pressure from the contraction of the ventricles A plasma protein that is not present in serum is: - ANSWER fibrinogen A specimen for a peak gentamicin level should be collected: - ANSWER 30-60 minutes after administration of the drug When performing a skin puncture, which specimen should be collected last? - ANSWER Heparin microcollection tubes