NCCT PHLEBOTOMY EXAM| REAL EXAM 2023/2024 LATEST UPDATED| CONTAINS VERIFIED AND ACCURATE QUESTIO NS AND ANSWERS| ALREADY GRADED A What is the first step in performing a venipuncture? - CORRECT ANSWER identify the patient RATIONALE To prevent error and main tain a culture of safety, at least 2 identifiers (ex. full name and date of birth) must be verified prior to performing a procedure. What is the proper way to identify a patient prior to performing a venipuncture? - CORRECT ANSWER Ask the patient to s tate his/her full name and DOB and compare to the chart. Before a venipuncture, the medical assistant should ask the patient to state his/her full name and DOB (comparing what is stated to what is written in the chart or on a wrist band patient identifier ). This minimizes the risk for mis -identification errors because it cross -checks what the patient says against written documentation. This provides a verified identity so that all tubes collected will be associated with the correct patient (provided the me dical assistant labels them properly). Using the guidelines for any method of venipuncture, what action should the medical assistant perform directly after confirming patient identity? – CORRECT ANSWER Review the requirements for collecting and handli ng the blood specimen as ordered by the physician To ensure accuracy and quality, it is important to anticipate your needs before beginning the actual venipuncture (i.e. tube color/size, minimum acceptable blood volume, whether or not the specimen needs t o be placed on ice). Therefore, the medical assistant would identify the patient, then review the requirements for collecting and handling the blood specimen as ordered by the physician. Next, assemble the appropriate equipment and select the proper evacua ted tubes for test to be performed. Then, apply the tourniquet and thoroughly palpate the selected vein. Finally, position the patient's arm and cleanse the site with an antiseptic wipe, then proceed with the venipuncture protocol. What should be avoided a s a form of patient identification? – CORRECT ANSWER insurance number An insurance number is not a common means of positive patient identification (entire families can share the same insurance policy number). Patients must be positively identified for medical services, whether they have insurance or not. Insurance informatio n is necessary for billing purposes. The only true unique identifier listed among these choices is the social security number. Patient name and date of birth are also commonly used to confirm identification. Name the two most used patient identifiers. - CORRECT ANSWER Patient's name/date of birth Name and DOB are most often used as positive patient identifiers as they are easily documented and work for inpatients or outpatients. Bed numbers should never be used as identifiers for inpatients or outpati ents, nor should physician name associations. Medical record numbers are valuable for inpatients, with name and DOB being used most often. Prior to any type of inpatient specimen collection, a phlebotomist must correctly verify their patient's identity by using which two -step procedure? - CORRECT ANSWER Check ID bracelet, and ask patient to verbally confirm their identity. The correct answer is to check the ID bracelet and ask the patient to verbally confirm his/her identity. Patients may not have foo t bed charts or IV bags, and the goal is to select the BEST answer of all choices. If a patient has both an ID bracelet and can verify his/her own identity, it is ideal. The phlebotomist is drawing blood from a patient that is taking blood thinners. What i s a necessary piece of additional equipment to have at the drawing station? - CORRECT ANSWER non -adhering bandage RATIONALE Non-adhering bandage material would be helpful for patients on anticoagulant therapy who may bleed more extensively than typical patient s after venipuncture. It is necessary to contain the bleed with a bandage, but adhesive might bruise once removed from a patient who has anticoagulated blood. In which of the following time frames should a tourniquet be routinely released on a patient while performing a blood draw? - CORRECT ANSWER within one minute RATIONALE The standard time limit for having a tourniquet on a patient is one minute. Inaccurate laboratory test results may occur if a tourniquet is not removed within one minute. When a tourniquet is applied, the local blood flow is stopped. This leads to concentration of the blood and blood entering the surrounding tissue. This may result in falsely high values for all protein -based analytes, increased packed cell volume, and changes in other cell ular elements. The most current edition of the CLSI Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture, H3 -A6, states that the tourniquet application for preliminary vein selection should not exceed one minute. For most patients, i t is easy to release the tourniquet within the one -
minute period. Most veins are easily located and the venipuncture procedure can be completed quickly. A medical assistant has active symptoms of the common cold. Under which of the following conditions may he perform venipuncture? - CORRECT ANSWER The medical assistant may perform venipuncture provided he is wearing a mask and afebrile. RATIONALE It is not uncommon for people to be able to work with the common cold. However, it is important for medical personne l to use good judgment and not transmit diseases to their patients. Medical personnel should take precautions and handle patient contact in a responsible manner. They should not have patient contact if they are febrile, since that is when colds are highly contagious. In this instance, the medical assistant may perform venipuncture provided he/she is wearing a mask and afebrile. The medical assistant should wear the mask to keep from transmitting the cold via coughing or sneezing on a patient. What is an app ropriate alternative to using a rubber tourniquet when attempting a venipuncture on a known patient who is difficult to obtain a sample from? – CORRECT ANSWER blood pressure cuff RATIONALE The only acceptable choice among the listed options is the blood pressu re cuff. Occlusion pressure may be adjusted as needed as an alternative to ensure circulation. In compliance with CLSI (Clinical and Laboratory Standards Institute) standards, the blood pressure cuff can provide uniform constriction, as long as the phlebot omist doesn't inflate the cuff beyond 40 mm of mercury. What evacuated tube should the medical assistant select for collection of electrolytes? - CORRECT ANSWER green -top RATIONALE A green top tube contains heparin. Green tops are used for collection of hepari nized plasma or whole blood for special tests. Note: After the tube has been filled with blood, the tube is inverted several times to prevent coagulation. Note: Green top tubes can contain ammonium, lithium, and sodium in addition to the heparin. In this i nstance, lithium heparin would be the green -top of choice (and sodium heparin would NOT be used for an electrolyte test). Electrolytes can also be collected in a red -top tube. What additive protects serum from interacting with red blood cells after a speci men has been centrifuged? –
minute period. Most veins are easily located and the venipuncture procedure can be completed quickly. A medical assistant has active symptoms of the common cold. Under which of the following conditions may he perform venipuncture? - CORRECT ANSWER The medical assistant may perform venipuncture provided he is wearing a mask and afebrile. RATIONALE It is not uncommon for people to be able to work with the common cold. However, it is important for medical personne l to use good judgment and not transmit diseases to their patients. Medical personnel should take precautions and handle patient contact in a responsible manner. They should not have patient contact if they are febrile, since that is when colds are highly contagious. In this instance, the medical assistant may perform venipuncture provided he/she is wearing a mask and afebrile. The medical assistant should wear the mask to keep from transmitting the cold via coughing or sneezing on a patient. What is an app ropriate alternative to using a rubber tourniquet when attempting a venipuncture on a known patient who is difficult to obtain a sample from? – CORRECT ANSWER blood pressure cuff RATIONALE The only acceptable choice among the listed options is the blood pressu re cuff. Occlusion pressure may be adjusted as needed as an alternative to ensure circulation. In compliance with CLSI (Clinical and Laboratory Standards Institute) standards, the blood pressure cuff can provide uniform constriction, as long as the phlebot omist doesn't inflate the cuff beyond 40 mm of mercury. What evacuated tube should the medical assistant select for collection of electrolytes? - CORRECT ANSWER green -top RATIONALE A green top tube contains heparin. Green tops are used for collection of hepari nized plasma or whole blood for special tests. Note: After the tube has been filled with blood, the tube is inverted several times to prevent coagulation. Note: Green top tubes can contain ammonium, lithium, and sodium in addition to the heparin. In this i nstance, lithium heparin would be the green -top of choice (and sodium heparin would NOT be used for an electrolyte test). Electrolytes can also be collected in a red -top tube. What additive protects serum from interacting with red blood cells after a speci men has been centrifuged? –
