American Medical Technologist - RPT Study Guide FULLY SOLVED & UPDATED.

A phlebotomist is allowed to perform venipuncture on an ankle vein when... - ANSWER-All other options have been exhausted and physician has given approval What is an accurate statement regarding specimen handling? - ANSWER-Blood smears made from EDTA specimens must be prepared within 1 hour of collection Preanalytical errors are mistakes made - ANSWER-Before laboratory testing When performing a capillary blood collection, the first blood drop is wiped away because - ANSWER-the first drop typically has more tissue fluid How far above the venipuncture site should the tourniquet be wrapped around the arm? - ANSWER-3-4 inches above venipuncture site If serum is left to remain on the blood clot for more than one hour, which of the following most likely will occur? - ANSWER-Serum glucose levels decrease Areas from which blood should NOT be collected include all the following with the exception of - ANSWER-Basilic vein Hemoconcentration of a specimen can be avoided by - ANSWER-Removing the tourniquet within one minute Petechiae are tiny, non-raised red spots on a patient's skin when the tourniquet is applied. This indicates, that - ANSWER-The venipuncture site may bleed excessively If additive contamination occurred from an EDTA evacuated tube, what test would potentially be affected? - ANSWER-Potassium level is affected if there is contamination of the EDTA additive. The phlebotomist would collect a blood sample in a tube containing the anticoagulant sodium citrate (which inhibits glycolysis) for which type of laboratory test? - ANSWER-Erythrocyte Sedimentation Rate (ESR) The color-coded tube that is most frequently associated with hematological tests is - ANSWER-Lavender top When blood collected in a syringe must be placed in evacuated tubes it is best if - ANSWER-a blood transfer device is attached to the syringe. f blood begins to flow and then stops when an evacuated tube is pushed into the needle the most likely cause is the - ANSWER-bevel of the needle resting against the vein wall. Following venipuncture, which of the following should be applied to the venipuncture site? - ANSWER-A clean, sterile gauze pad A serum or plasma specimen from a patient with severe lipemia would visibly appear - ANSWER-Milky Which of the following may cause hematoma formation? - ANSWER-Having patient bend elbow to apply pressure What information would NOT be indicated on the label of a blood bank specimen? - ANSWER-NPO status of the patient and time of last meal The phlebotomist places the blood specimen in circles on special filter paper, for what test? - ANSWER-PKU/Newborn Screening Test An individual comes in for an autologous donation, what is this person coming to do? - ANSWER-Donating their own blood for their own use A postprandial specimen is collected - ANSWER-directly after a meal is consumed. A blood sample is needed from a dialysis patient. Which of the following is an acceptable procedure? - ANSWER-Draw from a hand vein When is a phlebotomist allowed to use ankle veins to draw blood? - ANSWER-With a physician's order What is the correct procedure to stop the bleeding at a venipuncture site? - ANSWER-Place a gauze pad over the site and hold pressure for 5 to 15 minutes What color evacuated tube would be commonly used for coagulation testing? - ANSWER-Light blue The phlebotomist has to prepare a blood smear for a leukocyte alkaline phosphatase (LAP). What is the correct procedure? - ANSWER-Perform the skin puncture, wipe away the first drop of blood and then touch the slide to the next drop of blood You have to draw a 7 year old child for some blood work, what would be the best approach you should use when it is a child getting blood drawn? - ANSWER-Explain what you are going to do in simple terms and ask the child for his or her cooperation. Partial penetration of the upper wall of a vein may - ANSWER-allow blood to leak into subcutaneous tissue by way of the needle bevel If the plunger on the syringe is pulled back too fast... - ANSWER-The specimen may be hemolyzed The primary reason for using a syringe transfer device is to - ANSWER-safely transfer blood from a syringe into ETS tubes. When palpating, a vein having which one of the following characteristics would be most appropriate to select for venipuncture? - ANSWER-Bouncy Which of the following is of primary importance in preventing rolling veins during venipuncture? - ANSWER-Anchoring the vein while inserting the needle How long should a tourniquet be placed around a patient's arm? - ANSWER-No more than one minute The liquid portion of an anticoagulated blood specimen is called - ANSWER-Plasma A basal-state specimen, used to establish reference ranges for inpatients, is best collected - ANSWER-early in the morning, after fasting for 12 hours. When a patient states that he or she has a needle phobia, the phlebotomist should - ANSWER-have the patient lie down during the procedure. The heel is the recommended site for collection of capillary puncture specimens on infants and the phlebotomist is going to stick in the posterior curvature of the heel. Is this correct? - ANSWER-No the medial plantar surface of the heel is the best site to prevent possible bone damage If additive contamination occurred from an EDTA evacuated tube, what test would potentially be affected? - ANSWER-Potassium level You have properly prepared the antecubital venipuncture site, you have the corrrect collection device and enter the vein at a 20 degree angle. Is this the proper angle of insertion? - ANSWER-No, 30 degrees is the correct angle for the needle to be inserted into the skin Which of the following situations would most likely trigger hematoma formation? - ANSWER-Removing the needle while the tourniquet is still on the arm. When a patient develops syncope during a venipuncture, the phlebotomist should first: - ANSWER-Remove tourniquet and needle and call for help What instrument may be used when trying to visualize the veins during venipuncture? - ANSWER-Venoscope What antiseptic should the phlebotomy technician use to collect a blood culture? - ANSWER-Chlorhexidine gluconate Swelling caused from blood leaking from a blood vessel is - ANSWER-Hematoma Complete clotting of a blood specimen can take up to - ANSWER-30 minutes at room temperature Alcohol should be allowed to dry completely prior to skin puncture to - ANSWER-prevent lysis of red blood cells Specimens are scheduled for collection at specific times for different reasons. Which of the following is most likely not a factor? - ANSWER-Patients must be tested 2 hours before meals Which substance has a higher concentration in capillary blood than in venous blood? - ANSWER-Glucose To avoid contamination when should the needle cap be removed? - ANSWER-Just prior to performing the puncture Which of the following would be first in the sequence of performing a finger stick procedure? - ANSWER-Sanitize hands and put on gloves. By bracing the hand while holding the needle assembly against the patients arm you - ANSWER-prevent excess needle movement. Which of the following is proper care of a patient following collection of an arterial blood specimen? - ANSWER-Apply firm pressure to the puncture site for a minimum of 3-5 minutes. Which of the following tubes is normally used to collect a serum sample? - ANSWER-Red top Color coding indicates a needle's - ANSWER-Gauge size What abnormal color will be observed in serum collected from a patient with jaundice due to elevated bilirubin levels? - ANSWER-Yellow Which of the following conditions would be most likely cause hemoconcentration? - ANSWER-Dehydration A phlebotomist most likely not use a butterfly for which of the following patients? - ANSWER-A patient with resilient and bouncy veins Why is it necessary to wipe the first drop of blood away when performing a capillary procedure? - ANSWER-To reduce interstitial fluid contamination Proper identification of a coherent adult inpatient includes - ANSWER-ask the patient their name. check the identification band that is physically attached to the patient. What is the preferred method for infant blood collection? - ANSWER-Capillary A collapsed vein will cause a - ANSWER-cessation of blood flow A fully-stocked phlebotomy tray readily accessible to the phlebotomy technician while performing venipuncture should include which of the following? - ANSWER-Needles of various sizes Needle holder/adapter Evacuated blood collection tubes Which of the following anticoagulants is found in a green-topped blood collection vacuum tube? - ANSWER-Sodium Heparin A skin puncture is preferred over a venipuncture when the patient - ANSWER-has severe burns Which of the following would be the very first step in performing a routine venipuncture on a patient? - ANSWER-Identify yourself During venipuncture, a hematoma may result from which of the following? - ANSWER-Needle bevel is partially inserted into a vein The main reason not to use expired evacuated tubes for blood specimen collection is - ANSWER-they may exhibit incomplete filling. To prevent glycolysis, which additive is used? - ANSWER-Sodium Fluoride The most critical part of a blood culture collection is - ANSWER-skin antisepsis of the collection site. As the phlebotomist, you have just completed drawing the last blood sample tube, you place gauze over the puncture site, remove the needle from the arm, activate the needle safety device and then release the tourniquet before applying pressure. Is this the correct sequence of steps? - ANSWER-No the tourniquet should be released first before the gauze pad is place over the puncture site Older patients are more prone to hematoma formation because - ANSWER-their veins have decreased elasticity. Prior to bandaging the puncture site the phlebotomist should - ANSWER-examine the site for bleeding. When performing a heel puncture on an infant, proper technique includes - ANSWER-placing the lancet flat against the skin on the medial or lateral plantar surface of the heel. Heparinized plasma is preferred over serum for some chemistry tests. Heparin prevents clotting by - ANSWER-inactivating thrombin. The phlebotomist has prepared the patient's arm and found the basilic vein. Has the phlebotomist selected the preferred vein site for venipuncture? - ANSWER-No, the medial cubital vein is preferred When blood is inoculated into blood culture bottles using a butterfly apparatus the - ANSWER-aerobic bottle in inoculated first. The term calcaneus refers to - ANSWER-the heel bone in the foot. Which of the following is the most appropriate procedure when preparing a patient for blood specimen collection? - ANSWER-If a patient asks the phlebotomist to explain the purpose of a blood test, the question should be referred to the doctor or nurse to answer. The anticoagulant heparin is used in tubes with tops of what color? - ANSWER-Green The phlebotomist has a patient who has no known allergies and in preparing the venipuncture site the phlebotomist uses iodine to clean the site. Is this the best antiseptic to use and the most commonly used anticeptic used to prepare a routine venipuncture site on a patient with no known allergies? - ANSWER-No, the phlebotomist should use 70% isopropyl alcohol. After the last tube is filled, which of the following is done next? - ANSWER-Filled tube is removed from the holder Which of the following actions could cause the formation of a hematoma? - ANSWER-The needle penetrates all the way through the vein Which of the following is NOT mandated to be on a label of a blood specimen collected for blood transfusion testing? - ANSWER-Patient's phone number Which of the following are associated with the procedure during which a sterile plastic tube is inserted to provide urinary drainage? - ANSWER-Catheterization What is one of the first signs of liver disease? - ANSWER-Bilirubinuria Catheterization is performed for which of the following reasons? - ANSWER-To obtain a sterile urine specimen and to relieve urinary retention Which of the following is a point of care test (POCT) used in diagnosing problems with hemostatis? - ANSWER-Bleeding Time Exposure to light decreases concentrates in certain specimens. These specimens must be protected from light to prevent analytical errors. Which of the following needs to be protected from light? - ANSWER-Ammonia What is POCT? - ANSWER-Point-of-Care Testing Which of the following factor is important in the collection of a sputum specimen used for an acid-fast bacillus (AFB) test? - ANSWER-A minimum of 3-5 mL of sputum is required for testing Which of the following is the single, most important factor in collecting an uncontaminated blood culture? - ANSWER-Proper collection site preparation When should the specimen container for a blood sample be labeled? - ANSWER-Immediately after the draw Which type of catheter is inserted after plastic repair of the ureter and must remain in place for at least a week after surgery? - ANSWER-Splinting Which fluid is usually obtained by a physician through a lumbar puncture and must be processed through the laboratory "stat"? - ANSWER-Cerebrospinal fluid Which of the following nosocomial infections are most prevalent? - ANSWER-Urinary tract infections A sweat sample collected by forearm stimulation with the use of pilocarpine nitrate is a process known as - ANSWER-iontophoresis With adequate fluid intake, the average adult daily urine output is ____ mL per 24 hours. - ANSWER-1250 A normal cerebrospinal fluid specimen should appear - ANSWER-Clear and colorless Arterial blood collected in a plastic syringe for arterial blood gas (ABG) testing that may be delayed in testing should be transported to the laboratory: - ANSWER-In an ice slurry Careful site selection and limited needle relocation helps to prevent - ANSWER-Injury What amount of residual urine is considered abnormal? - ANSWER-70cc When instructing patients in the collection of a 24-hour urine specimen, which patient should be asked about possible leakage when laughing or coughing? - ANSWER-A 60-year-old female patient Which of the following best describes the proper collection of a sputum specimen? - ANSWER-Mucus is coughed up from deep in the lung and expel sputum into a sterile cup Which urine collection method is most suitable for culture and sensitivity testing of microbes? - ANSWER-Midstream clean-catch specimen How are bottles for a blood culture test filled when collecting blood through a butterfly needle? - ANSWER-Aerobic bottle, then anaerobic bottle Which of the following is the most common injury occurring during venipuncture if the procedure is NOT performed according to standards? - ANSWER-Nerve injuries or hematoma Alcohol pads are not used when collecting a blood alcohol specimen because the practice will - ANSWER-be considered invalid if presented in court. Synovial fluid is also known as - ANSWER-Joint fluid A pregnant patient who tells you that she is having pain during urination or in the kidney area may be experiencing - ANSWER-a urinary infection or kidney stones. What type of catheter is used to collect specimens or to instill medications? - ANSWER-Straight When an outpatient reports a history of syncope the phlebotomy technician should - ANSWER-require the patient to lie down during the venipuncture When transporting specimens from the patient unit down to the hospital laboratory which of the following systems is used? - ANSWER-Pneumatic tube The guaiac card occult blood test is commonly performed on what type of sample? - ANSWER-Stool The most common venipuncture site is located in which one of the following areas? - ANSWER-Antecubital area of the arm The timing for a glucose test begins - ANSWER-when the patinet finishes drinking the glucose. A phlebotomist who completes all work and documents all of the day's activities before leaving for the day is demonstrating - ANSWER-professionalism. Which of the following is the most common type of urine sample that may be obtained at any time of the day? - ANSWER-random urine specimen Which of the following specialists reads electrocardiograms (ECGs) for hospital laboratories? - ANSWER-Cardiologists When a patient has a stroke in a physician's waiting room, it is essential for the phelbotomy technician to first - ANSWER-Remain calm Which of the following situations should be reported to the supervisor? - ANSWER-A co-worker is not following proper blood draw technique. Bilirubin concentration decreases by what amount following one hour of exposure to light? - ANSWER-50% Which of the following would require the most attention when scheduling specimen collection assignments? - ANSWER-Tolerance test specimens Protime and aPTT analyses are conducted in what department? - ANSWER-Coagulation Which urine specimen is collected after a night of sleep and contains greater concentrations of substances? - ANSWER-first morning urine specimen Insurance companies refer to what groups as primary care physicians? - ANSWER-family practitioners and internists If levels of blood components fluctuate according to circadian cycle, it means that fluctuations occur - ANSWER-in a 24 hour cycle One of the major effects of chemotherapy on a blood test results is - ANSWER-a decrease in blood cells, especially WBC's. Six months after beginning employment a healthcare worker is given a sample by the POCT supervisor and is asked to perform a screening test for group A Strep and return the results to the supervisor. The employee is performing - ANSWER-competency testing What is the name for finding employment opportunity information by talking with other people? - ANSWER-Networking The term used to describe when the body is still at rest, approximately 12 hours after the last intake of food, exercise, or activity is the - ANSWER-Basal state A telephone is ringing in an area of the laboratory in which the phlebotomy technician is the only person present. The technician should - ANSWER-answer the telephone and immediately transfer the call to the proper department When the phlebotomist identifies with their patient's feelings or thoughts, they are exhibiting - ANSWER-Empathy Which of the following is NOT a communication skill? - ANSWER-anxiety When preparing to collect a blood specimen from a pediatric patient, the phlebotomist should - ANSWER-acknowledge both the child and the parent. When collecting specimens for urine drug screens, according to the National Institute on Drug Abuse, the phlebotomist must - ANSWER-explain the test purpose and procedure. What is the most appropriate way for a phlebotomist to initially address a new patient? - ANSWER-Good morning, I am Joe Smith, the phlebotomist. I need to draw a blood specimen if it is alright with you. Language limitations, cultural diversity, and hearing loss are examples of - ANSWER-barriers to communication. A phlebotomy technician is obtaining a diagnostic blood specimen when a family member of the patient enters the isolated room without proper precautions. The technician should - ANSWER-instruct the family member regarding the proper isolation protocol that must be observed Facial expressions made by the phlebotomist are - ANSWER-an example of non-verbal communication. The information that is collected for analysis or computation is called - ANSWER-Data When the laboratory computer connects to interact with the main hospital intranet it is called - ANSWER-interfacing How many identifiers are required to identify an inpatient prior to obtaining a blood sample? - ANSWER-Two Which of the following information on a specimen label is not optional? - ANSWER-Time of collection Which of the following devices answers calls for you and separates requests into categories so you can answer them efficiently? - ANSWER-automated menu Which of the following items would not be located on the laboratory requisition form? - ANSWER-Amount of blood to obtain The processed information or data generated by a computer to be received by the user is referred to as - ANSWER-Output Some fax machines use thermal paper, which - ANSWER-reacts to heat and electricity Manufacturers affix expiration dates to tubes. An expiration date of 12.05.11 - ANSWER-indicates that the tubes may be used through 12.05.11 One of the most important pieces of communication equipment in a medical practice is the - ANSWER-Telephone If an unlabeled specimen is received by the laboratory, the phlebotomy technician should - ANSWER-discard the specimen and request that it be recollected Phlebotomists should clean and sanitize all work surfaces at the end of each shift with - ANSWER-10% bleach solution (1:10) When using ergonomic principals when lifting, always - ANSWER-bend the knees, keep the back straight and do not stoop. What is the first step the phlebotomist should take if the patient faints or vomits during a venipuncture? - ANSWER-Stop the procedure immediately Which agency should a medical facility contact for proper information regarding the disposal of medical waste? - ANSWER-OSHA The physical transfer of an infectious agent to a susceptible host through close or intimate contact is - ANSWER-direct contact transmission Blood specimens should be drawn according to standards of the - ANSWER-Clinical and Laboratory Standards Institute (CLSI) Which document is required by OSHA, which provides guidelines regarding the handling and storage of chemical? - ANSWER-MSDS There are many routes by which phlebotomists can be exposed to biohazards. Which of the following is not a common biohazard exposure route? - ANSWER-Hand Sanitizers Which of the following is an allergen commonly present in blood collection equipment? - ANSWER-Latex Personnel drawing blood must follow Standard Precautions, which include all of the following EXCEPT - ANSWER-hand washing only when soap is available When dealing with patients who suspect that they have a latex allergy the phlebotomist should use - ANSWER-Non latex products National Patient and Safety Goals (NPSGs) are developed and maintained by - ANSWER-the Joint Commission Healthcare facilities achieve the greatest reduction in accidental exposures by requiring a combination of which of the following? - ANSWER-Safe products and safe practices A phlebotomist would help to prevent needle sticks by - ANSWER-using OSHA approved safety needles. Which one of the following is a primary function of isolation procedures? - ANSWER-Prevent transmission of communicable diseases Which of these statements accurately describes the various classes of fire extinguishers? - ANSWER-Class A extinguishers use soda and acid or water to cool the fire. The agency that investigates and manages the control of various diseases is - ANSWER-CDC Gloves worn for phlebotomy should be changed - ANSWER-Between each patient contact Which of the following reflects the concept that all patient blood and body fluids are contaminated? - ANSWER-Universal Precautions Which of the following fire extinguishers should be used when a fire occurs in or near electrical equipment? - ANSWER-Class C or ABC extinguisher Four elements must be present for a medical malpractice case and are often used as guidelines, which of the following is not considered one of the elements? - ANSWER-Code of Ethics In a court trial involving a phlebotomy-related nerve injury, a phlebotomy supervisor is asked to testify regarding the proper angle of needle insertion for a venipuncture. What angle range should the supervisor indicate? - ANSWER-15º - 30º If a patient feels threatened by the phlebotomist, he or she may bring suit under civil law for - ANSWER-Assault A process in which the opposing sides in a legal course of action, choose a person outside of the court system, with special knowledge in the field, to hear and decide a dispute is - ANSWER-arbitration When a physician is terminating the care of a patient, physician is - ANSWER-withdrawing from the case At the end of a labor and delivery nurse's shift, a nurse leaves a woman in labor before the nurse's replacement arrives. What kind of negligence does this constitute? - ANSWER-Abandonment A healthcare professional that stops care without providing an equally qualified substitute can be charged with - ANSWER-Abandonment What type of consent exists when an emergency procedure such as CPR is provided? - ANSWER-Implied consent "RESPONDEAT SUPERIOR" is Latin for - ANSWER-"let the master answer" Which of the following is demonstrated when a patient's leg healed incorrectly because of the way the cast had been applied? - ANSWER-Direct cause What is the document called in which a patient names someone to make decisions regarding medical care in the event he or she is unable to do so? - ANSWER-Durable Power of Attorney Malpractice lawsuits are part of ____ law. - ANSWER-Civil The physician order says to puncture a vein, which of the following would the phlebotomist perform? - ANSWER-Venipuncture Blood vessels are lined with the same cells as the heart's - ANSWER-Endocardium The integumentary system includes - ANSWER-Skin Which of the following is used in the capillary puncture technique? - ANSWER-Lancet Which of the following is the abbreviation for the blood group system? - ANSWER-ABO Which of the following is a digestive enzyme commonly tested for in the laboratory? - ANSWER-Lipase The symbol Δ means - ANSWER-Heat Another name for platelet is - ANSWER-Thrombocyte If an order instructs a patient's blood be drawn postprandial, when should it be drawn? - ANSWER-After eating What department is responsible for reporting a patient's blood type? - ANSWER-Blood Bank A sputum culture is helpful in detecting infections in which system? - ANSWER-Respiratory System The insertion of a needle into a vein for the purpose of withdrawing blood is - ANSWER-Phlebotomy Which of the following represents an accurate statement regarding the circulatory system? - ANSWER-Pulmonary circulation refers to the blood flow to the lungs and back to the heart Which of the following body systems provides for CO2 and O2 exchange? - ANSWER-Respiratory The prefix hyper- refers to something that is - ANSWER-high Of the following, which is the least desirable, vein to use for venipuncture? - ANSWER-Basilic Which of the following is a protein that contains iron and is the main component of erythrocytes? - ANSWER-Hemoglobin Which of the following are granular leukocytes that produce the chemical histamine and aid the body in controlling allergic reactions and other exaggerated immunologic responses? - ANSWER-Basophils