Which of the following is most likely to affect test results?

Which of the following is most likely to affect test results?

A. edema
B. petechiae
C. reflux
D. syncope

Answer: A

You insert the needle in a patients arm and properly engage the tube. No blood flows into the tube. You make subtle needle adjustments and there is still no blood flow. Which of the following is the best thing to do next?

You insert the needle in a patients arm and properly engage the tube. No blood flows into the tube. You make subtle needle adjustments and there is still no blood flow. Which of the following is the best thing to do next?

A. discontinue the draw and try somewhere else
B. keep redirecting the needle until you hit a vein
C. lift up on the needle to crease a steeper angle
D. try a new tube in case its a vacuum problem

Answer: D

The best way to keep a vein from rolling is to:

The best way to keep a vein from rolling is to:

A. insert the needle at a 45 degree angle
B. make certain to anchor it well
C. tie the tourniquet very tight
D. use a large diameter needle

Answer: B

Which activity is least likely to lead to failure to draw blood?

Which activity is least likely to lead to failure to draw blood?

A. choosing a vein that has patency
B. leaving the tourniquet on too long
C. loosely anchoring the vein
D. using a tube that was dropped

Answer: A

Which activity can contaminate a blood specimen and affect the testing performed on it?

Which activity can contaminate a blood specimen and affect the testing performed on it?

A. cleaning the site with alcohol before drawing an EOTH specimen
B. collecting blood cultures before the providone-iodine is totally dry
C. using providone-iodine to clean the site prior to a finger puncture
D. all of the above are activities can affect testing done on the specimen

Answer: D

Underfilling this tube will most likely result in a hemolyzed specimen.

Underfilling this tube will most likely result in a hemolyzed specimen.

A. EDTA tube
B. light-blue top
C. grey top
D. SST

Answer: C

The serum or plasma of a hemolyzed specimen would most likely look:

The serum or plasma of a hemolyzed specimen would most likely look:

A. cloudy or turbid
B. pale yellow
C. pinkish to red
D. yellowish brown

Answer: C

Which of the following is a clue that you have accidentally punctured an artery instead of a vein?

Which of the following is a clue that you have accidentally punctured an artery instead of a vein?

A. the blood is dark bluish red
B. the blood spurts into the tube
C. the patient feels great pain
D. all of the above are clues

Answer: B

Which of the following specimens would most likely be rejected for testing?

Which of the following specimens would most likely be rejected for testing?

A. a hemolyzed potassium specimen
B. an icteric bilirubin specimen
C. a nonfasting glucose specimen
D. an underfilled serum tube

Answer: A

Blood loss to a point where life cannot be sustained is called:

Blood loss to a point where life cannot be sustained is called:

A. diurinal variation
B. exsanguination
C. iatrogenic anemia
D. vasovagal syncope

Answer: B

A patient has a mastectomy on the left side and has an IV midway down the right arm. Where is the best place to perform a venipuncture?

A patient has a mastectomy on the left side and has an IV midway down the right arm. Where is the best place to perform a venipuncture?

A. above the IV on the right arm
B. below the IV on the right arm
C. in the left antecubital area
D. in the left hand or wrist

Answer: B

While you are in the middle of drawing a blood specimen, your patient starts to faint. The first thing you should do is:

While you are in the middle of drawing a blood specimen, your patient starts to faint. The first thing you should do is:

A. apply a cold compress directly to the patients forehead
B. grab ammonia inhabited and wave it near patients nose
C. quickly release the tourniquet and remove the needle
D. tell the patient to lower the head and breathe deeply

Answer: C

A patients arm is in anatomical position. There appears to be a loop under the skin between the wrist and the elbow. You feel a buzzing sensation when you touch it. What you are most likely feeling is a:

A patients arm is in anatomical position. There appears to be a loop under the skin between the wrist and the elbow. You feel a buzzing sensation when you touch it. What you are most likely feeling is a:

A. AV graft
B. implanted port
C. PICC
D. sclerosed vein

Answer: A

A phlebotomist needs to collect a plasma specimen for a coagulation test. The patient has IV in the left arm near the wrist and a hematoma in the antecubital area of the right arm. Which of the following is the best place to collect the specimen?

A phlebotomist needs to collect a plasma specimen for a coagulation test. The patient has IV in the left arm near the wrist and a hematoma in the antecubital area of the right arm. Which of the following is the best place to collect the specimen?

A. above the IV site
B. from the IV after shutting it off for 2 minutes
C. distal to the hematoma
D. all of the above are acceptable collection sites

Answer: C

Which of the following specimen conditions would lead you to suspect that the patient was not fasting when it was collected?

Which of the following specimen conditions would lead you to suspect that the patient was not fasting when it was collected?

A. cloudy white serum
B. pale-yellow plasma
C. pink to reddish plasma
D. yellowish brown serum

Answer: A

Results of this test have a direct correlation with the patients age:

Results of this test have a direct correlation with the patients age:

A. blood culture
B. creatinine clearance
C. glucose
D. hemoglobin

Answer: B

A hematoma may result from:

A hematoma may result from:

A. inadequate site pressure applied after a venipuncture
B. needle penetration through the back wall of the vein
C. using a needle that is to large for the size of vein
D. all of the above can result in hematoma formation

Answer: D

Which of the following tests is affected the most if collected from a crying infant?

Which of the following tests is affected the most if collected from a crying infant?

A. bilirubin
B. cholesterol
C. lead level
D. WBC count

Answer: D

According to CAP guidelines, drugs that interfere with blood tests should be stopped:

According to CAP guidelines, drugs that interfere with blood tests should be stopped:

A. 1 to 4 hours before a test
B. 4 to 24 hours before a test
C. 24 to 48 hours before a test
D. 48 to 72 hours before a test

Answer: B

The medical term for fainting is:

The medical term for fainting is:

A. edematous
B. exsanguination
C. reflux
D. syncope

Answer: D

Which of the following is proper procedure when dealing with an elderly patient?

Which of the following is proper procedure when dealing with an elderly patient?

A. dress your questions to an attendant if the patient has a hearing problem
B. make certain to hold adequate pressure after the draw until bleeding stops
C. speak extra laud in order to be certain that the patient can hear you
D. tie the tourniquet extra tight to make the veins more prominent

Answer: B

Which type of patient is most likely to have an arteriovenous fistula or graft?

Which type of patient is most likely to have an arteriovenous fistula or graft?

A. arthritic
B. dialysis
C. hospice
D. wheelchair bound

Answer: B

What is the best approach to use on an 8-year-old-child who needs to have blood drawn?

What is the best approach to use on an 8-year-old-child who needs to have blood drawn?

A. explain the draw in simple terms and ask for the child's cooperation
B. have someone restrain the child and collect the specimen
C. offer the child a treat of toy if he or she does not cry
D. tell the child it won't hurt and will only take a few seconds

Answer: A

Blood collection tubes are labeled:

Blood collection tubes are labeled:

A. as soon as the test order is received
B. before the specimen is even collected
C. immediately after specimen collection
D. whenever it is most convenient

Answer: C

After inserting a butterfly needle, the phlebotomist must "seat" it, meaning:

After inserting a butterfly needle, the phlebotomist must "seat" it, meaning:

A. have the patient make a fist to keep it in place
B. keep the skin taunt during the entire procedure
C. push the bevel against the back of the vein
D. slightly thread it within the lumen of the vein

Answer: D

Which statement is true of syringe venipuncture?

Which statement is true of syringe venipuncture?

A. a syringe is sometimes used for veins that collapse easily
B. a syringe is recommended for drawing most blood specimens
C. you must pull the plunger all the way back when you see the "flash"
D. with a syringe, it is difficult to tell when the needle is in the vein

Answer: A

The tourniquet should be released:

The tourniquet should be released:

A. as soon as blood flow is established
B. before needle removal from the arm
C. within one minute of its application
D. all of the above

Answer: D

After cleaning a venipuncture site with alcohol, the phlebotomist should:

After cleaning a venipuncture site with alcohol, the phlebotomist should:

A. allow the alcohol to dry completely
B. fan the site to help the alcohol dry
C. dry the site with a clean gauze pad or cotton ball
D. insert the needle quickly before the alcohol dries

Answer: A

An inpatient is eating breakfast when you arrive to collect a fasting glucose. What is the best thing to do?

An inpatient is eating breakfast when you arrive to collect a fasting glucose. What is the best thing to do?

A. consult with the patients nurse to see if the specimen should be collected
B. draw the specimen quickly before the patient finishes eating
C. draw the specimen and write "non fasting" on the requisition
D. fill out a form stating the patient had eaten so the specimen was not drawn

Answer: A

If a patient adamantly refuses to have blood drawn, you should:

If a patient adamantly refuses to have blood drawn, you should:

A. convince the patient to be cooperative
B. notify the patients nurse of physician
C. restrain the patient and draw the blood
D. write a note to the patients physician

Answer: B

You are asked to collect a blood specimen from an inpatient. The patient is not wearing an ID band. What is the best thing to do?

You are asked to collect a blood specimen from an inpatient. The patient is not wearing an ID band. What is the best thing to do?

A. ask the patients name and collect the specimen if it matches the requisition
B. ask the patients nurse to put an ID band on the patient before you draw the specimen
C. identify the patient by the name card on the door
D. refuse to draw the specimen and cancel the request

Answer: B

A member of the clergy is with the patient when you arrive to collect a routine specimen. What would you do?

A member of the clergy is with the patient when you arrive to collect a routine specimen. What would you do?

A. ask the patients nurse what you should do
B. come back after the clergy person has gone
C. fill out a form saying you were unable to collect the specimen
D. say "excuse me. I need to collect a specimen from this patient"

Answer: B

The following test orders for different patients have been received at the same time. Which test would you collect first?

The following test orders for different patients have been received at the same time. Which test would you collect first?

A. fasting glucose
B. STAT glucose in the ER
C. STAT hemoglobin in the ICU
D. ASAP CBC in ICU

Answer: B

Which of the following is required requisition information?

Which of the following is required requisition information?

A. ordering physicians name
B. patients first and last names
C. type of test to be performed
D. all of the above

Answer: D

NPO means:

NPO means:

A. new patient orders
B. needed post operative
C. nothing by mouth
D. nutrition postoperative

Answer: C

Which type of disease is most likely to cause tremors?

Which type of disease is most likely to cause tremors?

A. Alzheimer's
B. Arthritis
C. Diabetes
D. Parkinson's

Answer: D

Skin changes in elderly can make it harder to:

Skin changes in elderly can make it harder to:

A. anchor veins
B. injure veins
C. palpate veins
D. see the veins

Answer: A

Interventions to ease pain in collecting blood specimens from infants include:

Interventions to ease pain in collecting blood specimens from infants include:

A. EMLA
B. oral sucrose
C. pacifiers
D. all of the above

Answer: D

You are performing a venipuncture on a difficult vein using a butterfly. You have an SST and a light blue-topped tube to collect. How do you proceed?

You are performing a venipuncture on a difficult vein using a butterfly. You have an SST and a light blue-topped tube to collect. How do you proceed?

A. collect and mix the SST before filling and mixing the light blue top
B. collect and mix the light blue top before filling and mixing the SST
C. draw a clear tube, fill and mix the light-blue top, then fill and mix SST
D. draw half of the SST, the fill and mix the light blue top, then finish the SST

Answer: C

How can you tell that you are in a vein when drawing blood with a butterfly?

How can you tell that you are in a vein when drawing blood with a butterfly?

A. engage the tube to see if it will fill
B. blood usually appears in the tubing
C. you can hear a soft hoping sound
D. there is no easy way you can tell

Answer: B

The proper way to transfer blood from a syringe into an ETS tube is to:

The proper way to transfer blood from a syringe into an ETS tube is to:

A. discard the needle, open the tube, and slowly eject the blood into it
B. hold the tube carefully and insert the needle through the tube stopper
C. place the tube in a race and insert the needle through the tube stopper
D. safely remove the needle and attach a transfer device to fill the tube

Answer: D

You have made two unsuccessful attempts while trying to collect an ASAP specimen on an inpatient. The specimen cannot be collected by skin puncture. What should you do next?

You have made two unsuccessful attempts while trying to collect an ASAP specimen on an inpatient. The specimen cannot be collected by skin puncture. What should you do next?

A. ask another phlebotomist to collect it
B. ask the patients nurse to do the draw
C. collect it by arterial puncture
D. try to draw it one more time

Answer: A

When should addictive tubes be mixed?

When should addictive tubes be mixed?

A. after all the tubes have been collected
B. as soon as they are removed from the holder
C. never. additive tubes do not require mixing
D. when you are filling any of the other tubes

Answer: B

Which needle can be removed from the blood collection unit before disposal?

Which needle can be removed from the blood collection unit before disposal?

A. butterfly needle
B. ETS needle
C. syringe needle
D. none of the above

Answer: C

Which is the most critical error a phlebotomist can make?

Which is the most critical error a phlebotomist can make?

A. collecting a timed specimen late
B. failing to collect a specimen
C. giving a patient a hematoma
D. misidentifying a patient specimen

Answer: D

Which of the following statements describes proper venipuncture techniques?

Which of the following statements describes proper venipuncture techniques?

A. clean the site quickly while the tourniquet is still on
B. fill addictive tubes until the vacuum is exhausted
C. keep the tourniquet on until the last tube is full
D. wipe the alcohol dry to prevent it from stinging

Answer: B

The best way to judge patient of a vein is to:

The best way to judge patient of a vein is to:

A. feel it to determine the strength of the pulse
B. palpate above and below where you first feel it
C. press and release it several times to determine resilience
D. roll your finger from side to side while pressing against it

Answer: C

There are two patients in a room. One of them has a latex allergy. You have a request to collect a blood specimen on the other one. How should you proceed?

There are two patients in a room. One of them has a latex allergy. You have a request to collect a blood specimen on the other one. How should you proceed?

A. ask the allergic patient to wear a mask until you leave
B. do not take anything that contains latex into the room
C. pull the curtain between beds and proceed normally
D. your patient is not allergic to latex so proceed as usual

Answer: B

You are a phlebotomy student on rotation at an outpatient site. A patient who seems extremely apprehensive about having her blood drawn tells you that she is afraid of needles. What should you do?

You are a phlebotomy student on rotation at an outpatient site. A patient who seems extremely apprehensive about having her blood drawn tells you that she is afraid of needles. What should you do?

A. ask an experienced phlebotomist to perform the draw for you
B. explain to her that you will use a small needle that barely hurts
C. tell her that its not a big deal and that she shouldn't be afraid
D. use an ice pack to numb the site before drawing the specimen

Answer: A

You are in the process of identifying an inpatient. The patient's verbal confirmation of name and date of birth matches the requisition, but the medical record number is different. When should you do?

You are in the process of identifying an inpatient. The patient's verbal confirmation of name and date of birth matches the requisition, but the medical record number is different. When should you do?

A. change the requisition number to match the ID band and collect the specimen
B. collect the specimen and inform the patients nurse that the ID needs correcting
C. do not collect the specimen until the patient's nurse that the I'D needs and resolved
D. fill out an incident report and return to the lab without collecting a specimen

Answer: C

You have a request to collect a stat specimen. A doctor is with the patient when you arrive. What should you do?

You have a request to collect a stat specimen. A doctor is with the patient when you arrive. What should you do?

A. call your supervisor and ask what you should do
B. excuse yourself and politely ask the doctor for permission to do the draw
C. leave the room and return when the doctor is gone
D. stand there quietly until the doctor notices you and asks you want you want

Answer: B

A student asks the patient for permission to draw a blood specimen. Which of the following answers implies that the student does not really have permission.

A student asks the patient for permission to draw a blood specimen. Which of the following answers implies that the student does not really have permission.

A. as long as you're good at it
B. which arm do you want?
C. yes, but I would rather not
D. all of the above

Answer: C

The time is 0750 hours. You have received the following tests requests on different patients. Which test specimen should you collect first?

The time is 0750 hours. You have received the following tests requests on different patients. Which test specimen should you collect first?

A. CBC ordered asap
B. cortisol order for 0800
C. fasting glucose
D. postop hemoglobin

Answer: B

Which type of test requisition has been show to decrease laboratory errors?

Which type of test requisition has been show to decrease laboratory errors?

A. bar coded
B. computer
C. manual
D. verbal

Answer: A

A vein that has patency:

A vein that has patency:

A. feels hard and cord-like
B. has a bounce or resilience to it
C. is fairly deep in the tissues
D. should not be used for venipuncture

Answer: B

A Butterfly is typically used for:

A Butterfly is typically used for:

A. coagulation specimens
B. difficult and hand veins
C. draws from a basilic vein
D. all of the above

Answer: B

Of the following tubes or containers, which is filled last in the recommended order of draw?

Of the following tubes or containers, which is filled last in the recommended order of draw? 

A. blood culture bottle
B. lavender top
C. light blue top
D. red top

Answer: B

Lavender-top tubes are most commonly used to collect:

Lavender-top tubes are most commonly used to collect:

A. chemistry tests
B. coagulation specimens
C. hematology tests
D. immunology tests

Answer: C

What causes evacuated tubes to fill with blood automatically?

What causes evacuated tubes to fill with blood automatically?

A. arterial blood pressure
B. fist pumping by the patient
C. pressure from the tourniquet
D. premeasured tube vacuum



Answer: D

Which of the following needles has the LARGEST diameter?

Which of the following needles has the LARGEST diameter?

A. 18 gauge
B. 20 gauge
C. 21 gauge
D. 23 gauge

Answer: A

You are about to perform routine venipuncture on a patient with no known allergy to antiseptics. Which of the following substances would you use to clean the site?

You are about to perform routine venipuncture on a patient with no known allergy to antiseptics. Which of the following substances would you use to clean the site?

A. 5.25% sodium hypochlorite
B. 70% isopropyl alcohol
C. antibacterial soap and water
D. povidone-iosine

Answer: B

A tourniquet is used in venipuncture to:

A tourniquet is used in venipuncture to:

A. concentrate the blood specimen
B. find and enter veins more easily
C. keep the vein from collapsing
D. all of the above

Answer: B

Which of the following tubes can be used to collect a serum specimen:

Which of the following tubes can be used to collect a serum specimen:

A. light blue top
B. green top
C. PST
D. red top

Answer: D

The following supplies were gathered for a routine venipuncture. which item is incorrect?

The following supplies were gathered for a routine venipuncture. which item is incorrect?

A. ETS tube
B. iodine swab
C. safety needle
D. tourniquet

Answer: A

Which additive prevents glycolysis:

Which additive prevents glycolysis:

A. EDTA
B. heparin
C. potassium oxalate
D. sodium fluoride

Answer: D

What is the purpose of a royal-topped tube?

What is the purpose of a royal-topped tube?

A. minimize trace elements contamination
B. prevent the breakdown of glucose
C. prevent the specimen from clotting
D. protect the specimen from light

Answer: A

Which of the following tubes contains an anticoagulant that works by binding calcium?

Which of the following tubes contains an anticoagulant that works by binding calcium?

A. green top
B. light blue top
C. PST
D. SST

Answer: B

Which of the following additives provides a physical barrier to prevent glycolysis:

Which of the following additives provides a physical barrier to prevent glycolysis:

A. EDTA
B. silica
C. sodium fluoride
D. thixotropic gel

Answer: D

For which of the following tubes is the blood-to-additive ratio most critical?

For which of the following tubes is the blood-to-additive ratio most critical?

A. green top
B. lavender top
C. light blue top
D. red top

Answer: C

Of the following tubes or containers, which is filled FIRST in the ETS order of draw:

Of the following tubes or containers, which is filled FIRST in the ETS order of draw:

A. lavender top
B. light blue top
C. PST
D. SPS

Answer: D

A PST contains:

A PST contains:

A. citrate and gel
B. EDTA and gel
C. heparin and gel
D. silica and gel

Answer: C

Of the following tubes, which would be filled SECOND from a syringe according to the CLSI recommended order of draw:

Of the following tubes, which would be filled SECOND from a syringe according to the CLSI recommended order of draw:

A. grey top
B. lavender top
C. light blue top
D. green top

Answer: D

A light-blue-topped tube is most often associated with tests in this department:

A light-blue-topped tube is most often associated with tests in this department:

A. chemistry
B. coagulation
C. hematology
D. serology

Answer: B

EDTA is a(n):

EDTA is a(n):

A. anticoagulant
B. clot activator
C. glucose preservative
D. plasma separator

Answer: A

Which of the following tubes would typically be used to collect plasma for a stat chemistry specimen:

Which of the following tubes would typically be used to collect plasma for a stat chemistry specimen:

A. light blue top
B. green top
C. red top
D. yellow top

Answer: B

Which anticoagulation by inhibiting thrombin formation?

Which anticoagulation by inhibiting thrombin formation?

A. EDTA
B. heparin
C. sodium citrate
D. potassium oxalate

Answer: B

Which of the following equipment is required in collecting blood by syringe?

Which of the following equipment is required in collecting blood by syringe?

A. multisample needle
B. tube holder
C. transfer device
D. winged infusion set

Answer: C

Which of the following would be the best choice of equipment for drawing a small hand vein:

Which of the following would be the best choice of equipment for drawing a small hand vein:

A. a 21 gauge needle and syringe
B. a 22 gauge needle and ETS holder
C. a 23 gauge butterfly and ETS holder
D. a 25 gauge butterfly and syringe

Answer: C

The most common, direct, and efficient means of venipuncture is:

The most common, direct, and efficient means of venipuncture is:

A. butterfly and tube holder
B. butterfly and syringe
C. ETS needle and tube holder
D. needle and syringe

Answer: C

Needles are color-coded according to:

Needles are color-coded according to:

A. expiration date
B. gauge
C. length
D. manufacturer

Answer: B

This needle is the standard needle for routine venipuncture:

This needle is the standard needle for routine venipuncture:

A. 20 gauge
B. 21 gauge
C. 22 gauge
D. 23 gauge

Answer: B

Which of the following substances would be the best thing to use to disinfect a blood spill on a lab counter-top prior to clean up?

Which of the following substances would be the best thing to use to disinfect a blood spill on a lab counter-top prior to clean up?

A. a 1:10 dilution of bleach
B. 70% isopropyl alcohol
C. antibacterial soap and water
D. povidine-iodine

Answer: A

Sharps containers do not have to be:

Sharps containers do not have to be:

A. marked "biohazard"
B. disposable
C. puncture resistant
D. recyclable

Answer: D

An antiglycolytic agent:

An antiglycolytic agent:

A. enhances coagulation
B. inhibits thrombin formation
C. keeps a specimen from clotting
D. prevents the breakdown of glucose

Answer: D