phlebotomy study guide

7/30/2019 Phlebotomy Study Guide

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Copyright 2012 American Association Of Medical Personnel All Rights Reserved

PHLEBOTOMY STUDY GUI DE

TERMI NOLOGY

1) The ability of the body to maintain equilibrium orsteady state is called:

A. hematologyB. homeostasisC. hemochromatosisD. hemostasis

2)

What does NPO mean?

A. fastingB. newbornC. next priorityD. nothing by mouth

3) Which of the following is a suffix?A.

anB. neo

C. oxiaD. ren

4) Inflammation of a veinis:A. angitisB. cellulitisC. phlebitisD. vasomyelitis

5) CBC is an abbreviation for:A. complete blood cellsB. complete blood count


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C. cerebrospinal blood countD. cerebrospinal blood cells

6) Which of the following terms means muscle pain?A. atrophyB. myalgiaC. osteomyelitisD. tendonitis

7) The word root erythro means:A. cellB. earth-likeC. oxygenD. red

8) The abbreviation PT stands for:A. partial thromboplastinB. patient temperatureC. prothrombin timeD. phenylketonuria

9) What word means controlling blood flow?A. hemolysisB. hemostasisC. homeostasisD. venostasis

10) In the clinical laboratory, the abbreviation CSF isused for:A. clinical serum fluidB. cerebrospinal fluidC. cerebral serum fluidD. clinical spinal fluid


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LAB SAFETY

1) In which instance could an electrical shock to a patientmost likely occur?

A. drawing a patients blood during an electricalstorm

B. drawing a patients blood while standing in apuddle of water

C. drawing blood from a patient who is talking on thetelephone

D. touching electrical equipment while drawing apatients blood

2. Which is not true of disinfectants? Disinfectants are:A. corrosive chemical compoundsB. safe to use on human skinC. used to kill pathogenic microorganismsD. used on surfaces and instruments

3. If a health care provider is in an area of the healthcare facility where a fire starts, she or he shouldfirst:

A. attempt to extinguish the fire, using the properequipment

B. pull the lever in the fire alarm boxC. close all the doors and windows before leaving

the areaD. block the entrances so that others will not enter

the fire area

4. What are the major principles of self-protection fromradiation exposure?


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A. distance, combustibility, and shieldingB. time, distance, and shieldingC. anticorrosive, shielding, and distanceD. combustibility, anticorrosive, and distance

5. Primum non nocerecomes from the Hippocratic oathand means:

A. first do no harmB. first things firstC. quality is foremostD. ready to serve

6. What does the National Fire Protection ssociation(NFPA) codeword RACEmean?

A. rescue, alarm, confine, extinguishB. rescue, activate, cover, extinguishC. run, alarm, counter, extinguishD. run, activate, confine, escape

7. Disinfectants are:A. chemicals that are used to inhibit the growth

and development of microorganisms but do notnecessarily kill them

B. used frequently on skinC. chemicals that are used to remove or kill

pathogenic microorganismsD. quaternary ammonium compounds

8. If an electrical accident occurs involving electricalshock to an employee or a patient, the firstthingthat the health care worker should do is:

A. move the victimB. shut off electrical power


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C. start CPRD. place a blanket over the victim

9. Airborne precautions require the phlebotomist towear:

A. a maskB. a gownC. eye protectionD. an N95 respirator

10. It is important for the phlebotomist to visuallyinspect the needle tip before inserting it in a

patients vein to:

A. check for the presence of bacteriaB. check the needle point for imperfections that

might damage the patients veinC. ensure that the bevel is down during insertionD. make certain that the needle is not outdated

11. Which of the following is a required characteristic ofa sharps container?

A. bright red or orange in colorB. leak-proof and puncture-resistantC. marked with a biohazard symbolD. all of the above

12. The first step in giving mouth-to-mouth resuscitationis to:

A. open the airway by checking for obstructionsB. listen and feel for return of air from the victims

mouthC. determine whether the victim is conscious by

gently shaking the victim and yelling, Are youokay?


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D. look for the victims chest to rise and fall13. If a chemical is spilled onto a health care worker, she

or he should first:

A. rub vigorously with one handB. wait to see whether it starts to burn the skinC. rinse the area with a neutral chemicalD. rinse the area with water

14. For safety in the health care facility, which of thefollowing should not occur?

A. needles, syringes, and lancets should bedisposed of in a special sturdy containerB. liquid waste should be discarded rapidlyC. the specimen collection area should be

disinfected periodically according to the clinicallaboratory schedule

D. the patients specimens should be covered at alltimes during transportation

15. Mixing equipment from different manufacturers canresult in:A. improper needle fitB. needle coming unscrewedC. tubes popping offD. all of the above

BLOOD COLLECTI ON TECHN I QUES

1. Why are gauze pads rather than cotton balls considereda better choice for covering the site while holding pressurefollowing venipucture?


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A. gauze pads are more sterileB. gauze pads create more pressureC. cottons balls are not as absorbentD. cotton fibers tend to stick to the site

2. The evacuated tube system requires:A. a special plastic adapter, a syringe, and an

evacuated sample tubeB. an evacuated sample tube, a plastic adapter,

and a double-pointed needleC. a double-pointed needle, a plastic holder, and a

winged infusion setD. a special plastic adapter, an anticoagulant, and

a double-pointed needle

3. Identify the tubes needed to collect a complete bloodcount (CBC), partial thromboplastin time (PTT), andSTAT potassium by color and in the proper order ofcollection for a multi-tube draw.

A. lavender top, SST, royal blue topB. gold top, yellow top, light blue topC. light blue top, green top, lavender topD. red top, gray top, light blue top

4. An acceptable blood smear:A. covers the entire surface of the slideB. forms a bullet shapeC. has a feathered uniform edgeD. is short and thick

5. For newborns, the penetration depth of lancets forblood collection must be:

A. 3.0 mm or less


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B. 2.8 mm or lessC. 2.6 mm or lessD. 2.4 mm or less

6. Blood collected in a red stopper tube:A. may be used for most coagulation testsB. will not clotC. yields plasma and cellsD. yields serum and clotted red cells

7. Which of the following is a commonly usedintravenous device that is sometimes used in the

collection of blood from patients who are difficult tocollect blood by conventional methods?

A. heparinized Natelson tubeB. BD UnopetteC. Butterfly needleD. BD Microtainer

8. All of the following tube stopper colors indicate thepresence (or absence) and type of additive in thetube EXCEPT:

A. greenB. lavenderC. light blueD. royal blue

9. Proper finger puncture technique includes all of thefollowing EXCEPT:

A. avoid squeezing or vigorous massagingB. puncture parallel to the whorls of the

fingerprintC. puncture the middle or ring fingerD. wipe away the first drop of blood


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10. Which of the following procedures does not requirecleansing the blood collection site with povidone-iodine solution?

A. therapeutic drug monitoring collectionB. arterial blood gas collectionC. blood culture collectionD. blood donation collection

11. What do you do if the patients physician is in theroom and the specimen is ordered STAT?

A. ask the patients nurse what to doB. come back later when the physician has goneC. politely introduce yourself, explain why you are

there, and ask permission to proceedD. say Excuse me and proceed to collect the

specimen

12. In which instance is needle recapping recommended?A. after collecting a specimen in a syringeB. after collecting a specimen in the emergency

roomC. after collecting blood gasesD. recapping is neverrecommended procedure

13. The following tests have all been ordered at thesame time on different inpatients. There is only onephlebotomist on duty. Which test should the

phlebotomist collect first?

A. ASAP CBC in oncologyB. Hemoglobin in labor and deliveryC. Timed blood cultures in ICUD. STAT electrolytes in the emergency room (ER)


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14. You need to collect blood cultures, a gray top, and alavender top on an adult with difficult veins. Whichspecimens can be collected by skin puncture?

A. all of themB. blood cultures and gray top onlyC. gray top and lavender top onlyD. none of them

15. Which of the following is true concerning skinpuncture on an infant compared with the dorsal handvenipuncture procedure?

A. It is less stressful for the infantB. There is less dilution of the specimen withtissue fluid

C. Hemolysis occurs more oftenD. Fewer punctures are required

16. It is not a good idea to collect a CBC specimen froma screaming infant because the:

A. platelets are more likely to clumpB. specimen will be hemoconcentratedC. specimen will be more likely to hemolyzeD. white blood count may be falsely elevated

17. Why should a laboratory report form indicate the factthat a specimen has been collected by skinpuncture?

A. for liability and insurance purposesB. some test results may vary depending on thesource of the specimen

C. so that subsequent specimens will be collectedby skin puncture also

D. so that the patients nurse can check the sitefor signs of infection


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18. Which of the following analytes is significantlyincreased in the blood with changes in position?

A. ironB. cortisolC. glucoseD. testosterone

19. A vein may collapse because the:A. tourniquet is applied too tightlyB. tourniquet is too close to the venipuncture siteC. tube vacuum is too much for the size of theveinD. any of the above

20. You have no choice but to draw a specimen from asite with a hematoma. Where should you obtain thespecimen?

A. distal to the hematomaB. in the area of the hematomaC. proximal to the hematomaD. none of the above

21. Identification of an inpatient can best beaccomplished by which of the following?

A. number on the hospital bracelet and verbalconfirmation from the patient

B. hospital room number and bed assignmentC. confirmation from a patients relativeD. none of the above

22. A phlebotomist has attempted twice to draw a partialthromboplastin time on a patient with difficult veins.Both times the phlebotomist has been able to draw


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only a partial tube. What should the phlebotomistdo?

A. collect the specimen by skin punctureB. have another phlebotomist attempt to draw thespecimenC. pour the two tubes together and mix wellD. send the tube with the most blood to the

laboratory with a note that it was a difficultdraw

23. Where should the tourniquet be placed on thepatient during the venipuncture procedure?

A. 1 inch above the venipuncture siteB. Over the venipuncture siteC. 3 inches above the venipuncture siteD. 3 inches below the venipuncture site

24. You may have to be careful about what type ofequipment is brought into the room if a patient isseverely allergic to:

A. adhesive bandagesB. latexC. perfumeD. any of the above

25. Excessive or blind probing for a vein can cause:A. diurnal variationB. lipemiaC. nerve damageD. petechiae

26. If a blood collection site continues to bleed after 5minutes:


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A. bandage the site and tell the patient to holdpressure over the bandage

B. notify the patients physician or nurseC. wrap a pressure bandage around the siteD. none of the above

27. When collecting blood in a syringe, blood should beplaced in the specimen tubes in the correct order tominimize contamination or clotting, Therecommended order is:

A. coagulation tubes, anticoagulated tubes, thenblood culture tubes

B. blood culture tubes, coagulation tubes, otheranticoagulated tubes, tubes withoutanticoagulant additives

C. tubes without anticoagulants, blood cultures,coagulation tubes

D. none of the above28. A phlebotomist must collect a hemoglobin on a

patient in the intensive care unit. There is an IV in

the patients left arm. There is no suitableantecubital vein or hand vein in the right arm. Whatshould the phlebotomist do?

A. ask another phlebotomist to collect thespecimen

B. attempt to draw a hand vein below the IVC. collect the specimen by skin puncture of a

finger of the right hand

D. draw the specimen from an ankle vein29. What is the advantage of using a butterfly?

A. blood flow is increasedB. butterflies are less expensiveC. butterflies make it easier to draw difficult veins


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D. there is a greater choice of needle sizes30. A vein that feels hard and cord-like and lacks

resiliency may be:

A. an arteryB. collapsedC. superficialD. thrombosed

LAB MATH

1) Normal adult blood volume is 70 mL per kilogram.You weigh 130 lb. What is your blood volume?

A. 1300 mLB. 1.3 LC. 59 kgD. 4.1 L

2) If room temperature is 77o F, what is thetemperature in centigrade?

A. 20B. 25C. 32D. 37

3) A blood culture bottle containing 45 mL of mediarequire a 1:10 dilution of specimen. How muchblood should be added?

A. 4 mLB. 5 mLC. 8 mL


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D. 10 mL4) One teaspoon is approximately:

A. 1 mLB. 5 mLC. 10 mLD. 15 mL

5) Your requisition says that a specimen is to be drawnat 1530. What time would that be in 12-hour time?

A. 1:30 AMB. 3:30 PMC. 5:30 AMD. 7:30 PM

6) If a red blood cell is 8 m in diameter, what is itssize in millimeters?

A. .8B. .08C. .008D. .0008

7) What does 2.2 pounds (lb) equal in the metricsystem?

A. 1 kgB. 44 gC. 100 gD. 454 kg

8) 200 L is equal to:A. 2 mLB. 0.2 mLC. 0.02 mL


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D. 0.0002 mL9) 10 cc of blood equals approximately:

A. 1 mL of bloodB. 5 mL of bloodC. 10 mL of bloodD. There is no relationship between cc and mL

10) 1.2 kg is equal to how many grams?A. 12B. 120C. 1200D. 12,000

11) A test requires 3 mL serum. The laboratory requiresthat the amount of blood collected be 250% of thevolume of specimen required to perform the test.Which size tube should you use to collect thespecimen?

A. 4 mLB. 5 mLC. 10 mLD. 15 mL

12) Normal infant blood volume is 100 mL per kilogram.Calculate the approximate blood volume of a babywho weighs 6 lb.

A. 1.2 LB. 2.7 LC. 270 mLD. 600 mL

13) To prepare 100 mL of a 1:10 dilution of bleach, add:


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A. 1 mL water to 100 mL bleachB. 1 mL bleach to 99 mL waterC. 10 mL bleach to 90 mL waterD. 10 mL water to 100 mL bleach

14) One inch is equivalent to:A. 1 cmB. 1 mmC. 5 cmD. 2.54 cm

15) The civilian equivalent of 1448 isA. 2:48 AMB. 2:48 PMC. 12:48 PMD. 4:48 PM

16) In the metric system, a millimeter is:A. 1/10 meterB. 1/100 meterC. 1/1000 meterD. 1/10,000 meter

17) One gallon is equivalent to:A. 5 LB. 4 LC. 3.78 LD. 1 L

18) The military equivalent of 10:16 AM is:A. 1016B. 01000C. 0116


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D. 10:1619) A patient voids 1200 mL of urine for a creatinine

clearance test. How much urine is this?

A. less than a literB. less than a quartC. more than a literD. more than 2 liters

20) Which of the following symbols represents one cubicmillimeter?

A. mmmB. cu mm or mm3C. mLD. mM

I NFECTI ON CONTROL

1) Which of the following has the highest prevalence ofnosocomial infections?

A. urinary tract infectionsB. dermal infectionsC. respiratory tract infectionsD. wound infections

2) The main purpose of an infection control program isto:

A. determine the source of communicableinfections

B. isolate infectious patients from other patientsC. prevent the spread of infection in the hospital


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D. protect patients from outside contamination3) Which of the following is an example of an

engineering control that helps eliminate hazards

posed by bloodborne pathogens?

A. glovesB. laboratory coatC. sharps containerD. universal precautions statement

4) Which is not proper hand washing procedure?A. stand back so that clothing does not touch thesinkB. wet hands with water before applying soapC. wash for at least 15 secondsD. turn the faucet off with the towel used to dry

your hands

5) Which of the following chemicals should be used todisinfect tourniquets and items contaminated with

blood?

A. 70 percent isopropylB. 1:10 dilution of chlorine bleachC. Hydrogen peroxideD. Iodophors

6) What is the proper way to dispose of laboratoryspecimens and contaminated supplies, other than

sharps, when following BSI?

A. double bag and throw in the trashB. place in labeled biohazard bags or containersC. place in puncture-resistant containersD. throw in trash that is to be incinerated


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7) The manufacturer must supply a material safety datasheet (MSDS) for:

A. fluid-resistant laboratory coatsB. most patient medicationsC. isopropyl alcoholD. isotonic saline

8) Which of the following is the most importantprocedure in the prevention of disease transmissionin health care institutions?

A. use of personal protection equipmentB. use of appropriate waste disposal practicesC. hand washingD. reporting personal illnesses to supervisor

9) The two organizations responsible for the latestGuideline for Isolation Precautions in Hospitals arethe:

A. Centers for Disease Control and Prevention(CDC) and Hospital Infection Control PracticesAdvisory Committee (HICPAC)

B. Centers for Disease Control and Prevention(CDC) and Occupational Safety and HealthAdministration (OSHA)

C. Hospital Infection Control Practices AdvisoryCommittee (HICPAC) and National Institute forOccupational Safety and Health (NIOSH)

D. National Institute for Occupational Safety andHealth (NIOSH) and Joint Commission onAccreditation of Healthcare Organizations(JCAHO)

10) Which of the following is proper neonatal ICU blooddrawing procedure?


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A. keep your blood drawing tray as close to theisolette as possible

B. never awaken an infant to draw bloodC. use povidone-iodine to clean a skin puncture

siteD. wear mask, gown, and gloves

11) Under the new CDC isolation guidelines, the oldcategories of isolation and disease-specificprecautions have been collapsed into three sets ofprecautions that include:

A. airborne, droplet, and contactB. airborne, respiratory, and contactC. enteric, contact, and respiratoryD. complete, droplet, and airborne

12) Gloves are worn to:A. prevent contamination of hands when handling

blood or body fluidsB. reduce the chance of transmitting

microorganisms on the hands of personnel topatients during invasive procedures

C. minimize the possibility of transmittinginfectious microorganisms from one patient toanother

D. all of the above13) A person who has recovered from a particular virus

and has developed antibodies against a particular

virus is said to be:

A. a carrierB. immuneC. infectiousD. susceptible


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14) All of the following are proper laboratory safetyprocedures EXCEPT:

A. secure long hair away from the faceB. never eat, drink, or apply makeup in thelaboratoryC. wear closed-toe shoesD. wear your laboratory coat at all times

15) Which of the following is not an example of possibleparenteral means of transmission?

A. drinking contaminated waterB. getting stuck by a needle used on a patientwith AIDSC. rubbing the eye with a contaminated handD. touching infectious material with chapped

hands

16) A factor that increases a hosts susceptibility in thechain of infection is:

A. drug useB. an immunizationC. use of disposable equipmentD. proper nutrition

17) The right to know law primarily deals withA. electrical safetyB. first aid proceduresC. hazardous materials informationD. universal precautions

18) All of the following can be transmitted through bloodtransfusion EXCEPT:

A. diabetes mellitus


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B. hepatitis B virus (HBV)C. human immunodeficiency virus (HIV)D. syphilis

19) What precautions are to be used for a patient whohas an enteric pathogen?A. airborneB. contactC. dropletD. standard

20) What is the proper order for putting on protectiveclothing?

A. gloves first, then gown, mask lastB. gown first, then gloves, mask lastC. gown first, then mask, gloves lastD. mask first, then gown, gloves last

21) What should the phlebotomist do if the outside of apatient specimen tube has blood on it?

A. discard it after pouring the contents into a cleantube

B. discard it in the patients room and draw a newtube

C. place a biohazard label on itD. wipe it with disinfectant

22) All of the following are required parts of an exposurecontrol plan EXCEPT:

A. an exposure determinationB. communication of hazardsC. isolation guidelinesD. methods of implementation


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23) The most frequently occurring laboratory-acquiredinfection is:

A. hepatitis A virus (HAV)B. hepatitis B virus (HBV)C. human immunodeficiency virus (HIV)D. tuberculosis (TB)

24) Which of the following involves possible exposure tobloodborne pathogens by a percutaneous exposureroute?

A. getting stuck with a contaminated needleB. handling blood specimens with ungloved, badlychapped handsC. ingesting infectious materialD. mucous membrane contact with infectious

material

25) Which of the following is not a component thatmakes up the chain of infection?

A. mode of transmissionB. sourceC. mode of transportationD. susceptible host

PROFESSI ONAL ETHI CS

1) A patient is told that she must remain still duringblood collection or she will be restrained. Which tortis involved in this example?

A. assaultB. batteryC. fraud


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D. malpractice2) When a health care provider gives aid at an accident,

he or she is usually protected through:

A. imformed consentB. implied consentC. CPR LawD. rightful action consent

3) The definition of a minor is anyone:A. younger than 18 years of ageB. younger than 21 years of ageC. who has not reached the age of majorityD. who is not self-supporting

4) Which of the following is an example of a confirmingresponse to a patient?

A. I do not know what you meanB. I have no idea how long it will takeC. I understand how you must be feelingD. Im on a tight schedule right now

5) Before a patients laboratory test results can legallybe released, the patient must:

A. express verbal permissionB. tell his or her physician that t is okayC. provide written consentD. provide his or her lawyers consent

6) All of the following are examples of negligenceEXCEPT:

A. The phlebotomist does not return a bedrail tothe upright position


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B. The phlebotomist forgets to put a needle inthe sharps container

C. The phlebotomist fails to report significantchanges in a patients condition

D. The phlebotomist fails to obtain a specimenfrom a combative patient7) The bestway to handle a difficult or bad patient is:

A. help the patient to feel in control of thesituation

B. refuse to collect a specimen from him or herC. speak sharply to the patient to show that you

are in control of the situationD. threaten to report the patient to his or her

doctor

8) If a physician orders laboratory tests for diagnosisand the patient comes to the laboratory with arolled-up sleeve, he or she is giving:

A. implied consentB. informed consentC. rightful action consentD. preventive consent

9) Which of the following situations allows the patient tofeel in control?

A. agreeing with the patient that it is his right torefuse to have a blood specimen drawn

B. informing the patient that you are going todraw a blood sampleC. insisting that the patient cooperate and let

you draw bloodD. telling the patient not to eat or drink

anything during a test


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10) Unauthorized release of confidential patientinformation is called:

A. assaultB. invasion of privacyC. negligenceD. violation of informed consent

11) Which of the following is not part of communicating aprofessional appearance:

A. a clean pressed laboratory coatB. long hair pulled backC. short clean fingernailsD. wearing strong cologne

12) All of the following are ways to avoid malpracticelitigation except:

A. regularly participating in continuing educationprograms

B. reporting incidents within 48 hoursC. properly handling all confidentialcommunications without violationD. obtaining consent for collection of specimens

13) Which of the following examples is a good way toearn a patients trust?

A. act knowledgeableB. convey sincerityC. look professionalD. all of the above

14) A patient agrees to undergo treatment after themethod, risks, and consequences are explained tohim. This is an example of:


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A. implied consentB. informed consentC. Respondeat superiorD. Standard of care

15) Which of the following is not proper telephoneprotocol?

A. answer the phone promptlyB. clarify and record informationC. hang up on angry callersD. prioritize callers, if necessary

phlebotomy study guide

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