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Phlebotomy Chapter 8

Phlebotomy Essentials 5th Edition chapter 8

Question	Answer
When properly anchoring a vein, the	Thumb is 1 to 2" below the intended site and is pulling the skin toward the wrist.
Which of the following actions is unlikely to help a phlebotomist gain a patient's trust?	Collecting a specimen before the requested time
It's unlikely that misidentifying a patient specimen would result in	No reprimand if no one was hurt
Needle phobia is defined a/an	Intense fear of needles and being stuck
Symptoms of needle phobia can include	All of the above: arrhythmia, fainting, light-headedness
A basic step that can be taken to minimize any trauma associated with a venipuncture is to	Choose the most skilled phlebotomist available to preform the venipuncture
Proper use of a hand sanitizer includes	All of the above: Allowing the alcohol to evaporate completely, rubbing it in between and around the fingers, using a very generous amount of the sanitizer.
To examine by touch or feel is to	Palpate
In most cases, needle insertion should be performed	Using a smooth, steady motion forward
To "seat" the needle in the vein means to	Thread part of the needle within the lumen
Going without food or drink except water for 8-12 hours is defined as	Fasting
The reason a test is ordered "timed" is to	Draw it at the best time for accurate results
Examples of timed tests include	Blood cultures, cardiac enzymes, and cortisol
A test is ordered "fasting" to	Eliminate the effects of diet on test results
Bending the arm up to apply pressure to the site after venipuncture has not been shown to	Enable the site to quickly stop bleeding after needle removal
The unique number assigned to a specimen request is called the	Accession number
Failure of the patient to follow required diet restrictions before specimen collection could lead to	All of the above: Compromised patient care and treatment, erroneous and meaningless test results, misinterpreted test results by the physician
Which of the following individuals has legal authority to authorize patient testing?	Patient's physician
Test requisition information must include the	Ordering physician
Which type of requisition often serves as a test request, report, and billing form?	Manual
Information represented by a patient ID bar code typically includes the patient's	Medical record number and name
Outpatient requisitions are typically of this type	Manual
When received by the laboratory, inpatient requisitions are typically sorted according to	Collection priority, date & time, & patient location
Steps taken to unmistakably connect a specimen & the accompanying paperwork to specific individual are called	Accessioning the specimen
Which priority does a timed test typically have?	Second
A test that is ordered stat should be collected	Immediately, without hesitation
Which of the following tests is commonly ordered stat?	Lytes
If a test is ordered stat, it may mean that the patient is in	Critical condition
When a test is ordered ASAP, it means that	Results are needed soon for an appropriate response
Preop means	Before surgery
Tests are classified as routine if they are ordered	In the course of establishing a diagnosis
This term means the same as stat	Medical Emergency
NPO means	Nothing by mouth
An example of a test that is commonly ordered fasting is	Glucose
Which liquid is acceptable to drink when one is fasting	Plain water
Which a common postop test?	H&H (Hemoglobin & Hematocrit)
You arrive to draw a specimen on an inpatient. The patient's door is closed. What do you do?	Knock lightly, open the door slowly, and ask whether it's all right to enter.
There is a sign above the patient's bed that reads, "No blood pressure or venipuncture, right arm," the patient has an IV line in the left forearm. You have a request to collect a complete blood count (CBC) on the patient. How should you proceed?	Collect the specimen from the left hand by finger stick
A code is a way to	All of the above, convey important information without alarming the public, transmit messages over the facility's public address system, use numbers or words to represent important information.
DNR means	Do not resuscitate
You greet your patient in the following manner: "Hello, my name is Jean and I am here to collect a blood specimen, if that is all right with you." The patient responds by saying, "OK, but I would rather not." How do you proceed?	Do not draw blood!
Which one of the following tests is used to identify protein disorders that lead to nerve damage?	SPEP
Your inpatient is asleep when you arrive to draw blood. What do you do?	Say the patient's name softly and tap them gently.
Laboratory results can be negatively affected if the phlebotomist	While preparing to collect a specimen, startles a patient who is asleep
In collecting a blood specimen from an unconscious patient, it's unnecessary to	Move the patient to a special phlebotomy collection area
What do you do if a physician is with the patient and the specimen is ordered stat?	Introduce yourself and ask for permission to draw the specimen
What is the best thing to do if family or visitors are with the patient?	Ask them to wait outside of the room until you are finished
Your patient is not in the room when you arrive to collect a timed specimen. The patient's nurse states that the patient will be unavailable for several hours. What should you do?	Fill out a delay slip stating you were unable to collect the specimen
Misidentification of a specimen for this test is most likely to have fatal consequences	Type and screen
You arrive to collect a specimen on a patient named John Doe in 302B. How do you verify that the patient in 302B is indeed John Doe?	Ask him for his name and date of birth and match it to the requisitions.
Which requisition information must match information on the patient's ID band?	Medical record number
The medical record number on the ID band matches the number on your requistion, but the patient's name is spelled differently that the one on your requisition. What should you do?	Do not collect the specimen until the difference is resolved
An unconscious inpatient doesn't have an ID band. The name on an envelope on the patient's nightstand matches with the requisition. What should you do?	Don't start any procedure until the nurse attaches an ID bracelet.
What would be the system of choice to identify laboratory specimens from an unconscious woman in the ER?	Use a three-part identification band with special tube labels.
Which type of inpatient is most likely to have more than one ID band?	Newborn
What is the most critical error a phlebotomist can make?	Misidentify the patient's specimen
Your patient isn't wearing an ID band. You see that the ID band is taped to the nightstand. The information matches your requisition. What do you do?	Ask the patient's nurse to attach an ID band and proceed when it's attached.
Which one of following types of patients is least likely to need his or her identity confirmed by the patient's nurse or a relative?	A geriatric patient
You get a test request for a pt named Mary Smith. You call the name, and a woman who was just checked in responds. She is only pt in the wtg rm. How do you verify that she is the correct patient?	Ask the woman to state her complete name and date of birth to confirm her identity.
A cheerful, pleasant bedside manner and exchange of small talk are unlikely to	Keep the patient from fainting during venipuncture procedure.
Your patient is cranky and rude to you. What do you do?	Be a professional as you can and collect the specimen in a normal way.
Which of the following is part of informed consent for specimen collection?	Informing the patient that you are a student.
The patient asks if the test you are about to draw is for diabetes. How do you answer?	Explain that it's best to discuss the test with the physician
An inpatient vehemently refuses to allow you to collect a blood specimen. What should you do?	Notify the patient's nurse and document the patient's refusal
You arrive to draw a fasting specimen. The patient is just finishing breakfast. What do you do?	Check with the patient's nurse to see if the specimen should be collected or the draw rescheduled.
If you assemble equipment after selecting and cleaning the blood collection site, you will	All of the above: Be more apt to allow sufficient time for the alcohol to dry, Have a better idea of what equipment you will need to use, Waste less equipment by knowing exactly what is needed.
When performing venipuncture, hand decontamination is required	Before & after each patient
Which of the following is the best thing to do if your hands are visibly contaminated?	Wash them with soap and water.
You must collect a specimen on a 6 year old. The child is a little fearful. What do you do?	Explain what you are going to do to the child in simple terms.
If the patient asks whether the procedure will hurt, you should say that it	Might hurt just a little, but only for a short time
What is the proper arm position for routine veil-puncture?	Downward in a straight line from shoulder to wrist, palm up
Outpatients who have previously fainted during blood draw should be	Asked to lie down, or sit in a reclining drawing chair.
Which of the following acts can lead to liability issues?	Lowering a bed rail to make access to the patient's arm easier
Never leave tourniquet on for more than	1 minute
Where is the best place to apply the tourniquet?	About 3-4 inches above the venipuncture site
If the tourniquet is too tight	All of the above: Arterial flow below it may be stopped, Blood below it may hemoconcentrate, the pressure can cause the arm to ache.
Which of the following actions is prohibited during the vein selection process?	Having a patient pump his or her fist
In selecting a venipuncture site, how can you tell a vein from an artery?	An artery has a distinct pulse
What does a sclerosed vein feel like	Hard and cord-like
It's acceptable to use an ankle vein if	The physician gives permission
Which of the following will help you avoid inadvertently puncturing an artery during venipuncture?	All of the above: Avoid drawing the basilic vein in the antecubital area, don't select a site that is near where you feel a pulse, don't select a vein that overlies or is close to an artery.
You must collect a light-blue tube for a special coagulation test from a pt who has an IV line in left wrist and dermatitis all over the right arm and hand. The veins on the right arm and hand are not readily visible. What is the best way to proceed.	Apply a tourniquet on the right arm over a towel and do the draw.
What is the best thing to do if the vein can be felt but not seen, even with the tourniquet on?	Look for visual clues on the skin to remind you where the vein is.
Release the tourniquet as soon as blood flow is established to	Decrease hemoconcentration of the specimen
What is the CLSI-recommended way to clean a venipuncture site?	Cleanse with a circular motion fromthe center to the periphery
Which of the following is the least important reason to wait 30 seconds for the alcohol to dry before needle insertion?	It gives the phlebotomist time to prepare equipment and supplies.
What happens if you advance the tube past the guideline on the holder before needle insertion?	The ETS tube will fail to fill with blood because of loss of tube vacuum.
Visual inspection of the needle tip before inserting it in a patient's vein would be unable to detect	That the needle is out of date
Which of the following steps are in the right order for the venipuncture procedure?	Clean the site, prepare equipment, put on gloves, apply tourniquet.
You are about to draw blood from a patient. You touch the needle to the skin but change your mind and pull the needle away. What do you do next?	Stop & obtain a new needle before trying again
What is the best angle to use for needle insertion during routine venipuncture?	15-30 degrees
In performing venipuncture, the needle is inserted	Bevel facing up
How can you tell when the needle is in the vein as you insert it into the patient's arm?	You will feel a slight "give" or "pop.:
When is the best time to release the tourniquet during venipuncture?	As soon as blood begins to flow into the tube
Which of the following analytes is least affected by prolonged tourniquet application?	Red cell count
Which of the following would be considered improper specimen collection technique?	Position the arm so tubes fill from stopper end first.
It's important to fill anticoagulant tubes to the proper level to ensure that	There is a proper ratio of blood to anticoagulant additive.
It's important to mix anticoagulant tubes immediately after filling them to	Avoid microclot formation
You are in the middle of drawing a blood specimen using the evacuated-tube method when you realize that you just filled an EDTA tube and still have a green-top tube to collect. What do you?	DISCARD TUBE, then fill the green one.
How many times do you mix non-additive tubes?	None. NON-ADDITIVE TUBES DO NOT NEED TO BE MIXED!
What may happen if you mix tubes to vigorously?	Hemolysis
Use several layers of gauze during needle removal so that	Blood will not contaminate your gloved hand.
It's better to use gauze and not cotton balls for pressure over the site because cotton balls	Can stick to the skin upon removal causing the platelet plug to pull away from the puncture site
Applying pressure on the gauze as the needle is removed can cause	Pain, bruising, the skin to be split
A needle safety feature,other than a blunting needle, should be activated	Immediately after the needle is withdrawn
Which of these steps are in the right venipuncture procedure order?	Establish blood flow, release trouniquet, fill and mix tubes, remove needle.
Proper needle disposal involves	Disposing of the needle and tube holder in the sharps container as one unit.
Labeling of routine inpatient blood specimens should take place	At the bedside immediately after collection.
Which of the following information on a specimen label would be considered optional?	Patient room number and bed.
The patients identification number is included on specimen tube labels to	Avoid confusing specimens from patient with the same name.
The following precautionary information was given to an outpatient after venipuncture. No other tests were scheduled. Which information was unnecessary?	ALL
Which of the following specimens requires routine (normal) handling?	Cholesterol
Which of the following is not a valid reason for failure to obtain a blood specimen?	You didn't have the right equipment on your tray.
You have jut made two unsuccessful attempts to collect a fasting blood specimen from an outpatient. The patient rotates his arm, and you note a large vein that you had not seen before. How do you proceed?	Ask another phlebotomist to collect the fasting specimen
Where is the tourniquet applied when drawing a hand vein?	3" proximal to the wrist bone.
A patient has difficult veins and you decide to use a butterfly for the draw. Butterfly is another name for a	Winged infusion set
What is the advantage of using a butterfly?	Butterflies make it easier to draw difficult veins.
Although the evacuated tube system (ETS) is the preferred method of blood collection, it may be necessary to use a syringe when	The patient's veins are VERY fragile.
Specimen hemolysis can result from	Using a large-volume tube with a 23-gauge needle.
How can you tell that you are ina vein when you are using a syringe?	A "flash" of blood will appear in the hub of the needle.
Success of pediatric blood collection is most dependent on	Patient immobilization
Doing this before obtaining a blood specimen from a child is a bad idea	Telling the child it will not hurt
A butterfly and 23 gauge needle is the best choice to use for venipuncture on a young child because	Flexible tubing allows for arm movement.
In transferring blood from a syringe to evacuated tubes, which is the proper technique?	syringe transfer device.
Which of the following is the least effective way to immobilize a pediatric patient before a blood draw?	Allowing the child to sit with one arm bracing the other.
In drawing blood from an older child, the most important consideration is	Explaining the importance of holding still
Criteria used to decide which needle gauge to use for venipuncture include	The size and condition of the vein
An additive should be mixed	As soon as it's removed from the tube holder
Tremors associated with this disease can make blood collection difficult	Parkinson's
A diabetic outpatient has had a mastectomy on her right side and can't straighten her left arm because of arthritis. The best place to collect a blood specimen is	The left forearm or hand, using a butterfly
Which of the following is proper procedure when dealing with an elderly adult patient?	Refrain from drawing older adult patients if you have a cold, or else wear a mask.
The most common reason a patient must undergo dialysis treatment is	End stages of renal disease.
A type of care for patients who are terminally ill is	Hospice Care
Angle of butterfly needle	10-15 degrees

Created by: 708240517

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