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Phlebotomy Chapter 9
Phlebotomy Essentials 5th Edition Chapter 9
| Question | Answer |
|---|---|
| Preanalytical phase of the testing process begins for the laboratory when a: | Test is ordered by a patient's physician |
| Most reference ranges are based on normal laboratory test values for: | Healthy people in a basal state |
| Diurnal variations associated with some blood components are: | Normal fluctuations throughout the day |
| Swelling of patient's arm: | Edematous |
| Lipemia results from: | High fat content of the blood |
| Patient with a high degree of jaundice appears: | Yellow skin and sclerae |
| Lymphostasis is: | Obstruction of the flow of lymph |
| Nervous system response to abrupt pain, stress, or trauma: | Vasovagal syncope |
| Small non-raised red spots on patient's skin below tourniquet" | Petechiae (due to capillary or platelet defects) |
| Venous stasis is: | Stoppage of the normal venous blood flow |
| A hematoma is a: | Swelling or mass of blood |
| Mastectomy: | Removal of breast |
| Exsanguination is: | Life-threatening loss of blood |
| A product of the breakdown of red blood cells (RBCs)? | Bilirubin |
| A vein that feels cord like: | Thrombosed |
| A patient goes into convulsions while you are drawing his blood. The last tube has just started to fill. Which of the following is the wrong thing to do? | ... |
| Patient has IV in left forearm, large hematoma in antecubital area of right arm. Best place to collect venipuncture specimen: | Right arm distal to the hematoma |
| Which of the following is not true of hematomas? | All of the above are correct |
| Hemoconcentration from prolonged tourniquet application increases: | Non-filterable analytes |
| Fainting: | Syncope |
| Best specimen for establishing inpatient reference ranges for blood tests are: | Basal-state specimens |
| Test requiring patient's age when calculating results? | Creatine clearance |
| Test most affected by altitude? | RBC count |
| Persistent diarrhea in the absence of fluid replacement may cause: | Hemoconcentration |
| The serum or plasma of a lipemic specimen appears: | Cloudy white |
| A lipemic specimen is a clue that the patient was probably: | Not fasting |
| A 12-hour fast is normally required in testing for this analyte: | Triglycerides |
| Blood component exhibiting diurnal variation, w/peak levels in the morning: | Cortisol |
| Tests influenced by diurnal variation are typically ordered: | Timed |
| Drugs known to interfere with blood test results should be discontinued how many hours prior to blood test? | 4-24 |
| Analyte can remain elevated 24+ hours after exercise? | CK (creatinine kinase) |
| Hormone most affected by fever: | Insulin |
| Analyte with higher reference range for males: | Hematocrit |
| An icteric blood specimen indicates: | Bilirubin test results could be elevated |
| What changes occur in the bloodstream when a patient goes from supine to standing? | Non-filterable elements increase |
| Why do pregnant patients have lower reference ranges for RBC counts? | Increased body fluids result in the dilution of the RBC's |
| Analytes which are typically increased in chronic smokers? | Hemoglobin, Cortisol, WBC, (ALL) |
| It is not a good idea to collect a CBC from a screaming infant because the: | WBCs may be temporarily elevated |
| Factor known to affect basal state, which is automatically accounted for when reference ranges are established: | Geographic locale |
| Temperature and humidity control in a laboratory is important because it: | Maintains the integrity of specimens |
| Scarred or burned areas should be avoided as blood collection sites because: | Circulation is typically impaired |
| A vein that feels hard, cord-like, and lacks resiliency is most likely: | Sclerosed |
| Drawing blood from an edematous extremity may cause: | Erroneous specimen results |
| If you have no choice but to collect a specimen from an arm with a hematoma, collect the specimen: | Distal to it |
| Do not collect blood specimens from an arm on the same side as a mastectomy without permission from the patient's physician: | ALL |
| Which veins is often easiest to feel on obese patients? | Cephalic |
| Collecting a protime specimen from patient with IV's in both arms. The best place to collect the specimen is: | Below one of the IV's |
| A phlebotomist must collect a hemoglobin specimen from a patient in the ICU. There is an IV in the patient's left wrist. There is no suitable antecubital vein or hand vein in the right arm. What should the phlebotomist do? | Perform a fingerstick on the right hand |
| In selecting a venipuncture site, do not use an arm with: | An active AV shunt or fistula |
| A type of line commonly used to monitor blood pressure and collect blood gas specimens is: | An A-line |
| A vascular access pathway that is surgically created to provide access for dialysis is: | An AV shunt |
| Procedure for collecting blood specimen from a heparin lock: | A 5-ml, discard tube before the specimen tubes are filled |
| Which of the following is a type of CVC | Broviac |
| Subcutaneous vascular access device consisting of a small chamber attached to an indwelling line that is implanted under the skin and located by palpating the skin is: | An implanted port |
| The way to bandage a venipuncture site when the patient is allergic to the glue in adhesive bandages is to: | Wrap it with self-adhering material |
| If a patient is severely allergic to ________, never bring it into their room. | Latex |
| Venipuncture site continues to bleed 5+ minutes: | Report it to the patient's physician or nurse |
| Which patient should be asked to lie down during a blood draw? | History of syncope |
| During a blood draw, a patient says he feels faint. What should the phlebotomist do? | Discontinue the draw and lower his head |
| An outpatient becomes weak and pale after a blood draw. What should the phlebotomist do? | Have the patient lie down until recovered |
| If an outpatient tells you before a blood draw that she is feeling nauseated, you should: | Advise her to begin slow, deep breathing |
| Pain associated with venipuncture can be minimized by: | Putting the patient at ease with a little small talk |
| A site could potentially be used for venipuncture even if: | Petechiae appear below the tourniquet |
| A vein with walls that have temporarily drawn together and shut off blood flow during venipuncture is called a: | Collapsed vein |
| Patient has difficult veins. Redirected needle now in vein and 1st tube has just started to fill. Blood filling tube slowly. Skin around the site starts to swell. You have several more tubes to fill. What should you do? | Stop the draw at once and apply pressure to the site |
| Hematoma forms during venipuncture procedures, because: | Failing to apply adequate pressure after the draw |
| Best indication of accidental puncture of an artery? | Blood pulses into the tubes |
| Anemia brought on by the withdrawal of blood for testing purposes is described as: | Iatrogenic |
| If you suspect that you have accidentally collected an arterial specimen instead of a venous specimen: | See if the lab will accept it, and if so, label it as possibly an arterial specimen |
| Infection of a venipuncture site can result from: | Touching the site after cleaning it |
| Blind or deep probing for a vein can result in: | An arterial puncture |
| A patient complains of pain when you insert the needle. Pain doesn't subside. What should you do? | Discontinue the venipuncture immediately |
| A stinging sensation when the needle is first inserted is most likely the result of: | Not letting the alcohol dry thoroughly |
| Best way to avoid reflux? | Make certain that tubes fill from the bottom up |
| Least likely to impair vein patency? | Leaving a tourniquet on too long |
| Prolonged tourniquet application can affect blood composition because of: | Hemoconcentration |
| The serum or plasma of a hemolyzed specimen appears: | Pink or reddish |
| Which action is least likely to cause specimen hemolysis? | Transferring blood from a syringe to a tube |
| Ratio of blood to anticoagulant is most critical for which of the following test? | Prothrombin time (PT) |
| A phlebotomist has tried twice to collect a light blue top tube on a patient with difficult veins. Both times only able to collect a partial tube. What should the phlebotomist do? | Have someone else collect the specimen |
| Least likely to cause contamination of the specimen? | Cleaning a fingerstick site with isopropyl alcohol |
| Needle is in vein and blood flow has been established. You hear a hissing sound. | Bevel came out of the skin and the tube vacuum escaped |
| A needle that has gone through the back wall of the vein may cause: | Blood to enter the tube slowly or not at all |
| When a vein rolls, the needle typically: | Slips beside instead of in the vein |
| Needle inserted but tube is filling slowly. Hematoma starts to form rapidly. What has most likely happened? | Needle is only partly in the vein |
| In a multi-tube blood draw, 1st tube fills fine. 2nd tube fails to fill. Redirected needle, removed tube, pulled back needle a little, rotated bevel, and reset tube. Still nothing. Which of the following actions should you take next? | Try another tube. |
| You insert needle and engage tube, but do not get blood flow. You determine that needle is beside vein. You redirect it twice-still no blood flow, even after trying a new tube. What should you do next? | Discontinue the draw and try again at a new site. |
| Most likely reason to cause vein collapse during venipuncture? | Tube vacuum is too great for the size of the vein. |
| Drugs known to interfere with urinalysis results should be discontinued how many hours prior to test? | 48-72 |
| Excessive probing can result in: | Nerve damage |
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