Phlebotomy Final Test Practice Test

The purpose of wiping away the first drop of blood during skin puncture is to eliminate tissue fluid contamination. When a puncture is made, the first drop of blood that appears may contain tissue fluid, which can interfere with accurate testing. By wiping away the first drop, any potential contaminants are removed, ensuring that the subsequent blood samples collected are free from tissue fluid and providing more accurate test results.

When an ABG (Arterial Blood Gas) specimen is left at room temperature for a prolonged period of time, several things happen. Firstly, the blood cells continue to consume oxygen, leading to a decrease in oxygen levels. Secondly, continued metabolism produces acids, which can lead to a decrease in pH levels. Lastly, the levels of carbon dioxide increase due to ongoing cellular respiration. Therefore, all three choices are correct as they accurately describe the changes that occur when an ABG specimen is left at room temperature for a prolonged period of time.

A fistula is indeed a permanent fusion of an artery and a vein. It is a surgically created connection between an artery and a vein, usually in the arm, to allow for better access for hemodialysis treatment in patients with kidney failure. This connection allows arterial blood to flow directly into the vein, making it easier to remove and return blood during dialysis.

The first morning specimen is preferred for HCG testing because it typically has the highest concentration of HCG. HCG levels are usually more concentrated in the morning urine due to the longer period of time that the hormone has had to accumulate overnight. Therefore, testing the first morning urine sample is more likely to provide an accurate and reliable result for detecting pregnancy.

Pericardial fluid is the correct answer because it is the fluid that is found around the heart. It acts as a lubricant, reducing friction between the layers of the pericardium and allowing the heart to beat smoothly. Serous fluid is a general term for the watery fluid found in various body cavities, while cerebral fluid is found in the brain and spinal cord. Gastric fluid refers to the digestive juices in the stomach.

Capillary bilirubin specimens should be protected from light because exposure to light can cause the breakdown of bilirubin, leading to inaccurate test results. Bilirubin is a sensitive molecule that is easily oxidized by light, resulting in the formation of biliverdin, which can interfere with the measurement of bilirubin levels. Therefore, it is important to store and handle capillary bilirubin specimens in a way that prevents exposure to light to ensure accurate test results.

Capillary blood gases are less desirable than arterial blood gases (ABGs) for the following three reasons. Firstly, skin puncture blood is only partial arterial, meaning it does not fully represent the oxygen and carbon dioxide levels in the arterial blood. Secondly, skin puncture blood contains tissue fluid, which can dilute the blood sample and affect the accuracy of the results. Lastly, during collection, the blood is exposed to air, which can alter the gas levels and lead to inaccurate readings. Therefore, all of the above reasons contribute to why capillary blood gases are less desirable than ABGs.

The CLSI recommends a maximum depth of 2.0mm for a heel puncture. This depth is considered safe and appropriate for obtaining a blood sample from an infant's heel. It ensures that enough blood can be collected for testing purposes without causing excessive pain or injury to the baby.

It is not acceptable to collect a bilirubin specimen from a baby's big toe, regardless of its size or fleshy nature. Bilirubin specimens are typically collected from the baby's heel, as it is a common site for blood collection in infants. The big toe is not a recommended site for this procedure.

When blood is drawn too quickly from a small vein, the high suction force created can cause the vein to collapse. This happens because the pressure inside the vein decreases, leading to a collapse of the vein walls. As a result, blood flow is impeded, and the vein may become temporarily or permanently blocked. This can make it difficult to draw blood or administer medications through that vein in the future.

Sputum samples are typically collected to diagnose tuberculosis. Tuberculosis is a bacterial infection that primarily affects the lungs and can cause symptoms such as coughing, chest pain, and difficulty breathing. Collecting sputum samples allows healthcare professionals to test for the presence of the bacteria causing tuberculosis, known as Mycobacterium tuberculosis, and confirm the diagnosis. This is done through laboratory analysis, such as acid-fast staining or culturing the bacteria from the sputum sample. Early diagnosis and treatment of tuberculosis are crucial to prevent the spread of the infection and manage the disease effectively.

The safest area for an infant heel puncture is the lateral planter heel surface. This area is less sensitive and has a thicker layer of tissue, making it less likely to cause pain or injury to the infant. Puncturing the central area of the heel or the medial area of the arch can be more painful and may increase the risk of hitting a bone or nerve. The posterior curvature of the heel is also not recommended as it can cause discomfort and increase the risk of injury. Therefore, the lateral planter heel surface is the safest option for an infant heel puncture.

The correct answer is "all of the above are correct". This means that all three statements mentioned in the question are true for POC glucose analyzers approved for hospital use. These analyzers can use various sample types such as venous, arterial, or capillary blood. They also have the capability to download data from the glucose meter to a data management program. Additionally, they require quality control and either patient or authorized operator identification numbers.

A good blood smear should exhibit a feathered edge. This means that the edge of the smear should be smooth and gradually thinning out, resembling the shape of a feather. A feathered edge indicates that the blood sample was properly prepared and spread evenly on the slide. It allows for better visualization of individual blood cells and ensures accurate analysis under a microscope.

If a phlebotomist has attempted twice to draw a partial thromboplastin time (PTT) specimen from a patient with difficult veins and has only been able to draw a partial tube, they should get a more experienced phlebotomist to do the draw. This is because a more experienced phlebotomist will likely have better techniques and skills to successfully draw the specimen from a patient with difficult veins. Attempting to draw from the other arm or telling the patient to come back later may not necessarily solve the issue if the phlebotomist lacks the necessary experience.

The composition of venous blood does vary relative to the metabolic needs of the areas of the body it serves. Venous blood carries waste products, such as carbon dioxide, from the body's tissues back to the heart and lungs for elimination. The metabolic needs of different areas of the body can vary, so the composition of venous blood will reflect these differences. For example, venous blood returning from active muscles will have higher levels of carbon dioxide and lower levels of oxygen compared to venous blood returning from less active tissues. Therefore, the answer is true.

Isopropyl alcohol is the proper cleaning solution for preparing an arterial puncture site. This is because isopropyl alcohol is an effective antiseptic that kills bacteria and reduces the risk of infection. It is commonly used in medical settings to clean the skin before procedures such as blood draws or injections. Antiseptic soap and antiseptic wipes may also be used for cleaning, but isopropyl alcohol is specifically recommended for arterial puncture sites due to its strong disinfecting properties. Peroxide is not typically used for cleaning arterial puncture sites as it can be irritating to the skin.

When collecting a blood culture specimen directly from a butterfly into blood culture bottles, the aerobic bottle should be collected first. This is because aerobic bacteria require oxygen to grow and the aerobic bottle provides the necessary oxygen-rich environment for their growth. Collecting the aerobic bottle first ensures that any aerobic bacteria present in the specimen will have the optimal conditions for growth and can be accurately detected in the culture.

Lumbar puncture is a medical procedure in which a needle is inserted into the lower back to collect a sample of cerebrospinal fluid (CSF). CSF is a clear, colorless fluid that surrounds the brain and spinal cord, providing protection and nourishment. It is not pericardial fluid (fluid around the heart) or serous fluid (a type of bodily fluid found in various locations). Therefore, the correct answer is cerebral spinal fluid.

Lymphostasis refers to the obstruction or complete stoppage of lymph flow. This condition can occur due to various reasons, such as blockage of lymphatic vessels or lymph nodes, inflammation, or infection. When lymphostasis occurs, the normal flow of lymph fluid is disrupted, leading to a buildup of lymph in the affected area. This can result in swelling, pain, and impaired immune function. Treatment for lymphostasis typically involves addressing the underlying cause and may include compression therapy, manual lymph drainage, or surgical intervention.

The measure of the acidity or alkalinity of a patient's blood is known as the pH. pH is a scale that ranges from 0 to 14, with 7 being considered neutral. A pH below 7 indicates acidity, while a pH above 7 indicates alkalinity. Monitoring the pH of a patient's blood is important for diagnosing and managing various medical conditions, as it helps healthcare professionals assess the body's acid-base balance and overall health.

A pink color topped tube can be used to collect blood for a type and crossmatch. This is because pink top tubes usually contain an anticoagulant called EDTA, which helps prevent clotting and preserve the blood sample for further testing. Type and crossmatch is a procedure performed before blood transfusion to determine the compatibility between the donor and recipient blood types, ensuring a safe and successful transfusion.

Phenylketonuria is a hereditary condition where the body is unable to metabolize phenylalanine, an amino acid found in many foods. This inability leads to a buildup of phenylalanine in the blood, which can cause intellectual disability, developmental delays, and other health problems if left untreated. Galactosemia is a different condition that affects the body's ability to metabolize galactose, a sugar found in milk. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormone. Cystic fibrosis is a genetic disorder that affects the lungs and other organs.

When handling a nonblood specimen, in addition to biohazard warnings, it is typically required to have information about the specimen type and its source. The specimen type refers to the specific nature or category of the sample, such as urine, saliva, or tissue. The source refers to where the specimen came from, such as a specific patient or location. Having this additional information is important for accurate identification, labeling, and processing of the nonblood specimen.

To prevent introducing a contaminating substance into a trace-element collection tube, it is suggested that the phlebotomist draw by itself using a syringe or evacuated tube system. This method ensures that there is no cross-contamination from other substances or additives present in different tubes or needles. By using a separate syringe or evacuated tube for the collection of trace elements, the risk of contamination is minimized, ensuring accurate and reliable test results.

CLSI, or the Clinical and Laboratory Standards Institute, is the organization that develops standards for specimen handling and processing. This organization creates guidelines and best practices to ensure the accuracy and reliability of laboratory testing. These standards are crucial in maintaining quality control, preventing contamination, and ensuring the safety of laboratory personnel. CLSI plays a vital role in the healthcare industry by promoting consistency and uniformity in laboratory procedures, ultimately improving patient care.

Mucus or phlegm from the lungs is called sputum. Sputum is a thick, sticky substance that is produced by the respiratory system. It is often expelled through coughing and can contain various substances such as bacteria, viruses, and other particles. The term "sputum" is commonly used in medical contexts to describe the material that is coughed up from the lungs during respiratory infections or other respiratory conditions. Saliva, secretion, and spit are not specific terms for mucus or phlegm from the lungs, making them incorrect answers.

Warming the site before skin puncture increases blood flow up to 7 times. This is beneficial because increased blood flow allows for easier and quicker access to the veins, making it easier to locate and puncture them. It also helps in obtaining an adequate blood sample for testing purposes. Additionally, increased blood flow can help minimize discomfort for the patient during the procedure.

Sodium fluoride is recommended as an additive for collecting an ethanol test specimen. This is because sodium fluoride acts as a preservative and prevents the breakdown of ethanol in the specimen over time. By inhibiting the enzyme that breaks down ethanol, sodium fluoride ensures that the ethanol concentration remains stable and accurate for testing purposes.

The correct answer is TRACE ELEMENT FREE, ROYAL BLUE. This is because a patient who is suspected of having lead poisoning should have their lead test specimen drawn in a trace element-free tube to prevent contamination from other elements that could interfere with the test results. The royal blue color of the tube indicates that it is trace element-free.

Removing blood on a regular basis or in large amounts can lead to iatrogenic anemia. Iatrogenic anemia refers to anemia that is caused by medical intervention, such as blood removal through procedures like phlebotomy or blood donation. When blood is removed regularly or in large amounts, it can result in a decrease in the overall number of red blood cells in the body, leading to anemia.

Ammonia is the correct answer because it is a chemical compound that is highly volatile and can be toxic when inhaled in high concentrations. Therefore, in order to preserve and handle ammonia specimens safely, they need to be chilled. This helps to prevent the release of ammonia gas and minimize the risk of exposure to harmful levels of the compound.

Blood cultures are a test that requires strict antisepsis procedures before specimen collection. Antisepsis refers to the practice of using substances or techniques to prevent the growth or spread of microorganisms on living tissue. In the context of blood cultures, it is important to ensure that the skin is thoroughly cleaned and disinfected to minimize the risk of introducing any contaminants into the blood sample. This helps to maintain the integrity and accuracy of the test results.

Collecting a CBC specimen from a screaming infant is not a good idea because the stress and agitation caused by the screaming can lead to an increase in the number of white blood cells in the sample. This can result in an inaccurate reading of the white blood cell count, potentially leading to a misdiagnosis or unnecessary treatment.

Prolonged tourniquet application can cause hemoconcentration, which refers to an increase in the concentration of red blood cells and other blood components due to a decrease in plasma volume. This occurs because the tourniquet restricts blood flow, leading to the accumulation of cellular components in the affected area. As a result, the blood composition is altered, with a higher concentration of red blood cells and other components. This can have implications for the patient's health, potentially leading to complications such as blood clots or tissue damage.

Timing should begin after finishing the glucose drink during a GTT (Glucose Tolerance Test) because this is when the patient has completed consuming the required amount of glucose. The purpose of the GTT is to measure how the body metabolizes glucose, so it is essential to start timing after the glucose has been ingested to accurately assess the body's response to the sugar load. Starting timing before finishing the drink or at any other point would not provide an accurate measurement of glucose metabolism.

A urine, C&S (culture and sensitivity) test is commonly ordered to detect the presence of a urinary tract infection (UTI). This test helps identify the specific bacteria causing the infection and determines which antibiotics would be most effective in treating it. By analyzing the urine sample, healthcare professionals can detect the presence of bacteria, such as E. coli, which is a common cause of UTIs. Therefore, the correct answer is urinary tract infection.

The correct answer is LABELING SPECIMEN because it is the only action in the given list that does not involve any direct contact with the sample or the equipment used to handle the sample. Washing hands, putting gloves on, and touching the top of the tube all have the potential to introduce contaminants or compromise the sterility of the sample. However, labeling the specimen does not pose any risk of contamination as it is a separate task that can be done without touching the sample or the equipment.

A purple top microcollection container is used to collect a specimen for a Complete Blood Count (CBC) test. The CBC test is a common blood test that provides information about the different components of blood, such as red blood cells, white blood cells, and platelets. By using a purple top microcollection container, the laboratory can ensure that the blood sample remains stable and suitable for accurate analysis of the CBC parameters.

When a blood sample is collected, hemolysis refers to the rupture or destruction of red blood cells, causing the release of hemoglobin into the serum. Hemolysis can affect the clotting process of a serum sample because it can interfere with the coagulation factors present in the serum. Therefore, if the collection of the sample was difficult, it is least likely that hemolysis occurred, resulting in delayed clotting of the serum sample.

The term "basel state" refers to the body's state when it is at rest and has been fasting for an extended period, such as overnight. In this state, the body's metabolism is at its lowest, and there is minimal activity or digestion occurring. Therefore, a patient who has just awakened at 0600 after fasting all night closely resembles the basel state because their body has been at rest and without food for a significant period.

If blood pulses into the tube, it indicates a strong, rhythmic flow of blood. This suggests that the puncture was made in an artery rather than a vein. Arteries have a higher pressure and thicker walls compared to veins, which explains the pulsation. Therefore, the correct answer is artery.

A patient who is lactose intolerant will have a flat or minimal increase in glucose levels after ingesting lactose. This is because lactose intolerant individuals lack the enzyme lactase, which is necessary to break down lactose into glucose and galactose. As a result, the lactose remains undigested and unabsorbed in the small intestine, leading to minimal or no increase in blood glucose levels.

A drug screen is a test that may require special "chain of custody" documentation when collected. This documentation ensures that the sample is properly handled and tracked throughout the testing process to maintain its integrity and prevent tampering. This is particularly important for drug screens as they are often used in legal and employment settings where accurate and reliable results are crucial. Alcohol tests, blood tests, and urine tests may also be subject to chain of custody documentation in certain situations, but the question specifically mentions drug screens as requiring this documentation.

Drawing EDTA specimens first helps to minimize platelet clumping. EDTA (ethylenediaminetetraacetic acid) is an anticoagulant commonly used in blood collection tubes. It works by binding calcium ions, which are necessary for the activation of platelets and the clotting process. By collecting EDTA specimens before other specimens, the anticoagulant can quickly mix with the blood, preventing platelet clumping and ensuring accurate test results. This order of draw is recommended to maintain the integrity of the samples and avoid any interference with subsequent tests.

A PT (Prothrombin Time) test is the one that requires a specimen with a 9:1 ratio of blood to anticoagulant.

When a patient has an IV in both arms, it is best to draw a protime specimen below or distal from the IV site. This is because drawing the specimen above the IV site may result in contamination of the sample with IV fluids or medications. Drawing the specimen below or distal from the IV site helps to ensure that the sample is not affected by the IV fluids and provides accurate test results.

The correct answer is "lipemic" because lipemia refers to the presence of excessive lipids or fats in the blood, which can cause the serum to appear cloudy or milky. This can occur when a patient has not fasted before a test that requires a fasting specimen, as the intake of food can lead to an increase in lipid levels in the blood. A clear or yellow serum would be expected in a fasting specimen.

If the specimen is missing the phlebotomist initials, it may still be accepted for testing because this is a procedural error rather than a problem with the specimen itself. The missing initials can be seen as a minor oversight that does not affect the quality or integrity of the specimen. The other options, such as inadequate blood, missing patient date of birth, and misspelling patient's name, are more significant issues that could potentially impact the accuracy and reliability of the test results.

Hemoconcentration is a condition where blood components that cannot easily leave the blood stream become concentrated in the smaller plasma volume. This means that the concentration of red blood cells, white blood cells, and platelets increases in relation to the plasma. It can occur due to various reasons such as dehydration, prolonged physical exercise, or certain medical conditions.