CHAPTER 3: BLOOD SPECIMEN COLLECTION

Question 1

(1) Which step in the CLSI procedure for venipuncture is part of standard precautions?

a. Wearing gloves
b. Positively identifying the patient
c. Cleansing the site for the venipuncture
d. Bandaging the venipuncture site

Answer 1

a. Wearing gloves

Question 2

(2) Select the needle most commonly used in standard venipuncture in an adult:

a. One inch, 18 gauge
b. One inch, 21 gauge
c. One-half inch, 23 gauge
d. One-half inch, 25 gauge

Answer 2

b. One inch, 21 gauge

Question 3

(3) For a complete blood count (hematology) and measurement of prothrombin time (coagulation), the phlebotomist collected blood into lavender stopper and green stopper tubes. Are these specimens acceptable?

a. Yes, EDTA is used for hematologic testing and heparin is used for coagulation testing.
b. No, although EDTA is used for hematologic testing, citrate, not heparin, is used for coagulation testing.
c. No, although heparin is used for hematologic testing, citrate, not EDTA, is used for coagulation testing.
d. No, hematologic testing requires citrate and coagulation testing requires a clot, so neither tube is acceptable.

Answer 3

b. No, although EDTA is used for hematologic testing, citrate, not heparin, is used for coagulation testing.

Question 4

(4) The vein of choice for performing a venipuncture is the:

a. Basilic, because it is the most prominent vein in the antecubital fossa
b. Cephalic or accessory cephalic, because it is the least painful site
c. Median or median cubital, because it has the lowest risk of damaging nerves in the arm
d. One of the hand veins, because they are most superficial and easily accessed

Answer 4

c. Median or median cubital, because it has the lowest risk of damaging nerves in the arm

Question 5

(5) The most important step in phlebotomy is:

a. Cleansing the site
b. Identifying the patient
c. Selecting the proper needle length
d. Using the correct evacuated tube

Answer 5

b. Identifying the patient

Question 6

(6) The venipuncture needle should be inserted into the arm with the bevel facing:

a. Down and an angle of insertion between 15 and 30 degrees
b. Up and an angle of insertion less than 30 degrees
c. Down and an angle of insertion greater than 45 degrees
d. Up and an angle of insertion between 30 and 45 degrees

Answer 6

b. Up and an angle of insertion less than 30 degrees

Question 7

(7) Failure to obtain blood by venipuncture may occur because of all of the following except:

a. Incorrect needle positioning
b. Tying the tourniquet too tightly
c. Inadequate vacuum in the tube
d. Collapsed vein

Answer 7

b. Tying the tourniquet too tightly

Question 8

(8) What is the recommended order of draw when the evacuated tube system is used?

a. Gel separator, nonadditive, coagulation, and blood culture
b. Additive, nonadditive, gel separator, and blood culture
c. Nonadditive, blood culture, coagulation, and other additives
d. Blood culture, coagulation, nonadditive, and gel separator or other additives

Answer 8

d. Blood culture, coagulation, nonadditive, and gel separator or other additives

Question 9

(9) Which one of the following is an acceptable site for skin puncture on infants:

a. Back curvature of the heel
b. Lateral or medial plantar surface of the heel
c. Plantar surface of the heel close to the arch of the foot
d. Middle of the plantar surface of the heel

Answer 9

b. Lateral or medial plantar surface of the heel

Question 10

(10) An anticoagulant is an additive placed in evacuated tubes to:

a. Make the blood clot faster
b. Dilute the blood before testing
c. Prevent the blood from clotting
d. Ensure the sterility of the tube

Answer 10

c. Prevent the blood from clotting

Question 11

(11) Which one of the following is a reason for specimen rejection:

a. Clot in a red stopper tube
b. Specimen collected for blood cortisol in the morning
c. Specimen in lavender stopper tube grossly hemolyzed
d. Room number is missing from the specimen tube label

Answer 11

c. Specimen in lavender stopper tube grossly hemolyzed

Question 12

(12) One legal area of concern for the phlebotomist is:

a. Breach of patient confidentiality
b. Failure to obtain written consent for phlebotomy
c. Entering a patient’s room when the family is present
d. Asking an outpatient for his or her full name in the process of identification

Answer 12

a. Breach of patient confidentiality