Pre-Analytical Considerations in Phlebotomy

Question 1

This word means “before analysis”

Answer 1

Pre-Analytical

Question 2

T or F: Pre-analysis begins during testing and ends with a test order

Answer 2

False (begins when a test is ordered and ends when testing begins)

Question 3

Refers to the resting metabolic state of the body early morning after 12 hours of fasting (influenced by variables such as age, gender, and body conditions that CANNOT be eliminated)

Answer 3

Basal State

Question 4

T or F: Basal state results are used to establish the reference values used for test results to know what normal and abnormal numbers are

Answer 4

True

Question 5

T or F: RBC and WBC values are lower in newborns

Answer 5

False (higher)

Question 6

Refers to how fast the kidney can filter creatinine

Answer 6

Creatinine clearance

Question 7

T or F: Kidney function decreases with age

Answer 7

True

Question 8

T or F: RBC counts are elevated at places with lower altitudes

Answer 8

False (higher altitude = lower oxygen levels trigger more RBC production)

Question 9

This triggers higher concentration in test results due to a lack in solvent (water)

Answer 9

Dehydration

Question 10

These increase with ingestion of fatty foods

Answer 10

Lipids

Question 11

These are altered by drinking excessive water

Answer 11

Electrolytes

Question 12

These chemicals increase in patients on high-protein diets

Answer 12

Ammonia and Urea

Question 13

This is a byproduct of protein metabolism

Answer 13

Urea

Question 14

This occurs naturally in the body and undergoes detoxification in the liver to turn into urea

Answer 14

Ammonia

Question 15

This increases with ingestion of carbohydrates and sugary food

Answer 15

Glucose

Question 16

T or F: Melatonin increases at night and decreases during the day

Answer 16

True

Question 17

When are Renin and TSH at peak levels?

Answer 17

Predawn hours of the morning during sleep

Question 18

Also known as the stress hormone

Answer 18

Cortisol

Question 19

What are the peak hours of cortisol production?

Answer 19

Later in the morning (around 8am)

Question 20

T or F: Chemotherapy drugs can cause an increase in blood cells (WBCs and platelets)

Answer 20

False (decrease)

Question 21

What test is IMMEDIATELY followed after chemotherapy to measure blood components?

Answer 21

CBC Test

Question 22

What does increased level of liver enzymes mean?

Answer 22

Liver Failure

Question 23

These increase amylase and lipase

Answer 23

Steroids and diuretics

Question 24

T or F: During exercise, arterial pH and PCO2 levels are reduced to an acidic level

Answer 24

True

Question 25

T or F: Glucose decreases by moderate muscular activity

Answer 25

False (increases)

Question 26

This metallic element increases in the plasma whenever we exercise

Answer 26

Potassium

Question 27

These 2 skeletal muscle enzymes increase during exercise

Answer 27

Creatinine Kinase and Lactate Dehydrogenase

Question 28

T or F: Fever decreases insulin and glucagon levels

Answer 28

False (increases)

Question 29

This chemical allows glucose to enter the cell

Answer 29

Insulin

Question 30

This substance promotes glucose production

Answer 30

Glucagon

Question 31

T or F: Fevers can increase cortisol

Answer 31

True

Question 32

T or F: Blood components are higher for males than females

Answer 32

True

Question 33

T or F: RBCs, hemoglobin, and hematocrit are all directly proportional

Answer 33

True

Question 34

T or F: Androgen plays a key role in stimulating RBC production

Answer 34

True (Testosterone)

Question 35

During intramuscular injections, these 2 substances increase

Answer 35

CK and LDH

Question 36

Refers to jaundiced specimen having a deep yellow to yellow-brown color of serum or plasma

Answer 36

Icteric Specimen

Question 37

This is responsible for the yellow pigment of the skin for jaundiced patients

Answer 37

Bilirubin

Question 38

T or F: Bilirubin can interfere with chemistry tests based on color reactions

Answer 38

True

Question 39

T or F: Moving positions too quickly causes blood fluids to filter into the tissues, increasing plasma volume

Answer 39

False (decreasing)

Question 40

T or F: It is advisable to extract samples from the initial position of the patient

Answer 40

True

Question 41

T or F: Mild anemia is normal in pregnancy

Answer 41

True (RBC counts are lower)

Question 42

Characterized by decreased pulmonary function, increased RBC count, and hemoglobin level

Question 43

T or F: Smoking can increase the concentration of immunoglobulins

Answer 43

False (Decreased)

Question 44

T or F: WBCs increase with stress

Answer 44

True

Question 45

T or F: Temperature plays a factor in triggering hemoconcentration

Question 46

What is the mortal sin of medical technologists?

Question 47

T or F: Urea is photosensitive

Question 48

This cold temperature range describes improper transport conditions of samples

Question 49

T or F: Glucose can decrease if RBCs come in contact with the serum due to the RBCs consuming them

Question 50

T or F: Glucose can decrease if RBCs come in contact with the serum due to the RBCs consuming them

Question 51

T or F: Tattooed areas are acceptable places to draw blood from

Question 52

“Sclerosed” means what?

Answer 52

Hardened

Question 53

“Thrombosed” means what?

Question 54

T or F: You must choose veins that are proximal to damaged ones

Question 55

T or F: Edema may yield inaccurate results due to tissue fluid contamination

Question 56

Refers to swelling or mass of blood caused by blood leaking from a blood vessel during or following venipuncture

Question 57

T or F: Lymph node removal causes lymphostasis

Question 58

T or F: Lymphostasis does not change blood composition in the arm

Question 59

What is the most prominent vein for obese patients?

Question 60

T or F: Patients taking aspirin have a less chance of excessive bleeding

Question 61

T or F: You can apply a pressure bandage instead of maintaining pressure

Question 62

T or F: You can apply a pressure bandage instead of maintaining pressure

Question 63

Refers to fainting due to a nervous system response to abrupt pain, stress, or trauma

Question 64

Refers to fainting due to a nervous system response to abrupt pain, stress, or trauma

Question 65

Refers to fainting due to a nervous system response to abrupt pain, stress, or trauma

Question 66

→ tube inserted into a vein or artery → ready access to the patient’s circulation → eliminates the need for multiple draws → uses include: - administering of fluids or medication - drawing blood - central venous pressure reading

Question 67

T or F: You can apply a tourniquet or perform venipuncture on an arm with a VAD

Question 68

Refers to a catheter placed in an artery (most common in a radial artery)

Question 69

Refers to a surgical procedure that fuses veins with arteries commonly used for hemodialysis treatment

Question 70

→ used for administering medication and drawing blood → uses the vein in the lower arm above the wrist → can be left in place for up to 48 hours → flushed with heparin or saline to prevent clotting

Question 71

T or F: Drawing coagulation specimen is not recommended when a Hep-Lock is in place

Question 72

→ thin plastic tube/catheter → inserted in a vein to administer fluids

Question 73

T or F: Blood specimen can be contaminated or diluted with IV fluid causing erroneous test results

Question 74

T or F: Draw blood above the IV site if both arms have one

Question 75

T or F: Blood can only be collected within 24 to 48 hours of the time the IV was discontinued

Question 76

Refers to a needle-less closed device that is sometimes connected to an arterial or central venous catheter

Question 77

→ indwelling line that consists of tubes inserted into main vessels → used for administering fluids and medications, monitoring pressures, and drawing blood

Question 78

Device wherein the line is inserted into large veins (subclavian advancing into the superior vena cava)

Question 79

Surgically-implanted disk-shaped chamber attached to the indwelling line placed on the upper chest just below the collar bone

Question 80

Line is inserted into a vein (in an extremity) and threaded into a main vein leading to the heart

Question 81

This is the most common complication in venipuncture

Question 82

What is the color of arterial blood?

Question 83

Refers to blood loss due to blood draw

Question 84

Refers to an adverse condition brought by the effects of treatment/procedure

Question 85

T or F: Life is threatened if more than 5% of blood volume is removed at one time

Question 86

What artery is near the basilic vein?

Question 87

Refers to back flow of additive into the patient’s vein from the tube during the venipuncture procedure

Question 88

→ decrease in fluid content or plasma volume → caused by stagnation of the normal venous blood flow because of tourniquet application → increased concentration of RBCs and other non-filterable large molecules

Question 89

Complication wherein RBCs are damaged and hemoglobin escapes into the fluid portion of the specimen

Question 90

Slight hemolysis is indicated by what hue of red?

Question 91

Moderate hemolysis is indicated by what hue of red?

Question 92

Gross hemolysis is indicated by what hue of red?

Question 93

T or F: Short-draw serum tubes are generally unacceptable

Question 94

T or F: Never pour two partially filled additive tubes together to fill one tube (affects the blood-to-additive ratio)

Question 95

What forms in wrong/expired collection tubes?

Question 96

T or F: Tube vacuum can be lost if the bevel backs out the skin slightly

Question 97

T or F: When probing, move the needle horizontally

Question 98

T or F: If vein disappears as the tube is engaged or when tourniquet is removed, that is an indicator of a collapsed vein

Question 99

T or F: You can palpate the site of entry near the needle