Quiz #2 Flashcards by Mariel Najera

A key player in bringing quality assessment review techniques to healthcare is

A) Occupational Safety and Health Administration (OSHA)
B) Clinical Laboratory Improvement Amendments of 1988 (CLIA ’88)
C) the Joint Commission
D) College of American Pathologists (CAP)

C) the Joint Commission

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A sentinel event is

A) an unfavorable unexpected event resulting in death or serious injury, ONLY
B) any deviation from acceptable practice that continues to risk patient safety and increases the chance of undesirable outcomes, ONLY
C) an unfavorable unexpected event resulting in death or serious injury, and any deviation from acceptable practice that continues to risk patient safety and increases the chance of undesirable outcomes, BOTH
D) early loss of memory

C) an unfavorable unexpected event resulting in death or serious injury, and any deviation from acceptable practice that continues to risk patient safety and increases the chance of undesirable outcomes, BOTH

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The College of American Pathologists (CAP) offers

A) accreditation of pathology and laboratory services
B) laboratory inspection
C) proficiency testing
D) all listed

D) all listed

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Which of the following statements is NOT true regarding CLIA ’88 regulations?

A) The regulations apply to clinic and physician offices only.
B) The standards address QA and QC.
C) The standards ensure accuracy, reliability and timeliness of patient results.
D) Qualifications of personnel are addressed in the regulations.

A) The regulations apply to clinic and physician offices only.

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The CLIA ’88 regulations recognize which testing categories?

A) low complexity, medium complexity, and high complexity
B) waived complexity, medium complexity, and high complexity
C) primary complexity, secondary complexity, and tertiary complexity
D) waived complexity, moderate complexity, and high complexity

D) waived complexity, moderate complexity, and high complexity

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An international organization that sets standards for phlebotomy procedures is the

A) ASCP
B) CLSI
C) NCA
D) NAACLS

B) CLSI

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As a phlebotomist your role in quality assurance is the

A) analytic phase
B) preanalytic phase
C) postanalytic phase
D) None of these

B) preanalytic phase

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As a phlebotomist, which QA actions affect specimen integrity?

A) specimen collection procedures and analysis of the test
B) patient education and informing the patient of testing results
C) patient preparation and specimen collection techniques
D) use of PPE and specimen collection procedures

C) patient preparation and specimen collection techniques

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Established policies and procedures regarding phlebotomy fall under an overall process known as

A) NAACLS
B) CMS
C) CLIA
D) QA

D) QA

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An example of a QA indicator is

A) wearing laboratory coats when on break
B) no eating, drinking or applying make-up allowed in laboratory work areas
C) all phlebotomists will follow universal precautions
D) the contamination rate for blood cultures will not exceed the national contamination rate

D) the contamination rate for blood cultures will not exceed the national contamination rate

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When the threshold value of a QA clinical indicator is exceeded and a problem is identified

A) a corrective action plan is implemented
B) the patient’s physician must be notified
C) an incident report must be filed
D) the patient specimens must always be redrawn

A) a corrective action plan is implemented

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The use of controls and checks is called

A) CQI
B) QSE
C) QC
D) QA

C) QC

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The most critical step in specimen collection ensuring quality samples and protecting patient safety is

A) using the correct tube
B) drawing the specimen at the correct time
C) obtaining the correct specimen volume
D) identifying the patient

D) identifying the patient

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Areas of the preanalytic/pre-examination phase of phlebotomy subject to QC include all except

A) correct labeling of tubes
B) using proper venipuncture technique
C) proper skin cleaning/disinfecting
D) delta checks

D) delta checks

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As a phlebotomist you understand that QC includes checking expiration dates on your supplies. Outdated evacuation tubes may adversely affect specimen integrity by

A) causing cell distortion
B) dilution of the sample of the sample
C) both causing cell distortion and dilution of the sample of the sample
D) overfilling of the tube

C) both causing cell distortion and dilution of the sample of the sample

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You are the only phlebotomist in an outpatient drawing center. A physician orders a test with which you are not familiar. What is the most appropriate action to take?

A) call the physician’s office for assistance
B) draw both a serum and a plasma sample
C) refer to the reference collection manual for instructions
D) send the patient to another drawing station

C) refer to the reference collection manual for instructions

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What book describes in detail the steps to follow for each test or practice performed?

A) User Manual
B) QC Manual
C) Procedure Manual
D) Safety Manual

C) Procedure Manual

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Which of the following would you find in the Safety Manual?

A) procedures related to fire and radiation
B) disaster plan
C) exposure control plan
D) all listed

D) all listed

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Due to a specimen mislabeling error an incident report must be completed. What information should not be included in this report?

A) details of the corrective action taken
B) description of the consequence
C) how the phlebotomist feels about the incident
D) explanation of the problem

C) how the phlebotomist feels about the incident

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Risk management protects

A) the employee only
B) the institution only
C) the patient, employee and institution
D) the patient only

C) the patient, employee and institution

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Risk management is

A) an internal process
B) requires expert witness testimony
C) an external process
D) a phase of the litigation process

A) an internal process

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The risk management process includes

A) evaluation of outcomes
B) evaluation of occurrences
C) evaluation of trends
D) all listed

D) all listed

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In regard to the divisions of law which of the following statements is NOT true?

A) criminal law is concerned with the protection of all citizens
B) tort is a type of civil law
C) civil law is concerned with the actions between private parties
D) legal actions are solely criminal or civil

D) legal actions are solely criminal or civil

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Which statement is correct regarding tort?

A) Tort is always an intentional act.
B) Tort actions include fraud and malpractice.
C) Tort includes breach of contract.
D) Tort falls under criminal law.

B) Tort actions include fraud and malpractice.

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Facts concerning assault and battery include A) battery is the threatening act, assault is the act of physical contact B) assault and battery always occur at the same time C) assault requires 2 AA batteries, battery requires 2 C batteries D) assault is the threatening act, battery is the act of physical contact

D) assault is the threatening act, battery is the act of physical contact

Drawing a patient’s blood without his or her permission can result in a charge of A) invasion of privacy B) malpractice C) negligence D) assault and battery

D) assault and battery

Two phlebotomists are discussing a patient’s condition in the elevator. They are overheard by the patient’s daughter. This is an example of A) invasion of privacy B) failure to exercise reasonable care C) improper or unskilled care D) mistreatment of a patient

A) invasion of privacy

Acts considered to invade the privacy of another include A) drawing blood on an unconscious patient in the ER B) providing lab results to an unidentified caller C) collecting the specimen in the wrong tube D) billing for services that have not been provided

B) providing lab results to an unidentified caller

You have just seated a patient in the phlebotomy chair of the outpatient lab when the phone begins ringing at the desk just outside. After four rings you excuse yourself and answer the phone. The caller identifies themselves and requests lab results which you quickly find in the computer system and provide including: the patient’s name, tests done, and the results. What has occurred that might result in legal action? A) assault and battery B) breach of confidentiality C) negligence D) fraud

B) breach of confidentiality

A claim of negligence requires all of the following to be present except A) a legal obligation between the parties involved B) a breach of duty C) harm done as a direct result of the action D) a breach of confidentiality

D) a breach of confidentiality

Which of the following would not violate a patient’s right to confidentiality? A) indicating the nature of a patient’s disease on the hospital room door B) phlebotomists sharing venipuncture collection site information on a patient whose veins are difficult to locate C) keeping a list of HIV positive patients posted in the laboratory D) posting a patient’s laboratory results on a bulletin board in his or her room

B) phlebotomists sharing venipuncture collection site information on a patient whose veins are difficult to locate

Doing something that a reasonable person would not do is considered A) malpractice B) fraud C) standard of care D) negligence

D) negligence

Vicarious liability applies to A) employer liability including independent contractors B) employees operating within their scope of practice C) improperly trained employees D) the statute of limitations

A) employer liability including independent contractors

If a phlebotomist __________, he or she is negligent. A) puts the bedrail in an upright position B) does not obtain a specimen from a combative patient C) reports obvious changes in a patient’s condition D) fails to correctly identify the patient

D) fails to correctly identify the patient

Malpractice is a term associated with A) vicarious liability B) the statute of limitations C) respondeat superior D) professional standard of care

D) professional standard of care

What legal premise implies all health care personnel will perform their duties at a level that any other reasonable person with the same experience and training would do? A) the statute of limitations B) negligence C) malpractice D) standard of care

D) standard of care

A legal action involving respondeat superior "Let the master respond" encompasses? A) an employee working within the scope of employment B) the employee has been properly trainedan employer intentional act of an employee results in patient injury C) an employee operating beyond their scope of practice D) all listed

D) all listed

Which of these statements is NOT true regarding the statute of limitations? A) The federal government regulates laws relating to statute of limitations. B) The statute may not begin until a minor reaches the age of majority. C) Discovery of the alleged negligence may affect the time limit for filing a malpractice action. D) The statute of limitations may become effective on the day the alleged negligent act was committed.

A) The federal government regulates laws relating to statute of limitations.

Which of these statements is true regarding malpractice law suits? A) The plaintiff will most likely seek damages from the employer. B) The vicarious liability statute will protect the employee’s personal assets. C) If the employee did not intend to injure the patient they cannot be held liable. D) The employer always protects the employee under the respondeat superior umbrella.

A) The plaintiff will most likely seek damages from the employer.

As a working phlebotomist you can avoid lawsuits by any of the following actions or behaviors except A) performing unfamiliar procedures B) maintaining a current knowledge base C) properly using equipment D) performing within the expected standard of care

A) performing unfamiliar procedures

The phlebotomist is called to the ED/ER for a STAT blood draw. It is discovered by the ED/ER nurse that the wrong patient was drawn. The legal definition that applies to this situation is A) fraud B) vicarious liability C) res ipsa loquitur D) respondeat superior

C) res ipsa loquitur

what consent implies voluntary and competent permission for a medical procedure, test or medication? A) informed consent B) expressed consent C) implied consent D) all of these

A) informed consent

Expressed consent should NOT be in __________ form. A) verbal B) written C) general D) all of these

C) general

You are drawing pre-operative blood on a medical-surgical patient scheduled for surgery in one hour. What type of consent would you expect this patient to have given for the surgical procedure? A) expressed consent B) surgical consent C) informed consent D) implied consent

A) expressed consent

You approach your patient, introduce yourself, and explain you are going to draw their blood. The patient extends their arm for you and you proceed with the procedure. What type of consent has the patient given? A) expressed consent B) informed consent C) implied consent D) none of these

B) informed consent

HIV consent should include A) the test and its purpose B) how the test might be used C) the meaning of the test and its limitations D) all listed

D) all listed

Which statement is NOT true regarding consent for minors? A) Federal law determines the age of majority for each state. B) A minor who has reached the age of majority may give consent. C) Generally, minors cannot give consent for medical treatment. D) Performing phlebotomy on a minor without parental consent may result in charges of assault and battery.

A) Federal law determines the age of majority for each state.

Which of the following is NOT a phase of the litigation process? A) depositions are given while a court reporter records every word B) correction of the situation is begun using policies and procedures already in place C) a complaint against the defendant is filed by the plaintiffa complaint against the defendant is filed by the plaintiff D) appeal of the jury decision is begun by the losing party

B) correction of the situation is begun using policies and procedures already in place

Skin puncture is also known as A) bad boo-boo B) capillary puncture C) dermal puncture D) both dermal puncture and

D) both dermal puncture and

Selection of capillary puncture equipment depends on the A) collection site B) patient's age C) volume of specimen collected D) all listed

D) all listed

It is necessary to control depth of lancet insertion during skin puncture to avoid A) injuring bone B) bacterial contamination C) puncturing an artery D) excessive bleeding

A) injuring bone

Microcollection containers are also known as A) puncture devices B) lancets C) bullets D) vacutainer tubes

C) bullets

Microcollection tubes may A) have color-coded bodies, caps or stoppers B) have minimum and maximum fill levels marked C) include lot numbers ‘ D) all listed

D) all listed

Color coding of microcollection containers (“bullets”) indicates A) lot and manufacturer B) quantity of specimen that can be collected C) container size D) presence of and type of additive

D) presence of and type of additive

You are in ICU having difficulty obtaining a blood specimen by venipuncture syringe draw. You are only able to collect one forth of the required sample amount. The appropriate action to take is A) perform a skin puncture to obtain the ordered sample B) transfer the specimen into the appropriate microcollection tubes and indicate that it is a capillary specimen on the label C) deliver the blood to the lab in the syringe used for the draw D) transfer the specimen into the appropriate microcollection tubes and indicate the specimen is venous on the label

D) transfer the specimen into the appropriate microcollection tubes and indicate the specimen is venous on the label

Microhematocrit tubes fill by A) capillary action B) squeezing the puncture site C) venous action D) arterial action

A) capillary action

Hematocrit (Hct) is also known as A) capillary blood count B) complete blood count C) hemoglobin D) packed cell volume (PCV)

D) packed cell volume (PCV)

The presence or absence of an additive coating in a microhematocrit tube is indicated by A) the tube top B) a colored band on one end of the tube C) the size of the tube D) the color of the tube

B) a colored band on one end of the tube

A microcollection tube with a red or green band indicates A) heparin additive B) sodium citrate additive C) a nonadditive tube D) EDTA additive

A) heparin additive

The additive heparin is usually used for A) capillary Hct specimens B) capillary serum specimens C) capillary plasma specimens D) capillary blood gases

D) capillary blood gases

A ___________ is inserted into a capillary blood gas tube to enhance mixing. A) sealant B) magnet C) stirrer D) little bug

C) stirrer

Anaerobic means A) a cardio workout that leaves you breathless B) with oxygen C) blood gas D) without oxygen

D) without oxygen

Why are capillary blood gases less desirable than arterial blood gases (ABG’s)? A) skin puncture blood contains tissue fluid B) capillary puncture blood is only partly arterial in composition C) the blood is exposed to air during collection D) all listed

D) all listed

What is the purpose of warming the site before skin puncture? A) it prevents hemolysis of the sample B) it increases blood flow up to 7 times C) it comforts the patient D) it makes the veins more visible

B) it increases blood flow up to 7 times

Warming devices should not exceed A) 37º C B) 98.6º F C) 42º C D) 100º F

C) 42º C

Skin puncture blood most closely resembles A) intracellular fluid B) venous blood C) arterial blood D) interstitial fluid

C) arterial blood

Warming the skin puncture site increases A) venous flow B) intracellular exchange C) none of these D) arterial flow

D) arterial flow

Skin puncture specimens contain a higher proportion of arterial blood because A) intracellular pressure is greater B) venous and arterial pressures are equal C) venous pressure is greater D) arterial pressure is greater

D) arterial pressure is greater

Why should a laboratory report form indicate the fact that a specimen has been collected by skin puncture? A) for liability insurance and billing purposes B) so that subsequent specimens will be collected by skin puncture C) so that the patient’s nurse can check the site for signs of infection D) because test results may vary depending on the method of collection

D) because test results may vary depending on the method of collection

Which of the following values are lower in skin puncture blood specimens? A) total protein B) bilirubin C) calcium D) all listed

D) all listed

Skin puncture blood reference values (normal values) are higher for A) glucose B) phosphorous C) calcium D) total protein

A) glucose

Potassium levels collected by skin puncture may be falsely elevated if A) the specimen contains tissue fluid or air B) the puncture site is warmed beyond the recommended temperature C) the specimen is hemolyzed or contains tissue fluid D) the specimen is exposed to light

C) the specimen is hemolyzed or contains tissue fluid

Skin puncture blood collection may NOT be indicated for A) patients with poor circulation to the extremities B) patients in shock C) patients who are dehydrated D) all listed

D) all listed

When collecting blood from infants and young children the skin puncture procedure is more appropriate than venipuncture because A) loss of larger quantities of blood may lead to anemia or cardiac arrest B) total blood volumes are smaller for this age group C) venipuncture presents a higher risk of injury D) all listed

D) all listed

Blood tests that can be falsely elevated on skin puncture specimens include A) blood cultures B) coagulation studies C) potassium and glucose D) erythrocyte sedimentation rate (ESR)

C) potassium and glucose

The CLSI order of draw for capillary specimens is A) EDTA, other additives, serum specimen B) blood cultures, EDTA, serum C) sodium citrate, EDTA, serum specimens D) serum, EDTA, other additive specimens

A) EDTA, other additives, serum specimen

Appropriate skin puncture sites should be A) cyanotic B) free of scars and rashes C) edematous D) all of these

B) free of scars and rashes

Age appropriate guidelines for skin puncture include all EXCEPT A) skin puncture is appropriate for any age patient and any test ordered B) finger stick is performed on adults and children > 1 year of age C) heel stick is performed on infants D) none of these

A) skin puncture is appropriate for any age patient and any test ordered

The appropriate skin puncture technique for older children and adults includes all EXCEPT A) the distal, palmer surface of the finger B) parallel to the whorls of the fingerprint C) the middle or ring finger D) slightly to the side of the central fleshy portion of the finger

B) parallel to the whorls of the fingerprint

Osteomyelitis is A) inflammation of the bone marrow and adjacent bone inflammation of the bone marrow and adjacent bone B) inflammation of the cartilage C) inflammation of the nerve tissue D) inflammation of the cartilage and bone

A) inflammation of the bone marrow and adjacent bone inflammation of the bone marrow and adjacent bone

What does the term “calcaneus” mean? A) osteomyelitis B) bone infection C) calcium containing D) heel bone

D) heel bone

Which of the following is the safest area for infant heel puncture? A) the central area of the heel B) the posterior curvature of the heel C) the area of the arch D) the medial or lateral plantar surface of the heel

D) the medial or lateral plantar surface of the heel

What is the Clinical and Laboratory Standards Institute (CLSI) recommended maximum depth of puncture to be used during heel puncture? A) 2.4 mm B) 2.0 mm C) 1.4 mm D) 1.0 mm

B) 2.0 mm

You have a lab requisition to perform a heel stick on an infant in the nursery. After you properly identify the patient you examine the baby’s heels. You note that the right heel has a previous puncture site on the right medial plantar surface. The left heel has bruising and swelling. What site will you select for your procedure? A) the medial surface of the right heel B) the lateral surface of the right heel C) the posterior curvature of the left heel D) the arch area of the left foot

B) the lateral surface of the right heel

Which test result will be affected by the use of povidone-iodine? A) phosphorus B) potassium C) uric acid D) all listed

D) all listed

Allowing the alcohol cleansing agent to dry is important to A) prevent hemolysis B) ensure maximum antiseptic action C) prevent stinging D) all listed

D) all listed

Hemolysis means A) arterialized B) inflammation of the puncture site C) with oxygen D) destruction of RBC’s

D) destruction of RBC’s

Which of the following is NOT needed for skin puncture? A) lancet B) microcollection device C) tourniquet D) alcohol pad

C) tourniquet

The purpose of wiping away the first drop of blood during skin puncture is to A) minimize the effects of platelet aggregation B) eliminate tissue fluid contamination C) maximize the effects of hemolysis D) avoid bacterial contamination

B) eliminate tissue fluid contamination

When collecting a skin puncture sample which of these actions will increase the presence of tissue fluid in the sample? A) vigorous, repetitive pressure B) excessive squeezing C) rapid milking of the site D) all listed

D) all listed

When performing a skin puncture for a bilirubin and a CBC, the hematology specimen should be collected first to avoid A) contamination B) platelet clumping C) coagulation D) hemolysis

B) platelet clumping

Capillary blood gases must be collected carefully and quickly to prevent A) hemolysis B) exposure to air C) coagulation D) all of these

B) exposure to air

The appropriate collection technique for a capillary blood gas includes all except A) placing the specimen horizontally in a mixture of ice and water B) insertion of a flea into the collection tube -metal stirrer C) wiping away the first drop of blood D) arterializing the specimen by warming the site to 45ºC

B) insertion of a flea into the collection tube -metal stirrer

You have a requisition to collect a bilirubin on an infant in the nursery. To maintain specimen integrity, you will do all of the following EXCEPT A) collect the specimen carefully to avoid hemolysis B) keep the bililights (UV lights) on while collecting the specimen C) collect the specimen in an amber-colored microcollection container D) collect the specimen slowly to decrease trauma to the infant

B) keep the bililights (UV lights) on while collecting the specimen

Newborn screening provides testing for A) hormonal disorders B) metabolic disorders C) genetic disorders D) all listed

D) all listed

Which of the following statements is INCORRECT regarding collection of neonatal screening samples on filter paper? A) The blood should not be smeared. B) Avoid contaminating the filter paper with hands or gloves. C) Fill the circles from both sides of the paper to ensure an adequate sample. D) Layering with successive drops in the same circles should be avoided.

C) Fill the circles from both sides of the paper to ensure an adequate sample.

You have collected three neonatal screening samples while in the nursery. Being the wonderful and knowledgeable phlebotomist that you are, you know the appropriate way to handle the specimens. Which of the following statements is INCORRECT regarding neonatal screening specimen handling? A) protect the specimens from heat and sunlight B) carefully stack the specimens before going to your next patient in ICU C) allow specimens to air dry D) place specimens horizontally while drying

B) carefully stack the specimens before going to your next patient in ICU

A blood smear made from an EDTA specimen should be made A) within one hour of collection B) any time after collection C) within 4 hours of collection D) within 12 hours of collection

A) within one hour of collection

When making a blood smear slide, hold the spreader slide at a A) 15 degree angle B) 10 degree angle C) 30 degree angle D) 45 degree angle

C) 30 degree angle

The primary action you can take to prevent the spread of infection is A) use the biohazard container for contaminated needles B) wash your hands C) wear gloves D) become a member of your local “germaphobe” chapter

B) wash your hands

Quiz #2 Flashcards

(100 cards)