Quiz #3

Question 1

The FDA has banned the use of the following type of gloves
A) vinyl
B) non-sterile
C) powder
D) polyethylene

Answer 1

C) powder

Question 2

Which government agency regulates the quality of gloves worn when performing phlebotomy procedures?

A) CDC / HICPAC
B) FDA
C) OSHA
D) The Joint Commission

Answer 2

B) FDA

Question 3

Which statement is not true regarding antiseptics?

A) They are bacteriostatic, having the ability to kill bacteria
B) They inhibit the growth of bacteria
C) They prevent the growth of bacteria
D) They are considered safe for use on human skin

Answer 3

A) They are bacteriostatic, having the ability to kill bacteria

Question 4

Povidone-iodine
A) is available in swab sticks and sponge pads
B) is an acceptable prep for blood cultures
C) may be used to prep for blood gases
D) all of the above

Answer 4

D) all of the above

Question 5

Which statement is NOT true regarding disinfectants?
A) they are bactericidal
B) they are not safe for use on human skin
C) they are designed to be used on animate objects
D) they are generally used on surfaces and instruments

Answer 5

C) they are designed to be used on animate objects

Question 6

Which of the following antiseptics might be used as an alternative for patients allergic to iodine?
A) povidone-iodine
B) alcohol-based preparations
C) sodium hypochlorite
D) none of the above

Answer 6

B) alcohol-based preparations

Question 7

Which of the following is not an antiseptic?
A) benzalkonium chloride
B) isopropanol
C) povidone-iodine
D) sodium hypochlorite

Answer 7

D) sodium hypochlorite

Question 8

A 5.25% solution of sodium hypochlorite (household bleach)
A) may be used to prepare a 1:10 dilution for blood and other body fluid spills in the laboratory
B) requires a fresh preparation daily to effectively disinfect surfaces
C) requires 10 minutes of contact time to be effective
D) all of the above

Answer 8

D) all of the above

Question 9

Which dressing is more appropriate after venipuncture, gauze or cotton? Why?
A) Gauze is sterile
B) Cotton may stick to the puncture site
C) when removed it may re-initiate bleeding at the site
D) Gauze, it is less expensive

Answer 9

B) Cotton may stick to the puncture site

Question 10

Sharps containers must
A) be rigid
B) be puncture resistant
C) have locking lids
D) all of the above

Answer 10

D) all of the above

Question 11

The appropriate writing utensil to use on slides is a

A) ball point pen
B) highlighter pen
C) permanent marker
D) pencil

Answer 11

D) pencil

Question 12

When properly applied a tourniquet should
A) allow venous flow below the tourniquet and obstruct arterial flow away from the area
B) be fastened to allow a two-handed release
C) allow arterial flow below the tourniquet and obstruct venous flow away from the area
D) be tight enough to pinch the heck out of the patient’s arm, thus distracting them from the venipuncture

Answer 12

C) allow arterial flow below the tourniquet and obstruct venous flow away from the area

Question 13

To prevent a change of blood components the tourniquet should be released within
A) 30 seconds
B) 60 seconds
C) 90 seconds
D) 120 seconds

Answer 13

B) 60 seconds

Question 14

When using a blood pressure cuff as a tourniquet, the pressure is maintained
A) below the patient’s diastolic pressure
B) above the patient’s arterial pressure
C) below the patient’s venous pressure
D) above the patient’s systolic pressure

Answer 14

A) below the patient’s diastolic pressure

Question 15

When a disposable tourniquet becomes soiled with blood or is dropped, it is best to
A) autoclave them before reuse
B) throw them away
C) wash them in bleach
D) wipe them with alcohol

Answer 15

B) throw them away

Question 16

The slanted tip of the needle that enters the vein is called the
A) lumen
B) gauge
C) hub
D) Bevel

Answer 16

D) Bevel

Question 17

Which needle gauge has the largest lumen?
A) 18
B) 20
C) 21
D) 22

Answer 17

A) 18

Question 18

What is the most important factor when choosing the appropriate gauge needle for venipuncture?
A) age of the patient
B) number of tubes to be collected
C) size and condition of the patient’s vein
D) type of test being performed

Answer 18

C) size and condition of the patient’s vein

Question 19

Your patient is a 75-year-old female with a history of being difficult to draw. Which gauge and type of needle will you select to draw blood from her hand?
A) 20-gauge multi-sample hypodermic
B) 22-gauge multi-sample hypodermic
C) 23-gauge butterfly
D) 25-gauge butterfly

Answer 19

B) 22-gauge multi-sample hypodermic

Question 20

A needle that is too small may
A) damage the vein
B) cause hemolysis
C) cause platelet aggregation
D) cause glycolysis

Answer 20

B) cause hemolysis

Question 21

Size selection of evacuated tubes is based upon
A) patient age
B) sample requirement
C) size and condition of the veins
D) all listed

Answer 21

D) all listed

Question 22

Which of the following statements is not true?
A) inspection of needles prior to venipuncture is recommended
B) when blood reaches the stopper, the tube is properly filled
C) it is recommended that all ETS components come from the same manufacturer
D) evacuated tubes fill automatically due to negative pressure

Answer 22

B) when blood reaches the stopper, the tube is properly filled

Question 23

Premature loss of vacuum in the ETS can occur if the
A) tube is dropped
B) bevel of the needle is partially pulled out during venipuncture
C) tube is advanced too far onto the needle before the venipuncture is performed
D) all listed

Answer 23

D) all listed

Question 24

The term for a draw that does not fill the evacuated tube to its stated capacity is
A) inadequate sample
B) partial or short draw
C) quantity not sufficient
D) short stack (of buttermilk pancakes)

Answer 24

B) partial or short draw

Question 25

The fluid that separates from the clotted blood in a glass non-additive tube or tube containing a clot activator is called A) plasma B) fibrinogen C) serum D) SST

Answer 25

C) serum

Question 26

Which tube top color is identified as a trace element-free tube? A) light blue B) royal blue C) red and gray mottled D) lavender

Answer 26

B) royal blue

Question 27

Which of these statements is NOT true regarding additive tubes? A) tube top colors identify the type of additive B) all additives prevent the blood from clotting C) the additive to blood ratio is critical for specimen integrity D) additive integrity is guaranteed until the expiration date on the tube

Answer 27

B) all additives prevent the blood from clotting

Question 28

You have orders to collect blood for blood bank determinations (Type/Screen). Which tube(s) will you use for the ordered venipuncture? A) plain red top and/or EDTA BB tube-Pink B) green top (likely PST tube) and a lavender top C) light blue and a red top D) SPS and purple top

Answer 28

A) plain red top and/or EDTA BB tube-Pink

Question 29

Which additive is usually present in a lavender stopper tube? A) acid citrate dextrose B) sodium citrate C) EDTA D) heparin

Answer 29

C) EDTA

Question 30

When using a butterfly to draw a coagulation specimen, a discard tube should be drawn first to A) protect the critical blood to additive ratio B) prevent microbial contamination of the specimen C) prevent hemolysis of the specimen D) to prohibit glycolysis

Answer 30

A) protect the critical blood to additive ratio

Question 31

Which of the following statements is true regarding blood collection in an additive tube? A) blood from an additive tube cannot be transferred to a tube with the same additive. B) different additives may interfere with each other or the testing process. C) the combination of two tubes with the same additive will result in an excess of the additive affecting the reliability of test results. D) all listed

Answer 31

D) all listed

Question 32

As one of the best darn phlebotomists this side of the Rockies, you know that all of the following are true EXCEPT A) mixing of the blood with additives must be quick and vigorous B) prior to using a tube with a dry additive, you will lightly tap it C) after the blood is collected you will invert the tube between 3 – 8 times D) hemolysis makes most specimens unsuitable for testing

Answer 32

A) mixing of the blood with additives must be quick and vigorous

Question 33

Heparinized plasma anticoagulant tube (green top PST) is preferred over a serum tube for potassium testing because A) when blood clots, some potassium (K) is released from cells into the serum and may result in falsely elevated levels B) you do not have to wait for 15 minutes before centrifugation C) the green top tube is usually shorter and easier to draw D) both A and B are correct

Answer 33

D) both A and B are correct

Question 34

Anticoagulants prevent clotting through a process that includes A) chelating or precipitating calcium B) inhibiting the formation of thrombin C) preventing conversion of fibrinogen to fibrin D) all listed

Answer 34

D) all listed

Question 35

EDTA prevents coagulation by A) inhibiting the formation of thrombin B) inhibiting conversion of fibrinogen to fibrin C) inhibiting hemolysis D) binding or chelating calcium

Answer 35

D) binding or chelating calcium

Question 36

A _________ is needed to ensure a sample remains whole blood (not clotted) A) an antiglycolytic agent B) an anticoagulant C) a thixotropic gel separator D) none of the above

Answer 36

B) an anticoagulant

Question 37

Which of the following statements is NOT true regarding EDTA? A) it preserves cell morphology B) it promotes platelet aggregation C) samples must be inverted 8 times to prevent micro-clot formation D) in liquid form EDTA dilutes the specimen

Answer 37

B) it promotes platelet aggregation

Question 38

EDTA is in all of these different colored top tubes except A) light green B) royal blue C) lavender D) pearl E) Pink

Answer 38

A) light green

Question 39

You have orders to draw a specimen for coagulation assessment. Which tube will you select? A) light blue B) green C) royal blue D) gray

Answer 39

A) light blue

Question 40

Which of these statements is correct regarding the collection of specimens in a tube containing sodium citrate? A) This additive is the best choice for maintaining cell morphology. B) Coagulation tests are performed on serum. C) It is critical to fill this tube to its natural stop level D) The correct number of inversions is 8 – 10.

Answer 40

C) It is critical to fill this tube to its natural stop level

Question 41

Heparin prevents blood from clotting by A) activating calcium B) binding calcium C) it does not prevent clotting D) inhibiting thrombin

Answer 41

D) inhibiting thrombin

Question 42

A green stopper tube normally contains A) EDTA B) heparin C) sodium citrate D) thrombin

Answer 42

B) heparin

Question 43

You have orders to draw an electrolyte panel. Which additive (anticoagulant) would most adversely affect the integrity of the blood specimen? A) ammonium heparin B) sodium heparin C) lithium heparin D) thrombin heparin

Answer 43

B) sodium heparin

Question 44

Which statement is NOT true regarding oxalates? A) Oxalates are most commonly found in tubes with green stoppers B) Oxalates have an antiglycolytic affect. C) Under filled tubes containing oxalates cause hemolysis. D) Of ammonium, lithium, potassium, and sodium oxalate, potassium oxalate is more commonly used.

Answer 44

A) Oxalates are most commonly found in tubes with green stoppers

Question 45

Use of tubes with the additive ACD would be appropriate for A) DNA testing B) paternity evaluation C) transplant compatibility D) all listed

Answer 45

D) all listed

Question 46

You have orders to draw blood cultures. Your laboratory does not use blood culture bottles at the off-site draw location. You know the appropriate tube to use is the SPS because it A) promotes phagocytosis B) increases the activity of certain antibiotics C) reduces bacteria destruction D) has an antiglycolytic affect

Answer 46

C) reduces bacteria destruction

Question 47

Which is the best tube for collecting an ethanol specimen? A) ethylenediaminetetraacetate B) siliceous earth C) sodium citrate D) sodium fluoride

Answer 47

D) sodium fluoride

Question 48

Which statement regarding clot activators is false? A) Avoid mixing an SST tube after collection to maintain specimen integrity. B) Clot activators include substances such as silica particles, inert clays like Celite, and thrombin. C) Clot activators provide more surfaces for platelet activation. D) The clot activator in SST tubes is silica.

Answer 48

A) Avoid mixing an SST tube after collection to maintain specimen integrity.

Question 49

If blood in an SST tube is not mixed A) the blood will not clot B) silica particles can interfere with testing C) nothing will happen, you do not need to mix a SST tube D) the specimen will be hemolyzed

Answer 49

B) silica particles can interfere with testing

Question 50

Which statement is false regarding thixotropic gel separator tubes? A) The gel forms a physical barrier between the serum or plasma and the cells. B) Physical separation of the serum or plasma from the cells prevents metabolism of platelets. C) Centrifugation is required to separate the cells from the plasma or serum. D) There are several tubes that contain thixotropic gel.

Answer 50

B) Physical separation of the serum or plasma from the cells prevents metabolism of platelets.

Question 51

Which of the following is NOT a thixotropic gel separator tube? A) ACD B) SST C) PST D) PPT

Answer 51

A) ACD

Question 52

When multiple tubes with additives are being drawn (excluding blood cultures) the first tube to be filled should be the A) red B) light blue C) lavender D) green

Answer 52

B) light blue

Question 53

While the specific order may differ, the order of draw applies to which of these blood collection methods? A) skin puncture B) multiple draw tube C) syringe draw with tube transfer D) all listed

Answer 53

D) all listed

Question 54

Which tube is filled last when using a syringe according the CLSI order of draw recommendations? A) EDTA B) heparin C) sodium citrate D) sterile

Answer 54

A) EDTA

Question 55

The incorrect order of draw can interfere with testing caused by contamination of the specimen by A) microorganisms B) tube additives C) tissue thromboplastin D) all listed

Answer 55

D) all listed

Question 56

Which statement is NOT true regarding tube additive carryover / cross-contamination? A) The most common source of carryover problems is EDTA. B) Carryover can be minimized by filling specimen tubes from the bottom up. C) Heparin does not cause carryover concern because it occurs naturally in the blood. D) Preventing contact between the stopper puncturing needle and the blood can minimize cross-contamination.

Answer 56

C) Heparin does not cause carryover concern because it occurs naturally in the blood.

Question 57

Tissue thromboplastin contamination of the blood specimen occurs when A) EDTA is carried over to an SST B) The skin is punctured C) a butterfly assembly is used for blood collection D) when the phlebotomist blows her nose in a Kleenex and doesn’t wash her hands prior to performing venipuncture

Answer 57

B) The skin is punctured

Question 58

The specimen most adversely affected by microbial contamination is the A) prothrombin time B) blood chemistry C) blood culture D) partial thromboplastin time

Answer 58

C) blood culture

Question 59

When computer-generated labels are used, the phlebotomist typically is required to write what information on the label? A) patient name B) patient date of birth C) collection time and their initials D) all of the above

Answer 59

C) collection time and their initials

Question 60

Which of the following requisition systems reduces laboratory errors associated with clerical mistakes? A) hand written B) barcode C) manual D) none of the listed

Answer 60

B) barcode

Question 61

Accession means to A) accurately connect the requisition, specimen, and patient B) prioritize requisitions based upon patient status C) verify the tests to be collected D) assess dietary restrictions for ordered tests

Answer 61

A) accurately connect the requisition, specimen, and patient

Question 62

The status designation for a test request is based on all of the following classifications except A) diet restrictions to be followed B) location of the patient C) priority of collection according to patient condition D) specific timing of test collection

Answer 62

B) location of the patient

Question 63

Tests are classified as routine if they are ordered A) for collection at a specific time B) to specifically eliminate the effects of diet C) to assess a patient’s condition after surgery D) in the course of establishing a diagnosis

Answer 63

D) in the course of establishing a diagnosis

Question 64

The following tests have all been ordered at the same time on different inpatients. There is only one phlebotomist on duty. Which test would the phlebotomist collect first? A) STAT electrolytes in the ER B) ASAP CBC in oncology C) routine Hgb in long-term care D) timed blood culture in ICU

Answer 64

A) STAT electrolytes in the ER

Question 65

You arrive to draw a specimen on an inpatient. The patient’s door is closed. What do you do? A) knock softly and wait for someone to come to the door B) leave to draw another patient and come back later C) open the door and proceed into the room D) knock softly and open the door slowly, checking to see if it is all right to enter

Answer 65

D) knock softly and open the door slowly, checking to see if it is all right to enter

Question 66

A member of the clergy is with the patient when you arrive to collect a routine specimen. What should you do? A) Ask the patient’s nurse what to do. B) Come back later after the clergy member has gone. C) Fill out a form saying you were unable to collect the specimen and return to the lab D) Say, “excuse me: I need to collect a specimen from the patient.”

Answer 66

B) Come back later after the clergy member has gone.