The forearm vein most commonly used for venipuncture is the
median cubital
The smallest veins in the human body are known as
venules
The aorta branches into smaller divisions called arteries, which in turn branch into even smaller divisions called
arterioles
Characteristics of capillaries include
having thin walls, forming microscopic pathways, and connecting arterioles with venules
Within capillaries, blood cell functions include
releasing oxygen, binding carbon dioxide, and eliminating waste
The heart, lymphatic organs, and blood vessels are in the
cardiovascular system.
The suffix -URIA at the end of a medical term refers to what?
Urine
The study of blood is known as
hematology
The liver, stomach, mouth, and pancreas are in the
digestive system.
The most important step to insure accuracy in sample collection is
identifying the patient properly.
The bladder, urethra, kidneys, and ureters are in the
urinary system.
The trachea, nose, lungs, and pharynx are in the
respiratory system.
The sebaceous glands, skin, hair, and nails are in the
integumentary system.
The body system that is a primary regulator of hormones is the
endocrine system.
Neutrophils, eosinophils, basophils, lymphocytes, and monocytes are types of
white blood cells.
The common name for the thrombocyte is the
platelet.
The liquid portion of an anticoagulated blood sample is known as
plasma.
The instrument that measures blood pressure is called a
sphygmomanometer.
An artery can be distinguished from a vein because an artery will be
pulsating.
Lancets are used to collect blood samples by
capillary or skin puncture.
The abbreviation VAD is commonly used in hospitals to refer to
venous access devices.
To determine the size of a needle, remember that the higher the gauge, the
smaller the needle bore.
Adult capillary punctures most often involve the use of the
third and fourth (middle and ring) finger(s).
A centrifuge is used in a clinical laboratory setting to
separate liquid from cells in blood.
The oral glucose tolerance test is used for the detection of
diabetes.
Use a lavender-topped evacuated tube for
collection of blood for a CBC test.
Use a red (or green for STAT orders)-topped evacuated tube for
collection of blood for electrolyte testing.
Use a red-topped evacuated tube for
collection of blood for cholesterol testing.
Sodium citrate is an anticoagulant of choice for coagulation studies because it protects
clotting factors.
When preparing a blood smear directly from a skin puncture, it is best to
wipe away the first drop of blood.
The purpose of doing blood cultures is to detect
septicemia.
Anticoagulants are used to
prevent blood from clotting.
White blood cells help the body by
defending against foreign invaders.
Platelets help circulation by
participating in hemostasis.
When blood seeps into the surrounding tissue during venipuncture, a
hematoma may form.
In a patient with a clotting disorder, pressure should be applied to the puncture site for at least
5 minutes after venipuncture to insure blood stoppage.
Skin punctures may be indicated for use when
1)the patient is an infant, toddler, or preschooler, 2) only a small amount of blood is needed, or 3) patient veins need to be preserved for IV therapy.
All specimens should be labeled with
1) Patient's name, D.O.B., and numeric ID) 2) Date and time collected 3) Collector's initials
One test often used to assess hemostasis before surgery is
bleeding time.
One possible cause of unexpected clotting in an anticoagulated blood tube might be
insufficient mixing.
When performing a venipuncture, position the bevel of the needle
facing up (you should be able to see the opening).
If blood does not appear in an evacuated tube upon venipuncture, the phlebotomist's first course of action should be to
slightly reposition or turn the needle.
Redirecting a needle during venipuncture is sometimes necessary when
1) the vein was not properly anchored, 2) the patient moves unexpectedly, 3) blood flow starts, then stops.
A vein might be prone to collapse if the
vacuum tube is too large for the vein, or the syringe plunger was pulled back too quickly.
Hemolysis would cause rejection of a sample collected for
potassium testing.
If a patient is prone to syncope during venipuncture, the phlebotomist should
watch in case of fainting.
A tube of blood that arrives in the laboratory without a label must be
rejected automatically.
If a blood sample must be collected 2 hours post-prandial, the phlebotomist should collect the sample
2 hours after a meal.
Knowing when to collect peak and trough levels is important when drawing
therapeutic drugs.
A pre-warming technique may be used to
increase a patient's tendency to bleed.
The role of all anticoagulants is ultimately to prevent formation of
Fibrin.
The anticoagulant EDTA works by
binding calcium.
If the tourniquet is not released before the needle is withdrawn from the arm during venipuncture, this will most likely result in
bleeding from the site.
The bilirubin test is
light sensitive.
The Chain of Custody
must be followed exactly whenever drawing patient test samples that may be used in a legal proceeding.
The anticoagulant SPS (sodium polyanetholesulfonate) is recommended for use in blood cultures because it
does not inhibit bacterial growth.
Before entering an inpatient room if the door is closed, phlebotomists should always
Check for isolation signage, knock, and ask for permission to enter.
Before entering designated isolation rooms, phlebotomists should always
check requirements on signs.
The single most important means of prevent the spread of infection in a hospital is by
hand washing.
The most prevalent type of nosocomial infections are
urinary tract infections.
Phlebotomists have a statistically greater chance of contracting _____ in a work-related accident than they do of contracting AIDS.
hepatitis
AIDS is caused by
the HIV virus.
When performing heelsticks on infants in a hospital nursery, it is important to never
share supplies from one infant to another.
When delivering blood samples to a laboratory, they should always be transported inside
sealed plastic bags.
If a biohazard spills in the laboratory, a phlebotomist should first try to
contain the spill safely.
According to OSHA, a contaminated needle may be safely discarded into a
sharps container.
In most hospitals, a phlebotomist with a cough may draw from a patient provided the
1) Patient is not in reverse isolation 2) The phlebotomist does not have a fever 3) The phlebotomist wears a mask
When drawing blood from pediatric inpatients, a phlebotomist can increase the safety for the patients by
1) Using a smaller bore needle and smaller collection tubes 2) Getting help to hold the patient securely during the draw 3) Making sure the bed-rails are left raised if found that way
To eliminate bacteria from the skin of a bacterial culture venipuncture site _____ is sometimes used in addition to alcohol in the skin cleansing process.
iodine
The term that refers to right and wrong conduct is
ethics.
An unlawful threat or attempt to do bodily injury is
assault.
Law protects the health worker if it can be determined that he or she acted reasonably as compared with fellow workers; this is called
reasonable care.
Negligence by a professional person is called
malpractice.
Information given by a patient to medical personnel that can not be disclosed without consent constitutes
privileged communication.
Permission granted by a person voluntarily (and in his right mind) is
consent.
A phlebotomist who attempts to draw blood without sufficient training could be accused of _____ if the procedure is performed incorrectly, causing harm to the patient.
incompetence
Forcing venipuncture on a patient who has refused it would be considered
battery.
The branch of study of moral issues, questions, and problems arising in the practice of medicine and biomedical research is called
bioethics.
Conduct, courtesy, and manners, customary in the medical profession, is called
medical etiquette.
Each and every patient is entitled to _____ as part of his or her patient rights.
respect and complete care
Some suggested methods of controlling on the job stress during phlebotomy might include
taking deep breaths if anxious.
Appropriate means of communicating with a patient that is profoundly hearing impaired might include
using written communication.
In performing phlebotomy on children, it is best to
1) talk softly and gently 2) enlist the help of parents 3) tell the truth if asked
A patient who is making a fist and frowning is exhibiting _____ body language.
uncooperative
A 24-hour urine specimen must be kept
refrigerated.
A chronic disease in which the pancreas fails to secrete enough insulin is called
diabetes mellitus.
The purpose of the bleeding time test is to assess
platelet plug formation in the capillaries.
Diurnal rhythms refer to variations in the body's functions or fluids that occur during
every 24 hours.
EMLA is an emulsion of lidocaine and prilocaine that can be used to
topically anesthetize a draw site.
Another name for red blood cells is
erythrocytes.
The artery located in the groin, lateral to the femur bone, which is used as an alternative site for arterial blood gas collections is the
femoral.
The federal law that was expanded in 2000 to protect the confidentiality of electronically stored health information is abbreviated as
HIPAA.
The study of all aspects of disease in the body is known as
pathology.
The phase of laboratory testing that refers to test orders, test collection, and test sample preparation are all part of the _____ phase.
pre-analytical
A patient in reverse isolation has been so placed because he or she
needs protection from others carrying infection.
Contaminated objects that can penetrate skin, such as needles, scalpels, broken glass, and broken capillary tubes are called
contaminated sharps.
To use a physical-chemical procedure to destroy all microbial life including highly resistant bacterial endospores is to
sterilize.
The single most important source of HIV and HBV in the workplace is
blood.
After they are used, disposable syringes, scalpel blades, and other sharp items should be placed in _____ containers for disposal.
puncture resistant
Contaminated laundry should be _____ where it was soiled.
bagged or containerized at the location
The suffix _____ means blood.
-emia
The literal meaning of the word hemolysis is
blood breaking down.
PT is the lab abbreviation for the _____ test.
Prothrombin time
When a patient's arm is swollen with excess fluids, this is called
edema.
A nosocomial infection is an infection acquired
in the healthcare facility.
Choose the item that is NOT a single use only item: needles, tourniquets, tube holders, winged infusion sets.
Tourniquets
The name of the equipment used to separate plasma or serum from red blood cells is
centrifuge.
The tube holder and needle are to be disposed of _____ into a sharps container.
together, as a unit
Needles are color-coded to indicate their
gauge.
According the the CLSI, the maximum recommended depth for heel punctures is
2.0 mm
The _____ colored stopper indicates the blood collection tube contains sodium heparin.
green
When a lipid panel is ordered, the patient should be fasting for
at least 12 hours with water allowed.
The key principle of Universal Precautions is that
the blood and body fluids of all individuals are considered potentially infectious.
A patient having a glucose tolerance test does not have the restriction of
drinking water.
In the healthcare setting, HBV, HCV, and HIV can be transmitted by
1) sharps injuries, 2) splash of blood or body fluids to the mucous membranes, 3) touching non-intact skin without gloves
Needlestick injuries can be prevented by
using safe needle devices and following instructions for proper use.
Sharps containers should be closed, sealed, and made ready for disposal when it is
3\4ths full.
If you should recieve a needlestick injury, you should report it
immediately.
Antisepsis is a technique used on
skin.
The transmission based isolation category Airborne Precautions is used when a patient is known or suspected to have
tuberculosis.
The bloodborne disease most likely to be transmitted by a needlestick in the US is
Hepatitis C.
A patient experiences shooting pains in his arm when you are drawing from the antecubital area, which means you may have
punctured or nicked the basilic nerve.
The most likely reason a CBC specimen would clot is
the blood and the anticoagulant in the tube were not mixed sufficiently.
A patient had a mastectomy on the right side five years ago. The side you will draw from is
the left side, as blood is never drawn from the side with a mastectomy.
You are drawing blood from an outpatient when they begin to feel faint. The recommended course of action is to
remove the needle, and lower the patient's head between their legs.
Hemoconcentration may be cause by
prolonged application of the tourniquet.
The primary cause of a collapsed vein during venipuncture is
blood is withdrawn too quickly or forcefully.
Mixing the blood with the anticoagulant or additive by shaking may result in
a hemolyzed specimen.
If you find blood on the outside of the tube you have just filled, you should
wipe the outside of the tube with a disinfectant.
Name three things that could result in a lawsuit being filed against a phlebotomist.
1) Inserting the needle at an incorrect angle. 2) Excessive probing after missing a vein. 3) Mislabeling blood tubes.
Considering patient safety, the most dangerous phlebotomy practice is
labeling the empty collection tubes before the collection.
Per CLSI, the maximum number of venipuncture attempts by an individual phlebotomist is
no more than two.
According to standards of good practice, specimen collection tube labeling should always occur
before the phlebotomist leaves the patient's side.
The first drop of blood that forms following a skin puncture should be
wiped away.
When identifying a patient, you must ask them to state
their name and date of birth.
The _____ vein is recommended for use when drawing 5 mL of blood on an 18 month old.
dorsal hand
Cleansing the skin with Betadine for a skin puncture may interfere with the analysis of
bilirubin.
When performing a microcollection procedure, the best way to increase blood flow is to
pre-warm the site.
A patient's wristband matches your requisition form except for the birth date. It shows the same month and day, but the year is 1947 instead of 1945. In order to draw blood
all identification discrepancies must be resolved FIRST!
Drugs used to kill or destroy bacteria that cause disease are called
antibiotics.
CSF is the abbreviation for
cerebrospinal fluid.
Red and white blood cell counts are examples of _____ tests.
hematology
The blood cells most numerous in the circulating blood are the
red blood cells.
The medical term for fainting is
syncope.
Serum or plasma that has a milky white appearance is called
lipemic.
The lab test "T & C" is the abbreviation for
Type and Crossmatch.
The rubber sleeve (at the end opposite of the beveled needle tip) on an evacuated tube needle makes it possible for use with
multiple tubes.
Capillary blood sampling may be used if the laboratory tests require
very little blood.
A tube adapter visibly contaminated with blood should be
disposed in a biohazard waste container.
The evacuated tube containing sodium citrate has a _____ colored stopper.
blue or light blue
A fasting test is ordered to
eliminate the effects of diet on the test results.
A _____ topped tube should be used for a lab test requiring serum.
red
Hepatitis ____ is not a blood borne pathogen.
A
The LAST choice for blood collection in the antecubital area is the
brachial veins.
The venipuncture site should be cleaned in a circular motion from the center to the
periphery.
A patient on which you have been ordered a draw has no armband. You should
tell the patient's nurse that the patient does not have an armband, and you can not collect until it is placed on the patient.
Therapeutic phlebotomy is performed as a treatment for patients with
polycythemia vera.
The formed elements make up about _____ percent of the whole blood volume
45
The buffy coat consists of
leukocytes and thrombocytes.
The two components of blood found in a tube without anticoagulant are
serum and clot.
The fluid portion of the whole blood that contains fibrinogen is called
plasma.
The fluid portion of blood after clotting has taken place is called
serum.
The difference between plasma and serum is
plasma contains fibrinogen; serum does not.
Blood returns to the heart from the lungs into the
left atrium.
The pulmonary _____ does NOT carry oxygenated blood.
artery
A blood collection on dialysis patient with a fistula or graft should be drawn from
the opposite arm. Never draw on the arm with a fistula or graft.
The order of which veins should be used for draw in the antecubital area is
1) Median Cubital 2) Cephalic 3) Basilic 4) Median
The most common phlebotomy complication is
hematoma formation.
The test with cleaning techniques similar to those for blood culture tests is
Arterial Blood Gases.
The Allen test checks the patient for
collateral arterial circulation.
The two arteries are occluded during the Allen Test are
The radial and the ulnar.
The artery on the thumb side of the wrist is the
radial.
The safe area for heel punctures in an infant is
the most lateral portion of the plantar surface (the side of the pinkie toe).
Skin puncture blood is more likely to be contaminated by
hemolysis.
An estimate on how much time do you have for ASAP and STAT orders is
2-4 hours for ASAP orders, and 1 hour for a STAT order.
The amount of blood needed for blood culture draws for adults is
8-10 mL for Adults
The amount of blood needed for blood culture draws for children is
1-5 mL for children.
When using a butterfly needle for a blood culture test with two bottles, the _____ bottle goes first.
Aerobic
Examples of tests that must be chilled immediately after collection are
Ammonia, Catecholamines, Lactic acid, and PH\blood gasses.
Examples of tests that must be kept warm after collection are
Cold agglutinins, Cryoglobulin.
Examples of tests that must be kept from the light are
Bilirubin, and vitamins C, E, and K.
The two bottles used in blood culture collections are
Aerobic and Anaerobic.
Citrate tubes must be within _____ percent to full to give accurate results.
10
A phlebotomist certified by the American Society of Clinical Pathologists (ASCP) is required to maintain certification by completing and documenting continuing education. This is known as the
Certification Maintenance Program (CMP)
NPO means
'Non per os' or 'nothing by mouth'.
The lifespan of a red blood cell is
100 - 120 days.