Phlebotomy procedures: venipuncture and skin puncture

1. 1 You observe a new phlebotomist as they finished performing a skin puncture on a baby in the hospital. You ask him why he used iodine and he tells you that he had no more alcohol wipes in his phlebotomy tray but there was plenty of iodine swabs nearby in the baby's room so he just used one of those instead. What should you say? TIP: Which answer would sound the MOST accurate and professional?

   1. A"Actually, iodine can elevate some test results. The nurse's supply room just down the hall has plenty of alcohol wipes. We better note on the paperwork that you used iodine so the lab will know."
   2. B"Actually, you really messed up using the iodine. The doctor might misinterpret the results and the baby may become ill."
   3. C"Actually, iodine can really mess up test results so we better go back and redo the heel stick."
   4. D"Actually, you can just use soap and water next time you run out of alcohol wipes. The real problem is that iodine can lower some lab results. We better let the lab know so they can adjust the results."
2. 2 During a fingerstick, how should the puncture be aligned with the grooves of the fingerprint?

   1. Aperpendicular to the grooves
   2. Bparallel to / aligned with the grooves
3. 3 When performing a finger stick, it is important for the phlebotomist to determine the direction of the fingerprint in the desired puncture site.

   1. AVerdadero
   2. BFalso
4. 4IF an outpatient tells you before a blood draw that she is feeling nauseated, you should

   1. Ahave her lie down until she feels better
   2. Bsuggest that she come back another day
   3. Cadvise her to begin slow, deep breathing
   4. Ddraw the specimen and watch her closely
5. 5What does serum from an icteric sample look like?

   1. Aclear pinkish or clear red
   2. Bdeep yellow to yellow-brown color
   3. Ccloudy
   4. Dhighlighter yellow color
6. 6 A phlebotomist has tried twice to collect a light blue top tube on a patient with difficult veins. Both times the phlebotomist has been able to collect only a partial tube. What should the phlebotomist do?

   1. Asend one to the lab marked "hard draw"
   2. Bcollect the specimen by a skin puncture
   3. CMost institutions have a "two pokes maximum per phlebotomist" policy.
   4. Dpour the two tubes together and mix well
   5. Ehave someone else collect the specimen
7. 7Venous stasis is

   1. Avein collapse from excess pressure
      stage 1 of the coagulation process
   2. Bbackflow of tissue fluid into a vein
   3. Cstoppage of blood flow
8. 8What is the other word for icterus?

   1. Abilirubin
   2. Bhemolysis
   3. Cjaundice
   4. Dlipemic
9. 9Pain associated with venipuncture can potentially be minimized by

   1. Aputting the patient at ease with a little small talk
   2. Bdesensitizing the site by rubbing hard with alcohol
   3. Cwarning the patient that the draw might hurt a lot
   4. Dtying the tourniquet tight enough to numb the arm
10. 10
    
    If you suspect that you have accidentally collected an arterial specimen instead of a venous specimen,
    
    
    
    (there may be multiple answers)
    

    1. Akeep it, but label it as possible arterial specimen
    2. Bask another phlebotomist to recollect the specimen
    3. Cdiscard it and collect a new one from another site
    4. Dapply a pressure bandage to the venipuncture site

11. 11Phil Phlebotomist is performing a draw on his patient. He takes his eyes off the needle to pull the tourniquet early and hears a hissing sound. What most likely happened?

    1. AHe realized he was making a mistake by pulling the tourniquet too early and made the hissing sound himself.
    2. BHe took his eyes off the needle and the bevel became exposed, which caused the tube to suck in air.
    3. CHe took his eyes off the needle, and moved it, which hurt the patient. The patient made the sound.
    4. DHe pulled the tourniquet early and risked losing venous pressure.
12. 12A patient experiences a momentary loss of consciousness or a mini-seizure while you are drawing his blood. The last tube has just started to fill. Which of the following is the wrong thing to do?

    1. Acomplete the draw as quickly as you can
    2. Bprevent the patient from injuring himself
    3. Cnotify the appropriate first aid personnel
    4. Dimmediately discontinue the blood draw
13. 13You are performing a multi-tube blood draw with a straight needle. You collect blood into the first tube without a problem. Then second tube fails to fill with blood. You pull the needle back and nothing happens. You push the needle a little deeper and nothing happens.Which of the following actions should you take?

    1. Aredirect the needle until you get blood flow
    2. Blet someone else take over and give it a try
    3. Cdiscontinue the draw and try at another site
    4. Dtry a new tube in case it is a vacuum issue
14. 14What does vein patency refer to?

    1. Amedical condition of being blocked
    2. Bmedical condition of being scarred
    3. Cmedical condition of anemia
    4. Dmedical condition of not being blocked
15. 15Which of the following is a product of the break-down of RBCs?

    1. Aglucagon
    2. Bcreatinine
    3. Cbilirubin
    4. Dlipid
16. 16Diurinal variations associated with some blood components are

    1. Anormal fluctuations throughout the day
    2. Bchanges that follow a monthly cycle
    3. Cvariations that occur on an hourly basis
    4. Dabnormal changes that occur once a day
17. 17It is not a good idea to collect a CBC from a screaming infant because the

    1. Aplatelets are more likely to clump
    2. Bspecimen may be hemoconcentrated
    3. Cchance of hemolysis is increased
    4. DWBCs may be temporarily elevated
18. 18Lipemia results from

    1. Aimproper specimen handling
    2. Bincreased number of platelets
    3. Cspecimen hemoconcentration
    4. Dhigh fat content of the blood
19. 19Lymphostasis is

    1. Areduced lymphocyte production
    2. Bimpaired secretion of lymph fluid
    3. Cstoppage of lymphoid functions
    4. Dobstruction of the flow of lymph
20. 20
    
    In which instance was the patient closest to basal state?
    
    The patient who...
    

    1. Acame straight to the lab after working all night, but was fasting at work
    2. Bhas been awake but lying down quietly resting for the last several hours
    3. Cis awakened for a blood draw at 0600 after fasting since 0800 last night
    4. Darrived at the lab at 0800 and had not eaten since dinner the prior night
21. 21Small non-raised red or purple spots appear on the patient's skin below where the tourniquet has just been tied. What are they and what causes them?

    1. Aa rash from tying the tourniquet too tightly
    2. Bpetechiae due to capillary or platelet defects
    3. Cbilirubin spots as a result of a diseased liver
    4. Ddermatitis from an allergy to the tourniquet
22. 22A hematoma is a

    1. Apool of fluid from an IV
    2. Bswelling or mass of blood
    3. Csymptom of nerve injury
    4. Dblood clot inside of a vein
23. 23The best specimens to use for establishing inpatient reference ranges for blood tests are

    1. Apostprandial specimens
    2. Bbasal state specimens
    3. Csteady-state specimens
    4. Dfasting specimens
24. 24This is the medical term for a nervous system response to abrupt pain, stress, or trauma is

    1. ACircadian response
    2. BVasovagal Syncope
    3. CVenous stagnation
    4. DIatrogenic reflux
25. 25A lipemic specimen is a clue that the patient was probably

    1. Abasal state
    2. Bnot fasting
    3. Cjaundiced
    4. Ddehydrated
26. 26Blind or deep probing for a vein can result in

    1. Agreater vein patency
    2. Bloss of tube vacuum
    3. Ctube additive reflux
    4. Dan arterial puncture
27. 27Collecting blood specimens from an arm on the same side as a mastectomy without permission from the patient's physician is prohibited because

    1. Athat arm is susceptible to infection
    2. Bresults on that arm will be elevated
    3. Cthere is a lot less feeling in that arm
    4. Dveins in that arm will collapse easily
28. 28Hemoconcentration from prolonged tourniquet application increases

    1. Anonfilterable analytes
    2. Bblood plasma volume
    3. Cspecimen hemolysis
    4. DpH and oxygen levels
29. 29 A patient's arm is swollen. The term used to describe this condition is

    1. Athrombosed
    2. Bcyanotic
    3. Cedematous
    4. Dsclerosed
30. 30Which of the following tests is most affected by altitude?

    1. Amagnesium
    2. BRBC count
    3. Ccholesterol
    4. Delectrolytes
31. 31Exsanguination is

    1. Aautologous donation of blood
    2. Biatrogenic depletion of blood
    3. Clife-threatening loss of blood
    4. Dtherapeutic removal of blood
32. 32Most reference ranges are based on normal laboratory test values for

    1. Afasting patients
    2. Btreated patients
    3. Cill individuals
    4. Dhealthy people

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110 Phlebotomy Test sobre Sin título, creado por Rebecca Kaspers el 09/08/2018.

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Rebecca Kaspers

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