Phlebotomy NHA review

1) If you have a patient with a tight fist when should you have patient release their fist?
(syringe/ evacuated)
a) Once blood flood is established
2) If you are collecting blood culture from patient? Why?
a) FUO
3) Handling of bilirubin
a) Light sensitive
4) Action phlebotomist take
a) Legible; (not lab time and date just collection)
5) Fasting specimens preferred
a) Cholesterol
6) Which factors determine child should have blood drawn via capillary (finger stick) or heel
stick
a) Age in development
7) If using butterfly on dorsal hand vein
a) Hold by wings
8) If has to take seminal fluid mode of action?
a) Rapid transit (30mins)
9) Order verifying?
a) Call the doctor
10) Hard or cord like veins
a) Sclerosed vein
11) Research in clinical setting. Which method can you use for specimen ID?
a) Patient ID code
12) Collecting blood sample and having seizure. What should you do?
a) Clear area
13) If you have patient with a double mastectomy what should you do?
a) Contact physician; normally foot draw
14) If you just done venipuncture pulling needle what should you do?
a) activate safety
15) Purple blood clotting tube
a) Thrombin
16) Fasting time?
a) 8-12 hrs
17) Stat chem tube
a) Green
18) Liver profile; which tube to use
a) Tiger
19) Sputum specimen. How should we instruct patient to get specimen?
a) Take deep breath then cough
20) Heel-stick max depth
a) 2.0 mm
21) lactic acid what would you do to the sample
 a) chill
22) evacuated tube stopped filling? Why?
a) Went through the vein
23) If you had a contaminated microscopic slide what to do?
a) Sharps container
24) Urine sample for culture
a) Clean the genital area prior to collection
25) Active involvement by patient
a) Can you tell first and last name?
26) When use blood pressure cuff
a) Overweight
27) Blood culture ordered which antiseptics to use
a) Chlorohexidine
28) BAH venipuncture antiseptic
a) Chlorohexidine
29) Capillary collection, which micro container first
a) EDTA
30) Two most common complication
a) Osteochondritis and osteomyelitis
31) Newborn screening actions taken?
a) Wipe away first drop of blood
32) CLIA waived test (pose min risk to patient)
a) Point of care test.
33) Critical to patient ID
a) DOB
34) Anemia when you take too much blood
a) Iatrogenic anemia
35) Brief exam for potential blood donor. Which would exclude patient
a) Fever
36) Blood donation gauge
a) 16-18
37) accidental needle stick
a) wash area
38) fecal w/ urine?
a) Separate urine from fecal
39) Infant fecal collection
a) Disposable diaper; soaks up more urine
40) Blood donation required to inform patient about
a) Rights to ask about procedure
41) Transmission based precautions for C-diff
a) Contact
42) OSHA responsible for
a) Immunization schedules; ie HepB vaccinations for employees
43) Nonblood specimen should have what info
 a) Specimen source
44) MSDS has what
a) Chemicals
45) Implied consent
a) Extends arms
46) Stool collection at home for ova and parasite. Instructions
a) Separate from urine
47) What can cause a hematoma?
a) Going through vein
48) Draw from 6month old infant, iv in L antecubital, severe bruising on hand
a) Right antecubital
49) New med and old med office are combining; glucose monitoring needs to be checked
a) All
50) Variations depending on time of day, serum cortisol
a) Time of day
51) Capillary puncture
a) Across fingerprint of ring finger (perpendicular)
52) Not required on specimen label
a) Gender
53) Serum separating tube what to do?
a) Invert 5-8 and set for 30 mins prior to centrifuging
54) Appropriately prepared for transport
a) Green for ammonia on ice
55) Draw without consent you committed
a) Battery
56) Preferred time of sputum
a) Upon waking
57) Radical right breast mastectomy
a) Left antecubital
58) Process of cleaning up blood spill
a) Disinfection
59) Contact precaution what ppe to put on?
a) Gown and remove before leaving
60) Fear of needle; action
a) Close their eyes
61) blood smears
a) feathered edge
62) admin cpr to
a) no pulse
63) PT and PTT tube
a) Light blue and sodium citrate
64) CMP materials
a) Tourniquet, evacuated tube, multi-sample needle
65) Vitamin B6 sample
 a) Wrap in foil
66) Losing consciousness
a) Syncope
67) If you accidently squeeze too hard on puncture site
a) Hemolysis
68) 5 yr old what gauge needle?
a) 23 gauge
69) which test needs to go on ice within 30 mins
a) lactic acid
70) PKU what do you need?
a) Filter paper
71) Providing info to patient about stool sample
a) Urinate prior
72) Urine dipstick has
a) Reagent strip
73) How many times should EDTA be inverted?
a) 8-10
74) evacuated method and went in at 45 angle. What can happen
a) going through vein
75) needle out before remove tourniquet
a) hematoma
76) ESR which tube?
a) Lavender
77) Why collection date lose vacuum?
a) Expired
78) Blood spill, plan of action
a) Liquid thickening agent
79) Toxic drug screen for legal purposes needs
a) Chain of custody
80) PT test; what should be asked?
a) When was your last dose of anticoagulant?
81) Volume of blood safely drawn at one time/short period of time
a) 5% of patient’s body weight
82) multi-sample syringe  tube
a) carryover
83) Butterfly on dorsal hand vein, proper technique
a) Direct needle almost parallel
84) ER trauma what to do for ID
a) Put on temp band w/ temp info
85) Patient may experience which symptoms prior to syncope
a) Dizziness
86) Droplet precautions means of transmission
a) Sneezing
87) Capillary specimen, collect first
 a) Blood gas
i) Blood gas  blood smears  EDTA (lavender)  other
88) Requires chain of custody
a) Drug testing
89) PT to prevent cross-contamination
a) Before gold tube
90) Female urine collection
a) Clean front to back
91) Units of donated blood
a) 450ml
92) liquid at the bottom of LB tube, what to do?
a) liquid is supposed to be there
93) lumbar tap
a) cerebral spinal fluid
94) ID and type which color tube
a) Red no additive
95) When labeling non blood; why place on container and not lid
a) Soon as lid comes off considers non labelled
96) Standard precautions
a) Assume all bodily fluids are infected with pathogens
97) Glucose, cholesterol, protein; which department
a) Chemistry
98) Chain of custody time frame
a) Collection to disposal
99) Urinalysis: what is present when fever
a) Leukocytes
100) 3 hr GTT for an outpatient, consumed water and 1 cup of coffee 12-hour prior
a) continue
101) hospital employee to ask why there are two different color caps on blood culture body
a) aerobic from anaerobic
102) RBC function
a) Transport oxygen
103) Hemoglobin and hematocrit blood donation requirement
a) Male: 14-17 female: 10-12
104) 2hr postprandial glucose test. Which should be recognize as a panic value
a) <50 and >300
105) dialysis patient in the ICU, shunt on right forearm and IV on left hand. Optimal collection
for CBC
a) capillary of the left arm
106) newborns be tested for
a) PKU
107) Call from lab for critical value, plan of action
a) Contact physician out of office
108) Blood cultures, CBC, PTT, iron panel, he forgets to draw ptt
 a) Keep then redraw ptt
109) Instructions to give prior
a) Keep arm still during draw
110) Infant PKU should adhere to what protocol
a) Saturate the blotter circle; takes 3-4 hrs to dry
111) Blood ETOH tube
a) Green tube
112) CPR position
a) Supine posting
113) Which factor would exclude person from donating blood
a) Age
114) Full draw for LB tube why?
a) Standardize results for patients on and not on blood thinners
i) 9:1 ratio
115) blood component for hemostasis
a) thrombocytes
116) female patient refuses to have male phlebotomy
a) female phlebotomist collect
117) GT begins when
a) patient finishes drinking
118) what sterilizes
a) autoclave
119) what to calculate blood volume
a) weight
120) Dermal: 1 year or older
a) Middle