PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

1. it is the preferred vein for venipuncture in the H pattern because it is typically large,
closer to the surface, and the most stationary, making it the easiest and least painful to
puncture and the least likely to bruise.
a. Median cubital
It is larger than the other veins and closer to the surface.
b. Cephalic
c. Basilic
d. Dorsal metacarpal vein

2. It is the preferred method of blood collection because blood is directly collected from the
vein into a tube, minimizing the risk of specimen contamination and exposure to blood
contamination.
a. ETS
• The Evacuated Tube System or ETS is preferred in blood collection since the vacuum
within the tube allows blood to immediately flow inside upon puncture of the vein,
preventing contamination from external factors.
b. Needle and syringe
c. Winged infusion set
d. Pricking

3. All of the following statements concerning tourniquet application are correct, except.
a. It is applied to a patient’s arm during venipuncture
b. it should be fastened tight enough to restrict venous flow but not arterial flow
c. distends the veins, making them larger and easier to find, and stretches the walls so they
are thinner and easier to pierce.
d. It must not be left on longer than 3 minutes because specimen qualities ca be affected

• A tourniquet must not be left on for more than a minute as it restricts blood flow.
More than a minute may cause the veins to pop.

4. It is a number that relates to needle diameter or bore

a. Gauge
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

• The diameter of a needle is inversely proportional to the gauge number.

b. Bevel
c. Bore
d. Shaft

5. all of the following statements concerning phlebotomy needles are correct, except.
a. length selection depends on vein depth and user preference
b. the larger the gauge, the bigger is the bore
c. Gauge is selected for the size and condition of the vein and amount of blood required for
the test
d. needles are available with or without safety features
• Needles have a safety device that is used to insert them in tubes.

6. Most ETS tubes contain additives. If the additive is an anticoagulant, the blood will not
clot and the specimen will be the whole blood that can be centrifuged to obtain plasma. All
of the following statements concerning usage of ETS tubes are correct, except.
a. an additive function optimally when the tube is filled to its stated volume and gently
inverted immediately after collection to mix the additive with the blood
b. Shaking or vigorous mixing can hemolyze the blood, making it unsuitable for testing
c. additive reliability is guaranteed until an expiration date on the label if the tube is
handles and stored properly.
d. Specimen quality will not be affected even though the tube is partially filled as long as the
tube is inverted immediately after collection of blood

•
7. This H-patterned vein is located in the lateral aspect of the antecubital fossa, which is
fairly well anchored and often the only vein can be felt in obese patients.
a. Median cubital
b. Cephalic
• The cephalic vein is preferred for obese patients since when you eat excessively, the
subcutaneous tissue palpates.
c. Basilic
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

d. Dorsal metacarpal

8. this H-patterned vein is located on the medial side of the antecubital fossa, wherein this
vein is not well-anchored, and rolls easily. This vein is not used unless no other vein in
either arm is more prominent.
a. Basilic
• The basilic vein is close to the brachial artery. When pressure is applied, this artery
may be affected which is risky.
b. Cephalic
c. Median cubital vein
d. Dorsal metacarpal veins

9. The best site for collecting blood by skin puncture from a newborn is.
a. Big toe
b. Palm
c. Earlobe
d. Lateral portion of the heel

• Newborns have sensitive and fragile skin. The skin in this area is thicker than the
rest, decreasing the risk of infection for the newborn.

10. What is the range of the gauge of needle appropriate for venipuncture.
a. 21 and 23
• 21 for adults and 23 for children.
b. 23
c. 21
d. 20 to 25

11. What do you call a complication in venipuncture which occurs when there is a swelling
caused by an abnormal accumulation of fluid in the tissues.
a. Hematoma
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

b. Edema
c. Damaged veins
d. Collapsed veins

• Happens when the vein is wrongly punctured, causing the blood to accumulate in
the area due to collapsed veins.

12. What do you call a complication in venipuncture which occurs when a swelling or mass
of blood has escaped from a vein.
a. Hematoma
• The end result would be bruising in this situation.
b. Edema
c. Damaged veins
d. Collapsed veins

13. These parts of the vascular system are only one cell thick that allows exchange of gases
and other substances between tissues and the blood.
a. Capillaries
• They are the smallest blood vessels in the body.
b. Arteries
c. Veins
d. Nerves

14. This component of the evacuated tube system describes as a plastic cylinder with a
small opening for a needle at one end, and a large opening for tubes at the other end.
a. Tube holder or Adapter
•
b. Barrel
c. Plunger
d. Hub
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

15. All of the following ca result from venipuncture procedural error and have adverse
effects on the patient, except.
a. Hematoma
• The effect on the patient would be bruising which is temporary.
b. Iatrogenic anemia
c. Nerve injury
d. Sclerosed veins

16. Causes slow blood flow

a. Needle not deep enough
b. Needle beside the vein
c. Collapsed vein
d. Undetermined needle position

17. Major source of safety information for employees who may use hazardous materials in
their occupation
a. MSDS
b. Hazard communication standard
c. CDC
d. OSHA
• OSHA stands for Occupational Safety and Health Administration

18. According to the Hazards Identification System developed by NFPA, the blue diamond
indicates
a. the reactivity –stability hazard of the chemical
b. any special hazard information about the chemical
c. the flammability hazard of the chemical
d. the health hazard associated with the chemical

19. Yellow color of the diamond in the NFPA label indicates

 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

a. Flammable. Store in an area segregated for flammable reagents

b. Health Hazard. Toxic if inhaled, ingested or absorbed through the skin. Store in a secure
area.
c. Reactive and oxidizing reagents. May react violently with air, water or other substances.
Store away from flammable and combustible materials.
d. Corrosive, may harm skin, eyes, or mucous membranes.

20. Red color of the diamond in the NFPA label indicates

a. Flammable. Store in an area segregated for flammable reagents
b. Health Hazard. Toxic if inhaled, ingested or absorbed through the skin. Store in a secure
area.
c. Reactive and oxidizing reagents. May react violently with air, water or other substances.
Store away from flammable and combustible materials.
d. Corrosive, may harm skin, eyes, or mucous membranes.

21. Which additive prevents glycolysis?

a. EDTA
b. Heparin
c. Potassium oxalate
d. Sodium fluoride
• It is an antiglycolytic agent.

22. The following supplies were gathered for a routine

venipuncture. Which item is incorrect?
a. ETS tubes
b. Iodine swab

•
c. Safety needle
d. Tourniquet
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

23. Which of the following tubes can be used to collect a serum

specimen?
a. Light blue top
b. Green top
c. PST
d. Red top
• They contain silica which is a clot activator.

24. A tourniquet is used in venipuncture to:

a. Concentrate the blood specimen
b. Find and enter veins more easily
• A tourniquet restricts blood flow in veins, making them easier to be seen.
c. Keep the vein from collapsing
d. All of the above

25. You are about to perform routine venipuncture on a patient

with no known allergy to antiseptics. Which of the following
substances would you use to clean the site?
a. 5.25% sodium hypochlorite
b. 70% isopropyl alcohol
c. Antibacterial soap and water
d. Povidone-iodine

26. Which of the following needles has the largest diameter?

a. 18-gauge
• The smaller the gauge number, the bigger the diameter of the needle.
b. 20-gauge
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

c. 21-gauge
d. 23-gauge
27. What causes evacuated tubes to fill with blood
automatically?
a. Arterial blood pressure
b. Fist pumping by the patient
c. Pressure from the tourniquet
d. Premeasured tube vacuum
• The vacuum sucks the blood into the tube.

28. Lavender-top tubes are most commonly used to collect:

a. Chemistry tests
b. Coagulation specimens
c. Hematology tests
• Lavender-top tubes contain EDTA which is commonly used in hematology
procedures.
d. Immunology tests

29. Of the following tubes or containers, which is filled last in

the recommended order of draw?
a. Blood culture bottle
b. Lavender top
c. Light blue top
d. Red top

30. A butterfly is typically used for:

a. Coagulation specimens
b. Difficult and hand veins
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

c. Draws from a basilic vein

d. All of the above

31. EDTA can be found in:

a. Lavender-top tubes
b. Purple-top tubes
c. White-top tubes
d. All of the above

32. Blood in which type of tube normally clots within five

minutes?
a. PST
b. RST
c. SPS
d. SST

33. Which of the following is a biocide?

a. 70% isopropanol
b. Hydrogen peroxide
c. Povidone-iodine
d. All of the above

34. Mixing an additive correctly involves turning the wrist how

many degrees and back again?
a. 45
b. 90
c. 120
d. 180
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

35. If a CBC, PT, plasma potassium, and glucose (drawn with a

glycolysis inhibitor) are all to be collected during a multipletube
draw on a patient, which of the following choices shows
the correct stopper colors to use in the correct order of
draw?
a. Lavender, light blue, gold, green
b. Light blue, green, lavender, gray
c. Red, royal blue, green, lavender
d. Yellow, orange, lavender, gray

36. A green-colored stopper indicates the tube contains:

a. Citrate
b. EDTA
c. Heparin

• Used for tests using whole blood or plasma.

d. Oxalate

37. A trace element-free tube stopper is:

a. Green/gray
b. Lavender
c. Royal blue
• Used for toxicology, trace metal, and nutritional analyses so it requires little to no
trace elements.
d. Yellow

38. Thixotropic gel is found in:

a. PPTs
b. PSTs
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

c. SSTs
d. All the above
• All have gel separators.

39. A transillumination device is used to:

a. Contain sharps
b. ID patients
c. Locate veins
• Used near the skin to see the veins.
d. Transfer blood

40. The ratio of blood to anticoagulant is most critical for:

a. Coagulation specimens
b. Light blue stoppers
c. Sodium citrate tubes
d. All the above

Part II.
A mobile blood collector named Chi is collecting an SST and two lavender tops (one for a
glycohemoglobin and one for a CBC) on a client named Uchiha Madara. He fills the SST, lays
it down while he places the first lavender top in the tube holder, then picks it up and mixes
it as the lavender top is filling. When the lavender top is full, he lays it down while he places
the second lavender top in the tube holder. The second lavender top fails to fill with blood,
so he makes several needle adjustments to try to establish blood flow. Nothing works, so he
decides to try a new tube. The new tube works fine. While it is filling, he picks up the first
lavender top and mixes it. After completing the draw, he labels his tubes, putting the
hematology label on the lavender top he collected first. He finishes up with the client,
delivers the specimens to the laboratory, and goes to lunch. When he returns from break
his supervisor tells him to recollect the CBC on Louise Jones because the specimen had a
clot in it.
Questions
1. What can cause clots in EDTA specimens?
 PRELIMINARY TERM EXAMINATION PMLS 2 (LABORATORY)

2. What most likely caused the clot in this specimen?

3. How might the problem with the second lavender top have contributed to the clotting of
the first one?
4. Would the problem with the second lavender top have been an issue if Chi had handled
the first lavender top properly? Explain your answer.
5. What can Chi do to prevent this issue from happening in the future?
Case no. 2:
Jake, a phlebotomist, is sent to the ER to collect an EDTA specimen for a STAT type and
crossmatch on an accident victim. He properly identifies the patient and is in the process of
filling the lavender-top tube when an ER nurse tells him that the patient’s physician wants
to add a STAT set of electrolytes to the test order. Jake acknowledges her request. He
finishes filling the lavender top and grabs a green top. After completing the draw, he takes
the specimens straight to the laboratory to be processed immediately.
Questions
1. One of the specimens that Jake drew is compromised. Which one is it?
2. Why is the specimen compromised, and how may test results be affected?
3. How could Jake have avoided the problem without drawing blood from the patient
twice?