59. Aside from properly identifying the patient, which of the following is the most important step in the venipuncture p
Posted: Fri May 06, 2022 9:08 am
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65. The phlebotomist was having difficulty drawing blood from a patient and only got a small return of blood on both attempts-not enough for any of the tests ordered. Which of the following should the phlebotomist do? a. Ask the patient whether she can stick him again b. Get one of the nurses to stick the patient c. Cancel the order due to QNS d. Call down to the lab for another phlebotomist to come stick the patient 66. To obtain a sterile puncture site for blood culture collection, which of the following should the phlebotomist do? a. Disinfect the patient's arm with an alcohol swab, and let it dry 1 minute b. Use antiseptic soap and water to clean the area, and let it air-dry 30 seconds c. Swab the arm with 70% isopropyl alcohol, and wipe dry with sterile gauze d. Scrub the patient's arm with an alcohol swab for 60 sec, following with an iodine tincture scrub for 30 sec 67. Orders came through for two STATS at 21:50- one in the ED down the hall and one on the fifth floor. Mary was performing QC runs on the glucometer for the four 10pm glucose checks, John was sorting a large stack of reports for the doctors to be delivered in the adjacent medical office building before it closed at 22:30, and Jane was stocking the carts for day shift. Their shift ends at 22:30, and no overtime is approved. Which of the following is the best choice for getting the STATs and other work completed? a. Mary takes the third-floor STAT with her when she goes to perform the 10PM glucoses, and Jane goes to the ED. b. John takes both STATS, and Jane completes the reports c. John goes to draw the ED Stat, and Jane gets the fifth-floor STAT d. Jane goes to the ED first and brings it back, then goes to get the third-floor STAT 68. An elderly patient came in for a dermal puncture for H&H testing. The phlebotomist prepared the equipment and started to select the finger to be used when she noted that the patient's hand was very cold to the touch. Which of the following did she decide to do? a. Get a warming device to warm the patient's hand b. Wrap the patient's hand in a towel containing a glove filled with water that had been heated in the microwave c. Clean the ring finger and proceed a usual d. Perform a venipuncture using a butterfly syringe instead 11
69. The phlebotomist is processing samples that came by courier from a local clinic. Which of the following specimens will she reject for testing? a. CBC tube filled % of capacity. b. PT tube filled % of capacity c. BUN/Creatinine tube filled % capacity d. None; all are acceptable 70. The patient brings in a 24-hour urine collection that has small pieces of fecal matter in it. Which of the following will the phlebotomist do? a. Accept the specimen as is b. Remove the fecal matter and process as usual c. Reject the specimen d. Accept the specimen and make a notation on the label that fecal matter is present 71. The phlebotomist performed a venipuncture on an infant using a 25-gauge butterfly for electrolytes and a CBC. Which of the following is a preanalytical sample issue that could result in specimen rejection from the venipuncture? a. Lipemia b. Hemolysis C. Icteric d. Agitation 72. A phlebotomist who is having difficulty getting flashback in the syringe withdraws the needle and quickly inserts it into another location near the first stick. This is an example of which of the following? a Venipuncture adjustment b. Malpractice c. Negligence d. Compartment syndrome 73. A 2-hour postprandial test requires the patient to do which of the following? a. Fast for 2 hours before the blood draw b. Drink a measured amount of glucose with a blood draw 2 hours later c. Eat his/her usual breakfast and come inf for the blood draw 2 hours later d. Snack for 2 hours, then have blood drawn 74. Proper centrifugation of blood specimens requires all of the following except which? a. Balance of similar tubes-e.g., those with stoppers and those without stoppers b. Closed and/or locked lid c. Not stopping the spinning rotor by hand d. Situation of the centrifuge on a level, firm surface 75. The phlebotomist who has an order for a dermal puncture on a premature infant makes sure that he has which of the following types of lancets on his cart? a. 0.65mm depth with 3.0 mm width b. 0.85mm depth with 1.75mm width c. 30-gauge with 1.5mm depth d. 1.5mm depth with 20mm width 12
59. Aside from properly identifying the patient, which of the following is the most important step in the venipuncture process? a Order of draw b. Right size needle and tube for vein size c. Antiseptic cleansing of skin d. Tourniquet placement 60. Risk of bone injury due to a heelstick can result from making the dermal incision where? a. Medial side of the heel aligned with the center of the big toe b. Lateral side of the heel aligned between the fourth and fifth toes c. Center heel aligned with the middle toe d. Plantar surface medial to the big toe 61. Which of the following is the purpose of the chain of custody procedure for forensic specimens? a. Ensure that specimens have not been altered or switched out b. Prevent degradation of the samples c. Grant the phlebotomist the authority to collect the specimen d. Protect the laboratory from litigation 62. The phlebotomist placed her AM draws in the centrifuge, turned it on, and immediately it began to shake, bounce, and make a horrendous noise, because the phlebotomist did which of the following? a. Forgot to close the lid b. Put too many specimens in the centrifuge c. Did not balance the tubes d. Incorrectly set the speed of the centrifuge 63. The phlebotomist performed a dermal puncture on a newborn, collecting a glucose, CBC, and ABO/Rh. In which of the following orders did she collect them? a. CBC, glucose, ABO/Rh b. Glucose, ABO/Rh, CBC c. ABO/Rh, glucose, CBC d. Rh, CBC, ABO, glucose 64. Which of the following does the most appropriate blood collection equipment for CBC, lipid panel, and glucose on an obese patient with a palpable but deep median cubital vein include? a. 23-gauge butterfly b. 0.85 dermal puncture lancet c. Vacutainer, 21-gauge/1.5-inch needle d. Syringe, 23-gauge, 1-inch needle
65. The phlebotomist was having difficulty drawing blood from a patient and only got a small return of blood on both attempts-not enough for any of the tests ordered. Which of the following should the phlebotomist do? a. Ask the patient whether she can stick him again b. Get one of the nurses to stick the patient c. Cancel the order due to QNS d. Call down to the lab for another phlebotomist to come stick the patient 66. To obtain a sterile puncture site for blood culture collection, which of the following should the phlebotomist do? a. Disinfect the patient's arm with an alcohol swab, and let it dry 1 minute b. Use antiseptic soap and water to clean the area, and let it air-dry 30 seconds c. Swab the arm with 70% isopropyl alcohol, and wipe dry with sterile gauze d. Scrub the patient's arm with an alcohol swab for 60 sec, following with an iodine tincture scrub for 30 sec 67. Orders came through for two STATs at 21:50- one in the ED down the hall and one on the fifth floor. Mary was performing QC runs on the glucometer for the four 10pm glucose checks, John was sorting a large stack of reports for the doctors to be delivered in the adjacent medical office building before it closed at 22:30, and Jane was stocking the carts for day shift. Their shift ends at 22:30, and no overtime is approved. Which of the following is the best choice for getting the STATS and other work completed? a. Mary takes the third-floor STAT with her when she goes to perform the 10PM glucoses, and Jane goes to the ED. b. John takes both STATS, and Jane completes the reports c. John goes to draw the ED Stat, and Jane gets the fifth-floor STAT d. Jane goes to the ED first and brings it back, then goes to get the third-floor STAT 68. An elderly patient came in for a dermal puncture for H&H testing. The phlebotomist prepared the equipment and started to select the finger to be used when she noted that the patient's hand was very cold to the touch. Which of the following did she decide to do? a. Get a warming device to warm the patient's hand b. Wrap the patient's hand in a towel containing a glove filled with water that had been heated in the microwave c. Clean the ring finger and proceed a usual d. Perform a venipuncture using a butterfly syringe instead 1
69. The phlebotomist is processing samples that came by courier from a local clinic. Which of the following specimens will she reject for testing? a. CBC tube filled % of capacity b. PT tube filled % of capacity c. BUN/Creatinine tube filled % capacity d. None; all are acceptable 70. The patient brings in a 24-hour urine collection that has small pieces of fecal matter in it. Which of the following will the phlebotomist do? a. Accept the specimen as is b. Remove the fecal matter and process as usual c. Reject the specimen o d. Accept the specimen and make a notation on the label that fecal matter is present. 71. The phlebotomist performed a venipuncture on an infant using a 25-gauge butterfly for electrolytes and a CBC. Which of the following is a preanalytical sample issue that could result in specimen rejection from the venipuncture? a. Lipemia b. Hemolysis c. Icteric d. Agitation 72. A phlebotomist who is having difficulty getting flashback in the syringe withdraws the needle and quickly inserts it into another location near the first stick. This is an example of which of the following? Venipuncture adjustment b. Malpractice c. Negligence d. Compartment syndrome 73. A 2-hour postprandial test requires the patient to do which of the following? a. Fast for 2 hours before the blood draw b. Drink a measured amount of glucose with a blood draw 2 hours later c. Eat his/her usual breakfast and come inf for the blood draw 2 hours later d. Snack for 2 hours, then have blood drawn 74. Proper centrifugation of blood specimens requires all of the following except which? a. Balance of similar tubes-e.g., those with stoppers and those without stoppers b. Closed and/or locked lid c. Not stopping the spinning rotor by hand d. Situation of the centrifuge on a level, firm surface 75. The phlebotomist who has an order for a dermal puncture on a premature infant makes sure that he has which of the following types of lancets on his cart? a. 0.65mm depth with 3.0 mm width b. 0.85mm depth with 1.75mm width c. 30-gauge with 1.5mm depth d. 1.5mm depth with 20mm width