ICC Phlebotomy Final Exam Review
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Questions and Answers

Outpatient phlebotomy will be assigned a code for reimbursement using which national coding system?

  • HCPCS
  • NDC
  • ICD-10
  • CPT (correct)
  • Why is promoting good public relations part of the phlebotomy role?

    A phlebotomist is a representative of the laboratory throughout the facility.

    The term used to describe sophisticated and highly complex medical care is?

    Tertiary Care

    The term 'phlebotomy' is derived from Greek words that mean?

    <p>Vein Incision</p> Signup and view all the answers

    The stoppage of bleeding is referred to as?

    <p>Hemostasis</p> Signup and view all the answers

    What are the credentials for an ASCP-certified phlebotomist?

    <p>PBT</p> Signup and view all the answers

    What is one way that can communicate unprofessionalism?

    <p>Intense odor of cologne / perfume</p> Signup and view all the answers

    The femoral vein is considered an antecubital vein.

    <p>False</p> Signup and view all the answers

    Which needle gauge has the largest lumen?

    <p>18</p> Signup and view all the answers

    Which analyte test result will be adversely affected by chilling?

    <p>Potassium</p> Signup and view all the answers

    Some test specimens require immediate cooling in ice and water slurry to?

    <p>slow down metabolic processes</p> Signup and view all the answers

    A global organization that develops laboratory standards is called?

    <p>CLSI</p> Signup and view all the answers

    An icteric bilirubin specimen is least likely to be a reason for specimen rejection.

    <p>True</p> Signup and view all the answers

    The 'standard of care' in phlebotomy is influenced by which organization?

    <p>TJC</p> Signup and view all the answers

    When blood leaks into the surrounding tissue after an ABG procedure, a __________ may form.

    <p>hematoma</p> Signup and view all the answers

    A patient who has been at rest and has not had any changes in respiratory therapy for 20-30 minutes is in a?

    <p>steady state</p> Signup and view all the answers

    Which additive is usually present in a tube with a lavender stopper?

    <p>EDTA</p> Signup and view all the answers

    Vaccination against HBV involves?

    <p>a dose of vaccine, a second dose 1 month later, a third dose 6 months later</p> Signup and view all the answers

    A body fluid splash to the eyes requires the victim to immediately flush the eyes with water or saline for a minimum of how long?

    <p>10 mins</p> Signup and view all the answers

    An example of a nosocomial infection is?

    <p>catheter site of ICU patient becomes infected</p> Signup and view all the answers

    The second choice for the site of arterial puncture is the?

    <p>brachial artery</p> Signup and view all the answers

    The main principles involved in radiation exposure are?

    <p>exposure time, distance, shielding</p> Signup and view all the answers

    Federal law requires that hepatitis B vaccination be made available to employees assigned to duties with occupational exposure risk within ______ working days of initial assignment.

    <p>10</p> Signup and view all the answers

    What is the suffix in the term 'lipase'?

    <p>-ase</p> Signup and view all the answers

    This adds information about a term, modifies the meaning of the term, and precedes the word root?

    <p>prefix</p> Signup and view all the answers

    What will happen if you partially fill a liquid EDTA tube?

    <p>this will compromise the quality of the specimen</p> Signup and view all the answers

    How should the phlebotomist proceed when drawing blood from an elderly patient who is hard of hearing?

    <p>speak in a normal tone of voice</p> Signup and view all the answers

    If blood is drawn too quickly from a small vein, the vein will have a tendency to?

    <p>collapse</p> Signup and view all the answers

    The medical term for white blood cells is?

    <p>leukocyte</p> Signup and view all the answers

    An additive should be _____ as soon as it is removed from the holder.

    <p>mixed</p> Signup and view all the answers

    What should the phlebotomist do when entering a closed door of a patient?

    <p>knock softly, open slowly, ask for permission to enter</p> Signup and view all the answers

    Removing blood on a regular basis or in large amounts can lead to _____ anemia.

    <p>iatrogenic</p> Signup and view all the answers

    The procedure of identifying a patient using the written requisition, armband, and verbal confirmation is known as?

    <p>3 way ID</p> Signup and view all the answers

    A hereditary inability to metabolize phenylalanine is called?

    <p>PKU - Newborn screening</p> Signup and view all the answers

    Which is a preferred capillary puncture site?

    <p>middle finger</p> Signup and view all the answers

    Fluid that comes from between tissue cells is called?

    <p>Interstitial</p> Signup and view all the answers

    The hormone detected in a positive urine pregnancy test is?

    <p>HCG</p> Signup and view all the answers

    Tan-top tubes containing K2EDTA can be used to collect specimens for?

    <p>lead analysis</p> Signup and view all the answers

    The abbreviation 'UTI' stands for?

    <p>Urinary tract infection</p> Signup and view all the answers

    Which blood cell has the ability to pass through the blood vessel walls?

    <p>white/WBCs</p> Signup and view all the answers

    What are tiny, one-cell thick blood vessels that link arterioles and venules where gas exchange takes place?

    <p>capillaries</p> Signup and view all the answers

    The fluid portion of blood is approximately __% of the blood specimen.

    <p>55%</p> Signup and view all the answers

    What do the pulmonary veins provide to the heart?

    <p>oxygen-rich blood</p> Signup and view all the answers

    The Creatinine Clearance rate decreases in elderly patients due to a normal decline in their what?

    <p>Kidney Function</p> Signup and view all the answers

    If a venipuncture site is still bleeding after 5 minutes, what should the phlebotomist do?

    <p>call the nurse/physician</p> Signup and view all the answers

    A drug known to interfere with urine tests should be discontinued _____ to _____ hours prior to the test.

    <p>48 to 72</p> Signup and view all the answers

    What is the proper blood to additive ratio for a light-blue tube collected for a coagulation test?

    <p>9 : 1</p> Signup and view all the answers

    What could happen if a patient receives a transfusion of the wrong blood type?

    <p>an adverse reaction could result in the patient's death</p> Signup and view all the answers

    The solution normally used to clean the site before routine venipuncture is?

    <p>70% isopropanol</p> Signup and view all the answers

    Drugs of abuse can be detected in?

    <p>hair, saliva, and urine</p> Signup and view all the answers

    What is the most critical aspect of blood culture collection?

    <p>skin antiseptic</p> Signup and view all the answers

    When performing a GTT, the timing should begin?

    <p>as soon as the patient finishes the drink</p> Signup and view all the answers

    What is a confirming response to a patient?

    <p>I understand how you must be feeling.</p> Signup and view all the answers

    Drawing a patient's blood without his or her permission can result in a charge of?

    <p>assault and battery</p> Signup and view all the answers

    Partially filling an EDTA tube will?

    <p>compromise the quality of the specimen</p> Signup and view all the answers

    Letting the patient know that you are a student phlebotomist is the responsibility of?

    <p>the student phlebotomist</p> Signup and view all the answers

    What is the recommended angle of needle insertion for an antecubital vein and a hand vein respectively?

    <p>30 degrees or less, 10 degrees or less</p> Signup and view all the answers

    Which situation indicates that you may have accidentally punctured an artery?

    <p>blood pulses into the tube</p> Signup and view all the answers

    Capillary puncture blood most closely resembles?

    <p>arterial blood</p> Signup and view all the answers

    If a patient is complaining of sharp radiating pain from the needle insertion site, what should the phlebotomist do?

    <p>terminate the procedure</p> Signup and view all the answers

    What causes a microhematocrit tube to fill with blood?

    <p>capillary action</p> Signup and view all the answers

    A first morning specimen is preferred for HCG testing because it is?

    <p>more concentrated</p> Signup and view all the answers

    Proof of participation in workshops to upgrade skills required by some agencies to renew certification is called?

    <p>CEUs</p> Signup and view all the answers

    When collecting a blood culture specimen directly from a butterfly into blood culture bottles, which should be filled first?

    <p>aerobic</p> Signup and view all the answers

    Critical values are also called?

    <p>panic values</p> Signup and view all the answers

    A fluid found around a fetus is known as?

    <p>amniotic</p> Signup and view all the answers

    Postprandial means?

    <p>after a meal</p> Signup and view all the answers

    Which type of specimen must be protected from light?

    <p>amniotic fluid and bilirubin</p> Signup and view all the answers

    What type of specimen is required for a urine culture and sensitivity?

    <p>midstream clean catch</p> Signup and view all the answers

    Sputum samples are typically collected to diagnose?

    <p>TB</p> Signup and view all the answers

    What term means 'condition of clotting'?

    <p>thrombosis</p> Signup and view all the answers

    There are 3 example types of quality control which include?

    <p>checking expiration dates of evacuated tubes, documenting maintenance on centrifuge, recording refrigerator temperature daily</p> Signup and view all the answers

    The most common reason a throat swab is collected is to detect an infection with which type of microorganism?

    <p>streptococcus</p> Signup and view all the answers

    The word roots 'nephr' and 'ren' both refer to the?

    <p>kidneys</p> Signup and view all the answers

    ____________ ____________ is a preanalytical factor that can affect validity of test results and is not always under the phlebotomist's control.

    <p>patient preparation</p> Signup and view all the answers

    What is the word root in the word 'electrocardiogram'?

    <p>cardi</p> Signup and view all the answers

    What is an example of a nervous system disorder?

    <p>MS/multiple sclerosis</p> Signup and view all the answers

    ________________ would not violate a patient's right to confidentiality.

    <p>sharing a collection site information on a difficult patient</p> Signup and view all the answers

    ________________ is not included in the various phases of malpractice litigation.

    <p>a healthcare institution is informed of an injury to a patient</p> Signup and view all the answers

    What is the Clinical and Laboratory Standards Institute (CLSI) recommended maximum depth of heel puncture?

    <p>2.0 mm</p> Signup and view all the answers

    You must draw a protime specimen from a patient with IVs in both arms. Where should you obtain the specimen?

    <p>below an IV</p> Signup and view all the answers

    You have no choice but to draw a specimen from a site with a hematoma. Where should you obtain the specimen?

    <p>distal to the hematoma</p> Signup and view all the answers

    What department is responsible for administering oxygen therapy?

    <p>respiratory</p> Signup and view all the answers

    Examples of barriers to effective communication with a patient include:

    <p>the patient does not speak English, the patient is a very young child, the patient is emotionally upset</p> Signup and view all the answers

    An example of invasion of privacy is when?

    <p>two phlebotomists are in an elevator and are discussing a patient's condition that they are overheard by the patient's daughter</p> Signup and view all the answers

    Evacuated tubes fill with blood automatically because _______ exists in the tube.

    <p>vacuum</p> Signup and view all the answers

    A rapid serum tube contains?

    <p>thrombin</p> Signup and view all the answers

    An ABG specimen can clot if there is inadequate or delayed ________ of the specimen.

    <p>mixing</p> Signup and view all the answers

    What is the best way to avoid 'reflux' when drawing a blood specimen?

    <p>fill the tubes from bottom up</p> Signup and view all the answers

    The word elements of the term 'polycythemia' means?

    <p>blood condition of many cells</p> Signup and view all the answers

    A lumbar puncture is performed by a physician to withdraw what type of fluid?

    <p>cerebrospinal</p> Signup and view all the answers

    The 'e' at the end of this medical term is pronounced separately?

    <p>syncope</p> Signup and view all the answers

    To maintain the integrity of an ABG specimen collected in a plastic syringe, it should be analyzed within ___ minutes.

    <p>30</p> Signup and view all the answers

    A special protocol used when collecting forensic specimens is called?

    <p>chain of custody</p> Signup and view all the answers

    Series of bars and spaces representing numbers or letters is a?

    <p>barcode</p> Signup and view all the answers

    Placing tubes of equal size and volume opposite one another for balance describes a proper?

    <p>centrifuge operation</p> Signup and view all the answers

    ____________ would not be considered a preanalytical error.

    <p>misreporting patient results</p> Signup and view all the answers

    Analysis and reporting is least likely to take place in central processing or triage.

    <p>True</p> Signup and view all the answers

    A disadvantage of collecting ABGs from the radial artery is that?

    <p>it can be hard to locate on patients with decreased blood volume</p> Signup and view all the answers

    A sign posted on the door of a patient in contact isolation states that all who enter the room must use soap and water to wash their hands before leaving the room. This is a sign that the patient may be infected with a spore-forming microbe such as?

    <p>C-diff</p> Signup and view all the answers

    Study Notes

    Phlebotomy Key Concepts

    • Outpatient phlebotomy uses the CPT coding system for reimbursement.
    • Good public relations are important for phlebotomists as they represent the lab and impact patient perception of care.
    • Tertiary care refers to advanced and complex medical treatment.
    • The term "phlebotomy" translates from Greek to "vein incision."
    • Hemostasis is the process of stopping bleeding.
    • An ASCP-certified phlebotomist is designated as "PBT."
    • Unprofessionalism can be perceived through intense odors of cologne or perfume.
    • The femoral vein is not classified as an antecubital vein.

    Phlebotomy Procedures and Techniques

    • An 18-gauge needle has the largest lumen for blood draws.
    • Chilling can adversely affect potassium test results; quick cooling is necessary to slow metabolic processes in some specimens.
    • CLSI is a global organization that develops laboratory standards and guidelines.
    • Specimen rejection is least likely due to an icteric bilirubin specimen.
    • TJC influences "standard of care" practices in phlebotomy.

    Healthcare Standards and Protocols

    • A hematoma may form if blood leaks into the surrounding tissue following an arterial blood gas (ABG) procedure.
    • A "steady state" refers to a patient resting without changes in respiratory therapy for 20-30 minutes.
    • Lavender stopper tubes contain EDTA as an additive.
    • Hepatitis B vaccination protocol includes three doses over six months, starting within 10 working days of exposure risk.

    Emergency Protocols and Infection Control

    • Flush eyes with water or saline for at least 10 minutes after a body fluid splash.
    • A nosocomial infection can arise from an ICU catheter site.
    • The brachial artery is the second choice for arterial puncture.
    • Three key principles of radiation exposure are time, distance, and shielding.

    Quality Control and Sample Handling

    • The proper blood to additive ratio for light-blue tubes in coagulation tests is 9:1.
    • Misfilling an EDTA tube compromises specimen quality.
    • Critical values, or panic values, indicate urgent physiological conditions.
    • Skin antiseptics are crucial for blood culture collection.

    Communication and Patient Interaction

    • Phlebotomists should communicate clearly with patients, especially those with hearing difficulties, by speaking at a normal volume.
    • It is critical to obtain patient consent before drawing blood to avoid charges of assault and battery.

    Blood Collection Techniques

    • Optimal angles for needle insertion are 30 degrees for antecubital veins and 10 degrees for hand veins.
    • If blood pulses into the tube during a draw, an artery may have been punctured.
    • Capillary puncture blood resembles arterial blood.

    Specimen Types and Laboratory Analysis

    • Amniotic fluid and bilirubin specimens require protection from light.
    • Sputum samples are collected primarily to diagnose tuberculosis (TB).
    • A first morning urine sample is more concentrated for HCG testing.
    • Chain of custody protocols are vital for forensic specimen collection.

    Additional Important Notes

    • Barcodes represent data in a series of bars and spaces.
    • Proper centrifuge operation involves balancing tubes of equal size and volume.
    • Preanalytical errors do not include misreporting patient results.
    • Collecting ABGs from the radial artery can be difficult in patients with reduced blood volume.

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    Prepare for the ICC Phlebotomy Final Exam with this comprehensive review guide. Focus on key concepts such as outpatient coding systems and the role of public relations in phlebotomy. Ideal for students looking to solidify their understanding before the exam.

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