Phlebotomy and EKG Exam Review
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Questions and Answers

A phlebotomy tech is preparing to collect a patient's troponin T level. Which of the following troponin T levels should the tech immediately report to the provider?

  • 0.2 ng/mL
  • 0.4 ng/mL
  • 0.3 ng/mL (correct)
  • 0.1 ng/mL

    • If a technician notices that a patient does not have a wristband on his wrist, but there is one attached to the patient's IV stand, which of the following actions should the technician take?

  • Use the wristband on the IV stand
  • Proceed with the draw
  • Ask the patient for their name
  • Hold the draw until the nurse has attached a wristband (correct)

    • A phlebotomy tech is reviewing a laboratory test requisition form before obtaining blood specimens from a patient. Which of the following actions should the tech take prior to performing the venipuncture?

  • Obtain a verbal confirmation from the patient
  • Wash their hands
  • Check the requisition form for duplicate test orders (correct)
  • Prepare the necessary tools for the draw

    • A phlebotomy tech has a requisition form for a series of tests on a patient's serum. The tech should select a collection tube that contains which of the following additives?

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

    Which of the following tubes should a phlebotomy tech collect first when obtaining dermal samples?

    <p>Lavender Top</p> Signup and view all the answers

    Which of the following blood tests should a phlebotomy tech place in ice immediately following collection?

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

    A phlebotomy tech is instructing a patient about how to collect a fecal occult specimen. Which of the following instructions should the tech include?

    <p>Avoid taking ibuprofen</p> Signup and view all the answers

    Which of the following actions should a phlebotomy tech take when preparing a peripheral blood smear?

    <p>Place a 1 mm drop of blood one-half inch from the edge of the slide</p> Signup and view all the answers

    After exiting a patient's room, which of the following is the last piece of PPE a phlebotomy tech should remove?

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

    A phlebotomy tech is introducing herself to a patient and explaining the venipuncture procedure. In which of the following comfort zones is the tech working?

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

    A phlebotomy tech is collecting capillary blood drops on a filter paper card to screen a newborn for phenylketonuria. Which of the following actions should the tech take?

    <p>Apply blood to the printed side of the filter paper</p> Signup and view all the answers

    A phlebotomy tech uses alcohol to cleanse a venipuncture site. Before performing the venipuncture, the tech should allow the site to dry for which of the following reasons?

    <p>Alcohol requires time for antiseptic action to take effect</p> Signup and view all the answers

    After a phlebotomy tech performs a heel puncture for neonatal screening, which of the following is the correct procedure for collecting the blood?

    <p>Saturate each circle with one drop of blood</p> Signup and view all the answers

    A phlebotomy tech is preparing to obtain blood from a patient for thyroid studies. The tech should select a collection tube that has a top with which of the following colors?

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

    A phlebotomy tech is preparing to draw a peak level for a medication that was administered orally to a patient. After verifying when the patient received the medication, how long should the tech wait prior to attempting the draw?

    <p>2 hours after administration</p> Signup and view all the answers

    Which of the following collection tubes should a phlebotomy tech use when collecting for a routine chemistry test that requires serum?

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

    A phlebotomy tech is obtaining a blood culture from an adult patient. Which of the following actions should the tech take?

    <p>Withdraw the blood into a sterile safety syringe</p> Signup and view all the answers

    For which of the following reasons should a phlebotomy tech centrifuge a serum specimen before transport to an outside reference laboratory?

    <p>To separate cells from the serum</p> Signup and view all the answers

    A patient asks a phlebotomy tech to use her finger for blood work. In which of the following situations can the tech collect blood from the patient's finger?

    <p>When the ordered test can be performed on a capillary specimen</p> Signup and view all the answers

    A phlebotomy tech is preparing to collect a specimen for a blood alcohol level test. Which of the following antiseptics should the tech use to clean the venipuncture site?

    <p>Soap and water</p> Signup and view all the answers

    A phlebotomy tech is preparing to enter a patient's room to collect a blood specimen. Which of the following actions should the tech plan to take?

    <p>Communicate name and department affiliation to the patient</p> Signup and view all the answers

    A patient states that she is a 'difficult draw' and requests a skin puncture. The test ordered is for PTT. Which of the following should a phlebotomy tech perform?

    <p>Perform a syringe draw transferred into a light blue vacuum tube</p> Signup and view all the answers

    A phlebotomy tech is instructing a patient about proper semen specimen collection for determination of fertility potential. Which of the following instructions should the tech include?

    <p>Protect the specimen from exposure to bright light</p> Signup and view all the answers

    A phlebotomy tech has collected a blood specimen from a patient who is in an isolation room. Which of the following pieces of PPE should the tech remove first?

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

    A phlebotomy tech collects multiple specimens from a premature infant. Which of the following is a possible result of the procedure?

    <p>Iatrogenic anemia</p> Signup and view all the answers

    After completing a standard ECG on a patient, which of the following actions should an EKG tech take next?

    <p>Check that the tracing is free from artifacts then disconnect the patient from the machine</p> Signup and view all the answers

    An EKG tech is performing a standard 12-lead EKG for a patient who is experiencing accelerated junctional rhythm. Which of the following speed settings should the tech use?

    <p>25 mm/second</p> Signup and view all the answers

    For which of the following types of heart block should an EKG tech observe the patient for signs and symptoms of decreased cardiac output that could lead to cardiac arrest?

    <p>Third-degree AV block</p> Signup and view all the answers

    Which of the following terms describes an EKG tech writing defamatory comments in a patient's chart?

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

    A phlebotomy tech should transport a semen sample at which of the following temperatures?

    <p>36 degrees to 38 degrees C</p> Signup and view all the answers

    A phlebotomy tech is using a point-of-care test system to determine a patient's WBC count. For which of the following results should the tech immediately notify the provider?

    <p>1.8 /mm³</p> Signup and view all the answers

    A phlebotomy tech is selecting a site to collect a good specimen from a patient. After applying a tourniquet, the tech sees no apparent vein to use for the venipuncture. Which of the following actions should the tech take?

    <p>Have the patient dangle her arm for 1 to 2 minutes</p> Signup and view all the answers

    A phlebotomy tech is collecting a blood specimen from a patient to measure the trough level of a medication. The tech should collect the specimen at which of the following times?

    <p>Within 15 minutes before the patient received the next dose</p> Signup and view all the answers

    A phlebotomy tech is reviewing a tracing for a patient who has a ventricular pacemaker. Which of the following rhythm patterns should the tech expect after a pacing spike?

    <p>Wide QRS interval</p> Signup and view all the answers

    An EKG tech is monitoring a patient who is undergoing an exercise stress test. Which of the following findings should indicate the tech that the patient is experiencing an adverse reaction?

    <p>Report of tingling sensations in the lower extremities</p> Signup and view all the answers

    In which of the following locations should an EKG technician place the leads for a resting EKG training for a patient who is in an immobile fetal position?

    <p>On the patient's back</p> Signup and view all the answers

    A phlebotomy tech should identify that which of the following color signifies a health hazard in the National Fire Protection Association (NFPA)?

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

    A phlebotomy tech should use a capillary instead of a venipuncture in which of the following situations?

    <p>When the veins are inaccessible</p> Signup and view all the answers

    Study Notes

    Phlebotomy Key Concepts

    • Troponin T level exceeding 0.3 ng/mL indicates a need for immediate reporting to the provider.
    • Always verify patient identity; hold blood draws if proper wristband is not present.
    • Check for duplicate test orders on the requisition before performing venipuncture.
    • Choose thrombin-containing tubes for serum tests, particularly those for certain assays.
    • Collect dermal samples in the order of lavender top tubes for accurate results.
    • Ammonia levels require immediate placement in ice post-collection to prevent unstable results.

    Blood Collection Procedures

    • Instruct patients to avoid ibuprofen before collecting fecal occult specimens.
    • For peripheral blood smears, use a 1 mm drop of blood placed half an inch from the slide's edge.
    • The last piece of PPE removed should be the mask after exiting a patient's room.
    • Confirm that blood for thyroid studies is collected in a speckled top tube.

    Pediatric & Specialized Procedures

    • Newborn screening requires applying blood to the printed side of the filter paper card.
    • Saturate circles with individual drops of blood for neonatal screenings efficiently.

    Safety and Protocol

    • Allow alcohol drying on venipuncture sites to ensure proper antiseptic action.
    • When collecting for blood cultures, use a sterile safety syringe for withdrawal.
    • Protect semen specimens from bright light to preserve integrity for fertility testing.

    Testing and Specimen Handling

    • Place specimens in a lockable container during transport to the lab for security.
    • Collect blood specimens for trough levels within 15 minutes before the next scheduled dose of medication.
    • Hypoxemia is indicated by a pulse oximetry reading of 88%.

    Legal & Ethical Aspects

    • Slander involves making derogatory spoken comments, while libel refers to written defamatory remarks.
    • Maintain confidentiality in patient records, being aware of legal implications in documentation.

    Electrocardiogram (EKG) Insights

    • Accelerated junctional rhythm requires a speed setting of 25 mm/second during EKG.
    • Mobitz Type II heart block is characterized by low cardiac output and is a classic heart block scenario.
    • The presence of pathologic Q waves on an EKG can indicate a prior myocardial infarction.

    Conditions and Symptoms

    • Cyanosis signifies decreased cardiac output and potential myocardial infarction risk.
    • Stroke symptoms include facial drooping, speech difficulties (aphasia), and limb weakness.
    • Observe for decreased cardiac output signs in third-degree AV block cases.

    Additional Considerations

    • When preparing for a restless EKG, consider placing leads on the patient's back.
    • Environmental factors like temperature should be monitored during specimen transport.
    • Hemoptysis refers to coughing up blood, while orthopnea denotes difficulty breathing in a supine position.

    Best Practice and Quality Control

    • Regular daily quality control tests for glucometers are crucial for reliable results.
    • A phlebotomy tech should utilize the second drop of blood for peripheral blood smears to ensure accuracy.
    • Understand the variances in the order of draw for capillary versus venipuncture collections due to coagulation rates.

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    Description

    Prepare for your Phlebotomy and EKG exams with this review quiz. Each flashcard presents key scenarios and definitions that are critical for technicians. Enhance your understanding and readiness for the exam with real-world examples.

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