Phlebotomy Chapter 1 and 2

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Questions and Answers

What is the primary reason for performing an arterial puncture?

To draw a large volume of blood

To administer medication

To evaluate blood gases (correct)

To check blood pressure

What should a phlebotomist do if the patient requiring an ABG specimen is on a ventilator instead of breathing room air?

Consult with the patient's nurse (correct)

Use a different puncture site

Delay the collection until the patient is stable

Collect the specimen anyway

What does a weak or absent pulse distal to the site of arterial puncture suggest?

The puncture was successful

The blood sample is contaminated

The patient is experiencing shock

A thrombus may have formed (correct)

What is the purpose of performing the modified Allen test before arterial specimen collection?

To determine collateral circulation Signup and view all the answers

Why is heparin used during arterial sample collection?

To prevent clotting of the specimen Signup and view all the answers

What does the term 'proximal' refer to in anatomical terms?

Nearest to the point of attachment Signup and view all the answers

Which anatomical position describes a person lying face up?

Supine Signup and view all the answers

What is the primary function of the left ventricle in the circulatory system?

Delivering oxygenated blood into the aorta Signup and view all the answers

Which layers of the skin is considered avascular?

Epidermis Signup and view all the answers

Which of the following is an accessory organ of the digestive system?

Liver Signup and view all the answers

What is the primary function of capillaries in the circulatory system?

Facilitating gas exchange between blood and tissues Signup and view all the answers

Which body cavity houses the heart and lungs?

Thoracic cavity Signup and view all the answers

What does hemostasis refer to in medical terms?

The coagulation process Signup and view all the answers

What is the purpose of a tourniquet during venipuncture?

To constrict blood flow and make veins more visible Signup and view all the answers

What is the function of tube vacuum in evacuated blood collection tubes?

To automatically fill the tube with blood Signup and view all the answers

Why are gauze pads preferred over cotton balls after venipuncture?

Cotton balls can leave fibers that stick to the site Signup and view all the answers

Which of the following veins is not classified as an antecubital vein?

Femoral Signup and view all the answers

What is the main purpose of an antiglycolytic agent during blood collection?

To preserve glucose levels Signup and view all the answers

What should not be done to improve vein selection during venipuncture?

Encouraging the patient to pump their fist vigorously Signup and view all the answers

What is indicated by blood appearing in the hub of the needle during venipuncture?

The needle is correctly placed in a vein Signup and view all the answers

Which chamber of the heart is responsible for receiving blood from the systemic circulation?

Right atrium Signup and view all the answers

What is the maximum time a tourniquet should remain on during venipuncture?

1 minute Signup and view all the answers

What is the primary function of heparin in blood collection?

Inhibits thrombin Signup and view all the answers

In blood pressure measurements, what does the systolic pressure indicate?

Pressure when the first heart sounds are heard Signup and view all the answers

Which situation requires you to check with a nurse before proceeding with a specimen collection?

If the patient has just eaten a meal before fasting Signup and view all the answers

What is the most critical error a phlebotomist can make during the process?

Misidentifying a patient specimen Signup and view all the answers

Which additive is typically found in a tube with a lavender stopper?

EDTA Signup and view all the answers

What is the internal space of a blood vessel known as?

Lumen Signup and view all the answers

Which government agency is responsible for regulating the quality of gloves used in phlebotomy procedures?

FDA Signup and view all the answers

What should you do if a member of the clergy is with a patient when you arrive to collect a routine specimen?

Come back later after the clergy member has gone Signup and view all the answers

What is the recommended angle for needle insertion during a routine venipuncture?

15 degrees to 30 degrees Signup and view all the answers

Which liquid is typically acceptable to consume while fasting?

Plain water Signup and view all the answers

How can you determine that the needle is properly placed in the vein during venipuncture?

You will feel a slight 'give' Signup and view all the answers

Where should labeling of routine inpatient blood specimens occur?

At the bedside immediately after collection Signup and view all the answers

What is a critical reason for including the patient's identification number on the specimen tube label?

To avoid confusing specimens from patients with the same name Signup and view all the answers

What complication may arise from prolonged application of a tourniquet?

Hemoconcentration Signup and view all the answers

When drawing a protime specimen from a patient with IVs in both arms, what is the best practice?

Draw below an IV Signup and view all the answers

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

2.0 mm Signup and view all the answers

Why should a blood smear made from an EDTA specimen be prepared within 1 hour of collection?

To maintain accurate cell morphology. Signup and view all the answers

What is the purpose of wiping away the first drop of blood during a skin puncture?

To prevent contamination from tissue fluid. Signup and view all the answers

Which micro collection container is specifically used for a Complete Blood Count (CBC)?

Lavender top tube Signup and view all the answers

In which situation is a skin puncture preferred over a venipuncture?

When performing a glucose test. Signup and view all the answers

What does the term 'calcaneus' refer to?

The heel bone. Signup and view all the answers

Which test is NOT collectable by capillary puncture?

Blood culture. Signup and view all the answers

What is the primary reason for collecting EDTA specimens before other specimens during skin puncture?

To avoid platelet clumping. Signup and view all the answers

Study Notes

Chapter One

Blood Bank Synonym: Immunohematology
Therapeutic Drug Monitoring Coordination: Pharmacy
Electrolyte Testing Components: Sodium, potassium
Phlebotomist Role: Promoting good public relations, building harmonious relationships with visitors, staff, and patients.
Outpatient Phlebotomy Code: APC (Ambulatory Payment Categories)
Oxygen Therapy Department: Respiratory Therapy
Sophisticated Medical Care Term: Tertiary Care
Phlebotomy Greek Meaning: Incise a vein
Non-Phlebotomist Duty: Starting intravenous (IV) lines
Early Bloodletting Equipment Exclusion: Hemostat
Laboratory Scientist Classification: Clinical laboratory scientist
Continuing Education Certification: Continuing education units

Chapter Two

Barrier to Communication: Emotional upset, inability to speak English, or being a child
Confirming Response: Understanding the patient's feelings, empathizing
Negative Kinesics: Frowning
Professional Appearance Component Exclusion: Wearing strong cologne
Improper Telephone Protocol: Hanging up on angry callers
Local Public Health Agency Duty Exclusion: Licensure of healthcare personnel
Professional Conduct Term: Ethics
Protected Health Information Exchange Law: HIPAA
Federally Funded Insurance: Medicaid
Specialty for Treating Older Adults: Gerontology
Brain Wave Recording Department: Electroneurodiagnostics

Chapter Three

Specimen Collection Documents: Procedure Manual
Legal Period for Filing Lawsuits: Statute of limitations
Accreditation Agency: JCAHO
Procedure Standards Organization: CLSI
Incident Report Form Exclusion: Suggestion for new guidelines
Quality Assurance Indicator Example: Blood cultures will not exceed the national contamination rate
Unfamiliar Procedure Handling: Refer to the user manual
Quality Management Principle Exclusion: Reduction in staff.
Protected Health Information Exchange Legislation: HIPAA
Insurance Term: Medicaid

Chapter Four

Deceptive Practice Term: Fraud
Specimen Mislabeling: Incident report form exclusion: Suggestions for new guidelines
Procedure Standards Organization: CLSI
Professional Conduct Term: Ethics

Chapter Five

Severe External Bleeding Control: Applying direct pressure and elevating the extremity
Fire Classification: Class C fire involves electrical equipment
Vaccination Type: Two or more vaccine doses, one month and 6 months later, to be effective. Employee screening example: PPD test
Fire Response System: National Fire Protection Association (NFPA).

Chapter Six

Left Ventricle Function: Delivering oxygenated blood to the aorta
Heart Receiving Chambers: Atria
Cardiac Cycle Relaxing Phase: Diastole
Circulatory System Vessel Exclusion: Pulmonary artery
Blood Flow Direction: Arterioles, capillaries, and venules
Blood Clot in Circulation: Embolus
Blood Vessel Wall Passage: Leukocytes
Blood Type Determination: Antigen present on red blood cells
Serum vs. Plasma Difference: Plasma contains fibrinogen; serum does not.
Body Fluid Origin: Excess tissue fluid.
Healthcare Worker Exposure to Bloodborne Pathogens: All of the answers are correct.

Chapter Seven

Ethanol Specimen Collection Tube: Sodium fluoride
Largest Lumen Needle Gauge: 18 Gauge
Light Blue Stopper Tube Test Classification: Coagulation
Green Stopper Tube Contents: General Blood collection

Chapter Eight

Patient Identification Method: Looking at his ID band and asking his name, etc.
Priority Specimen Collection: STAT electrolytes in the ER
Vein Preparation Enhancement Method Exclusion: Having the patient vigorously pump his or her fist
Patient Procedures Before Blood Draw: tell patient it will not hurt.
Specimen Collection After Patient Consumes Food: If specimen is collected still write 'nonfasting' on the slip.

Chapter Nine

Accidental Artery Puncture Identification: Blood pulsing into the tube
Specimen Identification Error: Misidentifying patient specimen
Specimen Collection from Dorsal Hand Vein Method: Butterfly and small pediatric ETS tubes
Unconscious Patient Specimen Identification: Use a three-part identification band and labels
Patient with Difficult Veins: Have another phlebotomist attempt to draw the specimen
Timed Blood Test: Prothrombin time (PTT).
Patient with High Red Blood Cells: Pregnant patients.
Specimen Collection Technique: Sterile, antiseptic procedure method is needed
Blood Test Collection Method: Vein

Chapter Ten

EDTA Specimen Blood Smear Production Deadline: Within 1 hour
Capillary Blood Gases Less Desirable Than Arterial Blood Gases: All of the options are correct.
Heel Puncture Depth: 2.0 mm
EDTA Specimen Collection Priority: Before other specimens when collected by skin puncture.
Skin Puncture Test Result Variation: Because test results may vary depending on the method of collection.
Infant Heel Puncture Location: Lateral plantar surface
Skin Puncture Procedure Step Exclusion: When a light blue stopper tube is needed.
Blood Draw Cleaning Procedure: 70% isopropyl alcohol.

Chapter Eleven

Collection Sites: Distal segment of the middle finger
Difficult Blood Collection Cases: have another phlebotomist attempt to draw the specimen.
Skin Antiseptic Needed: Blood cultures

Chapter Twelve

Computer Access Procedure: Logging on.
Input Data Handling: Press the Enter key.
Specimen Identification Tracking Procedure: Accession number.
Chemical Reaction Analysis Procedure: Metabolism
Improper Procedure Test Results: Inadequate mixing of an EDTA tube.

Chapter Thirteen

24-Hour Urine Collection Method: Void the first morning specimen; start the timing; and collect all the specimens, including the next morning’s specimen.
Lumbar Puncture Fluid: Cerebrospinal fluid
Peritoneal Aspiration Fluid: Ascites
Specimen Identification Requirements: Specify the specimen type and source.

Chapter Fourteen

Artery to Use for Blood Collection During Low Cardiac Output: Femoral artery
Artery Released Primarily in Allen Test: Ulnar artery
Blood Specimen Storage at Room Temperature: Blood cells continue to consume oxygen; levels of carbon dioxide increase
Pulse Check Location: Distal to the puncture site
Arterial Puncture Complication: Arteriospasm
Common Radial Artery Needle Gauge: 22 gauge
ABG Specimen Storage Time: Analyzed within 30 minutes of collection

Chapter Fifteen

Patient Blood Collection: A patient who has been asleep for 30 minutes while breathing room air is in a steady state for blood collection.
Needle Angle for Artery Puncture: 45 degrees.
Arterial Blood Specimen Identification: Blood should pump into the syringe as it is collected.
Arterial Puncture Site Cleaning: Povidone-iodine
Respiratory Support Device and Blood Collection: Consult with the patient’s nurse.
Purpose of Arterial Puncture: Evaluate blood gases.

Studying That Suits You

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Test your knowledge of key concepts in phlebotomy from Chapters One and Two. This quiz covers essential topics such as blood bank terminology, the role of phlebotomists, communication barriers, and therapeutic drug monitoring. Perfect for students and healthcare professionals looking to reinforce their understanding.