Phlebotomy Chapter 11 Flashcards
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Questions and Answers

What is forensic toxicology concerned with?

legal consequences of toxin exposure

What does TB test administration involve?

injecting the antigen just under the skin

Which one of the following is an unlikely NIDA patient collection requirement for urine drug screens?

  • Documentation is carefully maintained from proctor to courier (correct)
  • Temperature testing of the urine
  • Rolling the bottle before collection
  • Witnessing the collection

    • What is the correct order in collecting a blood culture?

    <p>select equipment, perform friction scrub, cleanse bottle tops, perform venipuncture</p> Signup and view all the answers

    False-positive results of lactose tolerance tests have been found in all conditions other than?

    <p>male multiple myeloma</p> Signup and view all the answers

    If an assumed parent in a paternity case cannot be excluded by ABO grouping, which additional tests may be required?

    <p>Buccal sample for DNA</p> Signup and view all the answers

    Which one of the following should be deleted from the list of those allowed to order paternity testing?

    <p>Child who is a minor</p> Signup and view all the answers

    What is the recommended disinfectant for blood culture sites in infants 2 months and older?

    <p>Chlorhexidine gluconate</p> Signup and view all the answers

    Which one of the following statements about autologous donations is untrue?

    <p>Unused autologous units may be used by other patients</p> Signup and view all the answers

    What is the least likely role of the CPD additive in a donor unit of blood?

    <p>control bacterial contamination</p> Signup and view all the answers

    Why is a transfusion of incompatible blood often fatal?

    <p>causes lysis, or rupturing, of RBCs, within the vascular system</p> Signup and view all the answers

    In using a cell-salvaging procedure during surgery, what analyte must be evaluated before the patient's blood can be reinfused?

    <p>Free hemoglobulin</p> Signup and view all the answers

    Which one of the donor unit collection principles is untrue?

    <p>Additives EDTA and sodium fluoride are contained in the collection bag</p> Signup and view all the answers

    Which of the following are coagulation tests that can be monitored using a POC instrument?

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

    Some individuals lack the necessary mucosal enzyme to convert which of the following sugars so that it can be digested?

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

    Blood gases can be monitored using which instrument?

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

    This point of care testing instrument has recently been recognized as an accurate predictor of developing diabetic complications?

    <p>DCA Vantage</p> Signup and view all the answers

    Potassium is least likely to play a major role in:

    <p>transporting Hgb</p> Signup and view all the answers

    All POC glucose analyzers approved for hospital use have which of the following in common?

    <p>All of the above</p> Signup and view all the answers

    ARD or FAN blood culture bottles are designed to do what?

    <p>remove any antibiotics that are in the blood</p> Signup and view all the answers

    What is septicemia?

    <p>microorganisms found in the blood</p> Signup and view all the answers

    The Siemens Patient Identification Check-Blood Administration system is a:

    <p>portable bar-code scanning system for positive patient ID</p> Signup and view all the answers

    What are the eligibility requirements for donating blood?

    <p>All of the above</p> Signup and view all the answers

    Identify the condition in which a unit of blood is withdrawn from a patient as a treatment.

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

    Which specimen required especially strict identification and labeling procedures?

    <p>Cross-match</p> Signup and view all the answers

    Which of the following should be removed from a list of drugs of abuse?

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

    Donor units of blood are typically collected using needles that are:

    <p>16 to 18 gauge</p> Signup and view all the answers

    A typical unit of donated blood contains approximately:

    <p>450 mL</p> Signup and view all the answers

    Which of the following tests is collected from patients with FUO to rule out septicemia?

    <p>Blood cultures times two</p> Signup and view all the answers

    Of all of the following, which tubes should be eliminated for use in collecting specimens for a blood bank?

    <p>Large gel-barrier tube</p> Signup and view all the answers

    Which of the following tests is collected using special skin decontamination procedures?

    <p>Set of blood cultures</p> Signup and view all the answers

    What type of test is performed to determine the probability that a specific individual was the father of a particular child?

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

    Why would blood cultures be collected with an antimicrobial adsorbing resin?

    <p>The patient is taking a broad-spectrum antibiotic</p> Signup and view all the answers

    Which specimen tubes must contain a 9-to-1 ratio of blood to anticoagulant to be accepted for testing?

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

    What type of additive is best for collecting an ethanol specimen?

    <p>Sodium fluoride</p> Signup and view all the answers

    Which BC is inoculated first when the specimen has been collected by needle and syringe?

    <p>Anaerobic vial</p> Signup and view all the answers

    The most critical aspect of blood culture collection is:

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

    A site for blood culture collection can typically be cleaned with which of the following?

    <p>Chlorhexidine gluconate</p> Signup and view all the answers

    Which of the following additives is sometimes used to collect blood culture specimens?

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

    Which type of specimen may require collection of a discard tube before the test specimen is collected?

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

    This is an abbreviation for a test that evaluates platelet plug formation in the capillaries.

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

    Which test is used as a screening test for glucose metabolism problems?

    <p>2-hour PP</p> Signup and view all the answers

    Which of the following activities has no effect on glucose tolerance test (GTT) results?

    <p>Lying down during the test</p> Signup and view all the answers

    When does the timing of specimen collection begin during a GTT?

    <p>When the patient has finished the glucose beverage</p> Signup and view all the answers

    What should a phlebotomist do if they arrive to collect a 2-hour postprandial glucose specimen and discover that 2 hours have not elapsed since the patient's last meal?

    <p>Ask the patient's nurse to verify the correct collection time</p> Signup and view all the answers

    What action should the phlebotomist take if a patient undergoing a GTT vomits within 30 minutes of drinking the glucose beverage?

    <p>Notify the nurse or physician immediately to see if the test should be rescheduled</p> Signup and view all the answers

    Increased blood glucose is called?

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

    When does a blood glucose level in normal individuals typically peak after glucose ingestion?

    <p>In 30 minutes to 1 hour</p> Signup and view all the answers

    Which of the following must remain consistent throughout an oral glucose tolerance test (OGTT)?

    <p>Blood specimen source</p> Signup and view all the answers

    What does patient preparation before a GTT involve?

    <p>eating meals with a measured amount of carbohydrate days prior</p> Signup and view all the answers

    Which of the following can be used to clean a site before a blood alcohol specimen is collected?

    <p>Zephiran chloride</p> Signup and view all the answers

    Which of the following specimens may require chain-of-custody documentation when it is collected?

    <p>Drug screen</p> Signup and view all the answers

    The purpose of TDM is to?

    <p>determine and maintain a beneficial drug dosage</p> Signup and view all the answers

    Which of the following tests would not be subject to therapeutic drug monitoring?

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

    A peak drug level has been ordered for 0900 hours. What additional action does drawing the specimen minutes late necessitate?

    <p>Record the actual time of specimen collection</p> Signup and view all the answers

    A trough drug level is collected?

    <p>immediately before the next scheduled drug dose is given</p> Signup and view all the answers

    Which test requires the collection of multiple specimens?

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

    Timing of collection is most critical for drugs with short half-lives, such as?

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

    A bleeding time (BT) test assesses the functioning of which cellular elements?

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

    The most common reason for glucose monitoring through POCT is to?

    <p>monitor glucose levels for diabetic care</p> Signup and view all the answers

    Which one of the following tests could be collected using a tube other than a trace element-free tube?

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

    What is the definition of toxicology?

    <p>the scientific study of poisons</p> Signup and view all the answers

    Which test typically has the shortest TAT if performed by POCT?

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

    Which of the following is not a POCT analyzer?

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

    To prevent introducing a contaminating substance into a trace-element collection tube, it is suggested that you?

    <p>draw by itself using a syringe or evacuated tube system</p> Signup and view all the answers

    Which of the following is one of the most common bedside POCT tests?

    <p>Glucose testing</p> Signup and view all the answers

    Which of the following tests is used to monitor heparin therapy?

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

    Which of the following pieces of equipment can be eliminated from a list needed for a bleeding-time test?

    <p>Vinyl tourniquet</p> Signup and view all the answers

    At what intervals is the blood blotted during a bleeding-time test?

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

    In performing the bleeding-time test, a sphygmomanometer is inflated to?

    <p>40 mm Hg</p> Signup and view all the answers

    Of the following, which one is least likely to prolong a bleeding-time test?

    <p>Allowing the pressure on a BP cuff to drop</p> Signup and view all the answers

    This test can determine if an individual has developed antibodies to a particular antigen.

    <p>Skin test</p> Signup and view all the answers

    Ionized calcium plays a critical role in all of the following but one?

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

    Below-normal blood pH is referred to as?

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

    Which of the following is a protein that is specific to heart muscle?

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

    B-type natriuretic peptide is a cardiac?

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

    This is used to evaluate long-term effectiveness of diabetes therapy.

    <p>Hemoglobin A1c</p> Signup and view all the answers

    This test is also referred to as packed cell volume.

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

    This test detects occult blood.

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

    Which of the following is a skin test for tuberculosis exposure?

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

    The hormone detected in urine pregnancy testing is?

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

    Which point-of-care blood analyzer uses a microcuvette instead of a test strip?

    <p>HemoCue HB201+</p> Signup and view all the answers

    An uncorrected imbalance of which analyte in a patient can quickly lead to death?

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

    The POC instrument Verify Now does platelet testing to?

    <p>determine response to aspirin therapy</p> Signup and view all the answers

    How much diluted antigen is injected when a PPD test is performed?

    <p>0.1 mL</p> Signup and view all the answers

    Erythema means?

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

    In reading a patient's tuberculin (TB) test, there is an area of induration and erythema that measures 7 mm in diameter. The result of the test is?

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

    Point-of-care detection of group A strep normally requires a?

    <p>throat swab</p> Signup and view all the answers

    Which one of the following analytes is undetectable in urine when a urine dipstick is used?

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

    Which point-of-care test helps a physician detect low-grade inflammation even in asymptomatic individuals?

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

    Which of the following should be removed from a list of drugs of abuse?

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

    Study Notes

    Forensic Toxicology

    • Focuses on the legal implications of toxin exposure.

    TB Test Administration

    • Involves injecting antigen just beneath the skin for testing.

    Urine Drug Screen Requirements

    • Accurate documentation must be maintained during patient collection processes.

    Blood Culture Collection Order

    • Begin with selecting equipment, followed by performing friction scrub, cleansing bottle tops, and then venipuncture.

    Lactose Tolerance Test

    • False-positive results may occur in conditions excluding male multiple myeloma.

    Paternity Testing

    • If ABO grouping does not exclude a parent, a buccal sample for DNA may be necessary.

    Paternity Testing Orderers

    • A minor child is not permitted to order paternity testing.

    Blood Culture Disinfectant for Infants

    • Chlorhexidine gluconate is recommended for antisepsis.

    Autologous Donations

    • Unused units from autologous donations cannot be used by other patients.

    Blood Donor Additives and Bacterial Control

    • CPD additive in blood is unlikely to manage bacterial contamination.

    Transfusion Risks

    • Incompatible blood transfusions can lead to fatal RBC lysis in the vascular system.

    Cell-Salvaging Procedure

    • Evaluation of free hemoglobin is necessary before reinfusing the patient's salvaged blood.

    Blood Collection Principles

    • Collection bags do not contain EDTA and sodium fluoride additives.

    Coagulation Tests and POC Instruments

    • INR (International Normalized Ratio) and PTT (Partial Thromboplastin Time) can be monitored with point-of-care (POC) instruments.

    Lactose Digestion

    • Some individuals cannot digest lactose due to a lack of necessary mucosal enzymes.

    Monitoring Blood Gases

    • Blood gases can be measured using an AXOVimeter.

    DCA Vantage

    • Recognized as a reliable predictor for potential diabetic complications.

    Potassium Functions

    • Potassium is not significantly involved in hemoglobin transport.

    POC Glucose Analyzers

    • Approved devices share features ensuring reliability and specific purposes.

    Blood Culture Bottles and Antibiotics

    • ARD or FAN blood culture bottles effectively eliminate antibiotics present in collected samples.

    Septicemia

    • Defined as the presence of microorganisms in the bloodstream.

    Patient Identification in Blood Administration

    • Siemens Patient Identification Check system employs portable bar-code scanning for accurate patient identification.

    Blood Donation Eligibility

    • Requirements include being between 17–66 years old and weighing at least 110 pounds.

    Hemochromatosis

    • Involves withdrawing blood as a treatment method.

    Cross-match Specimen Collection

    • Cross-match specimens require particularly rigorous labeling and identification procedures.

    Drug of Abuse List

    • Phenobarbital should be excluded from the drugs of abuse list.

    Blood Donor Needle Size

    • Needles used for blood collection typically range from 16 to 18 gauge.

    Standard Blood Volume

    • A typical unit of blood donation is approximately 450 mL.

    Blood Cultures and FUO

    • Two blood cultures are collected in patients with fever of unknown origin (FUO) to check for septicemia.

    Use of Blood Bank Tubes

    • Large gel-barrier tubes should not be used for blood bank specimen collection.

    Blood Cultures and Skin Decontamination

    • Special procedures are necessary when collecting blood culture specimens.

    Paternity Testing Methodology

    • Conducted to determine the likelihood of an individual being the biological father.

    Antibiotic Presence and Blood Cultures

    • Collecting with antimicrobial-adsorbing resin helps when a patient is on broad-spectrum antibiotics.

    Coagulation Specimen Requirements

    • Coagulation tests necessitate a specific 9-to-1 blood to anticoagulant ratio.

    Ethanol Specimen Collection

    • Sodium fluoride is the ideal additive for ethanol specimen collection.

    Blood Culture Specimen Inoculation

    • The anaerobic vial should be inoculated first if collected via needle and syringe.

    Blood Culture Collection Integrity

    • Skin antisepsis is the most critical component during blood culture collection.

    Blood Culture Cleansing Agents

    • Chlorhexidine gluconate is commonly used for cleaning blood culture collection sites.

    Blood Culture Specimen Additives

    • Sodium Polyethanol Sulfonate (SPS) is an additive utilized in blood culture specimens.

    Coagulation Test Discard Tubes

    • A discard tube may need to be collected prior to coagulation testing.

    Bleeding Time (BT) Test

    • Assesses platelet plug formation in capillaries, crucial for clotting evaluation.

    Glucose Tolerance Test (GTT) Timing

    • Begins post-consumption of glucose beverage.

    GTT Patient Preparation

    • Requires prior meals consisting of measured carbohydrates for effective testing.

    Blood Alcohol Specimen Cleansing

    • Zephiran chloride can be used for cleaning prior to blood alcohol specimen collection.

    Chain-of-Custody for Drug Screens

    • Drug screen specimens often require detailed chain-of-custody documentation.

    Therapeutic Drug Monitoring (TDM)

    • Aims to maintain appropriate and beneficial drug dosage levels.

    Peak Drug Level Collection Timing

    • Must be recorded accurately even if collected slightly late.

    Trough Drug Level Collection

    • Taken right before the next prescribed dose of medication.

    Oral Glucose Tolerance Test (OGTT)

    • Typically requires multiple specimens across a set period.

    Bleeding Time Test Equipment

    • Vinyl tourniquet is not necessary for conducting a bleeding time test.

    Blood Pressure during Bleeding Time Test

    • A sphygmomanometer should be inflated to 40 mm Hg during testing.

    Antibody Detection

    • Skin tests can confirm antibody development against specific antigens.

    Blood pH Levels

    • Below-normal blood pH indicates acidosis.

    Cardiac-Specific Proteins

    • Troponin T is a protein specifically indicative of heart muscle injury.

    B-type Natriuretic Peptide (BNP)

    • Functions as a cardiac hormone, related to heart failure evaluation.

    Hemoglobin A1c Testing

    • Evaluates long-term effectiveness in diabetes management therapies.

    Packed Cell Volume (HCT)

    • Also known as hematocrit.

    Occult Blood Detection

    • Guaiac is a test used to detect hidden blood.

    Tuberculosis Skin Test

    • PPD (Purified Protein Derivative) is utilized to assess TB exposure.

    hCG in Pregnancy Tests

    • Human chorionic gonadotropin is the hormone detected in urine pregnancy testing.

    Microcuvette Usage in POC Testing

    • HemoCue HB201+ employs a microcuvette rather than a traditional test strip.

    Potassium Imbalance Risks

    • Unmonitored potassium levels can pose immediate health risks.

    Verify Now POC Instrument

    • Used for platelet testing, specifically to assess patient response to aspirin therapy.

    PPD Injection Volume

    • For PPD testing, 0.1 mL of diluted antigen is administered.

    Erythema Definition

    • Erythema refers to skin redness that often indicates inflammation.

    TB Test Results Interpretation

    • An area of induration measuring 7 mm is considered a doubtful result.

    Group A Strep Detection Method

    • Requires a throat swab for effective testing.

    Urine Dipstick Limitations

    • Thrombin cannot be detected using standard urine dipstick tests.

    Low-Grade Inflammation Detection

    • CRP (C-reactive protein) testing helps identify low-grade inflammation even when symptoms are absent.

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    Test your knowledge with these flashcards from Chapter 11 of Phlebotomy. This chapter covers key concepts like forensic toxicology, TB test administration, and urine drug screen requirements. Perfect for students preparing for their exams!

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