Quiz 46: Assisting in Blood Collection

Which of the following Vacutainer tubes is routinely used for hematology testing? A) Lavender topped B) Red topped C) Green topped D) Light blue topped

No anticoagulants are found in which of the following tubes? A) Lavender topped B) Red topped C) Green topped D) Yellow topped

Which type of tube should be used to collect blood specimens during a glucose tolerance test? A) Lavender topped B) Red topped C) Gray topped D) Yellow topped

_______________________________ is an anticoagulant that prevents platelets from clumping and preserves the appearance of blood cells for microscopic preparation. A) Thrombin B) Sodium heparin C) Ethylenediamine tetraacetic acid (EDTA) D) Sodium polyanetholsulfonate

The slant at the open end of a needle used for venipuncture is called the A) lumen. B) bevel. C) shaft. D) bore.

The needle size most commonly used for adult venipuncture is _____ gauge. A) 18 B) 10 C) 12 D) 21

The needle size most commonly used by the blood bank for donations is _____ gauge. A) 16 B) 10 C) 35 D) 21

The needle size most commonly used in infants and the elderly is _____ gauge. A) 16 B) 23 C) 35 D) 21

Plasma could be retrieved from a A) lavender tube. B) SST red-gray tube. C) PST green-gray tube. D) B and C. E) All of the above

A tourniquet is used during the phlebotomy procedure to A) collapse the artery. B) prevent venous flow out of the site. C) cause the vein to bulge. D) B and C. E) All of the above

A tourniquet should remain tied on a patient's arm no longer than A) 3 minutes. B) 2 minutes. C) 5 minutes. D) 1 minute. E) necessary.

Without a clot activator, whole blood typically clots in _________ minutes. A) 1 to 2 B) 60 to 90 C) 30 to 60 D) 5 to 10

The ____________ is the part of the venipuncture needle that fits into the syringe or Vacutainer adapter. A) shaft B) bevel C) hub D) retractable sheath

The laboratory requisition indicates that you are to collect a venous blood specimen for hematology testing, serum chemistry testing, and coagulation studies. What is the proper order of collection for these tubes? A) Red, light blue, lavender B) Yellow, red, light blue C) Light blue, red, lavender D) Two lavender, one red

You are required to collect a venous sample for a typical hematology test, the complete blood count. You collect A) red-topped and lavender-topped tubes. B) yellow-topped, red-topped, light blue-topped, green-topped, and lavender-topped tubes. C) a lavender-topped tube. D) a red-topped tube.

A syringe is preferred over a Vacutainer collection device when A) the patient's veins are fragile. B) the sample must be drawn from the hand veins. C) many tests have been ordered, and multiple tubes must be drawn. D) All of the above

Leaving a tourniquet tied on a patient's arm for longer than the recommended time results in A) syncope. B) hemoconcentration. C) hematoma formation. D) bifurcation.

Before a routine venipuncture or capillary puncture, the site typically is cleaned with A) isopropyl alcohol. B) ethyl alcohol. C) povidone-iodine solution. D) soap and water.

In a routine venipuncture, the angle at which the needle enters the arm should be _____ degrees. A) 80 to 90 B) 30 C) 15 D) 0 to 5

During a routine venipuncture, when should the phlebotomist request that the patient "make a fist"? A) After applying the tourniquet and before inserting the needle B) After the last tube has been drawn C) After the procedure is finished and the gauze has been applied so that bleeding stops D) Only if a tourniquet is not used

During a routine venipuncture, when should the phlebotomist request that the patient "release the fist"? A) When the procedure is finished, after the tourniquet has been removed B) When the last tube has been filled, before the tourniquet is removed C) When blood enters the first tube being drawn D) When the procedure is finished and the bleeding has stopped

A winged infusion set is also known as a A) Hemagard tube. B) Velcro tourniquet. C) butterfly needle. D) luer adapter.

A needle stick is more likely to occur if A) an attempt is made to recap a needle. B) a needle of inappropriate gauge is used. C) a Vacutainer set is used to obtain a specimen. D) needles are immediately retracted into a safety device after use. E) All of the above

Why should a tourniquet not be tied too tightly? A) It impedes arterial blood flow. B) It restricts venous blood return. C) It results in poor venous distention. D) All of the above are correct.

A hematoma can be caused by A) excessive probing to locate a vein. B) failure to insert the needle far enough into the vein. C) penetration of the needle through a vein. D) All of the above

Blood obtained via capillary puncture can be collected A) in Microtainer tubes. B) in capillary tubes. C) in microhematocrit tubes. D) onto filter paper. E) All of the above

The device used for dermal puncture is a(n) A) Unopette. B) lancet. C) butterfly. D) Vacutainer.

The most common phlebotomy site(s) in adults is (are) the A) radial vein. B) brachial artery. C) veins in the antecubital space. D) veins in the popliteal area.

The proper procedure for collecting a serum specimen is to A) use a green-topped tube. B) allow the specimen to clot. C) use a microhematocrit tube. D) use a red or marbled-top tube. E) B and D.

Which is the most correct method for performing a capillary puncture? A) Squeeze the finger to get an adequate blood sample. B) Use the anterior surface of the finger. C) Wipe away the first drop of blood and then collect the sample. D) Cleanse the finger with an alcohol antiseptic and immediately perform the finger puncture.

You are performing a capillary puncture on a patient and are having difficulty collecting an adequate sample. Which of the following is an accepted method to encourage blood flow from the site? A) Squeeze the finger. B) Wrap the finger in a cool towel. C) Make a second puncture mark close to the first. D) Gently rub the finger along the sides.

The clear part of whole blood that contains clotting agents is A) plasma. B) blood cells. C) serum. D) hemoglobin. E) B and D.

Which is the proper technique for performing a venipuncture? A) The needle bevel is face up, and the needle is inserted at a 15-degree angle. B) The needle bevel is face down, and the needle is inserted at a 15- to 30-degree angle. C) The needle bevel can be oriented in either direction, but the needle must be inserted at a low angle. D) The needle bevel is face up, and the needle is inserted at a 20- to 30-degree angle.

The color of the tube top for collection of a coagulation test is A) green. B) light blue. C) gray. D) lavender.

Phlebotomy certifying agencies include which of the following? A) ASCP B) IAPS C) NCA and NPA D) All of the above

Which of the following PPE is required by OSHA for healthcare workers to wear during venipuncture? A) Gloves B) Mask C) Gown D) All of the above

When a blood culture is ordered, which of the following is used at the venipuncture site to eliminate contaminating bacteria? A) 70% isopropyl alcohol B) Benzalkonium chloride C) Povidone-iodine D) Sterile soap pads E) All of the above

Which of the following collection tubes contains thixotropic gel? A) Lavender B) Red C) Green-gray D) Light green E) Both C and D

If samples for more than one tube must be drawn during a venipuncture, which order is adherent to CLSI standards? A) Red, lavender, then light blue B) Yellow, red, then green C) Gray, red, then lavender D) Light blue, green, then red

Which needle gauge is used for routine adult venipuncture? A) 16-gauge needle B) 23-gauge needle C) 20- to 21-gauge needle D) 30-gauge needle

Which of the following are designed for use on small veins? A) Butterfly needles B) Syringes C) Multisample needles D) Needle holders

Which of the following needle safety devices has a spring-activated shield attached to a disposable syringe needle? A) One-handed Vacutainer needle B) Butterfly needle safety lock C) Syringe needle safety device D) Push button butterfly safety device E) Needle blunting butterfly set

What is the first step OSHA recommends for the effective management of an accidental sharps exposure? A) Injury reported to the supervisor B) Site is washed for 10 minutes with antimicrobial soap C) Referred to a physician for confidential assessment and follow-up D) Incident report is completed

A tourniquet can remain in place for 2 minutes. After its removal, you must wait 5 minutes before reapplying it. A) Both statements are true. B) Both statements are false. C) The first statement is true; the second is false. D) The first statement is false; the second is true.

Light blue tubes for coagulation studies should be inverted how many times following removal and prior to placing them in the rack? A) Two times B) Three or four times C) Five times D) Eight to ten times

What is the most common cause of hematoma formation during a blood draw? A) Excessive probing with the needle to locate a vein B) Failure to remove the tourniquet before removing the needle C) Failure to withdraw the vacuum tube before the needle is withdrawn D) Elbow is bent while pressure is applied

What is the major cause of specimen rejection? A) Insufficient quantity B) Incorrect tube used for the test ordered C) Hemolysis D) Improper handling E) Defective tube

Which of the following collection containers is used to test neonates for certain metabolic disorders? A) Reagent strip B) Capillary tubes C) Microcontainers D) Guthrie card

In adults and children, which finger is usually used for a routine capillary puncture site? A) Thumb B) Index finger C) Ring finger D) Fifth finger

__________ is the liquid portion of the blood that contains clotting agents.

The typical site for a capillary puncture in an adult is the __________ finger.

The typical site for a capillary puncture on an infant is the medial or lateral side of the __________.

_______________ are used for small veins, such as those in the hand or in a pediatric patient.

A(n) ____________ is a special laboratory filter paper that is used to collect a blood sample from newborns.

Leaving a tourniquet on longer than 1 minute greatly increases the chance of _________________.

A(n) ___________ is applied to the skin 30 to 60 seconds before the blood draw to prevent infection at the puncture site.

The liquid portion of blood that remains after the blood has clotted in a collection tube is the __________.

Using a collection needle with a wider lumen reduces the chance that __________ will occur.

Securing a patient in a blood collection chair helps prevent injuries if the patient experiences ____________.

Describe the steps medical assistants must take to protect themselves and co-workers against needle-stick injuries.

Describe the postexposure management of a needle stick.

List the information required on the laboratory requisition.

The physician has ordered a number of laboratory tests for a patient, and you must make sure you are obtaining the blood samples in the correct order. Summarize the proper order of draw for a multitube procedure.

The Vacutainer tube with a marbled red-gray top contains silica particles to enhance clotting and a thixotropic gel to assist in the separation of serum and blood cells.

With regard to venipuncture needles, the smaller the gauge number, the larger the lumen of the needle.

The smaller the gauge of the venipuncture needle, the less likely it is that hemolysis of blood cells will occur.

The NCCLS has recommended that a red-topped "waste" tube be drawn before a light blue-topped Vacutainer tube, because thromboplastin released from cells during the venipuncture can interfere with coagulation tests.

A tourniquet should never be used when a venous blood sample is to be drawn from the hand.

A patient must give verbal consent before venipuncture can be performed.

Capillary blood is a mixture of arterial blood and venous blood.

When the needle is inserted into the vein during a routine venipuncture, the bevel of the needle should be facing up.

When a medical assistant obtains a capillary blood sample, it is important that he or she squeeze and "milk" the finger to obtain an adequate amount of blood.

According to the American Society of Clinical Pathologists, nearly 80% of physicians' decisions are based on laboratory test results.

The tourniquet should be left tied on the arm no longer than 1 minute.

If a patient faints while his or her blood is being drawn, the patient must remain in the facility for at least 15 minutes and should not operate a vehicle for at least 30 minutes.

Needles used during venipuncture may be used only once.

It is important to shake a Vacutainer tube after collecting a blood sample so that the sample and additive are properly mixed.

If a hematoma forms while you are performing a blood draw, you should move the needle around until you have re-entered the vein.

If you are drawing blood on an elderly patient with a history of collapsed veins, you should try to collect the blood sample with a syringe.

Under OSHA guidelines, needle holders for Vacutainers can be reused for multiple patients, because they are not contaminated during the blood draw.

You notice that a patient is developing petechiae during a blood draw. This typically means that the patient has a bleeding disorder.

If a patient has had a mastectomy on the left side, you should never draw blood on that side.

If the patient complains of tingling or numbness during a phlebotomy procedure, the medical assistant should continue the procedure to get it completed as soon as possible.

If blood is flowing into the Vacutainer too slowly, you should withdraw the needle slightly to center it in the vein.

All Vacutainer tubes should be inverted three to five times to mix the blood sample with the tube additive.

With phlebotomy on teenage patients, it is important to make sure a parent is present during the blood draw to give permission for the procedure.