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NHA Phlebotomy Certification Exam/ 218
Q&A/ A+ Score Solutions
- A phlebotomist has a requisition to draw blood on a patient with severe Down's syndrome. What steps would you take? - Answer: a. Speak with the patient guardian before performing venipuncture to ensure the patient understands
- A 69-year-old unconscious patient is brought ot the ER. Several blood tests are ordered. The phlebotomist collects blood under - Answer: a. Implied consent
- Which of the following actions is appropriate when labeling specimens? - Answer: a. Label specimens at the time of collection in front of the patient
- Before collecting blood on an inpatient, the phlebotomist notices there's no wristband on wrist. There is one on the IV pole. What do you do? - Answer: a. Don't draw until nurse puts an armband on patient
- Which is appropriate form of identification in inpatient setting? - Answer: a. Verbal and wrist band
- WBC, RBC, Electrolytes are ordered. Which tubes are used for capillary? - Answer: a. Lavender and red
- A blood specimen is rejected by lab with QNS as the reason? Why? - Answer: a. The specimen was insufficient-not enough blood
- Which of the following is best method to prevent internal or external bleeding from venipuncture site after needle is removed? - Answer: a. Apply pressure to prevent leakage of blood into the tissues
- What temperature should a semen sample be transported? - Answer: 36-38 degrees C
- Which of the following would result in a grossly hemolyzed specimen? a. Incorrect order of draw b. Incorrect needle gauge c. Applying tourniquet too close to the draw site d. Failure to invert tube - Answer: b. Incorrect needle gauge
- Which of the following is proper procedure after collecting ammonia specimen? a. Protect from light b. Keep specimen warm c. Keep specimen at body temp d. Place specimen in ice water slurry (or a cup of ice) - Answer: d. Place specimen in ice water slurry (or a cup of ice)
- The order of draw for capillary collections is different than venipuncture because - Answer: a. Increased risk of coagulation (remember platelets start to form)
- Upon entering a patient's room for routine blood draw, phlebotomist notices clergy member is with the patient. What should you do? - Answer: a. Return later after drawing other patients
- A phlebotomist notices a hematoma developing at the site of venipuncture. The phlebotomist should - Answer: a. Release the tourniquet and stop the draw
- Know ORDER of DRAW!! - Answer:
- A phlebotomist working in an infertility clinic and the patient is to submit a semen specimen. The phlebotomist would tell the patient: - Answer: a. As soon as you collect the specimen, keep it next to your body and bring it in right away. (the reason is it needs to stay at body temp and delivered in lab within 2 hours)
- After placing tourniquet on a patient’s arm, the phlebotomist notices small red spots below the tourniquet. - Answer: a. Petechiae
- The phlebotomist should examine the antecubital veins of both arms because: - Answer: a. The median cubital might be more accessible on one side than the other
- What is the appropriate cleanser to clean the meatus for a clean catch urine specimen? - Answer: a. Benzalkonium chloride
- When should the code on glucose cuvettes or strips be compared to the code on the glucose meter? - Answer: a. When the patient is tested
- Which of the following is appropriate to use when collecting for a chemistry test that requires serum? - Answer: a. SST (this is the red gel tube)
- A patient state she is a difficult draw and requests a skin puncture. The test is a PTT. Which should you do? - Answer: a. Use a syringe and transfer to a light blue tube
- Industry standard states needle insertion in the antecubital area should be: - Answer: a. 15- 30 degree angle
- Tubes with which additive should be used for CBC? - Answer: a. EDTA (purple tube)
- When preparing for transport, which specimen must be placed on ice within 30 minutes after collection? - Answer: a. Arterial Blood Gases
- Which provides the phlebotomist the best protection when drawing blood from a patient with active TB? - Answer: a. N-95 respirator mask
- During a draw, the patient becomes unresponsive. What should you do? - Answer: a. Check for breathing
- Why should a phlebotomist avoid drawing blood from a leg or foot of a diabetic patient? - Answer: a. These areas are more susceptible to infection
- Why is it important to place a specimen in a biohazard specimen bag outside the laboratory? - Answer: a. The biohazard bag prevents a possible exposure incident
- As a student. Proper introduction - Answer: a. Hi, my name is Sally Smith. I am a student phlebotomist and I'm here to collect blood specimen
- The phlebotomist draws a CBC at 1800. Lab closed at 1730 and will not process until 500. What temp should the CBC be stored - Answer: a. 2-10 degrees C (EDTA tubes may be processed at 12 hours if refrigerated)
- What test results can be affected if iodine is used to clean the site? - Answer: a. Potassium
- According to CLSI, what is collected first? - Answer: a. Blood cultures
- KNOW ORDER OF DRAW - Answer:
- KNOW ADDITIVES - Answer:
- KNOW ORDER OF VENIPUNTURE PROCEDURE - Answer:
- A physician ordered a Tobramycin level to be drawn one hour after dose. The Tobramycin has been ordered for 11am. What should you do - Answer: a. Check with the nurse to make sure meds were given (or not given)
- phlebotomist notices red spots. What is appropriate action? - Answer: a. Apply pressure after collecting During the draw, the the sample
- What is a potential consequence of mislabeling a blood bank specimen? - Answer: a. A Transfusion reaction
- When should a phlebotomist perform external liquid controls for quality control on CLIA waived point of care test? - Answer: a. When a new lot number or kit is opened
- A 3.3 kg infant has a total blood volume of 240-330ml - Answer:
- Cleanse in an outward spiral - Answer:
- What would you use for a hand draw? - Answer: a. Butterfly or winged infusion set
- Invert anticoagulant tubes to :prevent coagulation - Answer: Name the 3 types of blood samples - Answer: whole blood/ plasma/ serum What two States require licensure - Answer: Louisiana & California When the Phlebotomist collects blood, in which of the patient's zones of interpersonal space is he/she operating? - Answer: The patient's Intimate Zone or Space Define Phlebotomy - Answer: An incision into the vein What is the meaning of these acronyms: ASPT, ASCP, and NHA? - Answer: ASPT = American Society of Phlebotomy Technicians ASCP = American Society for Clinical Pathology NHA = National Healthcareer Association Define Reference Laboratory: - Answer: A reference laboratory is one that specializes in one test or one group of tests, or where more unusual or obscure tests are performed. . Number the following items to reflect the correct blood flow through the heart and lungs: 1_ Vena Cave (superior/inferior) 7_ Lungs 5_ Pulmonary Valve 6_ Pulmonary Artery 13_ Aorta 9_ Left Atrium
What is Assault? - Answer: The threat of touching another person without his or her consent and with the intention of causing fear of harm What is Battery? - Answer: Actual harmful touching of another person without his or her consent. What is Libel? - Answer: False defamatory writing that is published. What is a Sentinel Event? - Answer: An unanticipated death or permanent loss of function not related to a patient's illness or underlying condition.
. What does PPE stand for? - Answer: Personal Protective Equipment . How full should you fill the Sharps Container before using a new container? - Answer: ¾ full . What is the name of the multi-purpose fire extinguisher? - Answer: ABC To what does the term "aseptic techniques" refer? - Answer: Techniques that provide a degree of cleanliness that prevents infection and keeps the phlebotomy environment free of contamination by microorganisms. . A nosocomial infection is: a. Something acquired by healthcare workers. b. Something acquired by visitors to a hospital. c. Something acquired by patients. d. A Hospital Acquired Infection. e. Caused by antibiotic resistant bacteria. f. Both c and d.
g. Both a and c. - Answer: f. Both c and d. c. Something acquired by patients. d. A Hospital Acquired Infection When is hand hygiene performed? a. When gloves are visibly soiled. b. Before putting on gloves c. After removing gloves d. All of the above e. Both a and b - Answer: d. All of the above a. When gloves are visibly soiled. b. Before putting on gloves c. After removing gloves Before entering an isolation room, what is the first thing the phlebotomist should do? a. Wash hands b. Put on a gown, mask and gloves c. Read the posted instructions d. Obtain permission - Answer: c. Read the posted instructions What does the acronym PASS describe and stand for? - Answer: It describes the use of a fire extinguisher and stands for: Pull pin, Aim nozzle, Squeeze handle, Sweep from side to side. What does the acronym RACE stand for? - Answer: It stands for what a healthcare worker should do if a fire or explosion occurs in the workplace: Rescue, Alarm, Contain, Exit
. Before placing a call on hold, a phlebotomist should: a. record the caller's name.
Specimens collected in serum separator tubes are most frequently delivered to: a. blood bank. b. serology. c. hematology. d. chemistry - Answer: d. chemistry. To prevent blood from clotting the specimen must be: d. both A and B c. centrifuged right after collection. d. both A and B - Answer: d. both A and B d. both A and B Which of the following pairings is wrong? a. icteric and yellow. b. lipemic and cloudy. c. hemolyzed and red. - Answer: d. fasting and cloudy. The main anticoagulant for coagulation studies is: a. ethylenediaminetetraacetic acid (EDTA). b. sodium citrate. c. heparin. d. oxalate. - Answer: b. sodium citrate.
. ABO and Rh typing are performed in which laboratory section? a. Hematology b. Blood bank c. Chemistry
d. Cytology - Answer: b. Blood bank The activated partial thromboplastin time (APTT) or partial thromboplastin time (PTT) test is performed in: a. coagulation. b. chemistry. c. urinalysis. d. histology. - Answer: a. coagulation.
. Which test would a physician order on a patient with a suspected infection? a. Glucose b. Complete blood count (CBC) c. Cholesterol d. Antinuclear antibody (ANA) - Answer: b. Complete blood count (CBC) An anemia would be detected by a: a. glucose test. b. blood culture. c. urinalysis. d. complete blood count. - Answer: d. complete blood count. . An agency that assures quality care by hospitals is the: a. Joint Commission. b. Centers for Disease Control and Prevention. c. Occupational Safety and Health Administration. d. College of American Pathologists. - Answer: a. Joint Commission. . The most serious error a phlebotomist can make is: a. causing a hematoma.
An infection contracted by a patient while in the hospital is termed: a. antibiotic-resistant. b. staphylococcal. c. nosocomial. d. unfortunate - Answer: c. nosocomial. The recommended disinfectant for blood and body fluid contamination is: a. sodium hydroxide. b. antimicrobial soap. c. hydrogen peroxide. d. sodium hypochlorite. - Answer: d. sodium hypochlorite.
. The term universal precautions refers to: a. universal blood donors. b. mixing organic chemicals under a hood. c. wellness clinics available to everyone. d. treating all specimens as infectious. - Answer: d. treating all specimens as infectious. In addition to changing gloves between every patient, phlebotomists should also: a. change their lab coats. b. disinfect the phlebotomy tray. c. double-bag the specimens. d. wash their hands. - Answer: d. wash their hands. To comply with the current Bloodborne Pathogens Standard, phlebotomists must: a. discard sharps only into containers attached to the wall. b. activate the needle protection device before removing the needle from the adapter. c. decontaminate needle adapters between each patient.
d. activate the needle protective device and discard the needle and the adapter. - Answer: d. activate the needle protective device and discard the needle and the adapter. The code word PASS refers to: a. storage of volatile chemicals. b. operation of a fire extinguisher. c. labeling of hazardous material. d. the presence of radioactive material - Answer: b. operation of a fire extinguisher. Alcohol-based hand sanitizers may be used as a substitute for handwashing: a. only in a blood donation center. b. only in certain patient care areas such as oncology or obstetrics and gynecology. c. at any time. d. when the hands are not visibly contaminated with blood or other body fluid. - Answer: d. when the hands are not visibly contaminated with blood or other body fluid The prefix that means decreased is: a. hypo- b. hyper- c. hetero- d. haplo- - Answer: a. hypo- Which of the following abbreviations on a patient's chart, test requisition, or bedside notice would be most important if a patient asked a phlebotomist for a drink of water? a. TPR b. PRN c. OP d. NPO - Answer: d. NPO
. The primary role of the thrombocyte is to: a. transport nutrients. b. promote blood clotting. c. phagocytize bacteria. d. produce antibodies. - Answer: b. promote blood clotting. . Functions of the blood include all of the following except: a. transport oxygen. b. regulate pulse rate. c. deliver nutrients. d. transport waste products. - Answer: b. regulate pulse rate. The fluid that comprises approximately 55% of the total blood volume is made up of: a. hematocrit. b. plasma. c. tissue fluid. d. serum. - Answer: b. plasma. The primary antiseptic for routine venipuncture is: a. iodine. b. chlorhexidine. c. isopropyl alcohol. d. Betadine. - Answer: c. isopropyl alcohol. A properly tied tourniquet: a. permits arterial flow and blocks venous flow. b. blocks arterial and venous flow. c. prevents backflow.
d. permits venous flow and blocks arterial flow. - Answer: a. permits arterial flow and blocks venous flow. The color coding of evacuated tubes provides information about all of the following except the: a. volume of specimen collected. b. type of specimen collected. c. need to invert the tube. d. presence of an anticoagulant. - Answer: c. need to invert the tube.
. Which of the following tubes must always be completely filled? a. Gray b. Light blue c. Red d. Pink - Answer: b. Light blue The ratio of blood to anticoagulant in a light blue stopper tube is: a. 2:l b. 5:l c. 9:l d. 10:1 - Answer: c. 9:l Most anticoagulants in blood collection tubes prevent clotting by: a. binding calcium. b. acting as an antithrombin agent. c. binding fibrinogen. d. releasing heparin. - Answer: a. binding calcium. Which of the following is the most acceptable order of tube draw? a. Yellow, red glass, and light blue
