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Various phlebotomy procedures and best practices, including proper venipuncture techniques, blood collection methods, patient identification, safety protocols, and common issues that may arise during blood draws. It provides detailed guidance for phlebotomists on how to perform their duties effectively and safely, while ensuring the integrity of collected specimens. The document addresses key topics such as the order of draw, use of antiseptics, handling of blood cultures, capillary blood collection, and managing adverse patient reactions. It also discusses important considerations around iatrogenic anemia, blood donation, and infection control measures. Overall, this comprehensive resource aims to equip phlebotomists with the knowledge and skills necessary to deliver high-quality patient care and maintain the highest standards of practice in the field of phlebotomy.
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Release the tourniquet and stop the draw - Answer: A phlebotomist observes a hematoma developing at the site of a venous blood draw. The phlebotomist should?? When a patient is tested - Answer: When should the code on glucose cuvettes or strips be compared to the code on the glucose meter? Ask the patient when she last ate or drank - Answer: The phlebotomist needs to draw a glucose tolerance test (GTT) on a patient and notices an empty breakfast plate on the bedside table. Which of the following actions should the phlebotomist take? EDTA - Answer: Tubes with what additive should be used when collecting a sample for CBC Arterial blood gases - Answer: When preparing for transport, what specimens must be placed into an ice bath within 30 minutes after collection?
An incorrect needle gauge - Answer: Which of the following actions would result in a grossly hemolyzed specimen? An incorrect order of draw applying the tourniquet too close to the draw site failure to invert the tube an incorrect needle gauge Below the IV - Answer: The phlebotomist must perform a blood draw on a patient with an IV on the right side, and there has been a mastectomy on the left side. Where should the phlebotomist perform the venipuncture? Don't draw until the nurse has attached a wristband to the patient - Answer: Before collecting blood on an inpatient, the phlebotomist notices that the patient does not have a wristband on his wrist, but there is one attached to the patient's IV stand. Which of the following is the proper action? A phlebotomist must choose the right tube color and additive for the corresponding _______? - Answer: Laboratory test When a new lot # or kit is opened - Answer: When should a phlebotomist perform external liquid controls for quality control on a CLIA-waived point of care test? 1 to 2 minutes - Answer: A phlebotomist is drawing 5 blood collection tubes. When should the tourniquet be released? Providone Iodine" - Answer: What agent should a phlebotomist cleanse the skin with before drawing blood cultures?
O2 levels DNA Screening card The biohazard bag prevents a possible exposure incident - Answer: Why is it important to place a specimen in a biohazard specimen bag when transporting to an outside laboratory? 15 to 30 degree angle - Answer: Industry standard states that needle insertion in the antecubital area should be at?? Dorsal veins - Answer: Some older adults or obese patients may not have accessible antecubital veins. In this situation, the phlebotomist may use which of the following? Initial and mark date/time on each tube - Answer: Before leaving the patient's room, which of the following actions is required for the phlebotomist to take? Check for breathing - Answer: During a draw, the patient becomes unresponsive What is the next action the phlebotomist should take? Inspect the integrity of the needle's seal - Answer: What action should a phlebotomist take to verify the quality of veinpuncture supplies before beginning a blood draw on an adult patient? Engage the needle safety device - Answer: Which of the following is the next step after removing the needle from the patient's arm? Ask the patient to open his fist remove the tourniquet engage the needle safety device invert all tubes
To determine if the patient is at risk for developing iatrogenic anemia - Answer: Why should the phlebotomist document the total volume of blood drawn from a patient? Wear gloves when contact with blood is anticipated - Answer: Phlebotomists should comply with which of the following OSHA requirements specific to the venipuncture procedure? Wear gloves when contact with blood is anticipated wear safety glasses if spashes, spray, splatter or droplets of blood may be generated Recap contaminated venipuncture devices to reduce exposure incidents Green, lavender, gray (G,P,G) - Answer: Which of the following indicates the correct order of draw? Lavender, green, gray Gray, green, lavender Green, gray, lavender Green, lavender, gray Inform the patient to contact the ordering physician to get the results - Answer: A patient comes in to find out his test results. The phlebotomist notices the results are ready and verifies the patient's identity. Which of the following action is most appropriate? 2-10 degrees C - Answer: The phlebotomist draws a CBC at the physician's office at 1800. The laboratory closed at 1730 and will not process specimens again until 0500. Which of the following is the proper temperature for preserving the specimen?
Perform the venipuncture - Answer: Before a phlebotomist performs a venipuncture, the patient warns that he is HIV positive. According to OSHA regulations, after donning gloves, the phlebotomist should? The incorrect data may be reported to the healthcare provider - Answer: Which of the following outcomes is the most damaging if data is entered incorrectly into the automated laboratory information system? Implied consent - Answer: A phlebotomist is preparing to draw blood from a patient in the hospital. The patient extends his arm and turns his head away. What type of consent does this indicate? The lab rejects the mislabeled specimen - Answer: A physician orders a STAT specimen but the phlebotomist forgets to fill out the patient ID number. What is the appropriate procedure for an improper labeled specimen once the outside lab receives it? Send the results to the physician in a marked envelope - Answer: What is an example of the acceptable reporting of routine lab results? The median cubital vein could be more accessible on one side then the other - Answer: The phlebotomist should examine the antecubital veins of both arms for which of the following reasons? Shock - Answer: For which of the following does emergency first-aid treatment include maintaining an open airway, controlling bleeding, and keeping the victim warm until help arrives? Either heel - Answer: The phlebotomist has a request to collect a routine CBC From a healthy 10 month old infant. Which of the following is the most appropriate collection site?
36-38 degree C - Answer: At what temp should a semen sample be transported by the phlebotomist? Flush the injured area with running water (said "soap & water" on prior exams) - Answer: During venipunture the phlebotomist is stuck with a used needle. What is the first action the phlebotomist should take? Petechiae - Answer: After placing the tourniquet on the patient's arm, the phlebotomist notices small red spots below the tourniquet. Which of the following is the correct term for these spots? Patient's information - Answer: A phlebotomist should comply with HIPAA to protect which of the following? For no longer than 60 seconds - Answer: How long should a tourniquet be left on a patient's arm? Release the tourniquet and remove the needle. - Answer: During a venipuncture, the patient reports a sharp pain radiating down his arm. What action should the phlebotomist take? These areas are more prone to infection - Answer: Why should a phlebotomist avoid drawing blood from the leg or foot of a diabetic? Complete medical history - Answer: a phlebotomist is required to obtain which of the following from a potential blood donor? Clotting (coagulation) - Answer: A phlebotomist must invert anticoagulant tubes to prevent which of the following?
Report the results to the patient's physician - Answer: A phlebotomist performs a point-of-care glucose test on an outpatient. The results are in the critical value range. What is the appropriate action? Return after drawing other patients - Answer: Upon entering a patient's room, a phlebotomist notices a clergy member is with the patient. The phlebotomist should.... Describe the procedure - Answer: A patient states that this is his first blood draw. Which of the following actions is appropriate? Lavender top - Answer: Which of the following tubes should be collected first for dermal samples? Shut off power to the instrument - Answer: A phlebotomist sees a coworker receive a major electrical shock from an instrument. What is the first thing the phlebotomist should do? Assess the site, cleanse the site, insert the needle - Answer: Which of the following venipuncture steps are in the appropriate order? Insert the needle, place the tourniquet, label the tube Assess the site, cleanse the site, insert the needle Identify the patient, cleans the site, assess the site the site is cleaned more stringently - Answer: performing a venipuncture for blood cultures differs from other venipuncture procedures in that... Iatrogenic anemia - Answer: A phlebotomist collects multiple specimens on a premature infant. What is a possible result (complication) of the procedure?
Accession number - Answer: Which of the following identifies a specimen as long as it remains in the laboratory? ICD-10 code accession number CPT code medical record number Presurgical - Answer: When a phlebotomist is distributing lab results to ordering physicians, which results have priority? lead basal metabolic panel presurgical ferritin Speak with the patient's guardian before performing the blood draw to ensure the explanation is understood. - Answer: A phlebotomist has a requisition to draw blood on a patient who has severe Down syndrome. Which of the following steps should he take? Explain the procedure to the patient in simple terms, then proceed with the venipuncture. Speak with the patient's guardian before performing the blood draw to ensure the explanation is understood. Draw the patient's blood without trying to explain the procedure. Check with the nurse (you need to know the actual time the patient took the medication) - Answer: A physician ordered a Tobramycin level to be drawn one hour after dose. The
Cleanse the site in an outward spiral Cleanse the site in an overlapping circle Cleanse the site in an inward spiral Place the specimen tube in an ice water slurry - Answer: Which of the following is the proper procedure after collecting an ammonia specimen? Protect the specimen tube from light Keep the specimen tube warm Keep the specimen at body temp Place the specimen in an ice water slurry Position the needle in the same direction as the vein and at a 30 degree angle with the bevel up
Place a 1-mm drop of blood a half-inch from the edge of the slide - Answer: Which of the following actions is appropriate for preparing a peripheral blood smear? Place a drop of blood the size of a dime on the center of the slide Place a 1-mm drop of blood a half-inch from the edge of the slide Place a 1-mm drop of blood on the center of the slide Requires time for antiseptic action - Answer: When alcohol is used to cleanse the venipuncture site, it must be allowed to air dry prior to the venipuncture because alcohol....? Requires time for antiseptic action destroys WBCs Compromises the additives in the tubes Winged infusion set (butterfly) and adapter - Answer: A phlebotomist is preparing to perform a hand draw. which of the following should he assemble? Winged infusion set (butterfly) and adapter Syringe and vacutainer ETS needle and transfer device
An aerobic and anaerobic bottle - Answer: Blood cultures have been ordered on a patient in the ICU. Which containers should the phlebotomist bring for the blood draw? Syncope - Answer: During a routine blood draw the patient becomes pale and diaphoretic. What condition is most likely about to occur? "I will collect the specimen in a sterile container and return within 1 hour" - Answer: A phlebotomist is educating a patient about the proper at home collection procedure for a semen specimen. Which of the following statements indicates the patient understands the teaching? "I will collect the specimen in a sterile container and refrigerate" "I will collect the specimen in a sterile container and return within 1 hour" "I will abstain from ejaculation for three days prior to the test" 240-330 ml (easier to remember 3.3) - Answer: Which of the following is the total blood volume of a 3.3 kg infant? 350-390 ml 125-230 ml 240-330 ml 405-450 ml Shaking the tube vigorously - Answer: Which of the following can cause a hemolyzed specimen? Inverting the specimen four times partially filling the collection tube shaking the tube vigorously
allowing the specimen to clot N-95 respirator - Answer: What provides the phlebotomist the best protection when drawing blood from a patient with active TB? The specimen was insufficient ("quantity insufficient") - Answer: A blood specimen was rejected by the lab with the abbreviation of "QNS". What does this mean? Insert until a change in resistance - Answer: when performing a venipuncture on a patient of average weight, which of the following is a correct technique for needle insertion? Insert half an inch Insert 1.5" Insert until a change in resistance Insert until it meets resistance Cells must be separated from the serum - Answer: A phlebotomist must centrifuge a serum specimen before shipment to an outside lab because...? Cells will hemolyze cells must be separated from the serum platelets must be separated from the serum WBC will be elevated Insert a new tube to see if it will fill - Answer: While forming a venipuncture, the first tube fills, but the second tube slows and does not fill completely. The phlebotomist needs to draw 2 additional tubes. Which of the following steps should the phlebotomist take? Tell the patient she will need to perform another venipuncture
Therapeutic phlebotomy - Answer: intentional removal of a large amount of blood to lower the red blood cell concentration, or to lower iron levels. polycythemia vera - Answer: is a slow-growing blood cancer in which your bone marrow makes too many red blood cells. These excess cells thicken your blood, slowing its flow. They also cause complications, such as blood clots, which can lead to a heart attack or stroke. hemochromatosis - Answer: high iron levels in the blood
No more than 10% of blood volume - Answer: How much blood can be drawn on an infant? No more than 100 mL - Answer: What is the limit for a blood draw on an adult patient? 6.2 lb. x 2.2 = 2.82 kg. - Answer: Convert 6.2 lb. to kg 2.82 x 100 = 282 mL - Answer: Convert 2.82 kg to mL 282 mL /1,000 = 0.28 mL - Answer: Convert blood volume in mL to Liters Shortness of breath, fatigue, and need for blood transfusions. - Answer: What are symptoms/complications of iatrogenic anemia? c) mask - Answer: A patient has pneumonia, before a blood draw, besides gloves, what other PPD should a phlebotomist use? a) Gown b) N95 respirator c) Face mask d) goggles Dispose of the tube in a sharps container - Answer: while collecting a blood specimen, you notice the tube is cracked. What should you do? Ask for the patient's permission to disclose the results with the parent. - Answer: you are performing a glucometer reading for a young adult patient. The patient's parent is in the room and asks about the patient's glucose level. what action should you take?