Phlebotomy Techniques and Procedures, Exams of Nursing

Download Phlebotomy Techniques and Procedures and more Exams Nursing in PDF only on Docsity! NHA MEDICAL ASSISTING CERTIFICATION STUDY GUIDE WITH 100% CORRECTLY SOLVED ANSWERS CC -- Answer ✔✔ Chief Complaint Segment -- Answer ✔✔ Line between two waveforms P Wave -- Answer ✔✔ Arterial Depolarization How many 1mm boxes are in a 6 second rhythm strip? -- Answer ✔✔ 30 one millimeter boxes The SA node represents which waveform on the EKG? -- Answer ✔✔ Only the P wave What is the reading you can get from the RR interval? -- Answer ✔✔ Ventricular Pulse What is the primary stage of Hemolysis? -- Answer ✔✔ Vascular phase and platelet phase together What is Electrophoresis? -- Answer ✔✔ Analyzation of the chemical components of blood, e.g. hemoglobin, serum, urine, cerebrospinal fluid based on electrical charge. Positive testing for occult blood in a stool sample turns which color? -- Answer ✔✔ Turns blue on a positive test for occult blood in feces The stages of Hemostasis -- Answer ✔✔ 1. Vascular, 2. Platelet Phase, 3. Coagulation Phase, 4. Fibrinolysis Blood vessels -- Answer ✔✔ Aorta, Arteries, Arterioles, Capillaries, Venues, Veins, Superior and Inferior Vena Cavae Outer connective tissue layer of a blood vessel -- Answer ✔✔ Tunica Adventitia Inner endothelial tissue of a blood vessel -- Answer ✔✔ Tunica Intima The inner smooth layer of a blood vessel -- Answer ✔✔ Tunica tunica media The standards of right and wrong in a medical setting -- Answer ✔✔ Code of Ethics What do you find in capillaries? -- Answer ✔✔ A mixture of venous and arterial blood is found The average adult has how many liters of blood? -- Answer ✔✔ 5-6 Liters What is the percentage of water in the blood? -- Answer ✔✔ 92% Percentage of plasma in the blood? -- Answer ✔✔ 55% Percentage of formed elements in the blood? -- Answer ✔✔ 45% 99% of formed elements in the blood -- Answer ✔✔ RBC,s or Erythrocytes Where do you find hemoglobin? -- Answer ✔✔ RBC,s Where do all blood cells originate? -- Answer ✔✔ Bone marrow Fistula -- Answer ✔✔ Permanent surgical connection between an artery and a vein, never used for venipuncture Edima -- Answer ✔✔ Accumulation of fluid in tissue Thrombophlebitis -- Answer ✔✔ Inflammation of a blood clot formation Explanation of Hemoconcentration -- Answer ✔✔ The increase in proportion of formed elements to plasma caused by leaving on the tourniquet for more than two minutes Consequence of insufficient pressure applied after withdrawal of a needle -- Answer ✔✔ Thrombus Additives in a green top tube -- Answer ✔✔ Heparin, sodium, lithium, ammonium Why is the green top tube never used for hematology? -- Answer ✔✔ Green tops additive heparin interferes with the Wright's stained blood test Common tests for the lavender EDTA tube -- Answer ✔✔ CBC, differential or diff, ESR, sickle cell screening Common tests for this color tube are Chemistry tests performed on plasma such as ammonia, carboxyhemoglobin and STAT electrolytes -- Answer ✔✔ Green top tube (Heparin) tests How long does it take for blood to clot by the normal coagulation process in the red top tube -- Answer ✔✔ 30-60 mins The primary purpose is to provide reliable data about a patient’s health status by ensuring the accuracy of a test while detecting and eliminating error -- Answer ✔✔ What is Quality Control? Common test for the red topped tube -- Answer ✔✔ Serum Chemistry tests, serology tests, blood bank (Glass only) Order of the draw for capillary specimens -- Answer ✔✔ Lavender first, than tubes with other additives, than tubes without additives Antiseptic not used on a dermal puncture site -- Answer ✔✔ Betadine (Because it interferes with several tests like bilirubin, uric acid, phosphorus, and potassium) For which procedure would you warm the site for a minimum of 3-4 minutes to increase blood flow? -- Answer ✔✔ Dermal punctures (Heels sticks) Which are the preferred sites for dermal punctures? -- Answer ✔✔ The distal segment of the third or fourth finger of the non-dominant hand Heel sticks are performed on which patients? -- Answer ✔✔ Infants less than 1 years old Where on the foot is the dermal puncture made on patients less than 1 years old? -- Answer ✔✔ The medial and lateral areas of the plantar surface of the foot Dermal puncture is made in -- Answer ✔✔ The fleshy portion of the finger slightly to the side of the center perpendicular to the lines of the fingerprints what will occur if you puncture the heel too deep? More than 2mm -- Answer ✔✔ Osteomyelitis what are the identification requirements for the blood bank? -- Answer ✔✔ Patients full name or DOB, Hospital ID# or SNN for outpatient care, date and time of collection as well as the phlebotomist's initials What does the toxicology section of the lab analyze? -- Answer ✔✔ Plasma levels of drugs and poisons What is the percentage of the population with the D antigen present? -- Answer ✔✔ 85% of the population The 4 blood types -- Answer ✔✔ A, B, AB, O Which blood type has neither the Anti-A nor the Anti-B plasma antibodies -- Answer ✔✔ AB This section of the lab uses serum to analyze the presence of antibodies to bacteria, fungi, viruses, parasites, and antibodies against the body's own substances? -- Answer ✔✔ Serology (Immunology) Section Mycology -- Answer ✔✔ Study of fungi The physical examination of urine consists of -- Answer ✔✔ Color, Clarity, Specific gravity A low power microscope has a magnifying power of -- Answer ✔✔ 100X Oil immersion objectives on the microscope reach a maximal magnification of -- Answer ✔✔ 1000X This objective of the microscope is used for observing bacteria, WBC differential count and RBC morphology -- Answer ✔✔ Oil immersion Eyepiece of the microscope -- Answer ✔✔ Ocular lens Focal length is? -- Answer ✔✔ The distance of the object to be examined to the center of the lens Meter to inches -- Answer ✔✔ 39.37 High power objective on a microscope magnification -- Answer ✔✔ 400X 1000 meter are equal to -- Answer ✔✔ 1km Distilled water has a pH of? -- Answer ✔✔ 7.0 pH or neutral A urine pH of what is considered neutral? -- Answer ✔✔ 7.0 pH A positive urine nitrate test is an indication for -- Answer ✔✔ A significant number of bacteria are present What color is a test positive for in nitrate in urine -- Answer ✔✔ Pink The copper reaction test us used for what? -- Answer ✔✔ Screening for glucose in urine The presence of leukocytes in urine is an indicator for what? -- Answer ✔✔ Bacteriuria or UTI Urine screening for UCG or hCG -- Answer ✔✔ Pregnancy test HIPAA is for? -- Answer ✔✔ Patient confidentiality The four elements of negligence are -- Answer ✔✔ 1. Duty of care, 2.Derelict: Breach of duty, 3.Direct cause, 4.Damage Tort -- Answer ✔✔ Wrongful act that results in injury to one person or another Examples of A Tort -- Answer ✔✔ Battery, invasion of privacy, and defamation of character Defamation of character by written statement is considered -- Answer ✔✔ Libel Consists of injury to another person's reputation, name, or character through spoken (Slander) or written (Libel) -- Answer ✔✔ Defamation of character Unprivileged touching -- Answer ✔✔ Battery The release of medical records without the patient's knowledge or permission -- Answer ✔✔ Invasion of privacy Good Samaritan Law -- Answer ✔✔ Rendering first aid within the scope of knowledge by a healthcare worker without the fear of being sued for negligence Hypothalamus -- Answer ✔✔ Regulates and maintains body temperature Functions necessary for life -- Answer ✔✔ Heart function, blood pressure, respiration, and temperature Rectal temperature range in Celsius -- Answer ✔✔ 37.0-38.1 C Oral temperature range in Fahrenheit -- Answer ✔✔ 97.6-99.6 F Axillary temperature range in Celsius -- Answer ✔✔ 35.9-37.0 C Tympanic temperature range in F and C -- Answer ✔✔ 98.6F and 37C Intermittent fever -- Answer ✔✔ Fluctuating fever that returns to or below the baseline than rises again Remittent fever -- Answer ✔✔ Fluctuating, remains elevated does not return to baseline Continuous fever -- Answer ✔✔ Remains constant above baseline, does not fluctuate Rectal temperature is not taken from the following patients -- Answer ✔✔ Patients with heart disease When taking axillary temperature how long should it be taken -- Answer ✔✔ 5-10 mins or as required by office policy Pulse is taken where and how long -- Answer ✔✔ Radial for 30secs x2, it tachy or brady take it for 1 minute Explain blood pressure -- Answer ✔✔ Measurement of amount of force blood excretes on peripheral artery walls BP cuffs too short and narrow can give a false reading of what? -- Answer ✔✔ Hypertension If the brachial artery is far below the heart level the BP reading can be -- Answer ✔✔ Falsely high readings While taking BP the deflation rate is -- Answer ✔✔ 2-3mm Hg Taking BP hearing two consecutive beats gives which reading -- Answer ✔✔ Systolic The disappearance point whilst taking BP is usually what? -- Answer ✔✔ A few mm Hg below the muffling point which marks the diastolic pressure How long should the arm rest between re-inflating the cuff during BP taking -- Answer ✔✔ 1-2 minutes Repetitive inflation of BP cuff can result in -- Answer ✔✔ Venous congestion Venous caused by repetitive inflation of BP can lead to -- Answer ✔✔ Artificially low systolic and high diastolic reading Anthropometric measurements -- Answer ✔✔ BMI and growth development in infants, children, and adults The four principals of physical examination -- Answer ✔✔ Inspection, palpation, percussion, auscultation Used on instruments that easily corrode -- Answer ✔✔ Dry heat sterilization What is the most important means of preventing the spread of infections? -- Answer ✔✔ Handwashing PPE includes -- Answer ✔✔ Mask, goggles, face shields, respirator What defines standard precautions -- Answer ✔✔ All patients are presumed to be infected with blood borne pathogens This is an infection control method designed to prevent direct contact with blood or other body fluids -- Answer ✔✔ Standard precautions This replaces universal precautions and body substance isolation -- Answer ✔✔ Standard precautions Don gloves, face shields if in danger of splashing, dispose all needles without recapping into sharps container -- Answer ✔✔ Standard precautions This is the second tier of precautions when patient is contagious -- Answer ✔✔ Transmission based precautions Define contact precautions -- Answer ✔✔ Reducing the risk of transmission of microorganisms direct or indirect Special air handling and ventilation are required to prevent -- Answer ✔✔ Airborne diseases under airborne precautions This is an emerging and important problem in the health care field -- Answer ✔✔ Latex sensitivity Every health care worker with a latex allergy should wear this -- Answer ✔✔ Medical alert bracelet po -- Answer ✔✔ By mouth pr -- Answer ✔✔ By way of rectum/suppository sl -- Answer ✔✔ Sublingual IM -- Answer ✔✔ Intramuscular SQ -- Answer ✔✔ Subcutaneous qd -- Answer ✔✔ Every day bid -- Answer ✔✔ Twice a day tid -- Answer ✔✔ Three times a day qid -- Answer ✔✔ Four times a day pc -- Answer ✔✔ After a meal qhs -- Answer ✔✔ Each night or at bedtime prn -- Answer ✔✔ As necessary or when needed sig -- Answer ✔✔ From the latin, let it be labeled The innermost layer of the heart -- Answer ✔✔ Endocardium The sac containing the heart -- Answer ✔✔ Pericardium A muscular hollow organ located in the thoracic cavity between lungs -- Answer ✔✔ Epicardium Serous fluid -- Answer ✔✔ Prevents friction as the heart beats Receives deoxygenated blood returning to the heart from the body -- Answer ✔✔ Right atrium Receives deoxygenated blood from the right atrium which it pumps to the lungs through the pulmonary artery -- Answer ✔✔ Right ventricle Receives oxygenated blood from the left atrium and pumps it to the body thru the aorta -- Answer ✔✔ Left ventricle The AV valves -- Answer ✔✔ Tricuspid and mitral (Bicuspid) The semilunar -- Answer ✔✔ Aortic and pulmonic Valve located between the right ventricle and pulmonary trunk -- Answer ✔✔ Pulmonic valve Valve located between the left atrium and the left ventricle -- Answer ✔✔ Mitral or bicuspid Heart sounds produced by closure of the valves -- Answer ✔✔ Murmurs Caused by diseases of the valves or other structural abnormalities -- Answer ✔✔ Murmurs First heart sound due to the closure of the mitral and tricuspid valves -- Answer ✔✔ S1 in the upper chambers or atria S2 in the ventricles -- Answer ✔✔ Second heart sound due to the closure of the aortic and pulmonic valves Arteries supplying the heart -- Answer ✔✔ Right and left coronary from the aorta The ANS or autonomic nervous system is subdivided into -- Answer ✔✔ Sympathetic and parasympathetic nervous system The SP or sympathetic nervous system affects -- Answer ✔✔ Both, the atria and the ventricles by increasing heart rate, conduction and irritability The percentage of the target heart rate during a stress test that makes it valid -- Answer ✔✔ 85% Normal indication for a stress test -- Answer ✔✔ Evaluation of a patient with chest pain and a normal EKG, arrhythmia, monitoring a PT. with a recent MI Hematocrit is made up of -- Answer ✔✔ Hemoglobin X 3 Define Hematocrit -- Answer ✔✔ The percentage by volume of packed red blood cells in a given sample of blood after centrifugation. Opposite of anemia -- Answer ✔✔ Polycythemia Drugs used for a pharmacologic stress test, it is concluded when -- Answer ✔✔ 85% of the target rate is achieved When taking a pharmacologic stress, it is concluded when -- Answer ✔✔ 85% of the target rate is achieved Ectopic rhythms -- Answer ✔✔ Electrical impulses originating from somewhere else but the SA node Pre-Excitation syndrome -- Answer ✔✔ Electrical impulses of the heart bypass the normal pathway and instead go down an accessory shortcut Conduction block -- Answer ✔✔ Electrical impulses of the heart bypass the normal pathway and instead go down an accessory shortcut Indication for termination of a stress test -- Answer ✔✔ SOB, chest pain, dizziness, blood pressure abnormalities Ischemia -- Answer ✔✔ Decrease in amount of blood flow What is the hallmark of infraction -- Answer ✔✔ The presence of abnormal Q waves When is a Q wave (Hallmark of infraction) considered abnormal -- Answer ✔✔ >1mm (0.04 sec) wide and the height is greater than 25% of the height of the R wave in that lead The WHO criteria for the diagnosis of MI (At least two of them) -- Answer ✔✔ Clinical history of ischemic-type chest comfort, changes on serial EKG tracings, and the rise and fall of serum cardiac markers List some cardiac markers -- Answer ✔✔ Triponin, CK, LDH, SGOT, AST What is a negative holter? -- Answer ✔✔ A negative holter will have no significant arrhythmias or ST changes How long is a holter monitor worn -- Answer ✔✔ 24 hours or longer Why is a holter monitor done? -- Answer ✔✔ To rule out arrhythmias or ischemia How many electrodes are on a holter monitor? -- Answer ✔✔ 5 A positive holter is one that recorded at least one or more of these abnormalities -- Answer ✔✔ Tachy, bradycardia, ST segment elevation or depression, and pauses When is the event monitor used? -- Answer ✔✔ Only when symptoms occur List drugs given for acute MI -- Answer ✔✔ Oxygen, epinephrine, isoproterenol, dopamine (Intropin), beta blocker (olol) lidocaine, verapamil, digitalis, morphine, and nitroglycerin What is a powerful smooth muscle relaxant with the side effect of headache -- Answer ✔✔ Nitroglycerin patch or sl Digitalis does -- Answer ✔✔ increases the force of cardiac contractions as well as cardiac output, toxicity in 20% of patients Butterfly -- Answer ✔✔ Winged infusion set What is the most important task of a phlebotomist -- Answer ✔✔ Check patient ID With the bevel upward insert the needle at which angle -- Answer ✔✔ 15-30 degrees Prandial -- Answer ✔✔ Fasting What is important to do first after dermal puncture? -- Answer ✔✔ Wipe away the first drop Timed specimens -- Answer ✔✔ Hormone levels, blood levels of medications, monitor Pt. condition e.g. hemoglobin level (Internal bleeding) The BP cuff inflation for a bleeding time test -- Answer ✔✔ 40mm Hg Trough levels are collected -- Answer ✔✔ 30 minutes before the scheduled dose Indication for blood cultures -- Answer ✔✔ FUO indication the presence of pathogenic microorganisms in the blood (Septicemia) While administering a OGTT it is important to take with each sample? -- Answer ✔✔ Urine sample When are OGTT scheduled to begin? -- Answer ✔✔ 7-9am The two hour postprandial test is used for? -- Answer ✔✔ Evaluation of diabetes mellitus The OGTT is used for? -- Answer ✔✔ Diagnosing diabetes