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Solution to AMCA Phlebotomy Exam
A blood test that requires testing for aluminum would be placed in what tube? - answer -Royal Blue Tube Top What is the recommended disinfectant for blood and other bodily fluids? - answer - Sodium Hypochlorite Invasive surgery procedures require what? - answer -Informed Consent What tube would be used to collect blood for a pregnancy test? - answer -Red Tube Top What is the best vein to draw from in the antecubital area? - answer -Median Cubital Vein Which tube would be used for a Thyroid Panel; Tiger Top, Lavender, Light Green, Yellow? - answer -Tiger Top What additive is in a Dark Green Tube? - answer -Heparin
What tube would produce a serum sample; Green Top, Light Blue, Lavender, Red Top? - answer -Red Top If a doctor orders a CBC Test (Lavender Top), Comprehensive Metabolic Panel (SST), PT Test (Light Blue Top), and a set of Blood Cultures (BC), what would the order of draw be? - answer -BC, Light Blue, SST, Lavender Top If a EDTA tube is used before a serum tube it could cause cross contamination and could result in what? - answer -High potassium or a false low calcium value A CBC is collected into a Lavender tube and collected as what? - answer -Whole Blood Specimen A CBC would be performed in what department of the lab? - answer -Hematology What are included in electrolyte testing? - answer -Sodium and Potassium Coagulation testing requires blood to be collected in what tube? - answer -Light Blue Top After the needle is withdrawn from the vein, the first thing that needs to be done is what? - answer -Activate the needles safety device What would be the proper compression rate for a single adult CPR? - answer - Compressions and 2 Breaths
An Erythrocyte Sedimentation Rate (ESR) test is collected in what tube? - answer - Lavender Tube Top What is the best vein to draw from in the antecubital area? - answer -Median Cubital Vein You must never use what for cleansing a collection site for a blood and alcohol test?
- answer -70% Isopropyl Alcohol What should you never do from a patients arm whose had a mastectomy on that side? - answer -Never Draw Blood Over or under filling a Light Blue Top is a reason for a sample to be rejected by? The ratio must be 9:1 - answer -Quality not Sufficient (QNS) What finger is the best capillary puncture site on an adult? - answer -Middle Finger Even if the lab is backed up on resulting you should do what anyway? - answer -Send Samples What should always be worn when performing blood draws? - answer -Gloves What is the most common way of administering a TB test? - answer -Injecting a TB antigen under the skin When performing phlebotomy on a young, fearful child, what should you explain to them? - answer -Explain to them in simple terms what will be done
What is the name of the process that uses heat, steam, and chemicals to prevent infectious diseases? - answer -Sterilizing What is caused by leaving the tourniquet on to long? It should not be left on for longer than a minute. - answer -Hemoconcentration What could happen is blood is drawn from a patients arm to quickly? - answer -It could cause the vein to collapse What does it mean when a patient extends their arm for a blood draw? - answer - Implied Consent In a Standard Serum Separator Tube (SST), the blood should be allowed to clot for how long? - answer -At least 30 minutes but no longer than 2 hours What is the most important way to prevent cross-contamination of microorganisms from one patient to another? - answer -Proper Hand Washing What states a patient has a right to refuse a medical procedure and to be informed of all the consequences of doing so? - answer -A Patients Bill of Rights What should be used to bandage a patient free a blood draw that is on blood thinners? - answer -Coban Wrap What government agency is responsible for regulating the safety and health of workers? - answer -OSHA
The bevel of the needle should always be what? - answer -Facing up when inserting into the skin How do you avoid in patient identification errors? - answer -By checking the arm band on an in patient with the lab What is a good indicator that a patient is not fasting? - answer -The specimen is Lipemic (fat globs floating in blood) What is used to collect DNA samples by swabbing the inside of a patients cheek? - answer -Buccal Swab What helps to avoid confusing specimens from patients with the same last name? - answer -Patients Identification Numbers on tubes When should the tourniquet be released? - answer -Once blood flow has been established What department is responsible for sterile supplies? - answer -Central Supply If IVs are inserted in the antecubital area of the arms, where must the blood be drawn from? - answer -Below the IV site A patient who tends to faint during blood draw should what? - answer -Be placed lying down on an exam table or in a reclining chair
A heel puncture should not be performed on an infant older than what? - answer - months A phlebotomist should do what before and after venipuncture? - answer -Wash Hands Hematoma means what? - answer -Blood has leaked from the vein into the tissues of the skin What should be placed on the specimen tube? - answer -Patients complete name, date of birth, identification number, date and time of draw, and the collectors initials When doing a bleeding time test on a patient the blood pressure cuff is inflated to what? - answer -40mm Hg Where would biopsy tissue be sent to be analyzed? - answer -Anatomical pathology A patient who is on blood thinners or aspirin regimen may need what? - answer - Additional pressure applied to stop bleeding When a patient starts to sweat, look pale, and/or complain of blurred vision this could be signs of what? - answer -Vasovagal Syncope (fainting) What can be tested at the bedside using Point of Care instrument? - answer -PTT and INR A tourniquet should not be left on longer than what? - answer -1 minute
Blood leaking into the tissue around the draw site is called what? - answer - Hematoma What is the standard length of time for a sample to stand before it is loaded into a centrifuge? - answer -30 minutes A Chain of Custody would be required if what? - answer -A paternity test is ordered If you have a patient with small, thin, or fragile veins what needle would you use to acquire the specimen? - answer -Butterfly needle with syringe No more than how many attempts to draw will be permitted by a phlebotomist according to CLSI? - answer -2 attempts What is Hemoconcentration? - answer -Increased concentration of cells and solids in the blood What is preanalytical, analytical, and postanalytical? - answer -prior to testing - may include variables involving the process of obtaining the specimen; during testing; after test results are generated How much urine would a female need to produce for a STD test? - answer -20- mls How do you collect sputum samples? - answer -Have the patient take a deep breath, hold for 5 seconds, slowly breath out, another deep breath & cough hard until sputum comes up, then spit into a plastic cup
What is the reason for taut (pull back) skin? - answer -To anchor the vein so it does not role What is Semi-Fowlers position and why would you use it? - answer -The patient is usually in their back with the bed angle between 30 & 45 degrees. It is used for difficulty breathing and undergoing breathing treatments. How do you do proper hand washing and scrub techniques? - answer -Wet hands, apply soap, scrub for at least 20 seconds, rinse & dry After a patient has fainted during venipuncture and the phlebotomist has removed the tourniquet and needle, what should be done next? - answer -Lower the head to the knees What is appropriate dress code for a phlebotomist? - answer -Scrubs and closed toe shoes What is proper cough etiquette? - answer -Cough into a bent elbow For a fasting glucose test, how many hours should a patient be fasting at a minimum?
- answer -7 hours What item is donned first when wearing full PPE? - answer -Gown tied at neck and waist A female patient has never had her blood drawn before. What should a phlebotomist allow her to do? - answer -Sit in a chair with arm support
