NHA Phlebotomy National Exam 2022-2023. 300

What temperature should a semen sample be transported?
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
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 icewater slurry (or a cup of ice)
d. Place specimen in icewater slurry (or a cup of ice)
The phlebotomist has a request to collect a CBC from a healthy 10 month old. Which is appropriate?
a. Either heel
A phlebotomist is preparing to draw blood from a patient in hospital/ The patient extends his arm and turns head away. Which consent does this indicate?
a. Implied consent
Why should phlebotomist document volume of blood drawn from a patient?
a. Iatrogenic anemia could be a result fo too much taken
A phlebotomist has a requisition to draw blood on a patient with severe Down’s syndrome. What steps would you take?
a. Speak with the patient guardian before performing venipuncture to enmsure the patient understands
A 69 year old unconscious patient is brought ot the ER. Several blood tests are ordered. The phlebotomist collects blood under
a. Implied consent
Which of the following actions is appropriate when labeling specimens?
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?
a. Don’t draw until nurse puts an armband on patient
Which is appropriate form of identification in inpatient setting?
a. Verbal and wrist band
WBC, RBC, Electrolytes are ordered. Which tubes are used for capillary?
a. Lavender and red
A blood specimen is rejected by lab with QNS as the reason? Why?
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?
a. Apply pressure to prevent leakage of blood into the tissues
A physician orders a STAT but phlebotomist forgets to fill out patient ID number. What is appropriate procedure for an improperly labeled specimen when received in lab?
a. Lab rejects the mislabeled specimen
Phlebotomist is performing venipuncture and patient begins to seize. What is correct action?
a. Discontinue the draw
Phlebotomist receives orders to draw an infant screening card, O2 levels, bilirubin, and DNA. Which is to be drawn first?
a. O2 levels
When performing a venipuncture on a patient of average weight, which is the correct technique for needle insertion?
a. Insert until a change in resistance
Which is the best method to collect a blood specimen from an older adult patient who has fragile, easy to collapse veins?
a. Choose a syringe and butterfly assembly
Which of the following is the term for donation of a patient’s own blood for an upcoming surgery?
a. Autologous donation
The order of draw for capillary collections is different than venipuncture because
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?
a. Return later after drawing other patients
A phlebotomist notices a hematoma developing at the site of venipuncture. The phlebotomist should
a. Release the tourniquet and stop the draw
Know ORDER of DRAW!!
A phlebotomist working in an infertility clinic and the patient is to submit a semen specimen. The phlebotomist would tell the patient:
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 patients arm, the phlebotomist notices small red spots below the tourniquet.
a. Petechiae
The phlebotomist should examine the antecubital veins of both arms because:
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?
a. Benzalkonium chloride
When should the code on glucose cuvettes or strips be compared to the code on the glucose meter?
a. When the patient is tested
Which of the following is appropriate to use when collecting for a chemistry test that requires serum?
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?
a. Use a syringe and transfer to a light blue tube
Industry standard states needle insertion in the antecubital area should be:
a. 15-30 degree angle
Tubes with which additive should be used for CBC?
a. EDTA (purple tube)
When preparing for transport, which specimen must be placed on ice within 30 minutes after collection?
a. Arterial Blood Gases
Which provides the phlebotomist the best protection when drawing blood from a patient with active TB?
a. N-95 respirator mask
During a draw, the patient becomes unresponsive. What should you do?
a. Check for breathing
Why should a phlebotomist avoid drawing blood from a leg or foot of a diabetic patient?
a. These areas are more susceptible to infection
Why is it important to place a specimen in a biohazard specimen bag outside the laboratory?
a. The biohazard bag prevents a possible exposure incident
As a student. Proper introduction
a. Hi, my name is Sally Smith. I am a student phlebotomist and I’m here to collect blood specimen
When using evacuated tube system (EVS).
a. Position the needle in the same direction as the vein at 30 degree angle
What is additive for a PT/PTT?
a. Sodium Citrate (Blue top)
Blood cultures have been ordered on ICU patient. You would use:
a. Aerobic and anaerobic bottles
A phlebotomist is required to obtain what from a potential donor?
a. Complete medical history
Phlebotomist needs to draw a glucose tolerance test on a patient and notices an empty breakfast plate at bedside. What should you do?
a. Ask the patient when he or she ate last
Which vein should you attempt first?
a. Median cubital
If a phlebotomist is stuck with a used needle, first action is:
a. Flush the area with running water
correct specimen handling, what should you put on collection tubes?
Before leaving a patient room, make sure the date, time and initials are on the tubes.
When removing the needle from the arm, engage the safety device immediately
What can cause hemolysis?
a. Vigorously shaking the tube
A phlebotomist must centrifuge a serum separator tube before shipment:
a. Cells must be separated from the serum
The phlebotomist draws a CBC at 1800. Lab closed at 1730 and will not process until 500. What temp should the CBC be stored
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?
a. Potassium
According to CLSI, what is collected first?
a. Blood cultures
KNOW ORDER OF DRAW
KNOW ADDITIVES
KNOW ORDER OF VENIPUNTURE PROCEDURE
A physician ordered a Tobramycin level to be drawn one hour after dose. The Tobramycin has been ordered for 11am. What should you do
a. Check with the nurse to make sure meds were given (or not given)
phlebotomist notices red spots. What is appropriate action?
a. Apply pressure after collecting During the draw, the the sample
What is a potential consequence of mislabeling a blood bank specimen?
a. A Transfusion reaction
When should a phlebotomist perform external liquid controls for quality control on CLIA waived point of care test?
a. When a new lot number or kit is opened
A 3.3 kg infant has a total blood volume of 240-330ml
Cleanse in an outward spiral
What would you use for a hand draw?
a. Butterfly or winged infusion set
Invert anticoagulant tubes to :prevent coagulation

Name the 3 types of blood samples
whole blood/ plasma/ serum

What two States require licensure
Louisiana & California

When the Phlebotomist collects blood, in which of the patient’s zones of interpersonal space is he/she operating?
The patient’s Intimate Zone or Space

Define Phlebotomy
An incision into the vein

What is the meaning of these acronyms: ASPT, ASCP, and NHA?
ASPT = American Society of Phlebotomy Technicians
ASCP = American Society for Clinical Pathology
NHA = National Healthcareer Association

Define Reference Laboratory:
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
2_ Right Atrium 8_ Pulmonary Veins
4_ Right Ventricle 11_ Left Ventricle
3_ Tricuspid Valve 12_ Aortic Valve
10_ Mitral Valve (aka, Bi-Cuspid)

To whom does the phlebotomist report?
A technical phlebotomy supervisor

What two government agencies administer CLIA?
Center for Medicare/Medicaid Services (CMS)__
FDA

. Is the Joint Commission a non-profit organization?
No, it’s a not for profit organization

In what year and by what organization was The Patient’s Bill of Rights initiated?
1973 by the American Hospital Association.

. What is Informed Consent?
When you explain the procedure to the patient and they give you verbal or written permission to proceed.

What is Implied Consent?
When you explain the procedure to the patient and they make a gesture that implies their permission to proceed, such as extending their arm, rolling up their sleeve or nodding their head.

What is required to obtain Informed Consent for a child?
You explain the procedure to the parent or legal guardian and obtain their informed consent for the child.

What is the difference between a Criminal Lawsuit and a Civil Lawsuit?
A criminal lawsuit is initiated by the government, a civil lawsuit is between private parties.

What is Assault?
The threat of touching another person without his or her consent and with the intention of causing fear of harm

What is Battery?
Actual harmful touching of another person without his or her consent.

What is Libel?
False defamatory writing that is published.

What is a Sentinel Event?
An unanticipated death or permanent loss of function not related to a patient’s illness or underlying condition.

. What does PPE stand for?
Personal Protective Equipment

. How full should you fill the Sharps Container before using a new container?
¾ full

. What is the name of the multi-purpose fire extinguisher?
ABC

To what does the term “aseptic techniques” refer?
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.
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
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
c. Read the posted instructions

What does the acronym PASS describe and stand for?
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?
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.
b. check to see if it is an emergency.
c. transfer the call to the phlebotomy supervisor.
d. tell the caller his or her name.
b. check to see if it is an emergency.

A competent professional demeanor is shown by:
a. neatness and cleanliness.
b. courtesy and cheerfulness.
c. pleasantness.
d. all of the above.
d. all of the above.

Traditional duties of the phlebotomist include all of the following except:
a. correct labeling of all specimens with the required information.
b. selection of the appropriate specimen containers for the specified tests.
c. performance of tests on patient samples in the laboratory.
d. collection of the appropriate amount of blood by venipuncture or dermal puncture.
c. performance of tests on patient samples in the laboratory

. The two major areas of the clinical laboratory are:
a. chemistry and hematology.
b. cytology and histology.
c. anatomical and clinical.
d. urinalysis and microbiology.
c. anatomical and clinical.

The difference between plasma and serum is that:
a. serum contains fibrinogen.
b. serum is obtained from a non-clotted specimen.
c. plasma is obtained from a clotted specimen.
d. plasma contains fibrinogen.
d. plasma contains fibrinogen.

Specimens collected in serum separator tubes are most frequently delivered to:
a. blood bank.
b. serology.
c. hematology.
d. chemistry
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
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.
d. fasting and cloudy.

The main anticoagulant for coagulation studies is:
a. ethylenediaminetetraacetic acid (EDTA).
b. sodium citrate.
c. heparin.
d. oxalate.
b. sodium citrate.

. ABO and Rh typing are performed in which laboratory section?
a. Hematology
b. Blood bank
c. Chemistry
d. Cytology
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.
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)
b. Complete blood count (CBC)

An anemia would be detected by a:
a. glucose test.
b. blood culture.
c. urinalysis.
d. complete blood count.
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.
a. Joint Commission.

. The most serious error a phlebotomist can make is:
a. causing a hematoma.
b. failure to correctly identify a patient.
c. drawing a specimen in the wrong tube.
d. collecting a hemolyzed dermal puncture specimen.
b. failure to correctly identify a patient.

. A puncture device with a broken seal should not be used because:
a. it is no longer sterile.
b. the needle may contain a barb.
c. there may be a manufacturing defect.
d. the color coding will not match the size.
a. it is no longer sterile.

Using an evacuated tube after its expiration date can result in all of the following except:
a. a short draw.
b. a clotted specimen.
c. a lipemic specimen.
d. a contaminated specimen
a. a short draw.

The Patient’s Bill of Rights guarantees the patient all of the following except:
a. a private room.
b. informed consent.
c. confidentiality.
d. treatment refusal.
a. a private room.

To complete the chain of infection, all of the following are required except a:
a. source.
b. contaminated surface.
c. mode of transmission.
d. host.
b. contaminated surface.

An infection contracted by a patient while in the hospital is termed:
a. antibiotic-resistant.
b. staphylococcal.
c. nosocomial.
d. unfortunate
c. nosocomial.

The recommended disinfectant for blood and body fluid contamination is:
a. sodium hydroxide.
b. antimicrobial soap.
c. hydrogen peroxide.
d. sodium hypochlorite.
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.
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.
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.
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
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.
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-
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
d. NPO

The ability to keep body systems functioning in a steady state is called:
a. coagulation.
b. articulation.
c. metabolism.
d. homeostasis.
d. homeostasis.

The layer of skin that contains the blood vessels is the:
a. epidermis.
b. dermis.
c. keratinized epithelium.
d. root shaft.
b. dermis.

The artery of choice for measuring the pulse rate in an adult is the:
a. carotid.
b. radial.
c. brachial.
d. temporal.
b. radial.

The blood vessels that carry deoxygenated blood to the heart are:
a. arteries.
b. alveoli.
c. capillaries.
d. veins.
d. veins.

All of the following are formed elements found in the blood except:
a. erythrocytes.
b. platelets.
c. macrophages.
d. leukocytes.
c. macrophages

. The primary role of the thrombocyte is to:
a. transport nutrients.
b. promote blood clotting.
c. phagocytize bacteria.
d. produce antibodies.
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.
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.
b. plasma.

The primary antiseptic for routine venipuncture is:
a. iodine.
b. chlorhexidine.
c. isopropyl alcohol.
d. Betadine.
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.
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.
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
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
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.
a. binding calcium.

Which of the following is the most acceptable order of tube draw?
a. Yellow, red glass, and light blue
b. Lavender, red plastic, and yellow
c. Red plastic, light blue, and lavender
d. Yellow, green, and light blue
a. Yellow, red glass, and light blue

Failing to adequately invert a lavender stopper tube after collection will:
a. cause hemolysis.
b. falsely elevate calcium results.
c. destroy coagulation factors.
d. produce a clotted specimen.
d. produce a clotted specimen

. The presence of a clot is acceptable in:
a. red stopper tubes.
b. lavender stopper tubes.
c. green stopper tubes.
d. light blue stopper tubes.
a. red stopper tubes.

. Which of the following needles has the largest diameter?
a. 16 gauge
b. 18 gauge
c. 20 gauge
d. 22 gauge
a. 16 gauge

Collecting a large evacuated tube using a 23-gauge needle:
a. is recommended for geriatric patients.
b. is required for certain automated tests.
c. may cause a hemolyzed sample.
d. may cause a loss of vacuum in the tube.
c. may cause a hemolyzed sample.

Forcing blood from a syringe into an evacuated tube:
a. prevents the blood from clotting.
b. can only be done when using a small syringe.
c. may hemolyze the specimen.
d. is required when using a transfer device.
c. may hemolyze the specimen

The needle holder that is part of the evacuated tube collection system is:
a. disposed of in the general trash after removing the collection needle.
b. disposed of as a unit with the collection needle into a red bag.
c. disposed of as a unit with the collection needle into a sharps container.
d. made of a grade of plastic that does not require disposal in a sharps container.
c. disposed of as a unit with the collection needle into a sharps container.

All of the following are used to identify a patient except the:
a. bed sign.
b. requisition form.
c. identification band.
d. bar codes.
a. bed sign.

The most important purpose of a requisition form is:
a. authorization to perform the procedure.a. authorization to perform the procedure.
b. providing a system to report results.
c. location of the patient.
d. monitoring test result turnaround time.
a. authorization to perform the procedure.a. authorization to perform the procedure.

Blood should not be drawn from a patient who is:
a. standing.
b. nervous.
c. unable to make a fist.
d. not fasting.
a. standing.

The maximum time a tourniquet should remain on the patient’s arm is:
a. 1 minute.
b. 2 minutes.
c. 3 minutes.
d. 5 minutes.
a. 1 minute.

The vein of choice for routine venipuncture is the:
a. median cubital.
b. radial.
c. cephalic.
d.baslic
a. median cubital.

The vein located on the thumb side of the arm is the:
a. brachial.
b. median cubital.
c. basilic.
d. cephalic.
c. basilic.

Palpate means to:
a. perform a venipuncture.
b. examine by touch.
c. examine by sound.
d. obtain a specimen from an intravenous line.
b. examine by touch.

Prolonged application of a tourniquet will cause:
a. excessive bleeding.
b. difficulty locating a vein.
c. hemolysis.
d. both A and C
d. both A and C
a. excessive bleeding
c. hemolysis.

Failure to allow the alcohol to dry on the patient’s arm after site cleansing can cause all of the following except:
a. increased bacteriostatic action.
b. a stinging sensation for the patient.
c. a possible unsterile site.
d. specimen hemolysis.
a. increased bacteriostatic action.

Correct palpation of a vein includes all of the following except:
a. determining the depth of the vein.
b. detecting a pulse using the thumb.
c. determining the direction of the vein.
d. probing with the index finger.
b. detecting a pulse using the thumb.

Hemoconcentration can be caused by:
a. prolonged tourniquet application.
b. intravenous therapy.
c. excessive probing.
d. failure to clench the fist.
a. prolonged tourniquet application.

. Firmly anchoring the vein prior to needle insertion is necessary to prevent:
a. specimen hemolysis.
b. incompletely filled tubes.
c. an accidental needlestick.
d. the vein from rolling.
d. the vein from rolling.

. During the venipuncture, the phlebotomist should do all of the following except:
a. anchor the vein above and below the puncture site.
b. insert the needle with the bevel up.
c. insert the needle at a 15- to 30-degree angle.
d. brace the hand holding the adapter on the patient’s arm.
a. anchor the vein above and below the puncture site.

A properly labeled tube must have all of the following information except the:
a. patient location.
b. patient identification number.
c. date of collection.
d. phlebotomist’s initials.
a. patient location.

Two identifiers for patient identification before specimen collection are routinely secured by all the following means except:
a. verifying the patient’s identification number on the wrist or ankle identification band.
b. asking the patient to state his or her first name and last name.
c. asking the patient “Are you John Doe?” or “Are you Mary Doe?”.
d. comparing information obtained verbally and from the patient’s identification band with the information on the test requisition.
d. comparing information obtained verbally and from the patient’s identification band with the information on the test requisition

When encountering a patient who is sleeping, the phlebotornist should:
a. return at another time.
b. try to collect the specimen without waking the patient.
c. notify the nursing station.
d. awaken the patient before collecting the specimen
d. awaken the patient before collecting the specimen

The best way to prevent fainting in a patient during blood collection is to:
a. have the patient stand during the phlebotomy.
b. have the patient lie down during the phlebotomy.
c. have the patient pump the fist three times.
d. place a pillow under the patient’s head.
b. have the patient lie down during the phlebotomy

Patients are most likely to be in a basal state at:
a. 6:00 a.m.
b. 10:00 a.m.
c. 2:00 p.m.
d. 6:00 p.m.
a. 6:00 a.m

. A patient who appears pale and has cold, damp skin may develop:
a. coagulation problems.
b. septicemia.
c. sclerosis.
d. syncope.
d. syncope.

When encountering a patient with a fistula, the phlebotornist should:
a. apply the tourniquet below the fistula.
b. use the other arm.
c. collect the blood from the fistula.
d. attach a syringe to the T-tube connector.
b. use the other arm.

When collecting blood from a patient with a very edematous right arm and a large hematoma in the antecubital area of the left arm, the phlebotornist should collect the specimen from:
a. below the hematoma.
b. above the hematoma.
c. the antecubital area of the right arm.
d. the antecubital area of the left arm.
a. below the hematoma

The maximum number of attempts that a phlebotomist should make to collect a specimen is:
a. one.
b. two.
c. three.
d. four.
b. two.

. Prolonged tourniquet application will cause:
a. edema.
b. hemolysis.
c. hemoconcentration.
d. both B and C
d. both B and C
b. hemolysis.
c. hemoconcentration.

. Specimens are rejected by the laboratory for all of the following reasons except:
a. clots in a lavender stopper tube.
b. collection in the wrong tube.
c. incompletely filled light-blue stopper tubes.
d. clots in a red stopper tube.
d. clots in a red stopper tube.

. Allowing blood to leak from a vein into the surrounding tissue will cause:
a. hematoma.
b. hemolysis.
c. nerve damage.
d. syncope.
a. hematoma.

Hematomas can be caused by all of the following except:
a. having the patient bend the elbow.
b. inserting the needle partially into the vein.
c. drawing below an intravenous line.
d. removing the tourniquet after removing the needle.
c. drawing below an intravenous line.

The best reason why the majority of patient samples are drawn in the early moming hours is because:
a. the patient will not be in the basal state early in the rnorning because this requires several hours of normal physical activity by the patient.
b. patients should have consumed a meal no less than three hours prior to the time of collection.
c. the patient will be in the basal state, having restrained from strenuous exercise and having fasted for approximately 12 hours.
d. patients are generally more agreeable with collection times scheduled early in the morning.
c. the patient will be in the basal state, having restrained from strenuous exercise and having fasted for approximately 12 hours.

. Plasma differs from Serum in that:
a. Serum contains fibrinogen
b. Serum is obtained by centrifugation
c. Plasma contains fibrinogen
d. Plasma is obtained by centrifugation
c. Plasma contains fibrinogen

A sentinel event would be most likely caused by delivery of a mislabeled tube to which lab department:
a. Coagulation
b. Hematology
c. Immunology
d. Blood bank
d. Blood bank

. Which of the following tests is not part of the CBC:
a. Red blood cell count
b. Platelet count
c. Sedimentation rate
d. Differential
c. Sedimentation rate

. Testing of a fecal stool for parasites is performed in:
a. Hematology
b. Microbiology
c. Immunology
d. Urinalysis
b. Microbiology

A prothrombin test is performed in:
a. Coagulation
b. Immunology
c. Microbiology
d. Chemistry
a. Coagulation

True/False
Indicate whether the following statements are true or false.
The liquid portion of a specimen collected in a tube containing ethylenediaminetetraacetic acid (EDTA) is serum.
False

True/False
Indicate whether the following statements are true or false.
If a needle has not been used it can be recapped?
False

True/False
Indicate whether the following statements are true or false.
When using a butterfly, a light blue stopper tube should be collected first.
/False

. What zone does a phlebotomist work in, according to the American zone of comfort guide lines?
A. Intimate zone 18-24 inches
B. Intimate zone 24-36 inches
C. Personal zone 18-24 inches
D. None of the above
A. Intimate zone 18-24 inches

. In what department of the lab is a complete blood count performed?
A. Hematology
B. Microbiology
C. Chemistry
D. Blood bank
A. Hematology

Which of the following would not be needed when collecting a throat culture?
a. Flashlight
b. Blood agar culture plate
c. Tongue depressor
d. Sterile swab
b. Blood agar culture plate

What type of tube is used for a complete blood count?
A. Purple with clot activator
B. Lavender with EDTA
C. Lavender with EDTA
D. Lavender with NaK
C. Lavender with EDTA

. What chemical or additive is needed for performing an activated partial thromboplastin time?
A. EDTA
B. SPS
C. Clot activator
D. Sodium citrate
D. Sodium citrate

What color of tube is used for activated partial thromboplastin time?
A. Light blue
B. Light green
C. Purple
D. Yellow
B. Light green

What is the abbreviation for activated partial thromboplastin time?
A. PT
B. CBC
C. PTT
D. CHEM-7
C. PTT

Which of the following is not one of the three types of blood samples?
A. Whole blood
B. Plasma
C. Serum
D. Iron
D. Iron

In which part of the lab is a CMP performed?
A. Microbiology
B. Chemistry
C. Hematology
D. Blood bank
B. Chemistry

What does CMP stand for?
A. Comprehensive Metabolic Panel
B. Choke Mary Partially
C. Chemistry Metabolic Panel
D. Chloride Metabolic Panel
A. Comprehensive Metabolic Panel

. What color of tube does the phlebotomist use for blood bank testing?
A. Red plastic
B. Red glass
C. Yellow
D. Pink
D. Pink

Traditional duties of the phlebotomist include all of the following except:
A. Correctly label all specimens with required information
B. Select the appropriate specimen containers for the specified test
C. Perform test on patient samples in the lab
D. Collect the appropriate amount of blood by venipuncture or dermal puncture
C. Perform test on patient samples in the lab

. To prevent blood from clotting, the specimen must be:
A. Collected in a tube containing an anticoagulant
B. Inverted right after collection
C. Centrifuged right after collection
D. Both a and b
D. Both a and b
A. Collected in a tube containing an anticoagulant
B. Inverted right after collection

The primary antiseptic for venipuncture is:
A. 70% isopropyl alcohol
B. 80% isopropyl alcohol
C. 90% isopropyl alcohol
A. 70% isopropyl alcohol

. Most anticoagulants in blood collection tubes prevent clotting by:
A. Binding calcium
B. Acting as an antithrombin agent
C. Binding fibrinogen
D. Releasing heparin
A. Binding calcium

. List five (5) physical and/or emotional changes associated with the aging process that could impact phlebotomy procedures
Any 5 of the following:

Hearing loss leading to embarrassment and frustration
Impaired verbal communication
Failing eyesight
Loss of taste, smell and/or feeling
Memory loss
Thinner skin tissue
Smaller muscles
Increased susceptibility to accidental hypothermia
Increased sensitivities and allergies
Anxiety related to becoming older and less capable

List two other terms used to refer to point-of-care testing:
Any two of the following:

Decentralized laboratory testing
On-site testing
Bedside testing
Near-patient testing
Patient-focused testing

The nervous system that is made up of the brain and spinal cord is the:
a. central nervous system.
b. peripheral nervous system.
c. autonomic nervous system.
d. voluntary nervous system
a. central nervous system

Application of the tourniquet on the patient’s arm for longer than one minute may cause:
a. an increase in contaminated blood cultures.
b. a clotted sample in the red top tubes collected.
c. an increase in concentration of large molecules.
d. decreased pain and discomfort in the arm.
c. an increase in concentration of large molecules

The anterior portion of the body is the:
a. right side.
b. front side.
c. back side.
d. left side.
b. front side.

When a central venous access device (CVAD) is present:
a. blood is drawn from the line using a 30-mL syringe.
b. laboratory specimens should not be collected from the catheter.
c. blood is drawn and discarded before the specimen is collected.
d. an evacuated tube is attached to the line for specimen collection.
c. blood is drawn and discarded before the specimen is collected.

A phlebotomist may be requested not to transport a specimen through the pneumatic tube system if it is to be tested for:
a. glucose.
b. cholesterol.
c. creatinine.
d. potassium.
d. potassium.

Inflammation of the meninges caused by a bacterial or viral infection is called:
a. poliomyelitis.
b. chondrosarcoma.
c. meningitis.
d. cerebral palsy
c. meningitis.

Accessioning refers to:
a. a test performed in the chemistry section.
b. organization of requisition slips for morning sweeps.
c. assigning of identification numbers and distribution of specimens.
d. processing of specimens requiring special handling.
c. assigning of identification numbers and distribution of specimens.

Errors in prioritizing specimens appropriately (routine versus stat) for processing are classified as:
a. post-examination variables.
b. different types of variables depending on the type of laboratory.
c. pre-examination variables.
d. examination variables.
c. pre-examination variables.

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.
d. when the hands are not visibly contaminated with blood or other body fluid.

The physical examination of urine includes reports on:
a. odor and turbidity.
b. color and appearance.
c. clarity and foam color.
d. color and blood.
b. color and appearance.

Which of the following pairings is wrong?
a. icteric and yellow.
b. lipemic and cloudy.
c. hemolyzed and red.
d. fasting and cloudy.
d. fasting and cloudy.

Phlebotomists may be required to classify tests using a:
a. current procedural technology (CPT) code.
b. bar code.
c. International Classification of Diseases, 9th Revision (ICD-9) code.
d. Centers for Disease Control and Prevention (CDC) code.
a. current procedural technology (CPT) code.

The sweat electrolyte test is used in the diagnosis of;
a. multiple sclerosis.
b. cystic fibrosis.
c. muscular dystrophy.
d. electrolyte imbalance.
b. cystic fibrosis.

The puncture site may require additional pressure to stop bleeding when the patient:
a. has low blood pressure.
b. is taking anticoagulants.
c. frequently takes aspirin.
d. both B and C
d. both B and C
b. is taking anticoagulants.
c. frequently takes aspirin

. Which of the following pairings is incorrect?
a. Thumb and calluses
b. Index finger and increased nerve endings
c. Third finger and increased possibility of bone puncture
d. Fifth finger and decreased tissue mass
c. Third finger and increased possibility of bone puncture

. Lavender stopper tubes can be used for all of the following except:
a. coagulation tests.
b. platelet counts.
c. differential counts.
d. hematocrits.
a. coagulation tests.

The most economical and safest method for performing routine venipuncture is the use of:
a. butterflies.
b. plastic syringes.
c. glass syringes.
d. evacuated tubes
d. evacuated tubes.

. An elevated bilirubin might indicate a disorder of the:
a. heart.
b. kidney.
c. brain.
d. liver.
d. liver.

Areas that should be avoided for venipuncture include all of the following except:
a. hematomas.
b. deep cephalic veins.
c. sclerosed veins.
d. tattoos.
b. deep cephalic veins.

. To produce a rounded drop of blood, finger punctures should be made:
a. on the index finger.
b. on the fingerprint.
c. before the alcohol is dry.
d. across the fingerprint.
d. across the fingerprint.

Using a small-gauge needle with a large evacuated tube can cause:
a. a hematoma.
b. petechiae.
c. hemolysis.
d. patient discomfort.
c. hemolysis

An unexpected patient death that is not related to the patient’s illness is termed a:
a. root cause.
b. human error.
c. sentinel event.
d. professional liability.
c. sentinel event.

The maximum safe length of lancets used for heel puncture is:
a. 1.5 mm.
b. 2.0 mm.
c. 2.75 mm.
d. 3.4 mm.
b. 2.0 mm.

The main organ(s) of the integumentary system is (are) the:
a. nails.
b. hair.
c. skin.
d. sweat glands.
c. skin.

. If a patient refuses to have blood drawn, the phlebotomist should:
a. send another phlebotomist to collect the specimen.
b. report the situation to the nursing station.
c. return the requisition form to the laboratory.
d. ask someone to hold the patient and collect the specimen.
b. report the situation to the nursing station.

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