Title: Exam 3
Course: Allied Health Assistant (Phlebotomy) > Section: Module 4

Q: Which bore (diameter) of the needle is the smallest?
- 16-gauge needle
- 21-gauge needle
- 20-gauge needle
- 23-gauge needle
A: 23-gauge needle

Q: The common needle gauges used for drawing blood with an evacuated system are:
- 10, 12, or 14 gauge
- 16, 17, or 18 gauge
- 20, 21, or 22 gauge
- 24, 25, or 26 gauge
A: 20, 21, or 22 gauge

Q: Through which size needle will blood flow the fastest?
- 20
- 21
- 22
- 23
A: 20

Q: The unit of liquid volume in the metric system is the:
- gram
- meter
- centimeter
- millimeter
- liter
A: liter

Q: The gauge of the needle indicates the following relationship: the larger the gauge number, the:
- larger the diameter of the bore
- longer the needle
- shorter the needle
- smaller the diameter of the bore
A: smaller the diameter of the bore

Q: In general, a syringe is used when drawing specimens and/or patients, EXCEPT for:
- arterial blood gases
- persons with fragile vein walls
- persons with rolly veins
- requests for multiple testing, requiring different anticoagulants and multiple tubes
A: requests for multiple testing, requiring different anticoagulants and multiple tubes

Q: Which anticoagulant prevents coagulation of blood by removing calcium through the formation of insoluble calcium salt?
- EDTA
- oxalate
- citrate
- lithium heparin
- A, B, and C
A: A, B, and C

Q: You are preparing to draw blood for multiple tests in several tubes. The best and most cost-efficient technique would be:
- butterfly system
- syringe
- evacuated tube system
- lancet
A: evacuated tube system

Q: The anticoagulant heparin is used for blood gases and other chemistry tests. It works by:
- binding calcium ions
- preventing the conversion of prothrombin to thrombin
- preventing the conversion of plasminogen to plasmin
- activating tissue thromboplastin
A: preventing the conversion of prothrombin to thrombin

Q: All of the following statements are true EXCEPT:
- Gray-stoppered tubes are used for blood glucose tests.
- Gray-stoppered tubes are used for CBC and WBC tests.
- Lavender-stoppered tubes are used for CBC, WBC, and platelet testing.
- Red-stoppered tubes are used for many tests, including serum enzyme testing.
A: Gray-stoppered tubes are used for CBC and WBC tests.

Q: 10 mL is the same as:
- 1 liter
- 10 decimeters
- 10 cc
- none of the above
A: 10 cc

Q: Blood is needed for routine bleeding and coagulation studies (PT, PTT). Which color tube top is to be used?
- light blue
- gold
- green
- red
A: light blue

Q: When serum is needed for testing, which tube listed should be used?
- light blue
- green
- lavender
- red
A: red

Q: The anticoagulant preferred for hematology testing is:
- citrate
- EDTA
- fluoride
- heparin
A: EDTA

Q: An arterial puncture is more likely to result in a hematoma than a venipuncture is because of:
- higher pressure in the arteries
- the lack of coagulation factors
- the lack of elastic tissue in the arterial wall
- the anticoagulant in the arterial syringe
A: higher pressure in the arteries

Q: Which arteries are least suitable for drawing blood gases?
- radial
- brachial
- femoral
- ulnar
A: femoral

Q: A patient has a negative Allen test. What should you do?
- Perform the Allen test on the other arm.
- Perform the arterial puncture in the radial artery.
- Perform the arterial puncture in the ulnar artery.
- Perform the arterial puncture in the brachial artery.
A: Perform the Allen test on the other arm.

Q: The artery that lies on the thumb side of the wrist is the:
- popliteal
- radial
- temporal
- ulnar
A: radial

Q: If the blood is drawn too quickly from a vein, the vein will have a tendency to:
- bruise
- collapse
- disintegrate
- roll
A: collapse

Q: The bevel of the needle:
- attaches to the syringe or the holder
- should be held at a 50-degree angle to the skin
- should always be facing up when inserted into the skin
- should always be facing down when inserted into the skin
A: should always be facing up when inserted into the skin

Q: Under which of the following conditions would you avoid a site for venipuncture?
- edematous arm
- arm with IV
- hematoma
- all of the above
A: all of the above

Q: When drawing blood samples, which of the following should be performed first?
- Clean the site.
- Find the vein.
- Apply the tourniquet.
- Identify the patient.
A: Identify the patient.

Q: What is the primary source of information when labeling a patient sample in the hospital?
- nurse
- patient’s family
- name label at the foot of the bed
- wristband and patient verification of name
A: wristband and patient verification of name

Q: An arterial puncture site is more likely to bleed because:
- arterial blood does not clot as fast as venous blood
- arterial blood has a high oxygen content
- arteries have higher pressures than veins
- none of the above
A: arteries have higher pressures than veins

Q: Venipuncture is usually performed in the antecubital area. Which vein is usually the best to draw from?
- cephalic
- basilic
- median cubital
- none of the above
A: median cubital

Q: The doctor orders a CBC, serum drug level, PT, and a set of blood cultures. What is the order of draw?
- red, light blue, blood culture, lavender
- blood culture, light blue, lavender, red
- blood culture, light blue, red, lavender
- blood culture, green, light blue, red
A: blood culture, light blue, red, lavender

Q: What can happen if the tourniquet is left on too long before drawing blood?
- hematoma
- hemolysis
- hemoconcentration
- none of the above
A: hemoconcentration

Q: Which two arteries are occluded when the Allen test is performed?
- femoral and radial
- radial and ulnar
- brachial and ulnar
- radial and brachial
A: radial and ulnar

Q: Once an arterial blood sample is obtained, the puncture site should have pressure held for at least:
- 1 minute
- 5 minutes
- 30 minutes
- 60 minutes
A: 5 minutes

Q: As a general rule, you should not stick a person more than ____ in an attempt to obtain blood.
- once
- twice
- three times
- four times
A: twice

Q: Serum is described as icteric in the presence of increased:
- bilirubin, causing jaundice
- carbon dioxide from cell metabolism
- hemoglobin from ruptured RBCs
- lipids in a nonfasting sample
A: bilirubin, causing jaundice

Q: Serum is described as lipemic in the presence of increased:
- bilirubin, causing jaundice
- carbon dioxide from cell metabolism
- hemoglobin from ruptured RBCs
- lipids in a nonfasting sample
A: lipids in a nonfasting sample

Q: Serum is described as hemolyzed in the presence of increased:
- bilirubin, causing jaundice
- carbon dioxide from cell metabolism
- hemoglobin from ruptured RBCs
- lipids in a nonfasting sample
A: hemoglobin from ruptured RBCs

Q: Why is the first tube discarded when you are drawing from an indwelling line?
- to remove tissue fluid
- to wipe away any bacterial contamination
- to remove heparin or saline contamination
- to make the blood flow faster
A: to remove heparin or saline contamination

Q: The purpose of the Allen test is to:
- check for collateral circulation through the ulnar artery before sampling from the radial artery
- check for adequate pulse in the brachial artery
- check for the presence of a pulse in the radial artery
- verify that you are about to sample from an artery and not a vein
A: check for collateral circulation through the ulnar artery before sampling from the radial artery

Q: A patient sitting in a chair has fainted. Possible acceptable actions by the phlebotomist include all of the following EXCEPT:
- leaving the patient unattended
- placing a cold compress on the back of the patient’s neck
- putting the patient’s head between his knees
- calling for assistance
A: leaving the patient unattended

Q: Which is generally the most common complication from phlebotomy?
- convulsions
- fainting
- hematoma
- hyperventilation
A: hematoma

Q: A phlebotomist is requested to draw an unconscious patient. The patient’s name and identification number on the armband agree with the information on the request form and computer labels. What else should be done to ensure patient identification?
- Attempt to awaken the patient for verbal verification of identity.
- Attempt to find the patient’s name on some other item in the room.
- Nothing else is necessary.
- Get verification from a relative or nurse about the patient’s identity.
A: Nothing else is necessary.

Q: A conscious patient does not have an identification armband. The name on the water jug and room number on the door agree with the information on the request. What should the phlebotomist do?
- Ask the patient for verbal verification of his or her name.
- Draw the patient and take the sample to the lab.
- Do not draw the patient until an armband has been applied.
- Draw the patient and then ask the nurse to identify the patient.
A: Do not draw the patient until an armband has been applied.

Q: An unconscious, unidentified man is admitted to an emergency trauma center. What would be the system of choice to ensure patient identification?
- Assign a name to the patient, such as John Doe, and use that name for identification.
- Assign a number to the patient until the patient can be identified.
- Wait to process any samples until the patient can be identified.
- Use a three-part identification system that utilizes a temporary armband and labels for specimens and blood to be transfused.
A: Use a three-part identification system that utilizes a temporary armband and labels for specimens and blood to be transfused.

Q: To fill an evacuated tube with blood from a syringe, the phlebotomist should:
- puncture the diaphragm of the stoppered tube with the needle and push the blood quickly into the tube with the plunger of the syringe.
- remove the stopper of the tube and carefully pour the blood into the tube, after removing the needle from the syringe
- use a transfer device by removing the syringe needle after the safety shield has been engaged and then attaching the syringe to the transfer device for filling the evacuated tubes
- remove the stopper of the tube, and push the blood into the tube with the  syringe needle still on the syringe
A: use a transfer device by removing the syringe needle after the safety shield has been engaged and then attaching the syringe to the transfer device for filling the evacuated tubes

Q: In what order should a serum (SST) tube, a green tube, light blue tube and a lavender tube be filled from a syringe?
- serum, lavender, light blue and green
- light blue, serum, lavender and green
- green, light blue, serum and lavender
- light blue, serum, green and lavender
A: light blue, serum, green and lavender

Q: A patient comes to have a monthly Prothrombin time (PT) collected. You must use a butterfly system because of the patient’s small veins. This is the only test you need to draw. What must you remember to do first?
- Tell the patient that he cannot be drawn because butterfly needles are too expensive
- Draw a discard tube to remove the air in the tubing
- Draw extra tubes in case the physician orders more tests
- Draw the light blue tube. There is nothing special to do
A: Draw a discard tube to remove the air in the tubing

Q: You cannot perform a venipuncture successfully after two attempts. You should:
- try at least two more times
- notify the patient’s physician
- ask another phlebotomist to try
- request the rest of the day off
A: ask another phlebotomist to try

Q: In performing an arterial puncture, you should puncture the artery using a:
- 15-degree angle of insertion with the bevel of the needle facing the hand
- 15-degree angle of insertion with the bevel of the needle facing the elbow
- 45-degree angle of insertion with the bevel of the needle facing the hand
- 45-degree angle of insertion with the bevel of the needle facing the elbow
A: 45-degree angle of insertion with the bevel of the needle facing the elbow

Q: Using your best interpersonal skills, how would you respond to a patient who says she does not want her blood drawn because all phlebotomists hurt her?

Q: You have been given an order to draw patient Jane Smith in room 2232. When you go into that room, the patient identifies herself as Jane Smith but the armband indicates that the patient is Jane Smiley. What do you do next?