Phlebotomy Midterm Review

• A home care phlebotomist had a requisition to collect a CBC, plasma K, PTT, and PT.  He collected the tubes from the client, who was lying on the sofa with her arm elevated above her shoulder on a table next to the sofa.  As he collected the tests in the following order:  CBC, K, and finally the PT and PTT, he was careful to invert the tubes as specified.  Later that day, the lab called the phlebotomist to say that three of the tests would have to be redrawn.  Which three tests most likely had questionable results and needed to be redrawn?

  Potassium, PTT, and PT
• A phlebotomy needle that does not have a safety feature

  must be used with a holder that has a safety feature
• A pink-top tube containing EDTA is primarily used for

  blood bank tests
• A prothrombin time (PT) and platelet count are ordered on an 80-year-old female patient.  Deciding to use a butterfly and "short draw" evacuated tubes on the tiny cephalic vein on the dorsal side of her right arm, the phlebotomist collected one light blue-top tube and then a lavender top.  Why would you suspect that the PT results might be incorrect and the platelet count unaffected?


  No tube was drawn to remove air in the butterfly tubing, creating a short draw for the PT
• A royal blue-top tube with green color coding on the label contains

  heparin
• A serum specimen is requested. Which of the following evacuated tubes can be used to collect it?


  SST
• A solution used to clean the site before routine venipuncture is 


  70% isopropyl alcohol
• A specimen collected in this type of additive will separate if allowed to stand


  Heparin, Citrate, Oxalate
• A trace-element specimen tube should be collected


  separately or by syringe
• After a blood spill, a disinfectant is applied and must have at least 10 minutes of contact time to be effective
• An ETS holder and a syringe transfer device look very similar. What is the difference between the two?

  The hub on the transfer device attaches to a multisample needle or syringe barrel
• Antiseptics are

  safe for use on human skin
• Carryover from this tube has a greater potential to negatively affect the specimen in the next tube drawn

  underfilled EDTA tube
• CLSI standards advise against using these on infants and children younger than 2 years of age

  adhesive bandages
• decontamination of hands after glove removal is essential because

  hand contamination might not be visible to the naked eye
• Due to allergenic reactions, which type of glove is not recommended to be used in healthcare facilities

  Latex
• During venipuncture the tourniquet should not be left on longer than

  1 minute
• Electrolytes should never be collected in a gray top
• glass particles present in serum separator tubes activate clotting
• heparin prevents blood from clotting by inhibiting thrombin
• Identify the tubes needed to collect a CBC, PTT, and STAT potassium by color and in the proper order of collection for multiple tube draw

  light blue top, green top, lavender top
• identify the tubes needed to collect a PT, STAT lytes, and BC in the proper order of collection

  yellow, light blue, PST
• If a blood pressure cuff is used for venipuncture, in place of a tourniquet, the pressure used must be below the patient's diastolic pressure
• If hands are heavily contaminated with organic material and sink is not available, the phlebotomist should clean them with detergent-containing wipes followed by a sanitizer
• If phlebotomist have dermatitis, they should see if glove liners will help
• Improper handling of storage of evacuated tubes can affect additive integrity, shape of the tube, vacuum of a tube
• In a successful venipuncture, evacuated tubes fill automatically as soon as the tube stopper is pierced because of premeasured vacuum in each tube
• It is best if tourniquets are used once and then discarded
• lavender stopper tubes are most commonly used to collect hematology tests
• Lithium heparin is a suitable anticoagulant for which of the following tests?

  lytes
• Measurement of copper, a trace element, requires blood collection in a tube with a royal blue top
• Mixing additive tubes involves turning the wrist 180 degrees and back
• Mixing equipment from different manufacturers can result in improper fit of the needle
• Multisample needles are typically available in these gauages

  20 to 22
• Needle safety devices must create a barrier between a user's hand and the needle after use
• Needle safety features work by covering or shielding the needle, retracting the needle after use, using a device to blunt the needle
• OSHA regulations require that after use tubes holders with needle attached be disposed of as a unit
• Plastic red-top tubes used to collect blood specimen contain clot activators
• The best choice of equipment for drawing difficult veins is a butterfly and ETS holder
• The blood to additive ratio is most critical for a specimen collected in this tube

  light blue top