Phlebotomy Procedures and Laboratory Safety, Exams of Medicine

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CPT Phlebotomy Exam Study Guide 2024 What is phlebotomy? ✔ The process of drawing blood What is a phlebotomist? ✔ A trained professional in blood drawing Which of the following is a part of a phlebotomist's POC job related duties? ✔ Taking blood pressure, instructing patients on urine specimen collection, and performing POC testing All of the following are true about laboratory safety ✔ Protect your feet from spills, always wear required personal protection equipment As written in the Patient Care Partnership from the American Hospital Association, the patient has the right to: ✔ High quality care, protection of privacy, help with billing claims Certification is evidence that: ✔ The phlebotomist has demonstrated proficiency in the area of blood drawing Which of the is OSHA required personal protection equipment? ✔ Goggles, chin-length face shield, full-length lab coat The Clinical Laboratory Improvement Act of 1988 follows guidelines and standards set by the: ✔ CLSI Samples collected from a patient in a nursing home are sent to the: ✔ Reference laboratory Quality assurance for laboratory personnel includes all of the following ✔ Specimen collection procedures, Specimen transport processes, Specimen processing policies Personal protection equipment must be provided by the ✔ Employer Which of the following personal protection equipment must a phlebotomist use when performing a skin puncture or venipuncture? ✔ Gloves Under HIPPA, protected health is defined as: ✔ Any part of a pt's health information that is linked to information that identifies the pt. Employers must provide vaccination against what free of charge? ✔ Hep B Which of the following would be a reason for a rejection of a specimen by the lab? ✔ An ESR has been collected in a red-topped tube The quality of the test result depends on: ✔ The time between collecting the specimen and analyzing the specimen The purpose of Total Quality Management is to: ✔ Check machinery with automated procedures, ensure that proper laboratory procedures are being followed, ensure that adequate patient care is being provided. A specimen may be rejected by the lab if: ✔ The tube was not initialed, the blood is hemolyzed, the tube was not transported properly. Transport bags have a separate compartment (pouch) for the requisition to: ✔ Prevent contamination if the specimen leaks Acceptable methods of identifying a patient include: ✔ Ask the pt to give his or her name and DOB, check the pts ID band, ask the pt to present a photo ID What is the proper procedure for a phlebotomist to follow if a physician or member of the clergy is in the pts room at the time of draw? ✔ Return at another time if the specimen is not a stat request Most tubes that containing additives should be inverted: ✔ 5 to 8 times The lavender topped tube contains: ✔ EDTA The green topped tube contains: ✔ Heparin The yellow topped tube contains: ✔ SPS or ACD The glass red topped tube contains: ✔ No additive The most commonly occurring complication in phlebotomy is: ✔ Hematoma A tourniquet that has been left on too long can cause: ✔ Petechiae, hemolysis, hemoconcentration What should a phlebotomist do first if a pt has syncope during a phlebotomy procedure? ✔ Remove the needle and tourniquet, and apply pressure What are the signs and symptom of syncope? ✔ Cold, damp, clammy skin Blood that has seeped from a vein into tissue is called: ✔ Hemotoma Which of the following my cause vein occlusion? ✔ Sphygmomanometer What complication may occur if the phlebotomist punctures a bone? ✔ Osteomyelitis Veins that are hard and cordlike are called: ✔ Sclerosed The term that means the rupturing of red blood cell is: ✔ Hemolysis High bilirubin levels can lead to: ✔ Jaundice, which can lead to brain damage Thrombosis ✔ Clot formation within blood vessel Which of the following will cause a shortened bleeding time in a bleeding time in a bleeding time test? ✔ Hair at the incision site A hematoma can be prevented if: ✔ Pressure is applied on the vein until bleeding stops completely Aspirin may affect a pts: ✔ Bleeding time In a CSF collection, the phlebotomist will: ✔ Transport the specimen to the lab Midstream clean catch urine collection are: ✔ Obtained by a phlebotomist and collected in a sterile container The process for collecting amniotic fluid is known as: ✔ An amniocentesis The amniotic fluid must be: ✔ Transferred into a sterile container, protected from light, transported immediately to the lab for analysis Prompt delivery to the lab of semen samples is necessary to determine what: ✔ Viability in fertility Fecal specimens are collected for: ✔ Ova and parasite testing, testing for digestive abnormalities, occult blood analysis What is the best sample to determine blood pH and blood gases? ✔ Arterial blood An un-iced ABG must be delivered to the lab ✔ 5-10 minutes Arterial blood gas must be processed immediately to minimize ✔ Changes in the analyte All of the following are safety equipment for arterial blood gas collection except a: ✔ Transport container If the modified Allen test is negative, ✔ Another artery must be selected for blood collection The NP culture is used to diagnose: ✔ Whooping cough, croup, and respiratory infections The SE test is used to diagnose: ✔ Cystic fibrosis Which procedure is normally collected by a nurse or respiratory therapist? ✔ Arterial blood gas Dermal punctures can be used as an alternate for all of the following except: ✔ ESR For which of the following pts should a dermal puncture be performed? ✔ Ps who require frequent blood draws, pts with burns on the arms, pts who are at risk for venous thrombosis Which of the following is the reason for cleansing the first drop of blood in a dermal puncture? ✔ To rid the specimen of fluid from tissue When collecting blood from a child, the phlebotomist should: ✔ Consider the psychological aspect of the draw, log the amount of blood collected to avoid depletion, collect dermal punctures whenever possible Which of the following should a phlebotomist not do when drawing blood from a child? ✔ Tell the child that the procedure will not hurt What does the phlebotomist look for when identifying a newborn? ✔ The hospital identification number and the last name Improper cleansing of a venipuncture site can cause: ✔ Septicemia Which of the following components is needed in order to make what is known as the chain of infection? ✔ Causative agent A health care-related infection is: ✔ An infection contracted within a health care institution When a pt has a highly contagious disease, he or she is placed: ✔ In strict isolation A pt who is known to have a blood transmissible disease is placed: ✔ On blood and body fluid precautions A pt who has diarrhea and bacterial gastroenteritis disease is placed: ✔ In enteric isolation Pts within a neonatal ICU/burn unit or the recovery room are: ✔ In a protective environment The most infectious health care-acquired disease is: ✔ HCV An infection is: ✔ The invasion and growth of a pathogen Microorganisms that cause disease ✔ Pituitary The phlebotomist dropped a tube of blood on the floor and it broke on impact. The proper way to clean up the blood and broken glass includes all of the following: ✔ Don PPE as required by facility, pick up the glass using forceps, saturate site with bleach Mary the phlebotomist brought in ice cream bars in celebration of passing her certification exam. She put them in the freezer thinking it was alright because only test reagents, no blood or body fluids, were stored inside. She was reprimanded for all of the following: ✔ Test reagents can contain blood or vody fluids, no food or drink is allowed in the lab without permission, laboratories are designated as biohazardous, and OSHA regulations were violated. The phlebotomists prepares to draw blood on a child that refused to sit in the chair and have her blood drawn. Why can the phlebotomist proceed with the procedure? ✔ Parental consent was given in the case of the minor The phlebotomist donned gloves, gown, and goggles before performing an ABG procedure. She is still at risk for which type of exposure? ✔ Cutaneous, permucosal, and percutaneous A patient in open heart recovery has an order for an H&H, glucose, electrolytes, and ABGs. The phlebotomist tells the nurse to collect all of the specimens through the arterial line because: ✔ Blood samples will be labeled as arterial samples While in the ER performing a venipuncture, you, the pt, and the pt's family clearly overhear two nurses outside the room discussing the pt next to you. You should: ✔ Report the breach of confidentiality to your supervisor You are working quickly to complete your early AM draws when you encounter a difficult draw on a newborn. You should call down to the lab for assistance because you: ✔ Are nearing the acceptable time lapse between collection of the specimen and analysis While performing QC on a point-of-care instrument for glucose testing prior to the 10 PM patient glucose testing, the phlebotomist records a QC value for the abnormal control that is two points out of range. The appropriate course of action is to: ✔ Initiate trouble shooting protocol for out-of-range controls While processing a specimen, the phlebotomist accidently spills serum on the requisition. The phlebotomist should: ✔ Disinfect the contaminated area with 10% bleach and blot dry The phlebotomist has an order for a blood draw on his father who is in the hospital. The phlebotomist can identify his father by: ✔ Asking the pt to state his name and checking the requisition against the pt's armband As you are putting away the new order of vaccutainer tubes, you should: ✔ Position current stock so it will be used up first Why is it important that the pt see the phlebotomist wash his or her hands before and after the draw? ✔ So the pt is assured that infection control policies are being followed The ER nurse hands the phlebotomist an ID bracelet to put on a trauma pt so the phlebotomist can draw stat labs. The phlebotomist should: ✔ Inform the nurse that he or she is not allowed to do so and , request that the pt put it on The phlebotomist walks into open heat recovery to pick up the pt's specimens for transport to the lab and notices one nurse drawing from the arterial line while the other nurse transfer blood into a lavender, light blue, and heparin tube, placing each tube on the bed after filling, and then turns to help the other nurse flush the line. The proper course of action is to: ✔ Pick up all of the tubes and immediately begin inversion eight to ten times the pt was in a hurry to leave and the phlebotomist had not labeled all of the tubes. As she exits the room with the pt she takes the tubes and sets them down on the counter outside the room and walks the pt to the exit door, giving instructions for puncture wound care. Another phlebotomist comes by, picks up the tubes and the requisition, and puts them in the rack for delivery to processing. The proper course of action is to: ✔ Reject the specimen for labeling error and call the pt in for a redraw You are on your last pt for the AM draws only to find that you have almost depleted your supple of tubes. The order is for a CBC and electrolytes, and you only have lavender and red tops left on your tray. The proper course of action is to: ✔ Draw one lavender tube for Hematology and one red top tube for Chemistry You receive a specimen from a physician's office dated yesterday. The specimen is now 18 hours, but you do not reject it because it was: ✔ A glucose test drawn in a gray top When processing the specimens that the courier just dropped off, you find that there are four tests ordered but only two tubes received : one lavender and one SST tube. The requisition is marked for a CBC, RPR, BUN, and creatinine. The phlebotomist should: ✔ Make aliquots from the SST tube for the RPR and BUN/ Creatinine tests After putting a tourniquet on a pt, th phlebotomist notice the development of petechiae. She verified correct application of the tourniquet and should now: ✔ The phlebotomist removed the cap from the needle, proceeded to anchor the vein, and noticed he forgot to reapply the tourniquet. The appropriate course of action would be: ✔ Discard the vaccuatiner and needle unit and start the procedure over The phlebotomist enters a pts room and says, "Hi, John. I need to draw some blood again." The phlebotomist's identification of the pt is: ✔ Not ok because proper identification of the pt must be adhered to at all times.