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PHLEBOTOMY ALL VERSIONS 1 QUESTIONS AND
VERIFIED CORRECT ANSWERS (ACCURATE
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- What is the primary purpose of a tourniquet in phlebotomy? To make veins more visible and easier to access A tourniquet restricts venous blood flow, causing veins to fill and become more prominent for puncture.
- Which vein is most commonly used for venipuncture? Median cubital vein This vein is large, easily accessible, and has the lowest risk of complications.
- What angle should the needle be inserted when performing a venipuncture? 15 to 30 degrees This range allows entry into the vein without passing through it.
- What is the correct order of draw for blood collection tubes? Blood culture, light blue, red, gold/tiger top, green, lavender, gray This order prevents cross-contamination of additives.
- Which additive is found in lavender-top tubes? EDTA EDTA prevents clotting by binding calcium.
- When should a phlebotomist label the specimen tubes? Immediately after collection at the patient’s bedside Labeling in the presence of the patient ensures accuracy and reduces errors.
- What is the recommended antiseptic for routine venipuncture? 70% isopropyl alcohol This effectively disinfects the skin and reduces infection risk.
- Which patient position is safest for blood collection? Seated with arm extended and supported This minimizes the risk of fainting or injury during the draw.
- What should a phlebotomist do if a patient feels faint? Stop the procedure immediately and lower the patient’s head This prevents injury and helps restore blood flow to the brain. 10.Which test requires a chain of custody form? Drug screening Chain of custody ensures the sample’s integrity for legal purposes. 11.Which specimen should be protected from light? Bilirubin Light degrades bilirubin, leading to inaccurate results.
19.How should blood be mixed with an additive in a tube? Gentle inversion Vigorous shaking can cause hemolysis. 20.Which of these is an example of a nosocomial infection? An infection acquired in a hospital Nosocomial means hospital-acquired. 21.Why are blood cultures drawn first? To avoid contamination Sterile technique is critical to prevent introducing skin flora. 22.What is the purpose of the bevel on a needle? To create a clean entry into the vein It allows the needle to slice through tissue smoothly. 23.How should a site be cleaned for blood culture collection? Chlorhexidine or iodine in concentric circles This reduces skin contaminants for sterile samples. 24.What is implied consent? Nonverbal agreement through patient’s actions Example: Extending an arm for venipuncture. 25.What is the maximum depth for a heel puncture in infants? 2.0 mm Deeper punctures risk bone injury.
26.Which is the best site for a capillary puncture in adults? Middle or ring finger These sites avoid nerves and provide good blood flow. 27.Which of these can cause hemolysis? Using a needle that is too small Small needles cause high pressure, breaking red blood cells. 28.When should a phlebotomist wear gloves? During every blood collection Standard precautions require gloves for contact with blood. 29.What tube is used for glucose testing? Gray top Contains sodium fluoride to preserve glucose levels. 30.What is the main reason to invert tubes after collection? To mix blood with additives Prevents clotting or promotes proper clotting, depending on the test. 31.What is the proper procedure for collecting a 24-hour urine specimen? Discard first void, then collect all urine for 24 hours This ensures accurate total measurement. 32.What is the acceptable site for a heel stick in infants? Lateral or medial plantar surface These areas avoid bone and nerves.
40.What action should be taken after a needle stick injury? Wash area and report immediately Prompt action reduces infection risk. 41.Which lab department analyzes electrolytes? Chemistry Electrolytes are part of blood chemistry panels. 42.Which test is most affected by patient position? Potassium Changes in posture affect fluid balance and analyte levels. 43.What is basal state? Early morning, fasting, rested state Standard for accurate baseline test results. 44.What is the best practice for preventing infection transmission? Hand hygiene Hand washing is the single most effective prevention measure. 45.Which situation requires contact precautions? Patient with C. difficile infection Contact precautions prevent spread by direct touch. 46.Which tube has no additive? Red top glass tube This allows blood to clot naturally for serum tests.
47.Which is the first choice for dermal puncture in an infant? Heel Infant fingers are too small; the heel is safer. 48.Why should blood cultures be drawn from two sites? To detect contamination and ensure accuracy Multiple sites confirm true bacteremia. 49.What is the function of sodium fluoride in tubes? Inhibits glycolysis It preserves glucose for accurate testing. 50.Why should you avoid milking the finger during capillary collection? It dilutes the sample with tissue fluid This can alter test results and cause hemolysis. 51.Which antiseptic should be avoided when collecting a blood alcohol specimen? Isopropyl alcohol It can contaminate the specimen and falsely elevate results. 52.Which tube is used for blood bank testing? Pink top Contains EDTA and is specifically labeled for cross-matching and transfusions. 53.What condition results if a patient pumps their fist excessively during venipuncture?
61.What is the best way to confirm a patient’s identity? Ask them to state their name and date of birth This prevents misidentification errors. 62.What does the gauge number of a needle indicate? Diameter of the needle Higher gauge means a smaller diameter. 63.What is the minimum requirement for fasting glucose testing? 8 hours of fasting Ensures accurate baseline glucose levels. 64.Which condition can cause a false decrease in hematocrit? Hemolysis Destruction of red blood cells lowers the measured value. 65.What is the first thing to check if a patient has a seizure during venipuncture? Remove the needle and protect the patient Safety is the priority during medical emergencies. 66.What should be done if you must draw from a patient with an IV? Draw below the IV site after stopping the IV for 2 minutes Reduces dilution by IV fluids. 67.Which test result is critically affected by prolonged tourniquet application? Potassium Cellular exchange can cause falsely elevated levels.
68.What should you do if the patient has a latex allergy? Use non-latex equipment Prevents allergic reactions and anaphylaxis. 69.What is the acceptable angle for a finger stick? Perpendicular to fingerprint lines Encourages good blood flow and prevents tissue damage. 70.What is the best practice for drawing a bilirubin on an infant? Protect the specimen from light Light breaks down bilirubin. 71.How should a cold agglutinin specimen be handled? Keep at body temperature until lab processing Cold can affect results. 72.Which specimen should never be centrifuged? CBC Whole blood is needed for cell counts. 73.What is an example of negligence in phlebotomy? Failure to identify the patient This can result in serious harm and legal liability. 74.Which test can be affected by patient dehydration? Hematocrit Fluid loss falsely elevates concentration of cells.
82.How should a wound culture be collected? Use sterile swab without contaminating site Sterile technique ensures accurate results. 83.What should you do if you see a hematoma forming? Stop draw, remove needle, and apply pressure Prevents further bleeding into tissue. 84.Which tube should be filled completely to ensure accurate results? Light blue Citrate tubes require a full draw for correct blood-additive ratio. 85.What is the reason for using butterfly needles for hand veins? Better control and lower risk of vein collapse Hand veins are small and fragile. 86.What is iatrogenic anemia? Blood loss caused by medical treatment Frequent draws can cause anemia in patients. 87.What is the minimum time to apply pressure after needle removal? 1 – 2 minutes Allows clotting and prevents bleeding. 88.What test is used to monitor heparin therapy? PTT (Partial Thromboplastin Time) Measures clotting function for heparin management.
89.Why is proper tube inversion important? Mixes additives properly Prevents clots or inaccurate results. 90.Which test is sensitive to circadian rhythms? Cortisol Levels vary by time of day. 91.What is the correct term for fainting? Syncope Loss of consciousness due to decreased blood flow to the brain. 92.What must be done with a sputum specimen? Collected first thing in the morning Highest concentration of pathogens. 93.Which is an acceptable site for venipuncture in obese patients? Cephalic vein Often more accessible than the median cubital vein. 94.Which tube is used for STAT electrolytes? Green top Contains heparin for rapid plasma separation. 95.What type of hazard is a used needle? Sharps hazard Can puncture skin and transmit infection. 96.Why is a discard tube used when drawing with a winged collection set for coagulation tests?
- What is the best method to prevent needlestick injuries? Use safety-engineered devices Reduces risk of accidental sticks.
- Which tube is used for trace metal testing? Royal blue top Prevents contamination with trace elements.
- What is the purpose of quality control? Ensure accuracy and reliability of results Verifies equipment and procedures work properly.
- Which lab department performs blood crossmatching? Blood bank Ensures compatibility for transfusions.
- What is the purpose of point-of-care testing (POCT)? Provide rapid results at patient’s bedside Speeds up diagnosis and treatment.
- What should you do if the patient asks about their test results? Refer them to their physician Phlebotomists should not interpret results.
- Which test requires special timing for accurate results? GTT (Glucose Tolerance Test) Samples must be collected at specific intervals.
- Which tube is used for an ammonia test? Green top, kept on ice Ammonia must be chilled to prevent changes.
- Which hazard label color represents flammability? Red Red indicates fire risk on hazard labels.
- Which PPE is required for droplet precautions? Surgical mask Prevents transmission through respiratory droplets.
- Which infection requires strict airborne precautions? Tuberculosis TB spreads easily through airborne particles.
- Which condition can be caused by repeated venipuncture? Phlebitis Inflammation of a vein due to trauma.
- What does the term “analyte” mean? Substance being measured Example: glucose, sodium, potassium.
- Why is it important to note if a patient is fasting? Affects levels of many analytes Non-fasting can lead to inaccurate results.
Lactic acid Stasis increases lactic acid levels.
- What is the primary duty of the phlebotomist? Collect blood specimens accurately and safely Core responsibility is proper specimen collection.
- Which factor can cause false lab results? Patient not fasting Food intake alters glucose and lipid levels.
- How do you prevent backflow during venipuncture? Keep the patient’s arm angled downward Prevents tube contents from flowing into the vein.
- How should needles be discarded? In a puncture-resistant sharps container Prevents accidental injury and contamination.
- What is the maximum acceptable number of attempts at venipuncture? Two More than two should be escalated to a more experienced professional.
- What is a critical step when using a butterfly needle? Use a discard tube for coagulation tests Clears air and ensures proper fill volume.
- What does a light blue tube test for? Coagulation studies Contains sodium citrate for PT/PTT testing.
- What is the function of sodium citrate in tubes? Binds calcium to prevent clotting Allows measurement of clotting factors.
- Which test requires a patient to be fasting? Lipid panel Fasting ensures accurate cholesterol levels.
- What is the recommended site for venipuncture on an infant? Scalp vein Used when heel or foot veins are inaccessible.
- What is the primary reason to use a tourniquet? To engorge veins Makes veins easier to locate and puncture.
- Which tube should be used for a serum potassium test? Red or gold top These allow blood to clot for serum separation.
- Which type of specimen should be chilled? Ammonia Prevents analyte degradation.
