Which of the following groups of health care workers has the highest rate of needlestick injury:
A Nurses
B Phlebotomists
C Physicians
D Medical students
E Laboratory technologists
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Of the following vacutainer tubes, which should be drawn first:
A Yellow top for blood culture
B Light-blue top for coagulation studies
C Gray top for glucose
D Purple top for CBC
E Red top for electrolytes
All of the following conditions must be met when using a light-blue-top vacutainer tube EXCEPT:
A It should never be the first tube drawn
B It must be used only for coagulation tests
C It must be filled completely (full draw)
D It must always be the last tube drawn
E It must not be drawn from an IV line
Venipuncture at sites with each of the following could affect test results EXCEPT:
A In the region of a hematoma
B At a mastectomy site
C Near a tattoo
D In edematous extremities
E Above an IV line
Of the following vacutainer tubes, the only one that may be partially filled and not affect test results is:
A Red top for total protein
B Gray top for glucose
C Light-blue top for protime
E Black top for sed rate
Which of the following procedures is NOT part of universal precautions when performing phlebotomy:
A Wear a lab coat or gown
B Change gloves between each patient.
C Do not recap, break, or resheath needles
D Use sharps containers for disposal of ALL needles
E Inform the patient of your HIV status
The greatest real or potential hazard to the patient when performing phlebotomy is caused by failure to:
A Wear gloves
B Properly identify the patient
C Use the correct vacutainer tube
D Transport specimens to the lab in less than 1 hour
E Prevent hematoma formation
A student in a hurry does not wait for the site cleaned with antiseptic to dry before probing the phlebotomy site about 8 times with too small a needle before finally managing to get blood by using a syringe and drawing back forcefully on the plunger. What specimen artefact is probably present as a result:
A Hemoconcentration
B Elevation in WBC count
C Clotting
D Increase in creatine kinase
E Hemolysis
Which of the following procedures is NOT done to obtain blood if a problem occurs during collection:
A Reposition the needle
B Use an IV line
C Try another vacutainer tube
D Re-anchor the vein
E Loosen the tourniquet
The action of EDTA in a purple-top tube is to:
A Inhibit glycolysis within RBC's
B Remove calcium by forming calcium salts
C Inactivate thrombin in the plasma
D Activate the extrinsic coagulation pathway
E Inactivate complement
A red-stoppered vacutainer tube contains:
A Sodium fluoride
B EDTA
C Thrombin
D No additive
E Sodium citrate
In performing venipuncture on a 79-year-old female with Cushing syndrome, a hematoma forms. Correct statements regarding this phenomenon include all of the following EXCEPT:
A Test results may be affected when blood is drawn from a hematoma
B If a venipuncture area begins to swell, stop drawing blood
C If another venipuncture site is unavailable, draw distally from the hematoma
D The hematoma forms when blood leaks from the vein into surrounding tissues
E Remove the needle before removing the tourniquet to prevent hematoma formation
The action of sodium fluoride in a light-gray- stoppered tube is to:
A Inhibit glycolysis
B Activate thrombin to promote clotting
C Form calcium salts to remove calcium
D Inactivate complement
E Prevent microbial growth
While performing a venipuncture on a hospital board member, the blood suddenly stops flowing into a vacutainer tube. The best corrective action is to:
A Rotate the needle holder clockwise 1/4 turn
B Pull back slightly on the holder
C Have the patient open and close his/her hand slowly
D Push in slightly on the holder
E Take the tube off and replace with a new tube
Prolonged application of the tourniquet during phlebotomy can produce changes in the value of a total protein test due to:
A Hemolysis
B Hemoconcentration
C Glycolysis
D Hemostasis
E Complement activation
A poorly performed venipuncture that results in hemolyis of the specimen drawn into a red- top tube is most likely to produce which of the following results:
A Total protein 2.5 g/dl
B Glucose 40 mg/dl
C Sodium 165 meq/L
D Potassium 7.8 meq/L
E Ammonia 100 micromol/L
Quality assurance guidelines require that no more than what percentage of specimens sent to the laboratory be unlabelled or mislabelled:
A None
B <1%
C <5%
D 5 TO 10%
E <25%
(18) A 45-year-old female has a Medtronic-Hall mitral valve mechanical prosthesis. She is taking warfarin.
(19) An 8-year-old boy is suspected of having an acute leukemia.
A Yellow top
B Light-blue top
C Gray top
D Black top
E Purple top
When collecting blood for laboratory testing, which of the following procedures should NEVER be done:
A Send a partially filled red or light-green top tube to the laboratory
B Draw blood for microbiologic culture first
C Pour blood from a purple to a light blue top tube
D Draw blood distal to the site of a hematoma
E Wait for the venipuncture site to dry after cleansing
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