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HEMA 1 PRELIM

Total questions: 101

Worksheet time: 52mins

Name
Class
Date
1.

The process of formation and development of blood cells is termed:

a)

Hematopoiesis

b)

Hematemesis

c)

Hematocytometry

d)

Hematorrhea

2.

During the second trimester of fetal development, the primary site of blood cell production is the:

a)

Bone marrow

b)

Spleen

c)

Lymph nodes

d)

Liver

3.

The best source of active bone marrow from a 20-year-old would be:

a)

Iliac crest

b)

Femur

c)

Distal radius

d)

Tibia

4.

Which one of the following morphologic changes occurs during normal blood cell maturation:

a)

Increase in cell diameter

b)

Development of cytoplasm basophilia

c)

Condensation of nuclear chromatin

d)

Appearance of nucleoli

5.

When a patient has severe anemia and the bone marrow is unable to effectively produce red blood cells to meet the increased demand, one of the body’s responses is:

a)

Extramedullary hematopoiesis in the liver and spleen

b)

Decreased production of erythropoietin by the kidney

c)

Increased apoptosis of erythrocyte progenitor cells

d)

Increase the proportion of yellow marrow in the long

bones

6.

Hematopoietic stem cells produce all lineages of blood

cells in sufficient quantities over the lifetime of an individual because they

a)

Are unipotent

b)

Have the ability of self-renewal by asymmetric division

c)

Are present in large numbers in the bone marrow niches

d)

Have a low mitotic potential in response to growth factors

7.

Which of the following is the most mature normoblast?

a)

Orthochromic normoblast

b)

Basophilic normoblast

c)

Pronormoblast

d)

Polychromatic normoblast

8.

What erythroid precursor can be described as follows: the cell is of medium size compared with other normoblasts, with an N:C ratio of nearly 1:1. The nuclear chromatin is condensed and chunky throughout the nucleus. No nucleoli are seen. The cytoplasm is a muddy, blue-pink color.

a)

Reticulocyte

b)

Pronormoblast

c)

Orthochromic normoblast

d)

Polychromatic normoblast

9.

Hypoxia stimulates RBC production by:

a)

Inducing more pluripotent stem cells into the erythroid lineage

b)

Stimulating EPO production by the kidney

c)

Increasing the number of RBC mitoses

d)

Stimulating the production of fibronectin by macrophages of the bone marrow

10.

A hemoglobin molecule is composed of:

a)

One heme molecule and four globin chains

b)

Ferrous iron, protoporphyrin IX, and a globin chain

c)

Protoporphyrin IX and four globin chains

d)

Four heme molecules and four globin chains

11.

The maturational sequence(s) of the erythrocyte is

(are)

a)

rubriblast—prorubricyte—rubricyte—metarubricyte reticulocyte—mature erythrocyte

b)

prorubricyte—rubricyte—metarubricyte—reticulocyte—mature erythrocyte

c)

pronormoblast—basophilic normoblast-polychromatophilic normoblast—orthochromic normoblast—reticulocyte—mature erythrocyte

d)

All of the above

12.

Stimulation of erythropoietin is caused by

a)

tissue hypoxia

b)

hypervolemia

c)

inflammation

d)

infection

13.

With a normal diet, an erythrocyte remains in the reticulocyte stage in the circulating blood for

a)

1 day

b)

3 days

c)

35 days

d)

120 days

14.

Shift to the left on the oxygen dissociation curve results in the following except?

a)

Increase Hb affinity to O2

b)

Increase delivery of oxygen to tissues

c)

Decrease Carbon dioxide

d)

Decrease 2,3 DPG

15.

Shift to the right on the oxygen dissociation curve results on all of the following except?

a)

Decrease oxygen affinity

b)

Increase release of oxygen in the tissues

c)

Decrease Carbon Dioxide

d)

Increase 2, 3 DPG

16.

The types of granulocytic leukocytes found in the proliferative compartment of the bone marrow are

a)

myeloblasts, myelocytes, and metamyelocytes

b)

myeloblasts, promyelocytes, and myelocytes

c)

myeloblasts, promyelocytes, myelocytes, and metamyelocytes

d)

myeloblasts, promyelocytes, myelocytes, metamyelocytes, and band neutrophils

17.

The types of granulocytic leukocytes found in the maturation-storage compartment of the bone marrow

are

a)

metamyelocytes, band form neutrophils, segmented neutrophils, mature eosinophils, and mature basophil

b)

only band form neutrophils, segmented neutrophils, mature eosinophils, and mature basophils

c)

metamyelocytes, band form neutrophils, segmented neutrophils, mature eosinophils, and mature basophils

d)

segmented neutrophils, immature and mature monocytes, and mature lymphocytes

18.

The stages of neutrophilic granulocyte development are

a)

promyelocyte, myeloblast, myelocyte, metamyelocyte, and band and segmented neutrophils

b)

myeloblast, promyelocyte, myelocyte, metamyelocyte, and band and segmented neutrophils

c)

myelocyte, myeloblast, promyelocyte, metamyelocyte, and band and segmented neutrophils

d)

myeloblast, promyelocyte, metamyelocyte, myelocyte, and band and segmented neutrophils

19.

Identify the cell with these characteristics: prominent primary granules that are rich in myeloperoxidase and

chloroacetate esterase and has a diameter of 14 to 20 mm

a)

myeloblast

b)

promyelocyte

c)

myelocyte

d)

promonocyte

20.

The earliest granulocytic maturational stage in which secondary or specific granules appear is

a)

myeloblast

b)

monoblast

c)

promyelocyte

d)

myelocyte

21.

A leukocyte with the morphological characteristics of being

the largest normal mature leukocyte in the peripheral

blood and having a convoluted or twisted nucleus is the

a)

myelocyte

b)

metamyelocyte

c)

promonocyte

d)

monocyte

22.

Which of the following cells are important in immune regulation, allergic inflammation, and destruction of tissue invading helminths?

a)

Neutrophils and monocytes

b)

Eosinophils and basophils

c)

T and B lymphocytes

d)

Macrophages and dendritic cells

23.

Which of the following cell types is capable of differentiating into osteoclasts, macrophages, or dendritic cells?

a)

Neutrophils

b)

Lymphocytes

c)

Monocytes

d)

Eosinophils

24.

Which of the following molecules is stored in platelet dense granules?

a)

Serotonin

b)

Fibrinogen

c)

PF4

d)

Platelet-derived growth factor

25.

What plasma protein is essential to platelet adhesion?

a)

VWF

b)

Factor VIII

c)

Fibrinogen

d)

P-selectin

26.

WBC's are composed of granulocytes (neutrophils, _________,

and ________) and non-granulocytes ( _________ and monocytes).

a)

Eosinophils, Basophils, Lymphocytes

b)

Eosinophils, Lymphocytes, Basophils

c)

Basophils, Lymphocytes, Eosinophils

27.

Platelets are produced directly from the:

a)

megakaryocyte cytoplasm

b)

megakaryocyte nucleus

c)

Metamyelocyte

d)

Metarubicyte

28.

Which of the following is the correct maturation series of platelet?

a)

Promegakaryocyte, Megakaryoblast, Granular Megakaryocyte, Platelet

b)

Megakaryoblast, Promegakaryocyte, Granular Megakaryocyte, Platelet

c)

Platelet, Granular Megakaryocyte, Megakaryoblast, Promegakaryocyte

d)

Megakaryoblast, Granular Megakaryocyte, Promegakaryocyte, Thrombocyte

29.

This is considered the largest cell in the bone marrow.

a)

Osteoclast

b)

Osteoblast

c)

Macrophage

d)

Megakaryocyte

30.

This cell has a pink or rose violet granules.

a)

Eosinophil

b)

Neutrophil

c)

Basophil

d)

Platelets

31.

Which cell has orange granules?

a)

Eosinophil

b)

Neutrophil

c)

Basophil

d)

Platelets

32.

Which cell has dark purple or blue black granules?

a)

Eosinophil

b)

Neutrophil

c)

Basophil

d)

Platelets

33.

This is the first recognizable stage in the granulocytic series.

a)

Myeloblast

b)

Promyelocyte

c)

Myelocyte

d)

Metamyelocyte

34.

Which of the following is the correct maturation series of B lymphocyte?

a)

Plasmablast, Proplasmacyte, Plasma cell

b)

Proplasmacyte, Plasma cell, Plasmablast,

c)

Lymphoblast, Prolymphocyte, Mature lymphocyte

d)

Prolymphocyte, Lymphoblast, Mature lymphocyte

35.

Aka wandering cells.

a)

Macrophages

b)

Neutrophils

c)

Monocyte

d)

Plasmacyte

36.

This is the last stage capable of mitsosis in the granulocytic series.

a)

Myeloblast

b)

Promyelocyte

c)

Myelocyte

d)

Metamyelocyte

37.

This is the first recognizable stage in the granulocytic series.

a)

Myeloblast

b)

Promyelocyte

c)

Myelocyte

d)

Metamyelocyte

38.

Which cell has dark purple or blue black granules?

a)

Eosinophil

b)

Neutrophil

c)

Basophil

d)

Platelets

39.

2/3 of the circulating platelets are found in the?

a)

Liver

b)

Peripheral Blood

c)

Kidney

d)

Spleen

40.

1/3 of the circulating platelets are found in the?

a)

Liver

b)

Peripheral Blood

c)

Kidney

d)

Spleen

41.

This protein is found on the sol-gel zone of the platelet that is responsible in maintaining the shape of the platelet.

a)

Actin

b)

Myosin

c)

Tubulin

d)

Glycocalyx

42.

Platelets are produced directly from the:

a)

megakaryocyte cytoplasm

b)

megakaryocyte nucleus

c)

Metamyelocyte

d)

Metarubicyte

43.

Informed consent means:

a)

Patients must ask the doctor to have their blood drawn

b)

Patients waive their rights

c)

Patients must be informed of the risks associated with treatments and procedures before they are done

d)

an MA could draw a patient's blood without their permission

44.

Which is not a required personal characteristic of a professional medical assistant phlebotomist?

a)

Dependability

b)

Honesty

c)

Sense of humor

d)

Compassion

45.

When a patient refuses to have their blood drawn, the MA should:

a)

Persuade the patient to comply

b)

Notify the doctor immediately

c)

Perform the phlebotomy anyway

d)

Notify the patient's family member

46.

A Complete Blood Count (CBC) is performed in this department in the laboratory.

a)

Chemistry

b)

Serology

c)

Immunology

d)

Hematology

47.

Which of the following indicates the largest size needle?

a)

20 gauge

b)

23 gauge

c)

16 gauge

d)

21 gauge

48.

Contains Sodium fluoride:

a)

pink top

b)

blue top

c)

gray top

d)

green top

49.

Contains sodium citrate as anticoagulant:

a)

light blue top

b)

gray top

c)

lavender top

d)

yellow top

50.

Third tube in the order of draw:

a)

blue top

b)

pink top

c)

gray top

d)

none of the above

51.

Three methods of venipuncture except:

a)

arterial

b)

ETS

c)

syringe

d)

butterfly

52.

Which antecubital vein is considered the best vein for venipuncture?

a)

Medial cubital

b)

Basilic

c)

Brachial

d)

Cephalic

53.

Which of the following is NOT a characteristic of the Brachial Artery?

a)

It has pulse

b)

The wall is thicker than a vein

c)

The blood is bright red

d)

It is preferred for venipuncture

54.

Which of the following is an OSHA Standard violation?

a)

Applying the tourniquet 1 inch above the ben in the elbow

b)

Using a small gauge needle to collect the specimen

c)

Not labeling the blood tube

d)

Removing the plastic holder from the needle for reuse

55.

Which of the following represents the correct order of draw?

a)

Red, green, lavender, gray

b)

Red , lavender, green gray

c)

Lavender, red, gray, green

d)

Red, gray, green, lavender

56.

During a venipuncture procedure a sudden swelling occurs around the puncture site. You should...

a)

Call for help

b)

Immediately remove the tourniquet and then the needle

c)

Continue with the venipuncture

d)

Apply pressure with an antiseptic wipe

57.

Which of the following may result in the hemolysis of blood?

a)

Using a needle with too small a lumen

b)

Removing the needle before the tourniquet

c)

Storing the tube at room temperature

d)

Allowing the tube to fill to the exhaustion of the vacuum

58.

How is serum obtained?

a)

From whole blood that has been centrifuged

b)

By using a tube containing an anticoagulant

c)

From whole blood that was left standing

d)

From clotted blood that has been centrifuged

59.
The most common sites for venipuncture are which of the following areas?
a)
dorsal side of wrist
b)
antecubital area of arm
c)
middle finger
d)
middle forearm
60.
Palpating the venipuncture site serves which purpose?
a)
provides an indication of the size and depth of the vein
b)
distracts patient from discomfort
c)
pushes arteries out of the way prior to venipuncture
d)
helps health care worker determine age of patient
61.
Using a butterfly needle is beneficial for 
a)
heel punctures
b)
routine venipuncture in health adults
c)
geriatric patients
d)
patients who have prominent muscles
62.
How long should the tourniquet be placed around the patient's arm?
a)
approximately 4 minutes
b)
until the needle is removed
c)
until the entire venipuncture is completed
d)
no more than 1 minute
63.
What is the best angle for needle insertion during venipuncture?
a)
5 degrees
b)
30 degrees or less
c)
45 degrees 
d)
more than 45 degrees
64.
Containers for the disposal of needles and syringes should have which of the following features?
a)
puncture resistance
b)
label with a red and white cross
c)
yellow and black markings
d)
antiseptic solution
65.

Typically, what gauge of needle is used for venipuncture?

a)

16

b)

18

c)

21

d)

23

66.

Leaving a tourniquet on for too long can cause what complication?

a)

Syncope

b)

Hematoma

c)

Hemolysis

d)

Hemoconcentration

67.

What is common complication of venipuncture?

a)

Hematoma

b)

Bruishes

c)

Redness

d)

Swelling

68.

How long do we need to take for applying the pressure around venipuncture site?

a)

3-5 minutes

b)

10-15 minutes

c)

2 hours

d)

15-30 minutes

69.
WHERE is the BEVEL located
a)
At the end of the plunger
b)
On the tip of the needle
c)
Under the cap
d)
Inside the barrel
70.

The gauge is the diameter of the needles lumen (opening). The smaller the gauge the smaller the opening

a)

True

b)

False

71.
Your tourniquet should be how far above your puncture site?
a)
1-2 inches
b)
2inches
c)
3-4 inches
d)
5 inches
72.
The last thing you do when you leave the patient's room with your sample is...
a)
Label tube outside the room
b)
Wash your hands after removing gloves
c)
Check to make sure bleeding has stopped
d)
Through your trash away
73.
The first step in performing manual capillary puncture is to ________.
a)
assemble equipment
b)
explain the procedure to the patient
c)
wipe the site of the puncture with alcohol
d)
perform hand hygiene
74.

Coagulation procedures includes all of the following except?

a)

Prothrombin Time

b)

Partial Thromboplastin Time

c)

Fibrinogen Assay

d)

D-dimer

e)

Blood film examination for platelets

75.

This laboratory method that detects the presence or absence of white blood cell (WBC) markers called antigens.

a)

Immunophenotyping

b)

Coagulation tests

c)

Complete Blood Count

d)

Cytogenetic Analysis

e)

Molecular testing

76.

This field of study that deals with chromosomes and related abnormalities.

a)

Immunophenotyping

b)

Coagulation tests

c)

Complete Blood Count

d)

Cytogenetic Analysis

e)

Molecular testing

77.

A laboratory test that checks for certain genes, proteins, or other molecules in a sample of tissue, blood, or other body fluid.

a)

Immunophenotyping

b)

Coagulation tests

c)

Complete Blood Count

d)

Cytogenetic Analysis

e)

Molecular testing

78.

Check all the type of hazard that exist in the laboratory

a)

Fire

b)

Electrical

c)

Physical

d)

Chemical

e)

Biological

79.

Which if the following is not true in a safety management program?

a)

Written policies and procedures should be developed that explain the steps to be taken for all of the occupational and environmental hazards that exist in the hematology laboratory.

b)

New employees should receive safety information on the first day that they are assigned to the hematology laboratory

c)

Any unsafe practices should be corrected.

d)

There should be an existing emergency management plan.

e)

Risk assessment can be done only in certain events that posed great risk to laboratory personnel.

80.

This term in safety management program includes measures to prevent or reduce the adverse effects of the emergency.

a)

Mitigation

b)

Preparedness

c)

Response

d)

Recovery

81.

This term in safety management program includes actions that will be taken when responding to the emergency.

a)

Mitigation

b)

Preparedness

c)

Response

d)

Recovery

82.

This term in safety management program includes the procedures to assess damage, evaluate response, and replenish supplies so that the laboratory can return to normal operation.

a)

Mitigation

b)

Preparedness

c)

Response

d)

Recovery

83.

Which of the following is a physiological effect of smoking before blood collection on patient sample?

a)

increased white blood cell counts and cortisol levels

b)

increase cortisol, thyroid stimulating hormone, and iron

c)

temporary increase in the white blood cell count only

d)

decreased pulmonary function and result in increased hemoglobin level

84.

Infection or inflammation of the bone as a result of using a lancet that has a depth of more than 2.5 mm.

a)

palmer

b)

syncope

c)

aseptic

d)

osteomyelitis

85.
Which of the following statements applies to the venipuncture procedure?
a)
A. Standard Precaution must be observed
b)
B. The procedure includes preparation of the patient
c)
C. Selecting and preparing the puncture site is part of the procedure
d)
D. All of the above
86.
When assisting with hygiene on a patient who has hepatitis B, you should observe ______ precautions.
a)
airborne
b)
contact
c)
biohazard
d)
standard
87.
It is important to maintain the correct order of draw to ________.
a)
ensure the correct amount of blood is drawn
b)
maintain the drawn blood at the correct temperature
c)
ensure that the tubes are labeled with the name of the correct patient
d)
prevent contamination of a sample with chemicals from another 
88.

It refers to the ability to provide accurate, reproducible assay results that offer clinically useful information.

a)

Quality

b)

Accurate

c)

Precise

d)

Quality Control

89.

This term refers to the process of detecting analytical errors within the laboratory to ensure both the reliability and accuracy of test results in order to provide the best possible patient care.

a)

Quality Control

b)

Quality Assurance System

c)

Quality System

d)

Diagnostic Specificity

90.

Specimen transport and preparation

a)

Preanalytical/Pre-examination Variable

b)

Analytical/Examination Variable

c)

Postanalytical/Post Examination Variable

d)

None of the given choices

91.

Monitoring of specimen condition

a)

Preanalytical/Pre-examination Variable

b)

Analytical/Examination Variable

c)

Postanalytical/Post Examination Variable

d)

None of the given choices

92.

These are control values that are far from the main set of values.

a)

Outliers

b)

Delta Check

c)

Shift

d)

Trend

93.

Control results must fall within predetermined dispersal limits, typically on _________.

a)

+2 SD

b)

+1 SD

c)

+3 SD

d)

+4 SD

94.

It is a preserved human blood cell suspensions, sometimes supplemented with microlatex particles or nucleated avian red blood cells (RBCs) as surrogates for hard-to-preserve human white blood cells (WBCs).

a)

Primary Standard

b)

Secondary Standard

c)

Calibrator

d)

Control

95.

This type of QC is used to maintain long term accuracy of analytical methods.

a)

Internal QC

b)

Intralab QC

c)

Interlab QC

d)

None of the choices

96.

It is a measure of agreement between an assay value and the theoretical “true value” of its analyte.

a)

Accuracy

b)

Precision

c)

Sensitivity

d)

Specificity

97.

A control violation wherein 8 consecutive control measurements fall on one side of the mean.

a)

8x rule

b)

10x rule

c)

9x rule

d)

2 of 32s rule

e)

7T

98.

A control violation wherein 9 consecutive control measurements fall on one side of the mean.

a)

8x rule

b)

10x rule

c)

9x rule

d)

2 of 32s rule

e)

7T

99.

A control violation wherein 3 consecutive control measurements exceed the same mean plus 1s or minus 1s control limit.

a)

41S

b)

10x rule

c)

31s

d)

2 of 32s rule

e)

7T

100.

A control violation wherein 1 control value exceeds the mean +3SD.

a)

12s

b)

13s

c)

22s

d)

41s

101.

It serves as the warning according to Westgard Control rules.

a)

12s

b)

13s

c)

22s

d)

41s

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