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Worksheets10.11 Multiple Choice
Total questions: 60
Worksheet time: 30mins
Which of the following is the preferred collection site for laboratory testing of a patient at high risk for venous thrombosis?
Arterial sample
Dermal puncture
Hand vein with butterfly needle and syringe
Routine venipuncture of median cubital vein
What is the preferred method of blood collection in newborns and infants?
Arterial sample
Dermal puncture
Hand vein with butterfly needle and syringe
Routine venipuncture of median cubital vein
Which of the following tests cannot be collected using a dermal puncture?
Blood cultures
CBC
Glucose
Sodium
Which of the following has higher levels in capillary blood than in venous blood?
Calcium
Chloride
Glucose
Sodium
Which of the following has higher levels in venous blood than in capillary blood?
Calcium
Chloride
Glucose
Sodium
How long should a heel warmer be applied to an infant’s heel?
30 seconds
1–3 minutes
3–5 minutes
10 minutes
Puncture of a bone during dermal puncture can result in what potentially serious and sometimes fatal bone infection?
Osteochondritis
Osteomalacia
Osteomyelitis
What is the maximum acceptable depth for a heel puncture?
1 mm
2 mm
3 mm
4 mm
What is the maximum acceptable depth for a dermal puncture on an adult?
1 mm
2 mm
3 mm
4 mm
What is the recommended depth for a heel puncture on a premature infant?
0.65–0.85 mm
1.0–1.5 mm
1.5–2.0 mm
2.5–3.0 mm
Which of the following bones is close to the surface and at risk of being damaged during a heel puncture?
Calcaneus
Metatarsal
Navicular
Tarsal
What is the maximum acceptable width for a dermal puncture?
0.5 mm
1.0 mm
2.4 mm
4.0 mm
Which of the following is the appropriate site for dermal puncture on an infant’s foot?
Rear part of the arch of the foot
Medial and lateral borders of plantar surface
Fatty part of the middle toe
Center of the plantar surface
Which of the following is an appropriate dermal puncture site for adults?
Fleshy center of thumb
Thumb side of index finger
Ring finger, perpendicular to the ridges
Middle finger, parallel to the ridges
Which antiseptic may affect the results of tests for bilirubin, uric acid, potassium, and phosphorus from a dermal puncture and therefore should not be used on a dermal puncture?
Isopropyl alcohol
Chlorhexidine gluconate
Povidone-Iodine
Sodium Chloride
Betadine may elevate results of which tests if used to clean the skin for a dermal puncture?
Bilirubin, acid phosphatase, potassium, sodium
Bilirubin, uric acid, phosphorus, potassium
Sodium, potassium, chloride, bicarbonate
Glucose, BUN, creatinine, uric acid
Which of the following is an acceptable step during collection of blood by dermal puncture?
Constantly massage near the site to keep the blood flowing.
Keep the finger upright and collect as the blood flows downward.
Wipe away the first drop of blood with an alcohol pad.
Wipe away the first drop of blood with a dry, clean gauze pad.
Which screening test measures the overall integrity of primary hemostasis?
APTT
Bleeding time
FDP
PT
Which of the following over-the-counter medications is known to increase bleeding times?
Aspirin
Benadryl
Tums
Tylenol
Which of the following is the standard incision size for a bleeding time test?
0.1 mm deep by 5.0 mm long
1.0 mm deep by 5.0 mm long
0.5 mm deep by 1.0 mm long
5.0 mm deep by 0.1 mm long
Which of the following would be interpreted as a normal bleeding time?
1 minute
6 minutes
12 minutes
20 minutes
When performing a bleeding time test, the blood pressure cuff should be inflated to
10 mm Hg.
40 mm Hg.
70 mm Hg.
100 mm Hg.
What is the usual site for performing a standard bleeding time test?
Earlobe
Finger
Forearm, just below antecubital crease
Forearm, just above the wrist
At what intervals should blood be wicked with filter paper when performing a bleeding time test?
15 seconds
30 seconds
45 seconds
60 seconds
What is another name for a dermal puncture?
Arterial stick
skin puncture
Venipuncture
Microspecimen
Drawing excessive amounts of blood from a patient puts them at risk for what type of anemia?
Iatrogenic
Pernicious
Aplastic
Sickle cell
For which of the following cases would a capillary puncture be contraindicated?
Obese patients
Patients at risk for venous thrombosis
Geriatric patients
Severely dehydrated patients
For which of the following patients would a capillary puncture be preferred?
A patient with compromised lymphatic drainage
A patient requiring a blood culture
A patient requiring frequent blood tests
A patient requiring routine coagulation studies
Microcollection tubes
are only used for heel punctures.
are used to collect serum, plasma, or whole blood specimens.
contain no anticoagulant.
cannot be used for BURPP collections.
The emergency department has requested that blood alcohol level be drawn on a patient. What is the proper way to obtain the specimen?
Clean the site with alcohol and perform a routine venipuncture.
Clean the site with Betadine (povidone-iodine) and perform a routine venipuncture.
Call the laboratory to get a phlebotomist who is experienced in drawing from arteries.
Use alcohol to clean the site and perform a dermal puncture.
What is the medical term for fainting?
Emesis
Hematoma
Lymphostasis
Syncope
What condition can be caused by the removal of lymphoid tissue as part of a mastectomy?
Anemia
Hemoconcentration
Lymphostasis
Syncope
When you are unable to locate a vein after thoroughly examining a patient’s arm, what step should be taken next?
Examine the other arm for a vein.
Try to collect the sample even though you do not see or feel a vein.
Decide to perform a dermal puncture.
Call the laboratory for a more experienced phlebotomist.
A patient has a seizure while you are performing a venipuncture. What should you do?
Finish collecting the specimen and then call the nurse for help.
Remove the tourniquet and needle immediately, apply pressure, and call the nurse for help.
Call the laboratory for help restraining the patient, so you can obtain the sample.
Ignore the seizure and continue the procedure as usual.
When collecting blood from a vein in the back of the hand, where should the tourniquet be placed?
Above the elbow as usual
Just above the wrist
Just below the wrist
No tourniquet is used
Which of the following tests is most seriously affected by hemolysis?
Chloride
Creatine kinase (CK)
Glucose
Potassium
Which of the following can cause hemolysis of a blood specimen?
Using a needle with a larger gauge than necessary
Not mixing the tubes that contain anticoagulant
Using a small-gauge needle and a large vacuum tube
Using a syringe to draw the specimen
During a prolonged hospitalization, a patient requiring many laboratory tests may develop what condition as a result of multiple blood samples being drawn?
Anemia
Edema
Hemoconcentration
Reflux
Which of the following may cause a hematoma?
Going through the back side of the vein when inserting the needle
Using a needle of too-small gauge
Using a needle of too-large gauge
Leaving the tourniquet on for longer than 1 minute
Collections for which department require a special patient identification system in addition to the hospital ID bracelet?
Blood bank
Chemistry
Coagulation
Hematology
A large amount of bleeding into the tissues surrounding a puncture site (i.e., in a patient who takes anticoagulant medication) can cause what condition?
Compartment syndrome
Infection
Nerve damage
Vein collapse
What is the maximum amount of time that a tourniquet can be left on?
30 seconds
1 minute
2 minutes
5 minutes
What is the term used to describe a vein that is hardened due to repeated venipunctures, chemotherapy, or disease?
Blocked
Edematous
Occluded
Sclerosed
If an IV is in place and there are no other accessible sites, where should the blood specimen be collected?
From the IV port
Proximal to the IV
Above the IV
Distal to the IV
If the antecubital space is inaccessible when venipuncture is required, what is the next best site for specimen collection?
Dorsal Hand veins
Leg Veins
Jugular veins
Foot veins
If the bevel is stuck to the wall of the vein, what should be done?
Switch tubes
Slightly rotate the needle
Pull back on the needle
Terminate the procedure
Which of the following veins should be avoided to reduce chances of nerve damage?
Cephalic
Median cubital
Dorsal
Basilic
Preanalytic variables
occur after the sample is collected.
are not the responsibility of a phlebotomist.
are recognized during the testing process.
include site cleaning.
Basal state
refers to body’s state after 8 to 12 hours of fasting.
allows for variations in body’s normal fluctuations.
occurs within 1 hour of eating a meal.
is not affected by caffeine or nicotine.
Timed specimens are useful in monitoring
basal status.
cardiac enzymes.
viral loads.
patient locations.
Patient preparation includes verifying patient age on the requisition
because lab reference ranges may be set based on age.
for tracking patient demographics.
to ensure and document equal access to health care.
to assessing cognitive function of patient prior to draw.
Blood tested from patients who have been in a supine position for an extended period of time may exhibit what type of shift in certain blood test results?
elevated.
decreased.
no change in levels.
diurnal.
Which of the following is not a preanalytical variable?
Pregnancy
Medications
Exercise
Reporting of test result
Which antiseptic is not recommended for children under the age of 2?
70% isopropyl alcohol
Benzalkonium chloride
Povidone-iodine
Tincture of iodine
Which of the following is a serious bone infection that can occur if the bone is punctured during a heel stick?
Osteochondritis
Osteomalacia
Osteomyelitis
Osteoporosis
The maximum acceptable depth for a normal heel puncture is:
1 mm
2 mm
3 mm
4 mm
The maximum recommended width of a dermal puncture is:
1.5 mm
2.0 mm
2.4 mm
3.0 mm
What is the standard site for the bleeding time test?
Earlobe
Finger
Forearm about 5 cm below the antecubital crease
Upper arm
How often should blood be wicked during a bleeding time test?
Every 10 seconds
Every 30 seconds
Every 60 seconds
Every 5 minutes
What are preanalytic variables?
Factors that occur before sample collection (patient access, site selection cleaning, tourniquet application, sample collection, completion of the procedure, sample integrity)
Variables that affect the analysis of the sample in the laboratory
Factors that influence the interpretation of test results after analysis
Variables related to the storage of samples after testing
