Deck 49: Collecting, Processing, and Testing Blood Specimens

Question 1

Which of the following is most commonly used to cleanse the skin before drawing blood?

A) Alcohol
B) Soap and water
C) Hibiclens
D) Hydrogen peroxide
E) 10% bleach

Answer 1

Alcohol

Question 2

The most common sites for venipuncture are the ____.

A) femoral and inguinal veins
B) median cubital and cephalic veins
C) great saphenous and superior vena cava veins
D) popliteal and posterior tibial veins
E) radial and ulnar veins

Answer 2

median cubital and cephalic veins

Question 3

Whole blood is ____.

A) the clear, yellow liquid that remains after a blood clot forms
B) the total volume of plasma and formed elements
C) the main component of erythrocytes
D) the rupturing of red blood cells
E) the buffy coat in centrifuged blood

Answer 3

the total volume of plasma and formed elements

Question 4

Which of the following items forms the first line of defense during a phlebotomy procedure?

A) Face mask
B) Eye goggles
C) Laboratory coat
D) Gown
E) Gloves

Question 5

Which of the following is part of the preparation for a glucose tolerance test?

A) Instruct the patient to eat a high-carbohydrate diet for 3 days before the procedure
B) Offer the patient a high-carbohydrate snack immediately before drawing the blood
C) Instruct the patient to refrain from eating after the initial blood and urine samples are taken
D) Explain to the patient that only one blood and one urine sample will be taken
E) Direct the patient to use a laxative the night before to cleanse the digestive system

Question 6

Which of the following is used in the capillary puncture technique?

A) Lancet
B) Retracting needle
C) Syringe
D) Evacuation tube
E) Butterfly needle

Question 7

Which of the following would you include when performing venipuncture using an evacuation system?

A) Bunch up the patient's skin above and below the insertion site
B) Insert the needle at a 45º angle with the bevel side down
C) Penetrate the vein wall to a depth of 1/4 to 1/2 inch
D) Leave the tourniquet on until after you withdraw the needle from the vein
E) Be careful not to invert collection tubes that have additives in them

Question 8

Which of the following tests requires the use of a blood collection tube with a gray stopper?

A) Coagulation studies
B) Blood glucose tests
C) Viral studies
D) Arterial blood gases
E) Blood cultures

Question 9

Which of the following is characteristic of capillary puncture?

A) The blood is collected using a sterile needle and syringe.
B) It is used on patients with small or fragile veins.
C) The patient's non-dominant hand is used for this procedure.
D) It releases a greater amount of blood, compared to venipuncture.
E) The blood is collected into evacuated collection tubes.

Question 10

Which method of drawing blood would you use on a patient with small or fragile veins?

A) Evacuation system
B) Capillary puncture
C) Automatic puncturing device
D) Blood culture system
E) Butterfly system

Question 11

The insertion of a needle or cannula into a vein for the purpose of withdrawing blood is ____.

A) hematology
B) phlebotomy
C) morphology
D) coagulation
E) serology

Question 12

Which of the following is the liquid or fluid portion of the blood?

A) Plasma
B) Red blood cells
C) White blood cells
D) Platelets
E) Hemoglobin

Question 13

Which of the following is characteristic of lancets?

A) They are used when a large amount of blood is required for a specific procedure.
B) They puncture a vein for the purpose of drawing blood.
C) They require the use of a tourniquet and a syringe with a needle.
D) They are disposable instruments with sharp points used to puncture the skin.
E) They eliminate the need for an engineered safety device.

Question 14

Which procedure for obtaining a blood sample is usually performed on the middle finger or the ring finger?

A) Evacuation system
B) Capillary puncture
C) Needle and syringe system
D) Butterfly system
E) Blood culture system

Question 15

Which blood collection device uses interchangeable collection tubes that are calibrated to collect the exact amount of blood required?

A) Evacuation system
B) Needle and syringe system
C) Butterfly system
D) Capillary puncture
E) Blood culture system

Question 16

The red blood cells, white blood cells, and platelets are known as the ____.

A) whole blood
B) serum
C) monocyte
D) formed elements
E) hemoglobin

Question 17

Which of the following would you include when preparing a venipuncture site?

A) Elevate the chosen arm for the venipuncture site
B) Apply the tourniquet tight enough to stop the flow of blood
C) Palpate the proposed venipuncture site with your thumb
D) Cleanse the venipuncture site using a circular motion starting at the center and working outward
E) Use sterile gauze to dry the venipuncture site after cleansing it

Question 18

Which of the following refers to the rupturing of red blood cells?

A) Capillary puncture
B) Hemolysis
C) Coagulation
D) Venipuncture
E) Phlebotomy

Question 19

In tests for which the use of alcohol may result in inaccurate test results, which of the following chemicals may be used to prepare the skin before venipuncture?

A) Povidone-iodine
B) Hibiclens
C) Soap and water
D) Hydrogen peroxide
E) Sodium chloride

Question 20

Which tests require the use of a collection tube with a green stopper?

A) Blood glucose tests
B) Electrolyte studies
C) Coagulation studies
D) Blood cultures
E) Hematology studies

Question 21

Which blood test can help identify coronary artery disease and atherosclerosis?

A) Total cholesterol
B) Uric acid
C) Glucose
D) Bilirubin
E) Fasting glucose

Question 22

The normal blood calcium level is ____.

A) 8.6 to 10.0 mEq/L
B) 98 to 108 mEq/L
C) 136 to 145 mEq/L
D) 3.5 to 5.1 mEq/L
E) 27 to 29 mEq/L

Question 23

A blood test that measures creatine kinase (CK) can identify ____.

A) gout
B) heart disease
C) leukemia
D) diabetes mellitus
E) sickle cell anemia

Question 24

Which color stopper is used for a collection tube that contains no additive?

A) Yellow
B) Green
C) Lavender
D) Red
E) Gray

Question 25

Gout is identified by which of type of blood test?

A) Uric acid
B) Potassium
C) Glucose
D) Total cholesterol
E) Lactate dehydrogenase

Question 26

Which of the following refers to the study of the shape or form of objects?

A) Phagocytosis
B) Morphology
C) Coagulation
D) Phlebotomy
E) Differential

Question 27

Enzyme-linked immunosorbent assay (ELISA) and Western blot tests are used to confirm which of the following diagnoses?

A) Diabetes mellitus
B) HIV infection
C) Gout
D) Coronary artery disease
E) Anemia

Question 28

The best site for drawing blood from an infant is ____.

A) the veins in the antecubital fossa
B) the median cubital vein
C) the heel
D) the cephalic vein
E) the brachial vein

Question 29

Blood chemistries and HIV/AIDS antibody tests must be performed with a collection tube with what color stopper?

A) Red
B) Blue
C) Red/black
D) Gray
E) Green

Question 30

The normal sodium blood level is ____.

A) 3.5 to 5.1 mEq/L
B) 8.6 to 10.0 mEq/L
C) 136 to 145 mEq/L
D) 98 to 108 mEq/L
E) 21 to 28 mEq/L

Question 31

Which of the following identifies how much of the volume of a sample is made up of red blood cells after the sample has been spun in a centrifuge?

A) Hemoglobin determination
B) Platelet count
C) Hematocrit determination
D) Differential white blood cell count
E) Red blood cell count

Question 32

An erythrocyte (RBC) count is used to identify ____.

A) an infection
B) anemia
C) fluid and electrolyte imbalance
D) leukemia
E) viral hepatitis

Question 33

The normal range for potassium in the blood is ____.

A) 8.6 to 10.0 mg/dL
B) 136 to 145 mEq/L
C) 3.5 to 5.1 mEq/L
D) 6 to 20 mg/dL
E) 21 to 28 mEq/L

Question 34

The normal fasting blood glucose level is ____.

A) 136 to 145 mEq/L
B) 37 to 92 mg/dL
C) 21 to 28 mEq/L
D) 74 to 120 mg/dL
E) 200 to 400 mg/dL

Question 35

Hemophilia is ____.

A) the rupturing of red blood cells, which releases hemoglobin that can cause kidney failure
B) the study of blood
C) a disorder in which the blood does not coagulate at a wound or puncture site
D) the insertion of a needle or cannula into a vein for the purpose of withdrawing blood
E) a disorder in which the blood is thicker than normal, resulting in slow collection times

Question 36

After how many unsuccessful attempts at obtaining a good blood sample should you seek assistance from your supervisor or the doctor?

A) 1
B) 2
C) 3
D) 4
E) 5

Question 37

A blood urea nitrogen (BUN) test is used to identify ____

A) anemia
B) diabetes mellitus
C) kidney disorders
D) specific cancers
E) peptic ulcers

Question 38

Blood tests for potassium and sodium identify ____.

A) prostatic cancer
B) hyperparathyroidism
C) anemia
D) fluid-electrolyte imbalances
E) atherosclerosis

Question 39

Normal prothrombin time (PT) is ____.

A) 11 to 15 seconds
B) 30 50 60 seconds
C) 2 to 7 minutes
D) 8 to 10 minutes
E) 30 to 45 minutes

Question 40

Which of the following is important when drawing blood from an elderly patient?

A) Do not apply pressure after removing the needle
B) Wiggle the needle to position it precisely in the vein
C) Have the patient bend her elbow after removing the needle
D) Avoid using a butterfly collection device
E) Have the patient elevate her arm after removing the needle

Question 41

Number 1 in the picture is the ________vein, a vein commonly used for venipuncture.

Question 42

A blood collection tube with a yellow stopper is used to obtain blood ________.

Question 43

A blood collection tube with a gray stopper is used to obtain blood for a blood ________ test.

Question 44

The hemoglobin A1c test reflects blood glucose levels over what period of time?

A) 1 year
B) 6 months
C) 3 months
D) 1 month
E) 2 weeks

Question 45

To make sure you identify the patient correctly prior to blood collection, you should ____.

A) call the patient by name
B) Ask the patient what labs she will be having done
C) ask the patient to tell you her name
D) ask the patient to state her home address
E) verify the patient's name with the doctor

Question 46

A blood collection tube with a gold stopper contains a silicone serum separator and is used for studies requiring blood ________.

Question 47

A(n) ________ is a small, calibrated glass tube that holds a precise volume of fluid.

Question 48

A light blue-stoppered blood collection tube is selected for ________ studies.

Question 49

Julia is a pretty, 16-year-old patient who has come to the office for her annual physical. The physician has asked you to draw blood for routine blood tests. When she realizes that you are going to draw her blood, she frowns and backs away. She tells you that when "they" drew her blood last year, it left a huge, ugly bruise that took weeks to go away. Which of the following would be your best response?

A) "They probably didn't draw the blood correctly last time."
B) "Don't worry, I promise I will not cause a bruise on your arm."
C) "If you get a bruise, you can wear long-sleeve shirts for a few weeks."
D) "Some bruising is possible, but I will do everything possible to minimize it."
E) "Bruising is just one of the side effects of having your blood drawn."

Question 50

Which of the following are included in steps for collection of a blood specimen?

A) Tell the patient the process will not be painful
B) Identify the patient correctly
C) Ask the patient what test he needs
D) Use the same tubes for chemistry and hematology tests
E) Apply the tourniquet to the patient's lower arm

Question 51

Kaiden is a 32-year-old businessman who is being seen in the office because he has been feeling fatigued all of the time. He says he is having difficulty concentrating at work, and his appetite is off. The physician has ordered several blood tests. When you explain the procedure to Kaiden, he smiles and says, "Oh, sure, I've been through this many times before. Do what you have to do!" A few seconds after you insert the needle and begin drawing the first tube of blood, Kaiden suddenly goes limp. You realize that he has fainted and is beginning to slip out of the chair. What should you do?

A) Thrust his head down between his legs
B) Leave the room immediately to call for help
C) Release the tourniquet, but leave the needle in his arm until the physician arrives
D) Wipe his face with a towel soaked with cool water
E) Gently lower him to the floor while protecting his head

Question 52

After explaining the process, you are drawing blood on 82-year-old Mrs. Green using an evacuated tube system. As you insert the third tube into the holder, the Mrs. Green begins to cry. You ask if she is in pain and she says, "No, but I am so scared! Why do they need this much blood? I must have a terrible disease!" Which of the following is your best response?

A) "If you have a terrible disease, wouldn't you rather know about it?"
B) "We don't really need this much blood-we always draw a couple of extra tubes."
C) "Drawing blood does not necessarily mean you are ill; blood tests are one of the best ways to get an overall picture of your health."
D) "I am drawing several tubes of blood because, at your age, there are many different tests that we have to run."
E) "Don't worry; I'm sure everything will be fine."

Question 53

The vein used for venipuncture and represented by number 3 in the picture is the ________ vein.

Question 54

In addition to using appropriate engineered safety devices, NIOSH recommends that health-care workers ____.

A) recap needles before transporting them to the sharps container
B) throw sharps into the wastebasket
C) attend bloodborne pathogen training every three years
D) avoid using needles with hinged shields
E) use needles only if no safe alternatives are available

Question 55

The physician has asked you to draw blood from Peter, a 24-year-old patient, for routine pre-employment testing. As you begin explaining the process, Peter starts to look very uncomfortable. Although he pretends nothing is wrong, you soon discover that he is afraid of needles. Which of the following suggestions might you make to help Peter?

A) "Take rapid, shallow breaths while I insert the needle in your arm."
B) "Tense the muscles in your arm so it won't hurt as much."
C) "See the magazine in the rack on the wall? Focus on that while I draw the blood."
D) "This will be painful, but I know you are brave enough to get through it."
E) "If you do not let me draw your blood, the company won't hire you."

Question 56

A vein commonly used for venipuncture and indicated by number 2 in the figure is the ________ vein.

Question 57

A(n) blood collection tube with a ________ stopper contains heparin.

Question 58

When blood is centrifuged, the heavier red blood cells move to one end of the tube, lighter plasma moves to the other end, and the ________ ________ that contains the white blood cells and platelets is between the two.

Question 59

A blood collection tube with a lavender stopper is selected for ________ studies.

Question 60

Melanie is a 46-year-old unemployed patient who is being seen in the medical office because of a pain in her abdomen that has persisted for three weeks. The physician orders a urinalysis and several blood tests. When you begin preparing to draw her blood, Melanie says, "No! I don't want you to draw my blood. I just want to know what is causing the pain in my stomach. You don't need blood for that! I can't afford all these extra tests." You explain that the blood tests are needed to help diagnose the stomach pain, but Melanie continues to refuse to allow you to draw her blood. What should you do?

A) Inform Melanie that you must draw the blood because the physician ordered it
B) Report her refusal to your supervisor or the physician and make a note in her chart
C) Offer to draw the blood free of charge, since Melanie is unemployed
D) Assure Melanie that insurance will cover the cost of the tests
E) Ask colleagues in the office to assist you in drawing Melanie's blood

Question 61

A small, disposable instrument with a sharp point used to puncture the skin and make a shallow incision is called a(n) ________.

Question 62

The rupturing of red blood cells, releasing hemoglobin, is called ________.

Question 63

When blood is centrifuged, the red layer below the buffy coat consists of ________ red blood cells.

Question 64

The gel-like barrier between the serum and the clot in a coagulated blood sample is formed by a serum ________.

Question 65

The clear, yellow liquid in which the formed elements of blood are suspended is called _______.

Question 66

The red blood cells, white blood cells, and platelets are known as the ________ elements in a blood sample.

Question 67

A(n) ________ puncture is a superficial puncture of the skin with a sharp point, releasing a smaller amount of blood than venipuncture.

Question 68

The addition of a(n) ________ to a blood collection tube causes the blood to remain in a liquid state.

Question 69

When blood leaks out of the vein around the puncture site during venipuncture and collects under the skin, it forms a(n) ________.

Question 70

The non-automated erythrocyte ________ rate (ESR) test measures the rate at which red blood cells settle to the bottom of a blood sample.

Question 71

The insertion of a needle or cannula into a vein for the purpose of withdrawing blood is called ________.

Question 72

The total volume of plasma and formed elements is called ________ blood.

Question 73

The puncture of a vein performed with a needle for the purpose of drawing blood is called _______.

Question 74

The study of the shape or form of objects is called ________.

Question 75

A(n) ________ is a calibrated glass tube that holds a small, precise volume of fluid and is used to collect capillary blood for some tests.