Deck 9: Preanalytical Complications Causing Medical Errors in Blood Collection

Question 1

A solid mass derived from blood constituents that occludes a blood vessel is a:

A) lymphostasis
B) thrombus
C) petechia
D) hemolysis

Answer 1

thrombus

Question 2

If the tourniquet is applied to the arm for longer than 2 minutes, which of the following analytes will most likely become falsely elevated?

A) potassium
B) blood urea nitrogen
C) uric acid
D) bilirubin

Answer 2

potassium

Question 3

When blood is to be collected for a glucose tolerance test, the patient should fast for:

A) 3-5 hours
B) 6-8 hours
C) 8-12 hours
D) 12-14 hours

Answer 3

8-12 hours

Question 4

A basal state exists:

A) after the evening meal
B) in the early morning, 12 hours after the last ingestion of food
C) immediately before lunch
D) 3 hours after the ingestion of lunch

Question 5

Which of the following analytes is significantly increased in the blood with changes in position?

A) cortisol
B) calcium
C) glucose
D) testosterone

Question 6

An abnormal accumulation of fluid in the intercellular spaces of the body that is localized or diffused is referred to as:

A) hemoconcentration
B) atherosclerosis
C) hemolysis
D) edema

Question 7

Which of the following laboratory test results is affected most if the patient is not fasting?

A) triglycerides
B) cortisol
C) ACTH
D) testosterone

Question 8

Diurnal rhythm has a major effect on which of the following blood analytes?

A) creatinine
B) ACTH
C) cholesterol
D) CK

Question 9

Which of the following is another term for fainting?

A) fomite
B) lymphostasis
C) thrombi
D) syncope

Question 10

When the phlebotomist collected blood from the patient, the patient was in a supine position, meaning the patient was:

A) sitting
B) stooping
C) standing
D) lying

Question 11

Upon entering Ms. Newhouse's hospital room, the phlebotomist introduced herself and explained she was going to collect blood for laboratory tests requested by the physician. The patient became very anxious and said she was frightened of needles; then she started sweating from being frightened of the procedure. This patient's emotional stress could lead to a decrease in which of the following?

A) white blood cell count
B) serum iron level
C) albumin
D) glucose

Question 12

Which of the following has been shown to erroneously affect laboratory test results, leading to falsely elevated WBC counts?

A) smiling
B) syncope
C) violent crying
D) sneezing

Question 13

Swelling in the area around a venipuncture site usually leads to:

A) lymphostasis
B) atherosclerosis
C) hematoma formation
D) petechiae formation

Question 14

Which of the following should stop the health care worker from collecting blood from a patient's arm vein?

A) cardiac bypass surgery
B) high blood pressure
C) mastectomy on the same side
D) heart attack that occurred the previous evening

Question 15

When hemoglobin is released from RBCs and serum becomes tinged as pink or red, this condition is referred to as:

A) hyperlipidemia
B) hemolysis
C) hemoconcentration
D) hemophilia

Question 16

A decrease in the plasma volume occurring with an increased concentration of cells and larger molecules such as cholesterol is referred to as:

A) hemoconcentration
B) hyperlipidemia
C) hemophilia
D) hemolysis

Question 17

Which of the following occurs as the result of inflammation and disease of the interstitial compartments?

A) sclerosed veins
B) syncope
C) hematoma
D) hemoconcentration

Question 18

If a patient begins to have a seizure during venipuncture, the phlebotomist should immediately:

A) place the patient on the floor
B) run for a physician
C) release the tourniquet
D) hold pressure on the blood collection site

Question 19

When a patient is on IV therapy and the venipuncture must occur in the arm with the IV line, the:

A) nurse should hold the arm up with the IV line as the phlebotomist performs the venipuncture
B) nurse should shut off the IV for 2 minutes prior to the venipuncture
C) the tourniquet should be placed above the IV site
D) nurse should hold the arm completely down as the phlebotomist performs the venipuncture

Question 20

Hemolysis in collected blood can cause a falsely decreased value for:

A) hemoglobin
B) phosphorus
C) ammonia
D) total protein

Question 21

Which of the following analytes will be falsely increased when a sodium citrate blood collection tube is underfilled?

A) BUN
B) PT
C) creatinine
D) phosphorus

Question 22

Which of the following clinical laboratory departments usually use serum separator tubes for many of their blood collections?

A) transfusion medicine
B) clinical chemistry
C) clinical microbiology
D) urinalysis

Question 23

The EDTA blood collection tube must not be underfilled, since it has been shown to lead to:

A) high lithium levels
B) low hematocrit levels
C) low sodium levels
D) high blood cell counts

Question 24

What additive destroys the enzymes in the blood when the gray-topped tube is used to collect blood?

A) sodium citrate
B) sodium fluoride
C) sodium heparin
D) lithium heparin

Question 25

Which of the following laboratory test results are affected most if the patient is not fasting?

A) cortisol
B) prothrombin time
C) glucose
D) AST

Question 26

Basal state is approximately 16 hours after the last ingestion of food.

Question 27

The required fasting time for the fasting glucose blood collection is 8-12 hours.

Question 28

A healthy body mass index for adults is 20-25 kg/m².

Question 29

A thrombus can occlude arteries, but not veins.

Question 30

A transient increase in serum iron levels can occur due to emotional stress.

Question 31

Diurnal rhythms are the same as circadian rhythms.

Question 32

Blood aldosterone levels are not affected by posture changes immediately before blood collection, but blood glucose levels are greatly affected by posture changes.

Question 33

An abnormal accumulation of fluid in the intercellular space is hemolysis.

Question 34

Tylenol taken by a patient can cause the patient to have abnormal laboratory liver panel results.

Question 35

If the patient pumps his or her fist prior to blood collection, this action can lead to a falsely increased plasma phosphate concentrations.

Question 36

Plasma cholesterol will be incorrectly ________ if the tourniquet pressure is too tight or prolonged.

Question 37

When RBCs are lysed, hemoglobin is released and this results in ________.

Question 38

Hemolyzed plasma that is used to measure the RBC count will cause the RBC count to be incorrectly ________.

Question 39

Hemoconcentration is a ________ in the plasma volume with an increased concentration of cells and larger molecules.

Question 40

Hemolysis may be the result of physiological abnormalities such as ________ disease.

Question 41

Blood collected for a patient's lithium level cannot be collected in a green-topped tube containing ________ heparin.

Question 42

Antibody screens and crossmatching of blood run on blood from serum separator tubes will lead to false- ________ test results.

Question 43

Veins ________ when blood is withdrawn too quickly or forcefully during venipuncture.

Question 44

Syncope is another term for ________.

Question 45

Venipuncture should never be performed on the ________ side as that of a mastectomy.

Question 46

What should a phlebotomist do to avoid the risk of backflow of an anticoagulant from a blood vacuum tube into the patient's circulation during blood collection by venipuncture?

Question 47

If a patient indicates that he or she has a tendency to faint during blood collection, what should the phlebotomist do when preparing for the blood collection?