Deck 5: Special Blood Collection

Question 1

A blood collector who cannot locate the patient on whom a cortisol level is scheduled for collection at 1000 should:

A) return the requisition to the nursing station for rescheduling.
B) request that the nursing station to call the laboratory when the patient is available.
C) collect the sample 2 hours after the patient finishes lunch.
D) reschedule the test for 1600.

Answer 1

A

Question 2

The most important consideration when collecting a blood culture is:

A) aseptic technique.
B) the puncture site.
C) minimizing the number of sticks.
D) the amount of blood collected.

Answer 2

A

Question 3

To monitor changes in a patient's hemoglobin level,a blood collector may be requested to collect:

A) a fasting sample.
B) samples from both arms.
C) samples at specific times.
D) a sample as soon as possible.

Answer 3

C

Question 4

What information should be included on a peak or trough level requisition form?

A) Time the medication was given
B) Method of medication administration
C) Time the sample was drawn
D) All of the above

Question 5

Some blood culture collection systems contain a resin to:

A) prevent clotting.
B) inactivate antibiotics.
C) concentrate the microorganism.
D) remove skin contaminates.

Question 6

A trough level is drawn:

A) 30 minutes after drug administration.
B) while the patient is fasting.
C) prior to administering medication.
D) immediately after administering medication.

Question 7

To inoculate blood culture media with blood drawn in a syringe,the blood collector:

A) vents an anaerobic container.
B) inoculates an aerobic bottle first.
C) mixes the syringe before inoculation.
D) inoculates an anaerobic bottle first.

Question 8

Plasma cortisol levels are scheduled to be drawn between 0800 and 1000 because:

A) patients must be in a basal state.
B) patients must not be fasting.
C) cortisol exhibits diurnal variation.
D) cortisol is only produced during the morning.

Question 9

A glucose tolerance test is performed to diagnose or evaluate:

A) hypoglycemia.
B) diabetes insipidus.
C) diabetes mellitus.
D) Both A and C

Question 10

Blood cultures are performed to detect the presence of:

A) septicemia.
B) spiking fevers.
C) fever of unknown origin.
D) antibiotics.

Question 11

The test order with the highest priority is classified as:

A) fasting.
B) timed.
C) stat.
D) postprandial.

Question 12

When blood is inoculated into blood culture bottles using a winged blood collection set,the:

A) anaerobic bottle is inoculated first.
B) safety device is activated first.
C) aerobic bottle is inoculated first.
D) volume of blood inoculated is increased.

Question 13

The number of samples collected from a patient receiving a 2-hour oral glucose tolerance test (OGTT) is:

A) one.
B) two.
C) three.
D) four.

Question 14

The term diurnal variation is associated with:

A) blood cultures.
B) fasting samples.
C) forensic samples.
D) timed collections.

Question 15

A patient who is not allowed to have food or water for a specified time is classified as:

A) fasting.
B) NPO.
C) preprandial.
D) basal.

Question 16

The timing for an oral glucose tolerance test (OGTT) begins:

A) after collection of the fasting sample.
B) when the patient begins drinking the glucose.
C) when the patient finishes drinking the glucose.
D) 30 minutes after the glucose is finished.

Question 17

The purpose of sodium polyanetholsulfonate in a blood culture bottle is to:

A) inhibit bacterial growth.
B) prevent clotting.
C) prevent contamination.
D) identify bacterial growth.

Question 18

The ideal time for collecting a blood culture is:

A) just before the patient's temperature spikes.
B) after antibiotics have been given.
C) when the patient's white blood cell count is the highest.
D) when the patient's temperature is the highest.

Question 19

Peak and trough levels are collected to monitor:

A) illegal drug use.
B) diurnal variation.
C) therapeutic drug levels.
D) basal metabolism.

Question 20

The samples collected during the oral glucose tolerance test (OGTT) after the patient drinks the glucose will be analyzed at the end of the test.The samples should be collected in:

A) gray stopper tubes.
B) serum separator tubes (SSTs).
C) plasma separator tubes (PSTs).
D) red stopper tubes.

Question 21

Blood collector training in the performance of arterial punctures should include which of the following?

A) Safety precautions
B) Possible complications
C) Supervised practice
D) All of the above

Question 22

Select the response that lists the major steps of the 2-hour oral glucose tolerance test (OGTT) in the proper order.

A) Patient drinks a 75-g glucose solution within 5 minutes,a fasting glucose sample is collected,and patient returns for an additional glucose test in 2 hours.
B) Patient drinks a 75-g glucose solution within 5 minutes,patient returns for an additional glucose test in 1 hour,and patient returns for an additional glucose test in 2 hours.
C) A fasting glucose sample is collected,patient returns for an additional glucose test in 2 hours,and patient drinks a 75-g glucose solution within 5 minutes.
D) A fasting glucose sample is collected,patient drinks a 75-g glucose solution within 5 minutes,and patient returns for an additional glucose test in 2 hours.

Question 23

Samples for which of the following should be protected from light?

A) Beta-carotene
B) Vitamin A
C) Bilirubin
D) All of the above

Question 24

Blood cultures may be ordered on a stat basis because:

A) this makes collection of the samples more convenient for the blood collector.
B) the concentration of microorganisms fluctuates and is often highest at specific times of the day.
C) the stat sample will act as a control for the cultures drawn at scheduled times.
D) the concentration of microorganisms fluctuates and is often highest just before the patient's temperature spikes.

Question 25

Chain of custody refers to the:

A) method of infection control.
B) patient identification procedures.
C) documentation of sample handling for legal samples.
D) collection of samples for employment physicals.

Question 26

The artery located on the thumb side of the wrist is the:

A) brachial.
B) ulnar.
C) radial.
D) femoral.

Question 27

Which of the following tests must be placed on ice immediately after collection?

A) Cold agglutinins
B) Lactic acid
C) Cholesterol
D) Antibody identification

Question 28

When performing an arterial puncture,the finger of the nondominant hand is:

A) used to anchor the artery.
B) placed where the needle enters the skin.
C) placed where the needle enters the artery.
D) used to measure the patient's heart rate.

Question 29

Arterial blood may be requested for which of the following?

A) Ammonia
B) PCO₂
C) Lactic acid
D) All of the above

Question 30

Samples for cold agglutinins must be:

A) transported on ice.
B) drawn in a green stopper tube.
C) processed in a refrigerated centrifuge.
D) kept warm.

Question 31

A blood collector required to testify in a legal proceeding may be asked about:

A) sample collection method.
B) patient identification procedure.
C) time of collection.
D) All of the above

Question 32

Under normal conditions,arterial blood will have a(n):

A) higher PO₂ than PCO₂.
B) decreased PO₂ and PCO₂.
C) equal amount of PO₂ and PCO₂.
D) higher PCO₂ than PO₂.

Question 33

A blood collector on the evening shift draws a sample for cold agglutinins and places it in the refrigerator for the morning shift.Test results of this sample will:

A) be falsely decreased.
B) be falsely increased.
C) be unaffected.
D) represent the patient's true condition.

Question 34

An alternate pathway capable of supplying blood to an area if the main pathway is obstructed is referred to as:

A) circulatory bypass.
B) collateral circulation.
C) shunt circulation.
D) an arterial fistula.

Question 35

A large artery located near the basilic vein and the median nerve is the:

A) ulnar.
B) brachial.
C) radial.
D) cephalic.

Question 36

To ensure patient safety and medication effectiveness,the blood levels of many therapeutic drugs are monitored.The samples that are typically drawn to do this are:

A) a trough level drawn before the next scheduled dose is given and a peak level drawn after the dose is given.
B) a trough level drawn as a fasting sample at 6:00 a.m.and a peak level drawn 2 hours later.
C) a peak level drawn before the next scheduled dose is given and a trough level drawn after the dose is given.
D) a peak level drawn as a fasting sample at 6:00 a.m.and a trough level drawn 2 hours later.

Question 37

A falsely decreased blood alcohol level may be obtained if:

A) blood is collected in a gray stopper tube.
B) the site is cleansed with Zephiran chloride.
C) the tube is only partially filled.
D) the tube is overfilled.

Question 38

Samples that require chilling immediately after collection are placed in a:

A) container of ice cubes.
B) container of ice and water.
C) bag of dry ice.
D) flask of cold water.

Question 39

Which of the following statements regarding cold agglutinins testing is true?

A) The sample must be kept warm until it is processed because cold agglutinins act at cold temperatures.
B) Cold agglutinins are autoantibodies produced by persons infected with Mycoplasma pneumoniae.
C) Cold agglutinins are autoantibodies produced by persons with an autoimmune hemolytic anemia.
D) All of the above

Question 40

A blood sample for DNA analysis to determine paternity is considered a:

A) routine sample.
B) timed sample.
C) legal sample.
D) postprandial sample.

Question 41

Which of the following arterial puncture complications would cause a patient to lose consciousness rapidly?

A) Arteriospasm
B) Nerve damage
C) Vasovagal reaction
D) Hemorrhage

Question 42

Administering a local anesthetic before performing an arterial puncture may interfere with arterial blood gas (ABG) results.

Question 43

When performing an arterial puncture,the needle is inserted bevel:

A) down at a 90-degree angle.
B) up at a 30- to 45-degree angle.
C) up at a 15- to 20-degree angle.
D) down at a 10-degree angle.

Question 44

Failure to locate a radial pulse after arterial puncture of the radial artery indicates:

A) venous blood was collected.
B) the ulnar artery is occluded.
C) a possible arteriospasm.
D) the patient has expired.

Question 45

To achieve a steady state in a patient prior to collection of arterial blood gases,the patient should:

A) empty the bladder.
B) fast for 12 hours.
C) cough 5 to10 times to clear lungs.
D) rest for 30 minutes.

Question 46

When collecting blood from an artery,the designated collector should:

A) ask the patient to make a tight fist.
B) tighten the tourniquet to stop arterial flow.
C) request a nurse to be present.
D) make sure that the patient is in a steady state.

Question 47

After pressure is released in the modified Allen test,if color returns to the patient's palm within 5 seconds,the:

A) radial artery can be punctured.
B) ulnar artery can be punctured.
C) brachial artery should be used.
D) test must be repeated.

Question 48

Matching
Match the following arterial puncture complications with the possible cause or collection error.
A.
Arteriospasm
B.
Hematoma
C.
Hemorrhage
D.
Infection
E.
Nerve damage
F.
Vasovagal reaction
Deep puncture

Question 49

Which of the following information is required on the requisition form when collecting arterial blood gases (ABGs)?

A) Patient's respiration rate
B) Type of ventilation the patient is receiving
C) Type of patient activity
D) All of the above

Question 50

When performing the modified Allen test,pressure is released from the:

A) radial and ulnar arteries.
B) ulnar and brachial arteries.
C) radial artery only.
D) ulnar artery only.

Question 51

A blood collector would be most likely to perform an accidental arterial puncture when attempting to puncture the:

A) cephalic vein.
B) median cubital vein.
C) radial vein.
D) basilic vein.

Question 52

The modified Allen test is used to determine collateral circulation in the:

A) ulnar artery.
B) brachial artery.
C) radial artery.
D) cephalic artery.

Question 53

Following arterial sample collection,pressure is applied to the puncture site for:

A) 2 minutes by the blood collector.
B) 2 minutes by the blood collector or patient.
C) 3 to 5 minutes by the blood collector.
D) 10 minutes by the blood collector or patient.

Question 54

Collateral circulation is necessary to prevent complications caused by:

A) arteriospasm.
B) infection.
C) vasovagal reaction.
D) hemorrhage.

Question 55

The artery of choice for collecting arterial samples is the:

A) ulnar.
B) brachial.
C) cephalic.
D) radial.

Question 56

Upon completion of an arterial puncture,the syringe is rotated to:

A) expel air from the syringe.
B) activate the needle safety device.
C) attach the Luer tip cap.
D) mix the anticoagulant.

Question 57

When performing a glucose tolerance test (GTT),the fasting blood sample is tested before the patient drinks the glucose.

Question 58

After the artery has been entered,the syringe plunger:

A) will be pushed back by the blood.
B) should be rapidly pulled back.
C) must be rotated.
D) should be moved back and forth.

Question 59

When performing a modified Allen test,pressure is released on the radial artery.

Question 60

Blood cultures should be mixed after collection.

Question 61

Matching
Match the following arterial puncture complications with the possible cause or collection error.
A.
Arteriospasm
B.
Hematoma
C.
Hemorrhage
D.
Infection
E.
Nerve damage
F.
Vasovagal reaction
Apprehensive patient

Question 62

Matching
Match the following arterial puncture complications with the possible cause or collection error.
A.
Arteriospasm
B.
Hematoma
C.
Hemorrhage
D.
Infection
E.
Nerve damage
F.
Vasovagal reaction
Tissue destruction

Question 63

Matching
Match the following arterial puncture complications with the possible cause or collection error.
A.
Arteriospasm
B.
Hematoma
C.
Hemorrhage
D.
Infection
E.
Nerve damage
F.
Vasovagal reaction
Failure to apply adequate pressure

Question 64

Matching
Match the following arterial puncture complications with the possible cause or collection error.
A.
Arteriospasm
B.
Hematoma
C.
Hemorrhage
D.
Infection
E.
Nerve damage
F.
Vasovagal reaction
Not cleansing the site

Question 65

Matching
Match the following arterial puncture complications with the possible cause or collection error.
A.
Arteriospasm
B.
Hematoma
C.
Hemorrhage
D.
Infection
E.
Nerve damage
F.
Vasovagal reaction
Coagulation disorders