Deck 3: Regulatory, Ethical, and Legal Issues

Question 1

Accreditation reviews require documentation of all of the following except:

A) centrifuge calibration.
B) refrigerator calibration.
C) daily freezer temperature records.
D) centrifuge maintenance.

Answer 1

B

Question 2

The information to follow for specimen collection and testing is provided in the:

A) procedure manual.
B) floor book.
C) quality assurance manual.
D) chemical hygiene plan.

Answer 2

A

Question 3

Preanalytical variables associated with phlebotomy include all of the following except:

A) reporting results.
B) transporting specimens.
C) processing specimens.
D) collecting specimens.

Answer 3

A

Question 4

When reporting results by telephone, the phlebotomist should do all of the following except:

A) document the patient's identification number.
B) ask the call recipient to repeat the results.
C) document the name of the call recipient.
D) document the time of the call.

Question 5

To document the time from when a requisition arrives in the laboratory and the time when the specimen reaches the laboratory, the:

A) requisition is stamped on arrival in the laboratory.
B) requisition is stamped when the specimen reaches the laboratory.
C) phlebotomist records the collection time.
D) both A and B

Question 6

A comparison of a patient's previous and current test results is called:

A) a delta check.
B) quality control.
C) total quality management.
D) a corrective action.

Question 7

The most serious error a phlebotomist can make is:

A) causing a hematoma.
B) failure to correctly identify a patient.
C) drawing a specimen in the wrong tube.
D) collecting a hemolyzed dermal puncture specimen.

Question 8

Evaluation of records shows an increase in complaints concerning delays in collection of timed specimens and turnaround times. A possible corrective action would be to:

A) make changes to the floor book.
B) request a decrease in the number of STAT requests.
C) discuss the problem at a supervisors' meeting.
D) schedule additional phlebotomists at peak collection times.

Question 9

To avoid nontechnical errors in specimen processing, phlebotomists should:

A) reject all specimens with paperwork discrepancies.
B) require additional paperwork for body fluid specimens.
C) rapidly prioritize all specimens when they are received.
D) be able to locate a designated supervisor.

Question 10

Information present in a floor book should include all of the following except:

A) analytical testing methods.
B) times of scheduled phlebotomy sweeps.
C) normal laboratory test values.
D) laboratory test scheduling policies.

Question 11

Monitoring the quality of laboratory test results is a function of:

A) the Centers for Disease Control and Prevention (CDC).
B) the College of American Pathologists (CAP).
C) Quality Control (QC).
D) Total Quality Management (TQM).

Question 12

The program established by a health-care organization to guarantee appropriate patient care is:

A) quality control.
B) accreditation.
C) quality assurance.
D) continuous quality improvement.

Question 13

Collection of a blood specimen from a site above an intravenous line could be detected by a(an):

A) hematoma.
B) infection.
C) delta check.
D) failure to obtain blood.

Question 14

Laboratory procedures and policies are developed by considering all of the following except:

A) preanalytical variables.
B) postanalytical variables.
C) management variables.
D) analytical variables.

Question 15

To evaluate the performance of a pneumatic tube system, records should be kept of the:

A) number of unacceptable specimens.
B) length of transit time.
C) personnel using the system.
D) type of specimens placed in the system.

Question 16

The Health Insurance Portability and Accountability Act (HIPAA) primarily affects phlebotomists when they are:

A) processing specimens for shipment.
B) entering laboratory results into the computer.
C) scheduling patients for laboratory tests.
D) reporting test results to health-care providers.

Question 17

Which of these errors in phlebotomy technique could be detected by a delta check?

A) Failure to bandage the site
B) Improper cleansing of the site
C) Making three attempts to collect a specimen
D) Failure to properly identify the patient

Question 18

Serious errors in test results will occur if:

A) serum from a red stopper tube is aliquoted to Chemistry and Serology.
B) plasma from a gray stopper tube is sent to Chemistry for a glucose test.
C) plasma from a lavender stopper tube and light blue stopper tube is combined for a partial thromboplastin time (PTT).
D) an uncentrifuged lavender stopper tube is sent to Hematology for a complete blood count (CBC).

Question 19

A phlebotomist with a question concerning the specimen type or method of collection for a particular test would consult the:

A) floor book.
B) chemistry supervisor.
C) equipment manufacturer's instructions.
D) procedure manual.

Question 20

All of the following can affect specimen quality except:

A) failure to recap specimen aliquots.
B) storing frozen specimens in a self-defrosting freezer.
C) monitoring refrigerator temperature with an automatic reader.
D) including visible red blood cells in a plasma sample.

Question 21

Using an evacuated tube after its expiration date can result in all of the following except a:

A) short draw.
B) clotted specimen.
C) lipemic specimen.
D) contaminated specimen.

Question 22

Phlebotomists are involved in all of the following areas of total quality management except:

A) infrastructure.
B) support services.
C) direct patient care.
D) management structure.

Question 23

Under the Health Insurance Portability and Accountability Act (HIPAA), written consent by the patient is required to:

A) perform point-of-care testing (POCT).
B) report test results to health-care providers.
C) generate electronic requisitions.
D) send specimens to a reference laboratory.

Question 24

The expiration date on a box of evacuated tubes represents the:

A) last day the tubes will work.
B) day the lot number was manufactured.
C) last day correct performance is guaranteed.
D) day to begin using tubes from this box.

Question 25

An unexpected patient death that is not related to the patient's illness is termed a:

A) root cause.
B) human error.
C) sentinel event.
D) professional liability.

Question 26

Cleansing the venipuncture site with 70% isopropyl alcohol and blowing on the alcohol to dry it is an example of:

A) doing the right thing right.
B) doing the right thing wrong.
C) doing the wrong thing right.
D) doing the wrong thing wrong.

Question 27

Glucose and sodium values on a previously normal patient become markedly elevated when collected at 1500. An investigation of this situation discovers that the:

A) patient had just eaten dinner.
B) patient was on antibiotics.
C) specimen was collected in a red stopper tube.
D) specimen was collected above an intravenous line.

Question 28

The primary focus of continuous quality improvement is to improve:

A) testing quality control.
B) personnel communication.
C) patient outcomes.
D) workplace infrastructure.

Question 29

A sentinel event report to the Joint Commission must include:

A) the name of the person making the error.
B) a root cause analysis.
C) an action plan.
D) both B and C.

Question 30

A phlebotomist who makes a suggestion that shortens the turnaround time for tests ordered by the emergency department is contributing to:

A) quality control.
B) documentation of variable monitoring.
C) continuous quality improvement.
D) human resources management.

Question 31

Documentation of instrument calibration verifies control of:

A) manufacturer's defects.
B) preanalytical variables.
C) analytical variables.
D) postanalytical variables.

Question 32

A phlebotomist participates in and successfully completes training to perform arterial puncture procedures. Part of this training concentrates on proper collection site preparation. Which of the following Joint Commission Patient Safety Goals is most applicable to this activity?

A) Improving the Effectiveness of Communication among Healthcare Givers
B) Encourage Patients' Active Involvement in Their Own Case as a Patient Safety Strategy
C) Improving the Accuracy of Patient Identification
D) Reduce the Risk of Healthcare-Associated Infections

Question 33

The process used by the laboratory to monitor the accuracy of phlebotomy techniques is called:

A) Continuous Quality Improvement (CQI).
B) Total Quality Management (TQM).
C) Quality Control (QC).
D) Quality Assurance (QA).

Question 34

Phlebotomist error could be a root cause of:

A) a hemolytic transfusion reaction.
B) surgery performed on the wrong patient.
C) infant discharge to the wrong family.
D) amputation of the wrong leg.

Question 35

The accuracy of laboratory test results and phlebotomy techniques is monitored through the process of:

A) Continuous Quality Improvement (CQI).
B) Quality Assurance (QA).
C) Quality Control (QC).
D) Total Quality Management (TQM).

Question 36

Written policies, evidence of monitoring, and actions taken to resolve problems are referred to as:

A) compliance.
B) documentation.
C) methodology.
D) variables.

Question 37

The primary goal of total quality management is to increase:

A) electronic transmissions.
B) customer satisfaction.
C) availability of services.
D) worker performance.

Question 38

A puncture device with a broken seal should not be used because:

A) it is no longer sterile.
B) the needle may contain a barb.
C) there may be a manufacturing defect.
D)the color coding will not match the size.

Question 39

All of the following are performance improvement plans accepted by the Joint Commission except:

A) the 10-step process.
B) plan-design-measure-assess-improve (PDMAI).
C) plan-do-check-act (PDCA).
D) Health Insurance Portability and Accountability Act (HIPAA).

Question 40

Centrifuges are calibrated using:

A) a tachometer.
B) a stop watch.
C) manufacturer-supplied nomograms.
D) replacement brushes.

Question 41

Integrity, honesty, and morality are behavioral characteristics that describe:

A) ethical conduct.
B) legal conduct.
C) amateur conduct.
D) a job description.

Question 42

The medical code of ethics for phlebotomists dictates that they will:

A) discuss therapy with the patient.
B) prescribe medicine for the patient.
C) perform skills within their job description.
D) suggest a better physician to the patient.

Question 43

Potential malpractice for a phlebotomist is present when:

A) processing specimens.
B) performing microtechniques.
C) improperly performing a venipuncture.
D) starting a glucose tolerance test.

Question 44

A phlebotomist could be held legally responsible for:

A) misidentification of patient specimens.
B) releasing patient results to a friend.
C) releasing identification of a patient to the press.
D) all of the above

Question 45

All of the following are examples of sentinel events involving the phlebotomist that may be investigated by the Joint Commission (JC) except:

A) an improperly labeled patient specimen for pretransfusion testing.
B) a refusal by the patient to permit the drawing of a specimen as ordered by the patient's physician.
C) an instance of misidentification of a patient.
D) an improperly labeled patient specimen for chemistry testing.

Question 46

All of the following are associated with an incident report except:

A) it is a description of the problem.
B) it becomes part of the employee's permanent record.
C) it documents corrective actions taken.
D) a copy is given to the patient's physician.

Question 47

The Patient's Bill of Rights guarantees the patient all of the following except:

A) a private room.
B) informed consent.
C) confidentiality.
D) treatment refusal.

Question 48

Risk management departments do all of the following except:

A) develop policies to protect employers from financial losses.
B) identify potential risks to employees and patients.
C) evaluate changes to improve safety.
D) fill out incident reports for phlebotomists.

Question 49

Patients who extend their arms after a phlebotomist has explained a venipuncture procedure are:

A) giving informed consent.
B) waiving malpractice claims.
C) giving implied consent.
D) both A and B

Question 50

A phlebotomist obtained blood from a confused patient. After collecting the blood, the phlebotomist leaves the bed rail down and leaves the room. The phlebotomist may be charged with:

A) negligence.
B) assault.
C) battery.
D) libel.

Question 51

The phlebotomist treats a patient diagnosed with AIDS rudely and abruptly. This behavior is described as:

A) illegal.
B) unethical.
C) appropriate.
D) assault.

Question 52

A phlebotomist who forcibly tries to obtain blood from a patient who refuses can be charged with:

A) negligence.
B) libel.
C) slander.
D) battery.

Question 53

When placing information in a patient's medical record, health-care workers should do all of the following except:

A) write with ink.
B) completely document their actions.
C) correct computer entries without deleting the original error.
D) completely black out written errors and initial the result.

Question 54

A phlebotomist participates in and successfully completes training in the use of wireless communication devices and bar code scanners to permit positive patient identification and specimen labeling at the patient's bedside. Which of the following Joint Commission Patient Safety Goals is most applicable to this activity?

A) Reduce the Risk of Healthcare-Associated Infections
B) Improving the Effectiveness of Communication among Healthcare Givers
C) Encourage Patients' Active Involvement in Their Own Case as a Patient Safety Strategy
D) Improving the Accuracy of Patient Identification

Question 55

The failure to provide a standard of care that is due a patient is:

A) malpractice.
B) competence.
C) slander.
D) libel.

Question 56

All of the following could be considered an invasion of a patient's privacy except:

A) releasing patient information to a newspaper.
B) entering a patient's room without knocking.
C) interrupting a patient-clergy visit to collect a STAT specimen.
D) using a patient specimen with the patient's name on it for teaching purposes.

Question 57

Ethics are the:

A) law of medicine.
B) principles of right and wrong.
C) Patient's Bill of Rights.
D) communication in medicine.

Question 58

The document written by the American Hospital Association that describes what a patient has a right to expect during medical treatment is the:

A) medical constitution.
B) Hippocratic Oath.
C) Patient's Bill of Rights.
D) hospital insurance document.

Question 59

Failure to give reasonable care to a patient by a health-care provider is defined as:

A) malpractice.
B) breach of duty.
C) negligence.
D) battery.

Question 60

A wrongful act committed against another person is:

A) a tort.
B) a plaintiff.
C) a misdemeanor.
D) libel.

Question 61

Laboratory results can be transmitted directly from point-of-care testing instruments to health-care providers.

Question 62

Errors can occur when phlebotomists overestimate their ability.

Question 63

A patient's medical records cannot be used as a legal document.

Question 64

Match the following legal terms with their appropriate definitions.
a.Action punishable by imprisonment
b.Action seeking monetary compensation
c.Employers are responsible for negligent acts by their employees
d.Failure to give reasonable care
e.Harmful touching of a person without his or her consent
f.Lack of skill by a health-care worker that causes harm to a patient
g.Threat to touch a person and cause harm without his or her consent
h.Wrongful act causing harm to persons or property
Tort

Question 65

A phlebotomist gives detailed instructions to a patient in preparation for a fasting and 2-hour postprandial glucose test. This instruction involves informing the patient about possible side effects of the standard glucose load beverage used and the number of samples that will need to be drawn. Which of the following Joint Commission Patient Safety Goals is most applicable to this activity?

A) Improving the Accuracy of Patient Identification
B) Improving the Effectiveness of Communication among Healthcare Givers
C) Encourage Patients' Active Involvement in Their Own Case as a Patient Safety Strategy
D) Reduce the Risk of Healthcare-Associated Infections

Question 66

According to the Institute of Medicine, most medical errors are preventable.

Question 67

The Patient's Bill of Rights allows the patient to know that you are a student phlebotomist.
Matching

Question 68

Phlebotomists are often members of total quality management (TQM) teams but not continuous quality improvement (CQI) teams.

Question 69

The phlebotomy procedure manual is kept in the laboratory manager's office.

Question 70

Specimens collected in evacuated tubes are all centrifuged at the same speed.

Question 71

Most medical errors are the result of human negligence.

Question 72

The goal of continuous quality improvement (CQI) is doing the right things right.

Question 73

Phlebotomists may be required to fax test results to a health-care provider.

Question 74

The statute of limitations for malpractice claims ends when the patient transfers to another health-care provider.

Question 75

Match the following legal terms with their appropriate definitions.
a.Action punishable by imprisonment
b.Action seeking monetary compensation
c.Employers are responsible for negligent acts by their employees
d.Failure to give reasonable care
e.Harmful touching of a person without his or her consent
f.Lack of skill by a health-care worker that causes harm to a patient
g.Threat to touch a person and cause harm without his or her consent
h.Wrongful act causing harm to persons or property
Criminal law suit

Question 76

Match the following legal terms with their appropriate definitions.
a.Action punishable by imprisonment
b.Action seeking monetary compensation
c.Employers are responsible for negligent acts by their employees
d.Failure to give reasonable care
e.Harmful touching of a person without his or her consent
f.Lack of skill by a health-care worker that causes harm to a patient
g.Threat to touch a person and cause harm without his or her consent
h.Wrongful act causing harm to persons or property
Civil law suit

Question 77

Match the following legal terms with their appropriate definitions.
a.Action punishable by imprisonment
b.Action seeking monetary compensation
c.Employers are responsible for negligent acts by their employees
d.Failure to give reasonable care
e.Harmful touching of a person without his or her consent
f.Lack of skill by a health-care worker that causes harm to a patient
g.Threat to touch a person and cause harm without his or her consent
h.Wrongful act causing harm to persons or property
Assault

Question 78

An employer can be held responsible for an employee's actions.

Question 79

Confidentiality only means not to talk about a patient outside the hospital.

Question 80

Specimens that must remain frozen are stored in self-defrosting refrigerators.