Question 1

Phil the Medical Assistant accidently stuck himself with a needle just used to draw a specimen for a CBC. The patient is a young nun, who assures him, "I don't have anything you need to be worried about." Phil the Medical Assistant squeezes the site to promote bleeding, washes his puncture site, applies a bit of antibiotic ointment and a bandage over the site, and promises himself to be much more careful. What (if anything) has Phil done wrong?

Accepted Answer

Phil did not report the injury. Needle sticks must be reported immediately after the occurrence. Each facility has guidelines on the proper reporting system. The occupational health department of the facility will offer confidential counseling, treatment and follow up care, if needed.

Question 2

Phil the Medical Assistant has been notified that yet another of his finger sticks has been rejected by the lab. The lab tech tells him, "Dude, quit milking so much!" Phil is not sure what that means. Can you tell Phil what is causing rejection of his capillary collections from finger puncture?

Accepted Answer

Milking is a term used to describe a squeezing and pulling action used with a finger puncture. Inexperienced phlebotomy techs may try this, in an attempt to collect a specimen. The milking action causes fluid normally found in the soft tissue of the fingertip to be squeezed out into the blood. It can also cause hemolysis. Fluid from soft tissue and ruptured blood cells can skew test results, in which case the lab will request another draw, and the phlebotomy tech's rejection rate will increase.

Question 3

The processes of correcting erroneous test results, calling critical test values, and reporting the final test results are all examples of processes that are completed during the _____________ phase of specimen examination.

Accepted Answer

The processes of correcting erroneous test results, calling critical test values, and reporting the final test results are examples of processes that are completed during the postanalytical phase of specimen examination. All of these examples are processes that occur after a test has been completed and results are available. Testing is completed in the analytical phase of specimen examination. Preanalytical processes occur before the testing is started.

Question 4

Which of the following may cause false negative blood culture results?

Accepted Answer

All of the choices may cause false negative blood culture results. Not filling the container completely may produce a false negative result because the organisms present in the blood may be at levels undetectable unless the proper amount is collected. Injecting air into the anaerobic container will kill anaerobic organisms, resulting in a false negative result. Tincture of iodine is an antiseptic, used to create an aseptic puncture site. Some facilities may require iodine painting of the rubber stoppers in the collection tubes. Allowing the iodine to dry completely on the skin and/or stopper, as well as taking care not to over-paint the stopper, will avoid iodine-contamination of the blood sample. Introduction of iodine into the blood sample may kill the organisms present, producing a false negative.

Question 5

Phil the Medical Assistant has his first real requisition form! After checking it, he believes it may be incomplete. The requisition form has the following information: Patient name, birth date, and hospital ID number, name of ordering physician, name of tests to be performed, special instructions (fasting, timed, priority) along with date and time test is due. What information is missing from the requisition form?

Accepted Answer

Although the requisition form may appear different from what Phil trained with, it is complete and contains the basic information needed. Patient room numbers and gender may or may not appear on a requisition form, depending on facility policy. All requisitions must have patients' full name, and birth date and hospital ID number, for identification purposes. Requisitions must have name of ordering physician and name of requested tests, and special instructions. Laboratory test are only be ordered by a physician. Phil will initial the label, after he has drawn the blood, before he leaves the bedside.

Question 6

Which of the following tests require the specimen to be protected from light?

Accepted Answer

All of these tests are light- sensitive and require protection from exposure to light. Inaccurately lower results may occur if these specimens are not transported correctly. Light sensitive specimens are either wrapped in foil, immediately after collection, or placed inside a lightproof box for transportation to the laboratory.

Question 7

This laboratory professional has extensive training in both clinical and anatomical laboratory interpretations, has a medical degree, and is often classified as the laboratory director:

Accepted Answer

A pathologist is a laboratory professional who has extensive experience in both clinical and anatomical interpretations, has a medical degree, and is often classified as the laboratory director. A pathologist has several years of training specifically in laboratory medicine and is a medical doctor. Pathologists can perform autopsies, examine tissue samples for disease, and interpret laboratory clinical results to aid in diagnosis of disease.

Question 8

Pheona, a medical assistant, has entered a room to draw a blood specimen for VDRL and Hep C. The patient is sitting in bed. His wife is also in the room. After introducing herself and correctly identifying the patient, the patients' wife asks, "Oh is this for the tests the doctor mentioned earlier, what was the name of the tests?" How should Pheona respond?

Accepted Answer

Pheona's best response is one that protects her patients' right of confidentiality, without being impolite to her patients' spouse. Pheona is in a very sensitive situation, and should keep in mind her priority is to ensure the patients' confidentiality. The Patients' Bill of Rights requires healthcare workers to protect the patients' confidentiality by not openly discussing patients, their condition, or sensitive information without permission from the patient.

Question 9

Phil the Medical Assistant is preparing to perform a routine venipuncture. After allowing enough time for the skin wipe time to air dry, Phil begins the venipuncture procedure. He anchors the vein below the venipuncture site, by holding the patients arm in his non-dominant hand, using the thumb to pull the skin taut. He holds the collection container so that the needle forms a 45-degree angle to the patients arm. What (if anything) has Phil down wrong?

Accepted Answer

Phil is using too much of an angle for a puncture to a superficial vein. Most veins lay close to the surface, the needle does not have to go deeply into the tissue, to access most venous vessels. The usual angle for a venous puncture is 15 - 30 degrees. A 45-degree angle may be used for arterial punctures.

Question 10

Phil the Medical Assistant is feeling a bit distracted. He is finishing one specimen collection and thinking about the stat draw he was just notified of, as well as the timed draw already scheduled on his run. After the collection tube is filled to the correct level, Phil quickly removes the needle, covers the puncture site with gauze, labels the specimen, and leaves the patients room. What (if anything) has Phil done wrong?

Accepted Answer

Phil did not remove the tourniquet before removing the needle. He also did not check the site for bleeding before leaving the patient's room. Both are steps in the venipuncture procedure. Part of a phlebotomist's duty is prioritizing work and recognizing when help from co-workers is needed to meet the volume of orders, while keeping patients safe. Phil's error-leaving a tourniquet in place-could result in serious injury to the patient. If he had checked the site one more time before leaving the room, he may have noticed the tourniquet. The procedure for application of a tourniquet advises a tourniquet should not be applied for longer than one minute to prevent hemoconcentration. All venipuncture sites should be checked for bleeding before leaving the patient.

Quiz 1: Medical Assistant Practice

Phil the Medical Assistant has been notified that yet another of his finger sticks has been rejected by the lab. The lab tech tells him, "Dude, quit milking so much!" Phil is not sure what that means. Can you tell Phil what is causing rejection of his capillary collections from finger puncture?

The processes of correcting erroneous test results, calling critical test values, and reporting the final test results are all examples of processes that are completed during the _____________ phase of specimen examination.

Which of the following may cause false negative blood culture results?

Which of the following tests require the specimen to be protected from light?

This laboratory professional has extensive training in both clinical and anatomical laboratory interpretations, has a medical degree, and is often classified as the laboratory director: