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NEW QUESTION # 49
Which of the following actions may result in hemolysis of a specimen?

• A. Collecting a specimen from a VAD
• B. Gently inverting the specimen
• C. Leaving the tourniquet in place for 45 seconds
• D. Using a 22-gauge needle for collection

Answer: A

Explanation:
Collecting a specimen from a vascular access device (VAD) may result in hemolysis of a specimen. A specimen should also not be collected during an intravenous (livo line start. Additional precautions include ensuring that the needle is secure, avoiding forcibly pulling on a plunger to withdraw blood or forcefully transferring blood from a syringe into a tube, discontinuing a sluggish draw, avoiding the use of 25-gauge needles, limiting tourniquet use to 60 seconds, and avoiding shaking or vigorously mixing specimens.

NEW QUESTION # 50
If the laboratory institutes policy and procedural changes, the phlebotomist should:

• A. Expect to receive a salary increase.
• B. Expect to evaluate the procedures.
• C. Expect to be consulted.
• D. Expect to receive appropriate training.

Answer: D

Explanation:
If the laboratory institutes policy and procedural changes, the phlebotomist should expect to receive appropriate training. If training is not already planned, the phlebotomist should ask for training explaining the reasons why the training is needed. Approaches to training may vary widely, depending on the type and extent of changes being instituted. Without training, new policies and procedures are often adopted piecemeal and without consistency, increasing risks to staff and patients as well as liability risks.

NEW QUESTION # 51
The normal pH level for venous blood is:

• A. 7.31-7.41
• B. 7.25-7.35
• C. 7.41-7.51
• D. 7.35-7.45

Answer: A

Explanation:
The normal range of pH of venous blood is 7.31-7.41. The normal range of pH for arterial blood is slightly higher at 7.35-7.45.

NEW QUESTION # 52
The greatest risk when a tube breaks during centrifugation is:

• A. Equipment damage
• B. Lacerations/Puncture wounds
• C. Electric shock
• D. Aerosolization of sample

Answer: D

Explanation:
The greatest risk when a tube breaks during centrifugation is aerosolization of the specimen because the spinning specimen breaks down into droplets, which can be easily inhaled or can land on exposed skin, increasing risk of infection. Aerosolization can also occur if collection tubes are overfilled or if the caps come off during processing. Additionally, care must be used if removing a cap after centrifugation. Buckets, tubes, and rotors should be carefully spaced and balanced before centrifugation.

NEW QUESTION # 53
According to the order of the draw for venous blood, which of the following tubes is always drawn first?

• A. Pink(K2EDTA)
• B. Light blue (3.2% sodium citrate)
• C. Blood cultures
• D. Green (sodium heparin)

Answer: C

Explanation:
According to the order of the draw for venous blood, blood cultures are always drawn first to ensure that there is no contamination. The order of the draw is as follows:
1. Blood cultures
2. Light blue (sodium citrate)
3. Red, red speckled, gold (clot activators, gels)
4. Light green, dark green, speckled green (heparin, with orwithoutgel separator)
5. Lavender/purple, pearl, pink (EDTA, with or without gel separator)
6. Gray (sodium fluoride/potassium oxalate glycolytic inhibitor)

NEW QUESTION # 54
Control runs of automated systems should be carried out:

• A. At the end of each day
• B. Monthly
• C. At the beginning of each day
• D. Weekly

Answer: C

Explanation:
Control runs of automated systems should be carried out at the beginning of each day to ensure that the equipment is fully operational. Automated systems carry out laboratory tests with little input from personnel once the equipment is loaded with the appropriate samples. Automated systems may produce errors; therefore, close monitoring is essential. Routine maintenance should be carried out on a scheduled basis. Maintenance may include cleaning spills, changing reagents, discarding waste, changing parts as needed, and making adjustments.

NEW QUESTION # 55
When the phlebotomist is taking collection tubes with blood specimens from an isolation room, the specimens should be:

• A. Placed in a labeled paper bag
• B. Covered with a sterile drape
• C. Transported as usual
• D. Sealed in a leak-proof plastic bag

Answer: D

Explanation:
When the phlebotomist is taking collection tubes with blood specimens from an isolation room, the specimens should be sealed in a leak-proof plastic bag. A notice should be posted on each isolation room outlining the type of isolation and the requirements for PPE. The phlebotomist must always follow these guidelines and must enter wearing gloves, and should not take the phlebotomy tray into the room. Additionally, after the venipuncture and specimen collection is completed, all equipment except for the specimen containers must be left in the room in appropriate containers.

NEW QUESTION # 56
When the phlebotomist is using microcollection tubes for a fingerstick, the collection tube that should usually be filled first is:

• A. Gray-capped
• B. Green-capped
• C. Yellow-capped
• D. Lavender-capped

Answer: D

Explanation:
When the phlebotomist is using microcollection tubes for a fingerstick the collection tube that should usually be filled first is the lavender-capped tube (this different from the order used with venipuncture) to ensure that the volume collected is sufficient for hematology tests. This is followed by other collection tubes that contain additives, and the plain tubes utilized for serum collection are filled last. In most cases, the first drop of blood is wiped away and the second drop of blood is collected.

NEW QUESTION # 57
The preferred capillary puncture site for adults and children older than 1 year of age is

• A. Distal segment of the dominant third or fourth finger
• B. Earlobe
• C. Distal segment of the nondominant third or fourth finger
• D. Lateral heel

Answer: C

Explanation:
The preferred capillary puncture site for adults and children older than 1 year of age is the distal segment of the nondominant third or fourth finger (palmar surface). The nondominant hand tends to be less calloused than the dominant hand. The tip of the finger should be avoided, and the puncture should be made perpendicular to whorls. Capillary blood should not be obtained on the same side as a prior mastectomy without written permission of the physician.

NEW QUESTION # 58
When collecting a specimen from a patient in a long-term-care facility, the first thing the phlebotomist should do is to:

• A. Knock on the patient's door.
• B. Check in at the nursing station.
• C. Enter the patient's room.
• D. Contact the patient prior to arrival.

Answer: B

Explanation:
When collecting a specimen from a patient in a long-term-care facility, the first thing that the phlebotomist should do is to check in at the nursing station. The phlebotomist needs to ask for information about any special concerns regarding the patient, such as the need for assistance if the patient is confused or any type of restriction that applies to the patient. As in any other setting, the phlebotomist should always knock on the door or announce his or her arrival before entering the room and explain the purpose of the visit.

NEW QUESTION # 59
When venipuncture is performed in edematous tissue, the results will likely be:

• A. Altered
• B. The same as those from normal tissue
• C. Inconclusive
• D. Contaminated with bacteria

Answer: A

Explanation:
When venipuncture is performed in edematous tissue, the results will likely be altered because the sample may contain tissue fluid. Additionally, veins are often harder to locate in edematous tissue, and bleeding may persist longer than usual. Edematous tissue is more prone to injury from the tourniquet because the tissue is stretched. Whenever possible, a nonedematous site should be used for venipuncture. If the edema is because an IV has infiltrated, the phlebotomist must notify the nurse immediately.

NEW QUESTION # 60
Increased levels of which of the following are associated with heart attack?

• A. Albumin
• B. CEA
• C. PSA
• D. CK

Answer: D

Explanation:
Increased levels of creatine kinase (CK) are associated with heart attack The PSA, or prostate specific antigen, level is used to test for prostate cancer. Carcinoembryonic antigen (CEA) is used in digestive system testing. Albumin is used in urinary system testing.

NEW QUESTION # 61
A test request should include what specific information about the patient?

• A. Name, date of birth, and address
• B. Gender, ID/record number, indication for the test, and date of birth
• C. Name, identification (ID)/record number, gender, and date of birth
• D. Name, ID/record number, telephone number, and date ofbirth

Answer: C

Explanation:
A test request should include the following specific information about the patient:
*Name: first, middle, last
*Identification (LD)/ Record number
*Gender: male or female (typically the gender assigned at birth, but this may vary if the patient is nonbinary or transgender)
*Date of birth
In addition to information about the patient, the test request should include the name of the ordering healthcare provider, the tests to be performed, the collection site (if appropriate), the date the collection is to be made, and any additional instructions that are necessary.

NEW QUESTION # 62
A viral infection may result in increased:

• A. Monocytes
• B. Thrombocytes
• C. Lymphocytes
• D. Neutrophils

Answer: C

Explanation:
A viral infection may result in increased lymphocytes, which are one type of white blood cell (WBC). Lymphocytes usually comprise 24-44% of the total WBCs in adults. A bacterial infection often results in decreased lymphocytes but increased neutrophils. Increased lymphocyte count is also commonly found with some diseases, so it is not specific to viral infections. Conditionsassociated with increased lymphocyte count include Addison's disease, lymphocytic leukemia, ulcerative colitis, lymphomas, and lymphosarcoma.

NEW QUESTION # 63
If a patient sitting in a chair has a generalized convulsive seizure during venipuncture, the appropriate response is to discontinue venipuncture and:

• A. Call for help to ease the patient to the floor.
• B. Place a tongue blade between the patient's teeth.
• C. Support the patient in the chair and call 9-1-1.
• D. Restrain the patient in the chair.

Answer: A

Explanation:
If a patient sitting in a chair has a generalized convulsive seizure during venipuncture, the appropriate response is to discontinue venipuncture and call for help to ease the patient to the floor in order to avoid patient injury. The patient should be placed on one side if possible, but movements should not be restrained, and nothing should be placed in the patient's mouth. If possible, a pillow or blanket should be placed under the patient's head and restrictive clothing should be loosened. The time that the seizure begins and ends should be noted and first-aid personnel should be notified.

NEW QUESTION # 64
A butterfly infusion set is used for venipuncture in all of the following types of patients EXCEPT:

• A. Infants
• B. Adults with small veins
• C. Obese patients
• D. Elderly patients

Answer: C

Explanation:
A butterfly infusion set is used for venipuncture in patients with small, fragile veins, such as the elderly, infants and small children, and adults with small antecubital veins. A butterfly set is not routinely used in obese patients.

NEW QUESTION # 65
A sign with a picture of falling leaves may be used to indicate:

• A. Do not resuscitate order
• B. Miscarriage
• C. No venipuncture in right arm
• D. Fall precautions

Answer: D

Explanation:
A sign with a picture of falling leaves indicates that fall precautions are required for the patient The letters DNR indicate a "do not resuscitate" order. A pink wristband or sign labeled "restricted extremity" may be used to indicate that the arm should not be used for venipuncture, blood pressures, or other procedures.

NEW QUESTION # 66
A vital function of the capillaries is to:

• A. Secrete substances that prevent the clotting of blood.
• B. Exchange gases, nutrients, and metabolic by-products.
• C. Control the flow of blood.
• D. Stabilize the blood pressure.

Answer: B

Explanation:
A vital function of the capillaries is to exchange gases (carbon dioxide [C02J for oxygen), nutrients, and metabolic by-products (wastes). Capillaries are extensions of arteriole endothelium and are tiny, thin-walled vessels that carry a mixture of arterial and venous blood. The walls of the capillaries are semipermeable, with tiny openings where endothelial cells in the walls overlap. The density of capillary networks depends on the metabolism of the tissue, so capillaries are dense in muscle and nerve tissue and are less dense in cartilage, the epidermis, and the corneas.

NEW QUESTION # 67
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