ASCP Phlebotomy Exam Questions with correct Answers

Which color tubes should be used for HLA typing? - Answer- Yellow and green You enter a patient's room to collect an aldosterone sample. The nurse is helping the patient to the restroom and takes five minutes. When they return, you collect the sample. What error was made? - Answer- Patient should have been recumbent for 30 minutes prior to collecting the sample What could lead to errors in neonate testing? - Answer- Touching the infant's heel to the filter paper; adding blood to the paper from a heparinized tube; touching the circled portion of the paper with hands/gloves before, during or after collection; allowing the filter paper to come into contact with substances while drying. What is the name of the membranous sac surrounding the heart? - Answer- Pericaridial You are given a request to draw a specimen for a D-dimer test. You had just finished drawing the patient for an ESR and a serum study. What do you do? - Answer- Draw a light blue tube. On the NFPA hazard sign, what does the number on the right side of the diamond indicate? - Answer- Reactivity/instability What specimens require chilling? - Answer- Ammonia, blood gases (special note: if blood gases will get to the lab in 30 minutes or less, plastic tubes are acceptable, if not glass is preferred), catecholamines, gastrin, lactic acid, parathyroid hormone, pyruvate If you will be doing a capillary stick on an infant for lead, renin, or hematocrit, what must be done to the site prior to the capillary stick? - Answer- Wash the child's finger or heel with soap or water, then cleanse with alcohol. What test can be affected if chilled for more than two hours? - Answer- Potassium, so draw separate tubes for electrolytes if the sample will be chilled for an extended period of time. What specimens require transportation at 37 degrees? - Answer- Cold agglutinins, cyrofribrinogen, cyroglobulins What blood specimens are photosensitive and need to be protected from light? - Answer- Bilirubin, beta-carotene, folate, porphyrins, vitamin A, vitamin B6 If collecting a blood culture and the patient is sensitive to iodine or older than two months, what antiseptic can be used? - Answer- Chlorhexidine gluconate What is the generic name for tegtretol? - Answer- carbamazepine What is the most amount of blood you can take from an 11 pound baby? - Answer- 5.0 mL You go into a neonates room and a nurse is applying an EMLA to the patient. What should you do? - Answer- Come back in one hour INR is the same or associated with... - Answer- PT You go to collect a sample from a patient who is on coumadin, what should you expect? - Answer- Excessive bleeding What is the most abundant leukocyte in the blood? - Answer- Neutrophils (Never Let Monkeys Eat Bananas; Neutrophils, Lymphocytes, monocytes, Eosinophils, Basophils) A stool sample for C. difficile sat at room temperature for 8 hours before arriving at the lab. What action(s) should be taken? - Answer- Recollect the specimen. C. Diff can be undetectable after only 2 hours at room temperature. At what temperature should samples for DNA testing be kept at? - Answer- Room temperature (unless otherwise stated by the manufacturer) What is guiac tested for? - Answer- RBC's in stool According to CLSI, what is the correct order of (long) venous draw - Answer- 1. Blood culture/yellow stopper SPS/sterile 2. Light blue/clear shield over blue stopper 3. Red & Black stopper/Gold shield/Red stopper & shield/Royal blue shield with clot activator 4. Green & gray/light green/green stopper/green shield 5. Lavender stopper & shield/Pink stopper & shield/White (pearl) shield/Royal blue shield with EDTA/Tan tube with EDTA. 6. Gray stopper/shield 7. Yellow stopper solution A or solution B acid citrate dextrose ACD solution 8. All other tubes. What does CLIA stand for and what does it mean for health care workers? - Answer- Clinical Improvement Amendments of 1988; ensures quality laboratory testing What does ASCLS stand for and what does it mean for health care workers? - Answer- American Society for Clinical Laboratory Science; accredits clinical laboratory personnel What does NAACLS stand for and what does it mean for health care workers? - Answer- National Accrediting Agency for Clinical Laboratory Sciences; it accredits educational programs in clinical laboratory sciences A 25-year old patient is refusing to give a blood sample due to religious reasons, the doctor on rotation says to obtain the sample any way possible. What legal action could result from this? - Answer- Assault and battery, as well as civil litigation. What does HIPPA stand for and what does it mean for health care workers? - Answer- Health Insurance Portability and Accountabilty Act; created legal requirements for the protection, security and the appropriate sharing of a patient's personal health information. Which of these is considered a deep vein? (Axillary, ulnar, cephalic, median cubital) - Answer- Ulnar The POC ROCHE TROPT assay test is a machine that tests _________ in order to detect _______. - Answer- Troponin T; Heart damage When taking a blood culture sample using a butterfly needle and drawing directly into blood culture bottle, which bottle should you draw first? (Anaerobic or Aerobic) - Answer- Aerobic (the air in the butterfly needle tubing could adversely affect the anaerobic bottle) O&P samples should be kept at what temperature? - Answer- Ova and parasite stool sample should be kept at room temperature C&S requires what kind of collection procedure? - Answer- Culture and sensitivity urine sample requires a clean-catch midstream What temperature should 24-hour urine specimens be kept at? - Answer- Refrigerated and kept cool at all times. If CSF (cerebrospinal fluid) cannot be tested immediately, how should it be stored? - Answer- The tube for chemistry should be refrigerated, the tube for microbiology/hematology should be kept at room temperature, the tube for serology testing should be frozen. When transporting amniotic fluid, what precautions must the health care worker take? - Answer- Protect the specimen from light, keep at room temperature and transport immediately. What are some common additives in a 24-hour urine container? - Answer- Hydrochloric acid, boric acid, acetic acid and toluene Define room temperature - Answer- 23°C - 29°C (74°F - 84°F) Define refrigerated - Answer- 2°C to 8°C (36°F-46°F) Define frozen - Answer- -15°C or colder (5