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AMCA Certification - Phlebotomy

front 1

Phlebotomist performs a venous blood draw on a 91 year old patient. The phlebotomist should use what method?

back 1

Hand draw

front 2

What is the first thing a phlebotomist must do when performing a finger stick?

back 2

Confirm the correct identity of a patient

front 3

When performing a blood draw the phlebotomist notices red spots forming, what action should the phlebotomist do?

back 3

Release the tourniquet immediately

front 4

What is appropriate to use when collecting serum chemistry?

back 4

SST (Serum Separator Tube)

front 5

A phlebotomist collects a blood alcohol level for forensic testing and hands the specimen off to a lab tech. What represents the correct procedure?

back 5

The technologist writes both the time received and his initials on the chain of custody form

front 6

What result is affected when providone iodine is used to cleans the site for a dermal puncture?

back 6

Potassium

front 7

What can cause a hemolyzed specimen?

back 7

Shaking the tube vigorously

front 8

What is an appropriate cleanser for cleansing around the urinary meatus in a clean catch urine collection?

back 8

Benzalkonium chloride

front 9

What anti-coagulant should the phlebotomist use to collect a PT/PTT test

back 9

Sodium citrate

front 10

A phlebotomist received an order to draw an infant screening card 02 levels, bilirubin, and DNA. What should be drawn first?

back 10

O2 level

front 11

What is the correct order of draw?

back 11

Green, Lavender, and Grey

front 12

A phlebotomist is preparing a hand draw, what instrument should the phlebotomist assemble?

back 12

Winged infusion set and adapter

front 13

During a venipuncture the patient reports a sharp pain radiating down the arm. What action should the phlebotomist take?

back 13

Release the tourniquet and remove the needle

front 14

A blood specimen was rejected based on QNS, what does this mean?

back 14

Specimen quantity was insufficient

front 15

When collecting a sample for CBC, what vessel should the phlebotomist attempt to draw from first?

back 15

Medial cubital vein

front 16

A diabetic patient states that she prefers to be drawn on the inside of her wrist. What action should the phlebotomist take?

back 16

Attempt to draw from the antecubital region first

front 17

What is the best protection when drawing blood rom a patient with active tuberculosis?

back 17

N-95 respirator

front 18

According to CLSI order of draw guidelines, what sample should the phlebotomist collect first?

back 18

Blood cultures

front 19

A phlebotomist must invert anticoagulant tubes to prevent what?

back 19

Clotting of the sample

front 20

The following emergency fist aid treatment, maintaining an open airway, control bleeding, and keeping the victim warm until help arrives indicates the patient is suffering from?

back 20

Shock

front 21

What does the phlebotomist need to do first when collecting a blood culture using a winged infusion set and evacuated tube system?

back 21

Fill the aerobic bottles first

front 22

I phlebotomist is drawing five blood collection tubes. When should the tourniquet be removed?

back 22

After 1 minute (1-2 times tube)

front 23

A phlebotomist must choose the correct tube color and additive for the corresponding ....... test?

back 23

Laboratory

front 24

What is the appropriate action when labeling a specimen>

back 24

Label the specimen at the time of collection in front of the patient

front 25

Choosing to perform a capillary puncture is best determined by what?

back 25

Test ordered

front 26

What is the next step after removing the needle from a patients arm?

back 26

Engage the needle safety device

front 27

What is the first step un the blood collection procedure?

back 27

Test requisition - check that it is clear of labs needed, if not contact the appropriate person for confirmation

front 28

A 69 year old patient is brought in to the ER. Several blood tests are ordered. The phlebotomist collects blood under ........ consent?

back 28

Informed consent

front 29

A physician orders a specimen STAT, but the phlebotomist forgets to fill the out the patient ID number. What will the lab do when they receive the specimen?

back 29

The lab rejects mislabeled specimens

front 30

A patient states that this is his first blood draw. What action is appropriate?

back 30

Describe the procedure

front 31

When alcohol is used to cleanse the venipuncture site, it must be allowed to air dry prior to the venipuncture because alcohol

back 31

Requires time for the antiseptic to work

front 32

The phlebotomist needs to draw a GTT on a patient and notices an empty breakfast plate on the bedside table. What action should the phlebotomist take?

back 32

Ask the patient if they have had anything to eat or drink

front 33

While the phlebotomist is performing a venipuncture, the patient begins to seize, what action must the phlebotomist take?

back 33

Discontinue the draw immediately

front 34

During a routine phlebotomy procedure the phlebotomist is stuck with a used needle. What action should be taken next?

back 34

Flush the puncture site with running water

front 35

What statement by a phlebotomist regarding skin preparation for blood cultures is appropriate?

back 35

I will cleanse the area with providone iodine

front 36

What tube should be collected first for dermal samples?

back 36

Lavender top

front 37

What is the proper procedure after collecting an ammonia sample?

back 37

Place the specimen tube in an ice water slurry

front 38

A phlebotomist has a request to collect a routine CBC from a healthy 10 month old infant, what is the appropriate collection site?

back 38

Left heel

front 39

When performing an ETS venipuncture the phlebotomist should and the needle.......?

back 39

In the same direction as the vein and at a 30 degree angle with the bevel facing up

front 40

During a venipuncture the patient becomes pale and diaphoretic. What condition is most likely to occur in this patient?

back 40

Syncope (fainting)

front 41

A phlebotomist walks into a patients room and finds the patient bleeding profusely from the leg. What action should the phlebotomist do first?

back 41

Apply direct pressure to the wound

front 42

When preparing for transport, what specimen must be placed in a ice bath within 30 mins after collection?

back 42

Arterial Blood Gases (ABG)

front 43

What is an important question to ask the patient prior to collecting a metabolic panel?

back 43

When was the last time you ate

front 44

What additive should be used when performing a CBC?

back 44

EDTA (in a lavender tube)

front 45

What is the name for small red spots caused by the tourniquet?

back 45

Petechiae

front 46

A phlebotomist performs a urine dipstick on a pediatric inpatient and the value for blood is 4+. What is the best action for the phlebotomist to take when reporting this value?

back 46

Report the result to the patients physician

front 47

What includes all the appropriate forms of identification in the inpatient setting?

back 47

Verbal, identification band, and tube label

front 48

Serum sodium level and serum potassium level are main test for?

back 48

Electrolytes evaluations

front 49

Appropriate tubes to check coagulation factors (PTT, APTT, BT, CT, PTT, TT)?

back 49

Blue top tube

front 50

Chemical in blue top tube

back 50

Citrate (remember blue = citrate b after c)

front 51

Medical terminology for red blood cells?

back 51

Erythrocytes

front 52

Thrombocytes are what kind of cell?

back 52

Platelets

front 53

Medical terminology for ALL blood cells?

back 53

All of the above - ie, eurthro, thrombo and white

front 54

Main function of thrombocytes?

back 54

Coagulation

front 55

Main function red blood cells?

back 55

Transport O2 to cells

front 56

Life cycle of red blood cell?

back 56

120 days

front 57

What is not part of a complete blood count (Hemoglobin, Hematocrit and differential are part of the CBC?

back 57

Activate partial thromboplastin time test (APPT)

front 58

What is the most common occurring lab nosocomial infection?

back 58

HBV

front 59

Common and routinely performed test in the serology lab department?

back 59

Rapid Plasma Regain (RPR)(SST Tube)

front 60

What does CBC stand for?

back 60

Complete Blood Count (Lavender tube)

front 61

What does PTT stand for?

back 61

Prothrombin Time Test (Blue tube)

front 62

What does BUN stand for?

back 62

Blood, urea, nitrogen (SST tube)

front 63

What does BT stand for?

back 63

Bleeding time

front 64

What does GTT stand for?

back 64

Glucose Tolerance Test (SST tube)

front 65

Which lab department performs hemogram?

back 65

Hematology

front 66

Most common test for lavender top tube?

back 66

CBC - complete blood count

front 67

What is the additive present in the lavender top tube?

back 67

EDTA (E after D)

front 68

What are not included in the antecubital fossa?

back 68

Brachial veins

front 69

Vein choice order?

back 69

Ante cubital is 1st choice
Basilic is 2nd choice
Cephalic is 3rd Choice (or 1st in obese choice)

front 70

What is the process used to wash and remove blood and tissues from contaminated medical supplies?

back 70

Sanitization

front 71

What would be the first test the lab worker would draw if the patient is suspected to have FUO (fever unknown origin)?

back 71

Blood culture

front 72

BNP is a special test used to evaluate

back 72

Cardiac enzymes and cardiac markers

front 73

........ is the process where complex substances in the food are broken down into simple substances while releasing energy

back 73

Catabolism

front 74

Homeostasis definition?

back 74

The condition where healthy body through constant changes remains the same

front 75

Hemostasis definition?

back 75

Stoppage of excessive blood

front 76

The blood which contains more oxygen and less carbon dioxide is called?

back 76

Oxygenated blood, which is also red in color

front 77

The blood contains less oxygen and more carbon dioxide is called?

back 77

Deoxygenated blood and is blue in color

front 78

Name the main organ of the human body that is closer to the heart and contains deoxygenated blood?

back 78

Superior vena cava

front 79

What is found in plasma but not in serum?

back 79

Fibrinogen

front 80

An infection acquired in a health care facility is called?

back 80

Nosocomial

front 81

Three components of the chain of infection are?

back 81

Source, mode of transmission, and susceptible host

front 82

Important PPE's in an isolation room?

back 82

Gloves, gown, and mask

front 83

A sample for fimbrin degradation product testing would be sent to which department?

back 83

Coagulation department

front 84

What precaution require special air handlings and ventilation?

back 84

Airborne diseases

front 85

What is the current CDC guidelines for infection control?

back 85

Standard precaution

front 86

Legal action in which the alleged injured party sues for monetary damages are?

back 86

Civil action

front 87

The level of care that a person of ordinary intelligence and good sense would exercise under the given circumstance's is the definition of .... care?

back 87

Due care

front 88

What test is not associated with the muscular system of the human body?

back 88

HCG

front 89

Guides used to monitor all aspects of proper patient care are called?

back 89

QA Indicators

front 90

The concentration of H20 (water) in plasma is about 90% the ..... is the concentration of remaining solution in the plasma?

back 90

Dissolved substances

front 91

If patient has a blood group B, what agglutinins are present in that blood group?

back 91

Anti-A

front 92

When performing bleeding time test the blood pressure cuff must be inflated to?

back 92

40mm Hg

front 93

Educate the patient, not allowed to eat and drink anything by mouth, is called?

back 93

NPO (Nothing by mouth)

front 94

An example of QC measures in phlebotomy is?

back 94

Checking the expiration dates in all different evacuated tubes

front 95

What, according to CLIS, order of draw guidelines would be last?

back 95

Lavender top tube

front 96

What lab documents describes in detail the steps to follow specimen collections?

back 96

Procedure manual

front 97

In order to monitor therapeutic drug level the lab worker needs to know?

back 97

Time of the last dose

front 98

What test should be collected in a royal blue top tube?

back 98

Magnesium

front 99

How many tubes are drawn for a 3 hour glucose tolerance test (GTT)?

back 99

4 tubes (1st is always random fasting specimen then 3 tests)

front 100

If a lab test requires serum, which tube is used?

back 100

Red topped tube

front 101

Alanine amino transfearas test (ALAST) is associated with which part of the body?

back 101

Liver

front 102

The principals of right and wrong, as applied to professional issues are defined as?

back 102

Ethics

front 103

What is the abbreviation for a type of antibody?

back 103

IgM

front 104

Most coagulation tests require a plasma specimen collected in a ......... top?

back 104

Light blue top

front 105

What test requires a whole blood specimen?

back 105

CBC

front 106

Patient with a low grade fever, 1 month, doctor ordered EST, what tube will be used for this test?

back 106

Lavender top tube

front 107

A SST tube is frequently used for what path lab department (Serum Separator Tube)?

back 107

Chemistry

front 108

What is the chemical substance present in a serum separator tube (SST)?

back 108

Thixotropic gel

front 109

Three main parts of a needle?

back 109

Bevel, shaft, hub

front 110

The clear colorless fluid that functions in protecting and nourishing the ...... and ...... is called the cerebrospinal fluid?

back 110

Brain and spinal cord

front 111

Identifying the tubes need to collect a PT, Stat, and BC in order?

back 111

Yellow, light blue, plain silicone tube (PST)

front 112

What is collected in a trace element tube?

back 112

Lead

front 113

Verbal expressions are not an example of?

back 113

Kinesics

front 114

Location of antecubital veins

back 114

Basilic - thumb side
Cephalic - pinkie finger
Medial cubital is centered

front 115

Label the diagram

back 115

Bottles are culture bottles, then label as red, yellow, lavender etc. Yellow and black tube is a tiger top tube.

front 116

Sterile Blood Culture Tubes or Vials (YELLOW)

back 116

Sterile specimens are drawn first to prevent contamination that can occur during the procedure. The specimens you should draw first are blood culture bottles and SPS (yellow top) tubes.

front 117

Blue top tubes

back 117

Blue top tubes are used for coagulation studies and contain citrate additives. They have a light blue shield/stopper as well as a clear shield used over the blue stopper.

front 118

Red top tubes

back 118

These tubes may come with or without clot activator or gel separator. They may look like a red and black tiger top stopper, gold shield, or a red shield/stopper. These are used to draw samples for blood bank and HCG levels (pregnancy hormones).

front 119

Green top tubes

back 119

These tubes contain heparin as an additive and may come with or without a gel plasma separator. They may have a green and gray stopper, light green shield, as well as the green shield/stopper. These tubes are used to test ammonia and blood chemistry levels.

front 120

Purple (Lavender)top tubes

back 120

EDTA (Ethylenediaminetetraacetic Acid) tubes use a lavender stopper/shield, white (pearl) shield, pink stopper/shield, royal blue shield or tan shield. These tubes can be used to test CBC (Complete Blood Count), Hematocrit, Hemoglobin, and ESR (Erythrocyte Sedimentation Rate).

front 121

Grey top tubes

back 121

These glycolytic inhibitor tubes have a gray stopper/shield and are used for a variety of glucose studies

front 122

Order of draw:

back 122