Chapter 48
Collecting, Processing, and Testing Blood Specimens
Multiple Choice Questions
1. | Withdrawing blood from a vein is called ____.
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2. | Which of the following is the liquid or fluid portion of the blood?
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3. | Which of the following is the term for red blood cells, white blood cells, and platelets?
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4. | The description of whole blood is ____.
A. | the clear, yellow liquid that remains after a blood clot forms |
B. | the total volume of plasma and formed elements |
C. | the main component of erythrocytes |
D. | the rupturing of red blood cells |
E. | the buffy coat in centrifuged blood |
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5. | Which of the following refers to the rupturing of red blood cells?
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6. | Which of the following is the most common antiseptic used to cleanse the skin before drawing blood?
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7. | In tests for which the use of alcohol may result in inaccurate test results, which of the following chemicals may be used to prepare the skin before venipuncture?
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8. | Which of the following is part of the preparation for a glucose tolerance test?
A. | Instruct the patient to eat a high-carbohydrate diet for 3 days before the procedure |
B. | Offer the patient a high-carbohydrate snack immediately before drawing the blood |
C. | Instruct the patient to refrain from eating after the initial blood and urine samples are taken |
D. | Explain to the patient that only one blood and one urine sample will be taken |
E. | Direct the patient to use a laxative the night before to cleanse the digestive system |
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9. | Which of the following are the most common sites for venipuncture?
A. | Femoral and inguinal veins |
B. | Median cubital and cephalic veins |
C. | Great saphenous and superior vena cava veins |
D. | Popliteal and posterior tibial veins |
E. | Radial and ulnar veins |
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10. | Which of the following items forms the first line of defense during a phlebotomy procedure?
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11. | Which of the following would you include when performing venipuncture using an evacuation system?
A. | Bunch up the patient's skin above and below the insertion site |
B. | Insert the needle at a 45º angle with the bevel side down |
C. | Penetrate the vein wall to a depth of 1/4 to 1/2 inch |
D. | Leave the tourniquet on until after you withdraw the needle from the vein |
E. | Be careful not to invert collection tubes that have additives in them |
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12. | Which blood collection device uses interchangeable collection tubes that are calibrated to collect the exact amount of blood required?
B. | Needle and syringe system |
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13. | Which procedure for obtaining a blood sample is usually performed on the middle finger or the ring finger?
C. | Needle and syringe system |
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14. | Which method of drawing blood would you use on a patient with small or fragile veins?
C. | Automatic puncturing device |
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15. | Which of the following is characteristic of capillary puncture?
A. | The blood is collected using a sterile needle and syringe. |
B. | It is used on patients with small or fragile veins. |
C. | The patient's non-dominant hand is used for this procedure. |
D. | It releases a greater amount of blood, compared to venipuncture. |
E. | The blood is collected into evacuated collection tubes. |
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16. | Which of the following is used in the capillary puncture technique?
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17. | Which of the following tests requires the use of a blood collection tube with a gray stopper?
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18. | Which tests require the use of a collection tube with a green stopper?
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19. | Blood chemistries and HIV/AIDS antibody tests must be performed with a collection tube with what color stopper?
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20. | Which color stopper is used for a collection tube that contains no additive?
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21. | When drawing blood from an infant, what is best site to use to prevent injury to the infant?
A. | The veins in the antecubital fossa |
B. | The median cubital vein |
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22. | Which of the following is important when drawing blood from an elderly patient?
A. | Do not apply pressure after removing the needle |
B. | Wiggle the needle to position it precisely in the vein |
C. | Have the patient bend her elbow after removing the needle |
D. | Avoid using a butterfly collection device |
E. | Have the patient elevate her arm after removing the needle |
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23. | The medical term hemophilia is ____.
A. | the rupturing of red blood cells, which releases hemoglobin that can cause kidney failure |
C. | a disorder in which the blood does not coagulate at a wound or puncture site |
D. | the insertion of a needle or cannula into a vein for the purpose of withdrawing blood |
E. | a disorder in which the blood is thicker than normal, resulting in slow collection times |
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24. | After how many unsuccessful attempts at obtaining a good blood sample should you seek assistance from your supervisor or the doctor?
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25. | A blood urea nitrogen (BUN) test is used to identify ____
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26. | An erythrocyte (RBC) count is used to identify ____.
C. | fluid and electrolyte imbalance |
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27. | Blood tests for potassium and sodium identify ____.
D. | fluid-electrolyte imbalances |
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28. | A blood test that measures creatine kinase (CK) can identify ____.
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29. | Which blood test can help identify coronary artery disease and atherosclerosis?
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30. | Gout is identified by which of type of blood test?
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31. | What is the normal range of potassium found in the blood?
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32. | Normal prothrombin time (PT) is ____.
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33. | The normal blood calcium level is ____.
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34. | The normal sodium blood level is ____.
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35. | The normal fasting blood glucose level is ____.
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36. | Which of the following identifies how much of the volume of a sample is made up of red blood cells after the sample has been spun in a centrifuge?
A. | Hemoglobin determination |
C. | Hematocrit determination |
D. | Differential white blood cell count |
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37. | Which of the following refers to the study of the shape or form of objects?
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38. | Enzyme-linked immunosorbent assay (ELISA) and Western blot tests are used to confirm which of the following diagnoses?
D. | Coronary artery disease |
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39. | The hemoglobin A1c test reflects blood glucose levels over what period of time?
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40. | Which of the following are included in steps for collection of a blood specimen?
A. | Tell the patient the process will not be painful |
B. | Identify the patient correctly |
C. | Ask the patient what test he needs |
D. | Use the same tubes for chemistry and hematology tests |
E. | Apply the tourniquet to the patient's lower arm |
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41. | To identify the patient correctly prior to blood collection, you should ____.
A. | call the patient by name |
B. | ask the patient what labs she will be having done |
C. | ask the patient to verify her name |
D. | ask the patient to state her home address |
E. | verify the patient's name with the doctor |
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42. | In addition to using appropriate engineered safety devices, NIOSH recommends that health-care workers ____.
A. | recap needles before transporting them to the sharps container |
B. | throw sharps into the wastebasket |
C. | attend bloodborne pathogen training every three years |
D. | avoid using needles with hinged shields |
E. | use needles only if no safe alternatives are available |
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43. | The physician has asked you to draw blood from Peter, a 24-year-old patient, for routine pre-employment testing. As you begin explaining the process, Peter starts to look very uncomfortable. Although he pretends nothing is wrong, you soon discover that he is afraid of needles. Which of the following suggestions might you make to help Peter?
A. | "Take rapid, shallow breaths while I insert the needle in your arm." |
B. | "Tense the muscles in your arm so it won't hurt as much." |
C. | "See the magazine in the rack on the wall? Focus on that while I draw the blood." |
D. | "This will be painful, but I know you are brave enough to get through it." |
E. | "If you do not let me draw your blood, the company won't hire you." |
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44. | Julia is a pretty, 16-year-old patient who has come to the office for her annual physical. The physician has asked you to draw blood for routine blood tests. When she realizes that you are going to draw her blood, she frowns and backs away. She tells you that when "they" drew her blood last year, it left a huge, ugly bruise that took weeks to go away. Which of the following would be your best response?
A. | "They probably didn't draw the blood correctly last time." |
B. | "Don't worry, I promise I will not cause a bruise on your arm." |
C. | "If you get a bruise, you can wear long-sleeve shirts for a few weeks." |
D. | "Some bruising is possible, but I will do everything possible to minimize it." |
E. | "Bruising is just one of the side effects of having your blood drawn." |
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45. | After explaining the process, you are drawing blood on 82-year-old Mrs. Green using an evacuated tube system. As you insert the third tube into the holder, the Mrs. Green begins to cry. You ask if she is in pain and she says, "No, but I am so scared! Why do they need this much blood? I must have a terrible disease!" Which of the following is your best response?
A. | "If you have a terrible disease, wouldn't you rather know about it?" |
B. | "We don't really need this much blood—we always draw a couple of extra tubes." |
C. | "Drawing blood does not necessarily mean you are ill; blood tests are one of the best ways to get an overall picture of your health." |
D. | "I am drawing several tubes of blood because, at your age, there are many different tests that we have to run." |
E. | "Don't worry; I'm sure everything will be fine." |
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46. | Kaiden is a 32-year-old businessman who is being seen in the office because he has been feeling fatigued all of the time. He says he is having difficulty concentrating at work, and his appetite is off. The physician has ordered several blood tests. When you explain the procedure to Kaiden, he smiles and says, "Oh, sure, I've been through this many times before. Do what you have to do!" A few seconds after you withdraw the needle, Kaiden suddenly goes limp. You realize that he has fainted and is beginning to slip out of the chair. What should you do? rev: 02_19_2014_QC_44953
A. | Thrust his head down between his legs |
B. | Leave the room immediately to call for help |
C. | Release the tourniquet, but leave the needle in his arm until the physician arrives |
D. | Wipe his face with a towel soaked with cool water |
E. | Gently lower him to the floor while protecting his head |
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47. | Melanie is a 46-year-old unemployed patient who is being seen in the medical office because of a pain in her abdomen that has persisted for three weeks. The physician orders a urinalysis and several blood tests. When you begin preparing to draw her blood, Melanie says, "No! I don't want you to draw my blood. I just want to know what is causing the pain in my stomach. You don't need blood for that! I can't afford all these extra tests." You explain that the blood tests are needed to help diagnose the stomach pain, but Melanie continues to refuse to allow you to draw her blood. What should you do?
A. | Inform Melanie that you must draw the blood because the physician ordered it |
B. | Report her refusal to your supervisor or the physician and make a note in her chart |
C. | Offer to draw the blood free of charge, since Melanie is unemployed |
D. | Assure Melanie that insurance will cover the cost of the tests |
E. | Ask colleagues in the office to assist you in drawing Melanie's blood |
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Fill in the Blank Questions
48. | Number 1 in the picture is the ________vein, a vein commonly used for venipuncture.
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49. | A vein commonly used for venipuncture and indicated by number 2 in the figure is the ________ vein.
________________________________________ |
50. | The vein used for venipuncture and represented by number 3 in the picture is the ________ vein.
________________________________________ |
51. | A blood collection tube with a gray stopper is used to obtain blood for a blood ________ test.
________________________________________ |
52. | A blood collection tube with a yellow stopper is used to obtain blood ________.
________________________________________ |
53. | A blood collection tube with a lavender stopper is selected for ________ studies.
________________________________________ |
54. | A(n) blood collection tube with a ________ stopper contains heparin.
________________________________________ |
55. | A light blue-stoppered blood collection tube is selected for ________ studies.
________________________________________ |
56. | A blood collection tube with a gold stopper contains a silicone serum separator and is used for studies requiring blood ________.
________________________________________ |
57. | A small calibrated glass tube that holds a precise volume of fluid is a(n) ________.
________________________________________ |
58. | When blood is centrifuged, the heavier red blood cells move to one end of the tube, lighter plasma moves to the other end, and the ________ ________ that contains the white blood cells and platelets is between the two.
________________________________________ |
59. | A(n) ________ puncture is a superficial puncture of the skin with a sharp point, releasing a smaller amount of blood than venipuncture.
________________________________________ |
60. | The non-automated erythrocyte ________ rate (ESR) test measures the rate at which red blood cells settle to the bottom of a blood sample.
________________________________________ |
61. | The red blood cells, white blood cells, and platelets are known as the ________ elements in a blood sample.
________________________________________ |
62. | The rupturing of red blood cells, releasing hemoglobin, is called ________.
________________________________________ |
63. | A small, disposable instrument with a sharp point used to puncture the skin and make a shallow incision is called a(n) ________.
________________________________________ |
64. | A calibrated glass tube that holds a small, precise volume of fluid and is used to collect capillary blood for some tests is known as a(n) _______.
________________________________________ |
65. | The study of the shape or form of objects is called ________.
________________________________________ |
66. | The clear, yellow liquid in which the formed elements of blood are suspended is called _______.
________________________________________ |
67. | The total volume of plasma and formed elements is called ________ blood.
________________________________________ |
68. | The addition of a(n) ________ to a blood collection tube causes the blood to remain in a liquid state.
________________________________________ |
69. | When blood leaks out of the vein around the puncture site during venipuncture and collects under the skin, it forms a(n) ________.
________________________________________ |
70. | When blood is centrifuged, the red layer below the buffy coat consists of ________ red blood cells.
________________________________________ |
71. | The gel-like barrier between the serum and the clot in a coagulated blood sample is formed by a serum ________.
________________________________________ |
Multiple Choice Questions
72. | Which of the following blood tests is completed using a stained blood smear?
C. | Manual differential cell count |
E. | Hematocrit determination |
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73. | The erythrocyte sedimentation rate (ESR) blood test screens for which of the following?
A. | Potential bleeding problems |
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Fill in the Blank Questions
74. | A laboratory _______ form must be filled out when sending blood specimens to a reference laboratory for testing.
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75. | A butterfly collection system generally uses a ____-gauge needle.
________________________________________ |
