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AMCA PHLEBOTOMY EXAM LATEST EXAM
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AMCA PHLEBOTOMY EXAM 1
Which of the following will help a phlebotomist avoid having a patients vein roll away when the needle is inserted? ------CORRECT ANSWER------------- --Anchoring the site from below, using the thumb to pull towards the wrist Facility policy states that no more than 5% of a patients blood may be drawn in 30 days. What is the maximum amount of blood that can be drawn fro a 9-pound infant in a month? ------CORRECT ANSWER--------------- 16mL (9x0.45 =4.05kg/ 4.05kg x 75ml of blood= 303.75mL/ 303.75mL x 0.05= 15.18mL: rounded up to 16) A patients chart indicates that her veins are thin, fragile and frequently collapse. A total of 5mL of blood needs to be drawn for various tests. Which of the following techniques would be best for drawing blood from this patient? ------CORRECT ANSWER---------------Venipuncture using a 23g butterfly and syringe Which of the following is a significant difference between midstream and routine urine specimens? ------CORRECT ANSWER---------------The area around the urethra is cleaned before collecting a midstream specimen
Hemoconcentration may be caused by ------CORRECT ANSWER------------- --Leaving a tourniquet in place for too long. a patient begins to experience a seizure during a blood draw. What should be the phlebotomists first response? ------CORRECT ANSWER--------------- To remove and sheathe the needle Which of these tests is an entry-level phlebotomist most likely to be trained to perform in its entirety? ------CORRECT ANSWER---------------testing urine with dipstick which of these items may be reused between patients with proper cleaning? ------CORRECT ANSWER---------------A phlebotomy wedge One effective method to help control healthcare associated infections is ---- --CORRECT ANSWER---------------Using facility-approved disinfectants to clean reusable items like point-of-care testing devices Just as a needle is removed from a patient's arm, the patient has a coughing fit and the phlebotomy technician is accidentally stuck with the needle. What should the phlebotomy technician do after placing the needle in the sharps container? ------CORRECT ANSWER---------------Wash the injury with soap under running water for 15 minutes Which of the following is one acceptable way of confirming a patients identity? ------CORRECT ANSWER---------------Checking the name and date of birth on a wristband on the patients wrist against his stated name and date of birth
Which is a set of regulations deals with how labs are staffed and what tests they can perform? ------CORRECT ANSWER---------------CLIA When a patient's veins are difficult to access, how many attempts at venipuncture should a phlebotomy technician make before seeking help from other qualified personnel? ------CORRECT ANSWER---------------two Accidental artery puncture should be avoided for the following reason: ------ CORRECT ANSWER---------------It can be more difficult to stop arterial bleeding In addition to causing pain for the patient, probing for a vein can result in ____ which may affect analytes in a specimen ------CORRECT ANSWER--- ------------Hematoma Which of following is permitted during blood donation collections but should not be done during routine venipuncture collections? ------CORRECT ANSWER---------------Opening and closing the hand during collection When should gloves be removed and replaced? ------CORRECT ANSWER- --------------Always between patients The bloodborne illness that has most commonly affected healthcare workers is ------CORRECT ANSWER---------------Hepatitis B
Coagulation studies are ordered for a patent whose veins require use of a butterfly assembly. Which of the following is true? ------CORRECT ANSWER---------------A discard tube should be started first, then a light blue filled completely If a phlebotomist is not able to read a note made on a manual requisition form, she should ------CORRECT ANSWER---------------Contact the ordering physician for clarification Sharp, shooting pain during venipuncture is a possible sign of what? ------ CORRECT ANSWER---------------Nerve involvement Which of the following patients is most likely to require a syringe and transfer device? ------CORRECT ANSWER---------------An 80-year old man Hemolysis of a capillary specimen is most likely to have resulted from ------ CORRECT ANSWER---------------"milking" the finger during collection A patient indicates that phlebotomists have always had the best luck drawing blood from his right arm, but no suitable site can be found in the right arm after visual inspection and palpation. What should the phlebotomist do next? ------CORRECT ANSWER---------------Check the left arm Which of the following are effects of warming a capillary puncture site? -----
- CORRECT ANSWER----------------Improved blood flow
- Arterialization of the blood
inches below the venipuncture site and pulling firmly but gently toward the wrist. Drawing a patients blood for routine testing after she has expressed that she does not wish to have the procedure performed may be considered ---- --CORRECT ANSWER---------------battery Most collection tubes should be centrifuged within... of collection. ------ CORRECT ANSWER---------------2 hours Some swabs are transported in a tube with an ____ that must be ____ to release liquid ------CORRECT ANSWER---------------ampule, crushed which of the following equipment has an expiration date that must be checked prior to use? ------CORRECT ANSWER---------------Point-of-care testing strips A patient reports that during a previous blood draw he felt lightheaded and almost passed out. What should the RPT do? ------CORRECT ANSWER---- -----------Perform the draw with the patient reclined or in a supine position. a RPT at a primary care clinic is performing venipuncture on a patient with suspected influenza. The patient is wearing a mask. What PPE should the tech wear? ------CORRECT ANSWER---------------Gloves and a mask
A requisition calls for the following tests: CBC, CMP, and PTT. What is the correct order of draw? ------CORRECT ANSWER---------------Citrate, SST, EDTA Blood exits the heart through the body's largest artery. What artery is it? ---- --CORRECT ANSWER---------------Aorta What part of the evacuated tube system allows multiple collection tubes to be filled with one puncture? ------CORRECT ANSWER---------------the interior needle/tube holder When drawing a specimen for an ammonia test, what should a phlebotomy technician have ready for specimen transportation? ------CORRECT ANSWER---------------an ice slurry A phlebotomy tech asks a patient to state and spell his name. He says "Chris Morgan C-H-R-I-S M-O-R-G-A-N" The name listed on the requisition is "Criss Morgan." What should the RPT do? - -----CORRECT ANSWER----- ----------Call the ordering provider to resolve the issue and get a new requisition with the correct spelling When a blood culture is ordered along with other tests, which tube is filled first? ------CORRECT ANSWER---------------Yellow SPS Which of these patient reactions should be documented, but is not a cause for discontinuing a draw of likely to affect analysis? ------CORRECT ANSWER---------------Petechiae
An infants blood volume may be approximated by multiplying childs: ------ CORRECT ANSWER---------------Weight in kg times 80 Two sets of blood culture bottles are to be filled for a patient. What must happen? ------CORRECT ANSWER---------------The sets must be filled from two different venipuncture sites After assembling the ETS and double-checking that he has the correct tubes gathered for a venipuncture draw, a RPT realizes he forgot to remove the tourniquet after site selection. He knows that it has been in place for longer than one minute. If he continues with the draw, what is one possible consequence? ------CORRECT ANSWER---------------The specimens collected will not produce accurate test results Which of the following information on a requisition form is essential for a RPT to match exactly with information provided by patient? ------CORRECT ANSWER---------------complete date of birth Disposable tourniquets are intended to be used... ------CORRECT ANSWER---------------One patient only how should a phlebotomy tech respond if, after a site is selected and cleaned and equipment prepared, the patient pushed down his sleeve and clutches his arm to his chest? ------CORRECT ANSWER---------------She should ask th patient if he has any concerns she can address or if he would like to talk to his doctor
Which of the following is a HIPAA violation? ------CORRECT ANSWER------ ---------Failing to log out of a patient record on a visible screen before calling the next patient in A patient with a DNR order in place become unresponsive during the course of a blood draw, the RPT should: ------CORRECT ANSWER----------- ----Discontinue the draw and immediately call for help Which of the following is within the range of common microcollection tube volumes? ------CORRECT ANSWER---------------0.5ML In which of the following cases should a RPT seek out interpretation services? ------CORRECT ANSWER---------------A patient does not speak english and is accompanied by her 10 year old grandson who speaks fluent english Capillary blood gas testing is ordered on a newborn infant. Where and how should the specimen be drawn? ------CORRECT ANSWER---------------From the lateral or medial plantar surface of the foot by capillary puncture Which set of differences is true of collection of donor blood as compared to routine venipuncture for diagnostic testing? ------CORRECT ANSWER------- --------A larger needle is used and the patient is first given a brief medical exam
The veins in both arms of a patient who is obese are difficult for a RPT to palpate and the patient is complaining of pain from the standard disposable tourniquet applied to her arm. Which steps might help the RPT locate a vein and improve comfort for the patient? ------CORRECT ANSWER---------- -----Remove tourniquet, ask patient to dangle arms for several minutes, and then use a blood pressure cuff inflated to just below the patients diastolic blood pressure in place of tourniquet Capillary blood will flow more easily when this is done prior to capillary puncture: ------CORRECT ANSWER---------------The site is warmed for 3- 5 minutes When a patient enters a phlebotomists drawing station, how can the phlebotomist best communicate a positive, professional attitude? ------ CORRECT ANSWER---------------By greeting the patient, introducing themself by name and title and inviting the patient to be seated What is an illness spread by droplets? ------CORRECT ANSWER--------------
- Influenza Microclotting of an anticoagulated specimen may occur if the RPT does not ------CORRECT ANSWER---------------Use gentle inversions to mix the specimens with the tube additive immediately after it is collected In which of the following situations should a RPT report a point-of-care testing result that is in the critical value range? ------CORRECT ANSWER--- ------------Any time a result is in critical value range, even if the repeated test is normal
Why is it especially important that a phlebotomist take care when drawing from a patient who is quadriplegic? ------CORRECT ANSWER--------------- The patient is unable to alert the phlebotomist to pain that might signal nerve involvement A new patient is seated at the drawing station before the phlebotomist realizes he forgot to label and initial the collection tubes from the last patient. What would be his best course of action? ------CORRECT ANSWER---------------Excuse himself and try to catch the last patient before she leaves the facility, then label and initial the tubes in her presence Which of the following tests cannot be performed on capillary blood? ------ CORRECT ANSWER---------------erythrocyte sedimentation rate At what temperature should a specimen drawn to for cryofibrinogen testing be held? ------CORRECT ANSWER---------------37 degrees Celsius Which of the following tubes contain an anticoagulant that acts by inhibiting thrombin? ------CORRECT ANSWER---------------A heparin tube Specimens drawn for testing cold agglutinins must be: ------CORRECT ANSWER---------------Drawn in warmed tubes and kept at body temperature Veins carry blood ______ the heart. Arteries carry blood _____ the heart. -- ----CORRECT ANSWER---------------Toward; away from
Which of the following processes is part of appropriate medical asepsis in a lab? ------CORRECT ANSWER---------------Thoroughly cleaning a venipuncture site with 70% isopropyl alcohol When a phlebotomist begins work at a facility, the employer must offer this protection against bloodborne pathogens? ------CORRECT ANSWER-------- -------A free hepatitis B vaccine A patient with measles is in an airborne infection isolation room. When drawing blood from this patient, a phlebotomist will need to wear: ------ CORRECT ANSWER---------------An N95 respirator Where is venipuncture most commonly performed if no suitable site can be found in the antecubital area of either of the patients arms? ------CORRECT ANSWER---------------The dorsal aspect of one of the patients hands When passing another phlebotomist drawing station a PBT overhears him telling the patient that if she does not extend her arm, he will have to extend it for her and strap it down for the draw. What is the passing PBT's course of action? ------CORRECT ANSWER---------------Politely ask the coworker to pause for a moment, then immediately find a supervisor to intervene The needlestick safety and prevention act requires that employers ------ CORRECT ANSWER---------------Involve staff in the selection of safer medical devices
If a patient asks a phlebotomist for her opinion about the doctor who ordered his tests, the phlebotomist should ------CORRECT ANSWER--------- ------politely decline to offer any opinion How is a five-year-old child most likely to be positioned for venipuncture? -- ----CORRECT ANSWER---------------In a parent or guardians lap Which of these choices lists lab tests in the order in which tubes would be drawn to conduct the tests? ------CORRECT ANSWER---------------Thyroid panel, CBC, glucose A transfer device allows blood to be safely be transferred from... ------ CORRECT ANSWER---------------A syringe to evacuated tubes After introducing herself, confirming the patients identity and matching it to the requisition, what should a phlebotomist do? ------CORRECT ANSWER-- -------------Explain the procedure to the patient In which of the following situations must a phlebotomist ask nursing staff to complete a blood draw? ------CORRECT ANSWER---------------A hospitalized patient's chart indicates blood should only be drawn from central port Which of these statements is true? ------CORRECT ANSWER--------------- Citrate tubes must be filled to at least 90% capacity.
When can a phlebotomist puncture the patients skin for either a venipuncture or capillary puncture? ------CORRECT ANSWER--------------- After the site has been cleaned and dried If after centrifuging a specimen, a phlebotomist notices a pink or red tint to the serum, the specimen is likely ------CORRECT ANSWER--------------- Hemolyzed Which of these tasks is typically considered within a phlebotomists scope of practice ------CORRECT ANSWER----------------creating a peripheral blood smear slide
- performing a throat culture
- Drawing blood from the dorsal aspect of the hand using a syringe and transfer device Blood pulsing into collection tubes is an indication that: ------CORRECT ANSWER---------------The needle has struck an artery A phlebotomist needs to collect gold, pink, and green topped tubes by venipuncture. Which order is correct? ------CORRECT ANSWER--------------
- gold, green, pink Collection tubes with ________ should not be used for therapeutic drug testing ------CORRECT ANSWER---------------Separator gel Adhesive bandages are never placed on ------CORRECT ANSWER---------- -----patients under 2 years of age
Which set of adaptions is appropriate when drawing blood from a pediatric patient? ------CORRECT ANSWER---------------Use of a higher gauge needle, removing any sharp or potentially dangerous objects from within the patients reach, and never leaving the patient alone at the drawing station _____ is an organization that develops stands of practice for labs worldwide ------CORRECT ANSWER---------------CLSI Drawing blood from ____ is usually considered to by beyond the scope of practice for entry-level phlebotomists ------CORRECT ANSWER--------------- Arteries A patient who uses a cane or walker is at a higher risk for this type of hazard ------CORRECT ANSWER---------------uneven walkways and tripping hazards The following tests may be related to assessing kidney health ------ CORRECT ANSWER---------------renal panel and 24-hour urine collection What step immediately follows removing the needle from the venipuncture site? ------CORRECT ANSWER---------------Activating the needle's safety mechanism
