National Phlebotomy Certification Exam Questions and Answers with Certified Solutions

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National Phlebotomy Certification Exam Questions and Answers with Certified Solutions An individual who has little resistance to an infectious microbe is referred to as a susceptible what? ✔✔H... ost Which of the following is an example of a work practice control that reduces risk of exposure to bloodborne pathogens? ✔✔Wearing gloves to draw blood This ion is essential to the coagulation process. ✔✔Calcium QC protocols prohibit use of outdated evacuated tubes because why? ✔✔Tubes my not fill completely, changing additive-to-sample ratios. Molecular genetic testing requires what? ✔✔Specimens to be collected in sterile EDTA. What is the purpose of an antiglycolytic agent? ✔✔Preserve glucose Which on of the following tubes is filled first when multiple tubes are filled using an evacuated tube system? ✔✔Blood culture (SPS) tube What is the recommended disinfectant for blood culture sites in infants 2 months and older? ✔✔Chlorhexidine gluconate Latent fibrin formation in serum can result from what? ✔✔Incomplete clotting when centrifuged In which of the following areas does capillary specimen collection differ from routine venipuncture when collecting a BUN and CBC? ✔✔Order of draw This is an example of a preanalytical error made at the time of collection. ✔✔Failing to mix tubes What constitutes a positive modified Allen test? ✔✔The hand color returns to normal in 15 seconds. According to CLSI, which tubes should be placed upright as soon as they are mixed? ✔✔Nonanticoagulant gel tubes Reference values are higher for capillary specimens with what test? ✔✔Glucose According to CLSI, the maximum time limit for separating serum or plasma from cells is how long? ✔✔2.0 hours from time of collection All of the following are a reason for transporting tubes with the stoppers up EXCEPT which of the following? ✔✔Maintains the sterility of the sample. The liquid portion of a clotted specimen is called what? ✔✔Serum The most common reason for glucose monitoring through POCT is to what? ✔✔Monitor glucose levels for diabetic care. The AMT, ACA, and ASCP are agencies that do what? ✔✔Certify laboratory professionals A quadriplegic patient can do what of the following? ✔✔Can feel pain if there is no sensory damage. The standard of care used in phlebotomy malpractice cases is often based on guidelines from what organization? ✔✔CLSI - Clinical and Laboratory Standards Institute In collecting blood cultures, one of the most frequent errors made is what? ✔✔Improper cleansing of the collection site Which type of specimen is typically used for routine urinalysis? ✔✔Random A positive FIT test indicates what? ✔✔Bleeding in the colon or rectum Accessioning a specimen involves what? ✔✔AOTA-Connecting it with the correct individual, giving it a unique identification number, and recording it in the order it was received. A blood specimen collected in nongel tube has been centrifuged. The cells at the bottom are free flowing and can be resuspended if the tube is inverted. The term used to describe the liquid portion on top of the cells is what? ✔✔Plasma The composition of capillary puncture blood more closely resembles what? ✔✔Arterial Blood A phlebotomist arrives to collect a 2-hour post-prandial glucose specimen on an inpatient and discovers that 2 hours have not elapsed since the patient's meal. What should the phlebotomist do? ✔✔Ask the patient's nurse to verify the correct time to draw the specimen. Which of the following is referred to as a delivering chamber of the heart? ✔✔Left ventricle According to laboratory policy, specimens collected need to yield 2.5 times the amount of sample needed to perform the test. If a chemistry test requires 0.5mL of serum, which of the following tubes is the smallest that can be used? ✔✔3-mL red top The main difference between serum and plasma is what? ✔✔Plasma has fibrinogen, serum does not. Which of the following represents proper collection and handling of newborn screening specimens? ✔✔Use one free-flowing drop to fill both sides; air-dry flat and elevated. Which of the following is a safe area for infant heel puncture? ✔✔Medial plantar surface Generally, the minimum force and time required to result in good separation of serum or plasma from the cells is what? ✔✔1,000 g for 10 minutes All of the following statements concerning an employee bloodborne pathogen exposure incident are true EXCEPT what? ✔✔The source patient must submit to HIV and HBV testing within 48 hours. Which additive prevents coagulation by binding calcium? ✔✔Potassium EDTA A prothrombin specimen must be collected from a patient with IVs in both arms. The best place to collect the specimen is from where? ✔✔Below on of the IVs Biological Substance Category B regulations must be followed when shipping laboratory specimens for diagnostic purposes by public transportation. These regulations require the specimens to be what? ✔✔Triple packaged in a watertight primary container. Which of the following microcollection containers should be filled first if collected by capillary puncture? ✔✔Lavender top Which of the following specimens is negatively affected by chilling? ✔✔Potassium The CAP requires QC for many waived tests to be performed when? ✔✔When test manufacturer specifies. A technologist asks the phlebotomist to collect 5cc of whole blood for a special test. What volume tube should be used? ✔✔5 mL Transporting tubes with the stopper up has nothing to do with what? ✔✔DOES NOT MAINTAIN THE STERILITY OF THE SAMPLE! The first tube of cerebrospinal fluid (CSF) collected is typically used for what? ✔✔Chemistry studies The manufacturer must supply an SDS for which one? ✔✔Isopropyl and methyl alcohol. The abbreviation for the federal agency that instituted and enforces regulations requiring the labeling of hazardous materials is what? ✔✔OSHA What is NAACLS? ✔✔National Accrediting Agency for Clinical Laboratory Sciences - developed the standardized educational curriculum with a recognized body of knowledge, skills, and standards of practice for the phlebotomy profession. What is CLIA? ✔✔Clinical Laboratory Improvement Amendments TJC ✔✔The Joint Commission - independent, not for profit organization charged with, among other things, establishing standards for the operation of hospitals and other health related facilities and services. NPSG ✔✔National Patient Safety Goals CAP ✔✔College of American Pathologists - not for profit organization for professionals in the field of laboratory medicine. Offers proficiency testing and a continuous form of laboratory inspection by a team made up of pathologists and laboratory managers. CLIAC ✔✔Clinical Laboratory Improvement Advisory Committee - to provide technical and scientific advice and guidance to the appropriate people in CMS. NAACLS ✔✔National Accrediting Agency for Clinical Laboratory Sciences - an authority on quality clinical laboratory education. CLSI ✔✔Clinical and Laboratory Standard Institute - organization that develops clinical and laboratory practices and promotes their uses worldwide. NHSN ✔✔National Healthcare Safety Network - provides data on healthcare associated infections. HICPAC ✔✔Healthcare Infection Control Practices Advisory Committee - provides the CDC with advice and guidance regarding the practice of infection control and prevention in healthcare settings. CDC ✔✔Centers for Disease Control - investigates and controls various diseases. NIOSH ✔✔National Institute for Occupational Safety and Health - part of the CDC, responsible for conducting research and making recommendations for the prevention of work related illness and injury. OSHA ✔✔Occupational Safety and Health Administration - mandates and enforces safe working conditions for employees. HCS ✔✔Hazard Communication Standard - HazCom - right to know. First tube Culture - Cinnamon ✔✔Yellow - Microbiology - Blood Culture - SPS Additive - Bacteremia or septicemia 2 bottles - Anaerobic and aerobic (butterfly needle-collect aerobic first) No capillary stick. 2 sets collect 30 minutes apart from different arms. Second tube Citrate - Can ✔✔Light Blue - Coagulation - Sodium Citrate - PT/INR, PTT, APTT, D-dimer, 9:1, butterfly-throw first tube away Orange-Chemistry-Thrombin-Coagulation Black-Chemistry-Sodium Citrate- ESR-4:1 Third tube Serum - Surely ✔✔Red-Chemistry/Blood Bank-No Additive-Type&Xmatch Tiger-Chemistry-No Additive-STDs, HIV, HCG, Drugs, BMP, Lipid, T3-T4, Antibodies, FBS, Liver/Kidney issues Gold-Chemistry-No Additive- Same tests as Tiger Fourth tube Heparin - Help ✔✔Light Green-Chemistry-Lithium-Inhibits thrombin-PST, BMP, Stat electrolytes, Plasma Green-Chemistry-Sodium-Inhibits thrombin-Tropin, Lactic acid on ice, Stat electrolytes Fifth tube EDTA - Eliminate ✔✔Lavender-Hematology-EDTA-CBC, Malaria, A1C, ABROH, Blood type, DAT, ESR, Retic, Mono, Hemoglobin Ammonia-Chemistry- Delivered on ice Sixth tube Sodium Fluoride/Potassium Oxalate - Odors ✔✔Gray-Chemistry-Sodium Fluoride/Potassium Oxalate-2hr post, ETOH, GTT, Fasting BS, Antiglycolytic (glucose tolerance) Seventh tube ACD ✔✔Yellow-Blood Bank/Immunohematology-ACD-DNA, HLA, Organ Transplant, Bone Marrow match Royal Blue-By Itself EDTA, None, Sodium Heparin ✔✔Royal Blue-Chemistry-Trace Free/EDTA/Sodium HeparinHeavy Metals-aluminum, arsenic, copper, lead, iron, zinc Which of the following specimens would most likely be rejected for testing? ✔✔A hemolyzed potassium specimen. 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