Basic Venipuncture, 3rd Edition
P.A.C.E.® Continuing Education Exam
Choose the one best answer to the questions or statements below
- Laboratory test results represent what percentage of information physicians rely on to diagnose and manage their patients?
- 90%
- 20%
- 70%
- 50%
- Inaccurate results due to improperly collected specimens can misrepresent the patient's actual physical status, leading to:
- over-medication
- under-medication
- an incorrect diagnosis
- all of the above
- What is the correct statement regarding the ability of the laboratory to know if a blood specimen was incorrectly collected?
- those who test altered samples won't always know when the results are inaccurate
- the laboratory staff can tell by looking at a tube if any errors in blood specimen collection were committed
- the laboratory testing equipment will always signal an error if the sample was improperly collected
- both B & C
- Blood specimen quality relies heavily on:
- the number of times the patient has been drawn at the same site
- how the sample is drawn, handled and transported
- the number of blood samples currently being processed in the lab
- whether the patient ate a high fat meal within 24 hours of testing
- What can occur if a tourniquet is left in place for longer than one (1) minute?
- vasoconstriction
- hemolysis
- hematoma formation
- hemoconcentration
- In terms of vein selection, which veins pose the highest risk of injury to the patient?
- median cephalic & median cubital veins
- basilic vein and the medial aspect of the median cubital vein
- hand and antecubital veins
- accessory cephalic & median cephalic veins
- According to CLSI standards, what is the order of draw for both tube holder and syringe draws?
- blood culture tubes or vials, serum tubes, sodium citrate tubes, EDTA tubes, heparin tubes, oxalate tubes
- blood culture tubes or vials, serum tubes, EDTA tubes, oxalate tubes, sodium citrate tubes, heparin tubes
- blood culture tubes or vials, sodium citrate tubes, serum tubes, heparin tubes, EDTA tubes, oxalate tubes
- EDTA tubes, oxalate tubes, sodium citrate tubes, serum tubes, heparin tubes, blood culture tubes or vials
- What is hemoconcentration?
- a temporary increase in the concentration of red blood cells, white blood cells, potassium, and other analytes, frequently caused by excess tourniquet time
- the breaking up of red blood cells due to excessive probing or pulling on a syringe plunger
- the result of drawing tubes in the wrong order
- the bruising and mounding of the tissues at a venipuncture site due to excess movement of the needle in the vein
- A patient's impression of the laboratory is based upon:
- the difficulty encountered in finding a parking place at the hospital
- the confidence they have in their doctor
- the cleanliness of the draw area and the phlebotomist’s appearance, attitude & skill
- the comfort of the seating in the waiting area
- To properly identify a patient, the phlebotomist should:
- compare the information on the requisition with the information on the patient’s armband
- compare the information on the requisition with the information on the labels
- ask the patient to affirm his/her name, and compare that with the information on the requisition
- ask the patient to state his/her full name and birth date, spell their first and last names, and compare it with the requisition and patient’s armband
- How many adverse patient events occur in the United States each year as a result of lab-related specimen identification errors?
- 160,000
- 5,000
- 100,000
- 75,000
- Proper post-venipuncture care includes:
- checking the needle safety device twice to be sure it has been activated before discarding in the sharps container
- comparing the patient’s armband with the tube label
- checking twice to make sure all used venipuncture supplies are properly discarded
- observing the puncture site for at least five seconds to confirm there is no bleeding at the puncture site or into tissues below the puncture site
- When is it acceptable to re-touch a cleansed site that has been prepared for a blood culture collection?
- after cleaning a gloved finger with the same antiseptic solution
- it is never acceptable to touch a cleansed site prior to the puncture
- if the vein cannot be visualized and the draw will be unsuccessful otherwise
- after pulling the fingertip off the glove and cleansing the finger according to the same scrub protocol that was used on the collection site
- What is the correct procedure for filling tubes after collecting a blood specimen using a syringe?
- activate the needle safety device, remove and discard the needle, attach a transfer device to the syringe, and fill the tubes in the correct order of draw through the transfer device
- activate the needle safety device, remove and discard the needle, attach a new needle to the syringe, then fill each tube in the correct order of draw by piercing the top of each tube with the needle
- upon completion of the draw, insert the needle into each tube in the correct order of draw, activate the safety device on the needle & discard the needle & syringe together in a sharps container
- activate the safety device on the needle, discard the needle, attach a transfer device to the syringe and fill the tubes in any particular order since there is no special order of draw for syringes
- According to CLSI, how might a failed venipuncture be recovered?
- try another tube in case the original tube is defective
- change to position of the needle by pulling back a bit or slightly advancing it farther into the vein
- laterally probe the area until a vein is accessed and blood is obtained
- both A & B