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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3852_Библиотеки_им_академика_М_И_Перельмана
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APPEN DI X E Mock Certification Exam http://evolve.elsevier.com/Warekois/phlebotomy
182. You receive an order for a blood gas on a
10-day-old baby in the pediatric unit. You
check your phlebotomy cart for the following
equipment:
a. heparinized syringe and 25-gauge needle.
b. 2-mL green top tube for venous blood
gases.
c. Natelson tube and plastic end caps.
d. heparinized capillary tubes and clay.
183. The phlebotomist is processing a chain of custody specimen and is called to a code blue
when she has not yet completed the process.
The appropriate course of action is to:
a. seal the specimen and place it in the courier
pick-up basket.
b. sign the specimen over to another tech to
nish up the process.
c. go to the code and then call the client to
come back for a recollection.
d. put the specimen on the phlebotomy cart
and take it to the code blue.
184. You are performing a therapeutic phlebotomy
on a patient with polycythemia. After collection of the unit of blood you will:
a. discard the unit according to laboratory
policy.
b. process the unit for delivery to the blood
bank.
c. separate the unit into pack cells, plasma,
and platelets.
d. prepare the RBCs for re-infusion into the
patient.
185. The phlebotomist enters the room of an elderly patient who tells her she had difculty
manipulating the cup while collecting her
midstream clean-catch specimen, so she just
voided all of the urine into the collection cup.
The phlebotomist should:
a. take the specimen back to the laboratory
for analysis.
b. give the patient a new kit and tell her to
recollect it correctly.
c. inform the nurse so that he or she can assist
the patient or collect a cath specimen.
d. inform the physician so he or she can per-
form a suprapubic collection.
186. A child suspected of having whooping cough
comes in for testing. The phlebotomist will
perform a:
a. blood draw.
b. urine collection.
c. throat swab.
d. nasopharyngeal swab.
187. The phlebotomist is up on the obstetrics oor
and is given an amniotic uid to transport
back to the laboratory. He should:
a. wrap the specimen in foil or place in a
brown bag.
b. place the specimen on a slurry of ice.
c. wrap the specimen in a heel warmer.
d. separate the specimen into three tubes.
188. The phlebotomist receives a specimen for bilirubin testing from the courier about 1.5 hours
after collection, and notices that the tube is
clear and has not been packaged to be protected from light. This is or is not an appropriate example of transport because:
a. the tube was delivered on time.
b. the specimen needed to be protected from
light.
c. the specimen is too old.
d. bilirubin specimens do not need to be pro-
tected from light.
189. The phlebotomist completes a difcult venipuncture on a very angry patient. After returning to the laboratory the phlebotomist should:
a. document what occurred during the proce-
dure and interaction with the patient.
b. tell the other phlebotomists about how an-
gry the patient was as she drew his blood.
c. call her friend to vent and calm down be-
fore going out to collect the remaining
draws.
d. forget about it because she followed proper
protocol and procedure.
190. The phlebotomist completes a draw in the ER.
She is then asked to perform a stat ABG on
another patient. She has never performed an
ABG but has been observing other phlebotomists over the past week or so. She is the only
phlebotomist available so she goes ahead and
performs the arterial draw. The phlebotomist
had a duty to the patient for all of the following except:
a. performing the arterial procedure because
it was a stat.
b. getting someone who was qualied to per-
form an arterial draw.
c. making sure all of the necessary equipment
was available.
d. relieving the other phlebotomist so he or
she could perform the draw.
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
http://evolve.elsevier.com/Warekois/phlebotomy APPEN DI X E Mock Certification Exam
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191. The phlebotomist was preparing to deliver
pathology reports to the doctors’ mailboxes
when she noted her neighbor had been diagnosed with prostate cancer. She promptly
called her neighbor who had been anxiously
awaiting the news. All of the following apply
to the phlebotomist’s action except:
a. violation of HIPAA.
b. created a liability issue for the laboratory.
c. okay because her neighbor asked for the
information.
d. violated physician-patient integrity.
192. While restocking the phlebotomy cart, the
phlebotomist nds a labeled specimen in the
rack. The phlebotomist should:
a. check the time and date of collection and
process accordingly.
b. discard the specimen in the biohazardous
waste.
c. leave it on the tray until someone comes
looking for it.
d. reprint the label and go redraw the patient.
193. While processing specimens, the phlebotomist
nds a tube labeled with the patient’s name,
medical record number, DOB, date, and time.
The phlebotomist should:
a. reject the specimen because it does not
have the phlebotomist’s ID on the label.
b. process the specimen and deliver it to the
appropriate department for analysis.
c. relabel the tube because it contains pro-
tected personal information.
d. call the oor and ask who the physician is
and write it on the label.
194. The phlebotomist performed an I-STAT electrolyte test on a patient. The results were abnormal but within linearity of the instrument.
The phlebotomist should:
a. rerun the controls before reporting the result.
b. enter the results into the computer and
report out.
c. draw a venous blood sample for testing in
the laboratory.
d. recalibrate the instrument and then retest
the patient.
195. While performing a venipuncture procedure,
the phlebotomist checks the expiration date of
the tube being used. This action is considered
part of:
a. quality assurance.
b. a delta check.
c. a point of care check.
d. quality control.
196. When performing POCT, the phlebotomist
must make sure the cartridge is seated properly in the instrument. This is an example of:
a. a preanalytic variable.
b. an analytic variable.
c. a postanalytic variable.
d. a delta check variable.
197. When completing a buttery draw on a pregnant woman, the phlebotomist accidentally
scratches the top of her hand through the glove
as she withdrew the needle. The phlebotomist
should:
a. not worry about it because the woman is
pregnant and therefore not a risk.
b. wash it off and not report it because it is a
supercial wound and not a puncture wound.
c. complete an accidental exposure report
form after performing rst aid.
d. get a complete history on the woman to
give to her supervisor.
198. While in the middle of performing a difcult
venipuncture, the patient states that she feels
like she is going to vomit. You observe her
and note that she is pale and diaphoretic. You
should:
a. withdraw the needle and grab an emesis
basin and cool cloth.
b. continue drawing the blood quickly so you
do not have to restick the patient.
c. tell the patient to put her head down on her
other arm and continue the draw.
d. pull the needle out and go get someone
from the laboratory to help you.
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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APPEN DI X E Mock Certification Exam http://evolve.elsevier.com/Warekois/phlebotomy
199. A 10-year-old child comes into the laboratory
with an insurance card and a requisition for a
blood draw, stating his mother is in the car.
The phlebotomist or patient representative
should:
a. call the physician to verify the information
on the requisition.
b. draw the blood because the child is a mature
minor.
c. send the child home without performing
the venipuncture.
d. ask the child to go and get his mother from
the parking lot.
200. A physician brings in her elderly mother who
is in a wheelchair. She states that her mother is
a difcult draw and that she will perform the
procedure. She cleanses the arm and proceeds
to insert the syringe needle multiple times in
multiple sites along the elderly woman’s arm
until she nally gets blood. The phlebotomist
should:
a. do nothing because the physician knows
what she is doing.
b. keep quiet because the patient was a rela-
tive and gave consent.
c. document the incident and inform her
supervisor.
d. take the syringe away from the physician
and do the procedure herself.
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Glossary
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APPENDIX F Answers to Chapter Questions
and Mock Certification Exam
CHAPTER 1
STUDY QUESTIONS
1. Phlebotomy is the practice of drawing blood samples for analysis.
2. Six steps in routine blood collection are:
1. Correctly and positively identify the patient.
2. Choose the appropriate equipment for obtaining the sample.
3. Select and prepare the site for collection.
4. Collect the sample, ensuring patient comfort and safety.
5. Correctly label the sample.
6. Transport the sample to the laboratory in a timely manner, using appropriate handling procedures.
3. A phlebotomist must adhere to safety regulations, interact with patients, keep accurate records, and
operate computers.
4. Certication is evidence that an individual has demonstrated prociency in a particular area of
practice.
5. CEUs are required to remain certied and provide updates on new regulations and techniques to
help refresh skills.
6. Organizations that provide accreditation for phlebotomy programs are the American Medical Tech-
nologists (AMT), the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS),
the National Phlebotomy Association (NPA), and the American Society of Phlebotomy Technicians
(ASPT).
7. Organizations that provide certication for phlebotomists are the American Society for Clinical Pa-
thology (ASCP), the NPA, the American Certication Agency for Healthcare Professionals (ACA),
the AMT, and the ASPT.
8. Phlebotomists may wish to become members of a professional organization to follow changes in
the eld and learn new techniques.
9. A patient must be informed of intended treatments and their risks and must give consent before
these treatments are performed; this is known as informed consent.
10. HIPAA violations would include providing protected health information with anyone not autho-
rized to receive it, allowing PHI in your control to be viewed by nonauthorized people, and discussing PHI in a public place where it may be unintentionally overheard.
11. Ancient phlebotomy procedures included bloodletting and the use of leeches. These practices were
used to bleed a person and thus rid that person of his or her ailment.
12. Both ancient and modern phlebotomy involve blood and the veins, but unlike ancient phlebotomy,
modern phlebotomy has set protocols, procedures, and guidelines. Phlebotomy is used in the diagnosis and treatment of disease and as a therapeutic procedure.
13. Job-related duties in the phlebotomist’s job description may include correctly and positively identi-
fying the patient, choosing the appropriate equipment for obtaining the sample, selecting and
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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14. Required personal characteristics for a phlebotomist include dependability, honesty, integrity, posi-
15. (This answer is up to the student’s discretion and class discussion.)
16. The two most important legal aspects to a phlebotomist are obtaining informed consent and main-
APPEN DI X F Answers to Chapter Questions and Mock Certification Exam http://evolve.elsevier.com/Warekois/phlebotomy
preparing the site for collection, collecting the sample, ensuring patient comfort and safety, and
correctly labeling the sample.
tive attitude, professional detachment, professional appearance, interpersonal skills, telephone
skills, and communication skills.
taining patient condentiality.
CERTIFICATION EXAM PREPARATION
1. b
2. b
3. a
4. c
5. d
6. d
CHAPTER 2
STUDY QUESTIONS
1. The four branches of support personnel in the hospital organizational system are scal, support,
nursing, and professional services.
2. The two main areas of the laboratory are the anatomic and clinical areas; the phlebotomist works
in the clinical area.
3. A physician specializing in pathology oversees the laboratory.
4. Laboratory tests performed in the coagulation department:
Test Therapy Monitored
PT Coumadin
INR Coumadin
APTT Heparin
5. The immunology department performs tests to monitor the immune response through the detection
of antibodies.
6. Molecular diagnostics characterize genetic and biochemical techniques used to diagnose genetic
disorders, analyze forensic evidence, and track diseases.
7. The following are liver function tests: ALT, AST, GGT, ALP, enzymes, and bilirubin.
8. The microbiology department performs culture and sensitivity testing.
9. CLIA ‘88 mandates that facilities that perform patient testing meet performance standards to en-
sure the quality of procedures.
10. The Joint Commission and College of American Pathologists.
11. The Clinical Laboratory Standards Institute sets laboratory standards and guidelines.
12. A phlebotomist may also be employed in HMOs, PPOs, POLs, nursing homes, urgent care centers,
or reference laboratories.
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
http://evolve.elsevier.com/Warekois/phlebotomy APPE NDIX F Answers to Chapter Questions and Mock Certification Exam
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13. The blood bank or immunohematology department is the laboratory that has a special patient
or specimen identication process. Mislabeling or mishandling these specimens may result in a
patient’s death.
14. The technologist looks for agglutination of specimens; if the specimen agglutinates, the blood type is
not compatible and cannot be transfused to the patient. If the blood does not agglutinate, the blood
type is compatible with that of the patient and can be transfused.
15. Professional services are services that are provided at the request of the physician to aid in the
diagnosis and treatment of a patient. Examples of professional services are physical therapy,
occupational therapy, and respiratory therapy.
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CERTIFICATION EXAM PREPARATION
1. d
2. c
3. c
4. a
5. b
6. d
7. c
CHAPTER 3
STUDY QUESTIONS
1.
Safety Hazard Example
Biological Bacteria, viruses
Sharps Needles, lancets, broken glass
Electrical High-voltage equipment
Chemical Lab reagents, preservatives
Latex sensitivity Gloves
Physical Wet floors, lifting heavy objects
Fire, explosive Oxygen, chemicals
Radioactive, x-ray Equipment, reagents
8. c
9. b
10. a
11. b
12. a
13. c
2. Safety precautions include wearing personal protective equipment; never storing food with biohazard
substances; protecting feet from spills, slips, and falling; avoiding putting things in the mouth in the
work area; avoiding eye-hand contact in the work area; and not wearing loose clothing, hair, or jewelry that can get caught in equipment or contaminated.
3. Never recap after collection; needle sticks can occur.
4. Hazardous material labels must display a warning to alert you to the hazard, the manufacturer or
other responsible party, an explanation of the hazard, a list of precautions to reduce risk, and rst aid
measures to take in case of exposure.
5. A safety data sheet provides information on the chemical, its hazards, the procedure for its cleanup,
and rst aid in case of exposure.
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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APPEN DI X F Answers to Chapter Questions and Mock Certification Exam http://evolve.elsevier.com/Warekois/phlebotomy
6. A chemical hygiene plan describes all safety procedures, special precautions, and emergency pro-
cedures used when working with chemicals.
7. If a chemical spills on your arm, proceed to the safety shower, ush the area for 15 minutes, and
go to emergency room for treatment.
8. In the event of electric shock to someone, turn off the equipment or break contact between the
equipment and the victim using a nonconductive material, do not touch the victim until the risk of
further shock is removed, call 911, start CPR if indicated, and keep the victim warm.
Extinguisher Type Contains
9.
A Pressurized water or soda and acid
BC Carbon dioxide or foam
ABC Dry chemical
Halon Chlorofluorocarbons
10. The protocol for assistive breathing is as follows: determine consciousness; if there is no response,
call 911 and begin rescue breathing; make sure the victim is at on a rm surface; check the airway; position the victim’s head; if the victim is not breathing, pinch the nose shut, place your
mouth over the victim’s mouth, and exhale; check to see whether the victim’s chest rises, indicating a clear airway; give two full ventilations and check for breathing; and continue until breathing
occurs or until assistance arrives.
11. Skin conditions associated with latex use include the following:
• Irritant contact dermatitis: redness, swelling, itching
• Allergic contact dermatitis: the body’s immune system reacts to proteins absorbed through the skin
• Anaphylaxis: rapid severe immune reaction; airway may swell shut, heart rate increases, and blood
pressure decreases
12. The Occupational Safety and Health Administration (OSHA) regulates all work environments to
prevent accidents. It provides guidelines for accident prevention.
13. To control a bleeding emergency, you must apply pressure to the area or wound, elevate the limb
unless it is fractured, and maintain pressure until medical help arrives.
14. The early signs of shock include pale, cold, clammy skin; tachycardia (rapid pulse); shallow
breathing; weakness; and nausea, vomiting, or both. In case of shock, keep the victim warm and
lying down with the airway open, and call for professional assistance.
15. The plan to follow during a disaster emergency varies from institution to institution. It is important
to learn and know your institution’s disaster plan.
16. No answer provided.
CERTIFICATION EXAM PREPARATION
1. c
2. a
3. b
4. c
5. b
6. d
7. a
8. d
9. d
10. c
11. d
12. c
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
http://evolve.elsevier.com/Warekois/phlebotomy APPE NDIX F Answers to Chapter Questions and Mock Certification Exam
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CHAPTER 4
STUDY QUESTIONS
1. Infection is the invasion and growth of disease-causing microorganisms in the human body.
2. Four classications of pathogens are viruses, bacteria, fungi, and protists.
3.
Disease Causative Infectious Organism
AIDS Human immunodeficiency virus (HIV)
Gonorrhea Neisseria gonorrhoeae
Hepatitis Hepatitis virus (A-E and G)
Malaria Plasmodium
Oral and genital herpes Herpes simplex
Strep throat Streptococcus
Syphilis Treponema pallidum
Trichomoniasis Trichomonas vaginalis
Tuberculosis Mycobacterium tuberculosis
4. Health care-related infections are contracted by a patient during a hospital stay as the result of direct
contact with other patients or by failure of hospital personnel to follow infection control protocols.
5. The chain of infection is made up of a source, a means of transmission, and a susceptible host.
6. The chain of infection is broken by preventing transmission, which can be achieved by hand wash-
ing, using personal protective equipment, isolating patients at risk of spreading or contracting infections, and using standard precautions.
7. Direct contact involves the transfer of microorganisms from an infected person to a susceptible
host by body contact; indirect contact involves contact between a susceptible host and a
contaminated object.
8. Fomites are objects, whereas vectors are organisms.
9. Hand washing is the most effective way to prevent the spread of infection.
10. Personal protective equipment includes uid-resistant gowns, masks, respirators, face shields,
gloves, and shoe covers.
11. Standard Precautions are an infection control method that uses barrier protection and work control
practices to prevent direct skin contact with biohazardous materials.
12. Bloodborne pathogens include syphilis, HIV, hepatitis A through E, HTLV types I and II, malaria,
babesiosis, and Colorado tick fever.
13. Hepatitis B may be stable in dried blood for at least 7 days.
14. Bleach should be in contact with a contaminated area for 20 minutes for complete disinfection.
15. In 1992 OSHA issued Standard Precautions, which dictated that employers must have a written
bloodborne pathogen exposure control plan and provide personal protective equipment to all workers (health care and others) at no charge to the employee. The Standard Precautions also dictated
that employers must provide hepatitis B vaccine, free follow-up care for accidental exposure, and
yearly safety training and ensure that needles are not being recapped.
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APPEN DI X F Answers to Chapter Questions and Mock Certification Exam http://evolve.elsevier.com/Warekois/phlebotomy
CERTIFICATION EXAM PREPARATION
1. d
2. b
3. c
4. d
5. c
6. c
7. c
8. c
9. b
10. c
11. b
12. a
CHAPTER 5
STUDY QUESTIONS
1. The parts of a word always include a root and may include a sufx or prex.
Prefix Meaning
2.
ante- before
antibradycirrho- yellow
cyan- blue
epi- on, over
erythro- red
hemi- half
hyper- above
hypo- below
inter- between
intra- within
leuko- white
lute- yellow
micro- small
nano- billionth
neo- new
peri- around
poly- many
post- after
rube- red
tachy- fast
tetra- four
against
slow
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Root Meaning
3.
agglut- clump together
angio- vessel
arthro- joint
bili- bile
cardio- heart
derm- skin
heme- blood
hepato- liver
nephr- kidney
oste- bone
phagophlebo- vein
-pnea breath
pulmon- lung
ren- kidney
thromb- clot
tox- poison
4.
Suffix Meaning
-ectomy surgical removal
-emia blood condition
-genous originating from
-itis inflammation
-oma tumor, growth
-pathy disease
-penia deficiency
-plasty shape
-plegia paralysis
-stasis stopping
-tomy cut
eat
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Abbreviation Meaning
5.
AIDS acquired immunodeficiency syndrome
ASAP as soon as possible
BP blood pressure
CCU cardiac care unit
COPD chronic obstructive pulmonary disease
CPR cardiopulmonary resuscitation
CV cardiovascular
CVA cerebrovascular accident
DM diabetes mellitus
DOB date of birth
DVT deep vein thrombosis
Dx diagnosis
ECG/EKG electrocardiogram
FUO fever of unknown origin
GI gastrointestinal
hypo hypodermically
Copyright 2016, 2011, 2007, 2002 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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