Basic Venipuncture, 2nd Edition
P.A.C.E.® Continuing Education Exam

Choose the one best answer to the questions or statements below

  1. Laboratory test results represent what percentage of information physicians rely on to diagnose and manage their patients?
    1. 90%
    2. 20%
    3. 70%
    4. 50%
  2. Inaccurate results due to improperly collected specimens can misrepresent the patient's actual physical status, leading to:
    1. over-medication
    2. under-medication
    3. misdiagnosis
    4. all of the above
  3. What is the correct statement regarding the ability of the laboratory to know if a blood specimen was incorrectly collected?
    1. other than hemolysis in a centrifuged plasma or serum tube, the laboratory staff would not know any errors were committed during specimen collection
    2. the laboratory staff can tell by looking at a tube if any errors in blood specimen collection were committed
    3. the laboratory testing equipment will always signal an error if the sample was improperly collected
    4. both B & C
  4. Blood specimen quality relies heavily on:
    1. the number of times the patient has been drawn at the same site
    2. the skill and integrity of the person who drew the blood
    3. the number of blood samples currently being processed in the lab
    4. whether the patient ate a high fat meal within 24 hours of testing
  5. Adhering to CLSI standards for every blood sample collection can:
    1. protect patients from injury and medical mismanagement
    2. assure a phlebotomist is able to renew their certification
    3. prevent all re-draws on patients
    4. guarantee higher patient satisfaction ratings
  6. What can occur if a tourniquet is left in place for longer than one (1) minute?
    1. vasoconstriction
    2. hemolysis
    3. hematoma formation
    4. hemoconcentration
  7. In terms of vein selection, which veins pose the highest risk of injury to the patient?
    1. median cephalic & median cubital veins
    2. basilic & wrist veins
    3. hand and antecubital veins
    4. accessory cephalic & median cephalic veins
  8. When performing a venipuncture, which veins pose the lowest degree of risk to the patient?
    1. median cephalic & median cubital veins
    2. femoral veins
    3. basilic & wrist veins
    4. veins on the ankle or foot
  9. According to CLSI standards, what is the order of draw for both tube holder and syringe draws?
    1. blood culture tubes or vials, serum tubes, sodium citrate tubes, EDTA tubes, heparin tubes, oxalate tubes
    2. blood culture tubes or vials, serum tubes, EDTA tubes, oxalate tubes, sodium citrate tubes, heparin tubes
    3. blood culture tubes or vials, sodium citrate tubes, serum tubes, heparin tubes, EDTA tubes, oxalate tubes
    4. EDTA tubes, oxalate tubes, sodium citrate tubes, serum tubes, heparin tubes, blood culture tubes or vials
  10. What is hemoconcentration?
    1. a temporary increase in the concentration of red blood cells, white blood cells, potassium, and other analytes, frequently caused by excess tourniquet time
    2. the breaking up of red blood cells due to excessive probing or pulling on a syringe plunger
    3. the result of drawing tubes in the wrong order
    4. the bruising and mounding of the tissues at a venipuncture site due to excess movement of the needle in the vein
  11. A patient's impression of the laboratory is based upon:
    1. the difficulty encountered in finding a parking place at the hospital
    2. the confidence they have in their doctor
    3. the cleanliness of the draw area and the phlebotomist’s appearance, attitude & skill
    4. the comfort of the seating in the waiting area
  12. To properly identify a patient, the phlebotomist should:
    1. compare the information on the requisition with the information on the patient’s armband
    2. compare the information on the requisition with the information on the labels
    3. ask the patient to affirm his/her name, and compare that with the information on the requisition
    4. ask the patient to state his/her name and birth date and compare it with the requisition and patient’s armband
  13. How many adverse patient events occur in the United States each year as a result of lab-related specimen identification errors?
    1. 160,000
    2. 5,000
    3. 100,000
    4. 75,000
  14. What percentage of transfusion-related deaths occurs each year as a result of incorrect patient or specimen identification by a phlebotomist?
    1. 2%
    2. 11%
    3. 50%
    4. 75%
  15. A two-point check after the draw refers to:
    1. checking the needle safety device twice to be sure it has been activated before discarding in the sharps container
    2. comparing the patient’s armband with the tube label
    3. checking twice to make sure all used venipuncture supplies are properly discarded
    4. observing the puncture site long enough to confirm there is no bleeding at the puncture site or into tissues below the puncture site
  16. How long must the antiseptic be in contact with the skin prior to drawing a specimen for blood cultures?
    1. for at least 30 seconds with a friction scrub and allowing it to air dry
    2. for 1 minute after a vigorous two minute scrub and allowing it to air dry
    3. for 5 minutes after a vigorous scrub with iodine or chlorhexidine
    4. for at least 30 seconds with a friction scrub then patted dry with clean gauze
  17. When is it acceptable to re-touch a cleansed site that has been prepared for a blood culture collection?
    1. after cleaning a gloved finger with the same antiseptic solution
    2. it is never acceptable to touch a cleansed site prior to the puncture
    3. if the vein cannot be visualized and the draw will be unsuccessful otherwise
    4. after pulling the fingertip off the glove and cleansing the finger according to the same scrub protocol that was used on the collection site
  18. What is the correct procedure for filling tubes after collecting a blood specimen using a syringe?
    1. 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
    2. 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
    3. 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
    4. 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
  19. According to CLSI, how might a failed venipuncture be recovered?
    1. try another tube in case the original tube is defective
    2. change to position of the needle by pulling back a bit or slightly advancing it farther into the vein
    3. laterally probe the area until a vein is accessed and blood is obtained
    4. both A & B
    5. all of the above