Processing — All Questions

What is the typical centrifugation speed range used for separating serum or plasma from blood cells?

A phlebotomist places four tubes in the centrifuge but realizes one tube is significantly heavier than the others. What must the phlebotomist do before starting the centrifuge?

What is the purpose of a serum separator tube (SST)?

A phlebotomist centrifuges a serum separator tube and notices that the gel barrier did not form properly. Instead, the gel is mixed throughout the specimen. What should the phlebotomist do?

What is an aliquot in specimen processing?

A phlebotomist is aliquoting serum from a centrifuged SST into two transfer tubes. While pipetting, the phlebotomist accidentally aspirates some of the gel barrier material into the transfer pipette. What should the phlebotomist do?

How long should a red top tube (no additive) typically be allowed to clot before centrifugation?

A STAT specimen in a gold top SST arrives in the processing area. The phlebotomist knows that SSTs with clot activator need clotting time. The laboratory protocol states a minimum of 15 minutes for SSTs with clot activator. The specimen was collected 10 minutes ago. What should the phlebotomist do?

What is the buffy coat layer that appears after centrifuging a whole blood specimen?

A phlebotomist receives a specimen for a test that requires frozen serum. After centrifuging and aliquoting the serum, what is the correct procedure?

What is the difference between serum and plasma?

A phlebotomist is using a centrifuge that requires settings in relative centrifugal force (RCF) rather than RPM. The laboratory protocol specifies 1,500 RCF. The phlebotomist is unsure how to convert. What should the phlebotomist do?

Which type of transfer device is commonly used to move serum or plasma from a centrifuged tube to an aliquot tube?

A phlebotomist opens the centrifuge after a spin cycle and finds that one tube has cracked, leaking blood inside the centrifuge. What is the immediate action?

How many times should most tubes with anticoagulant additives be gently inverted after collection?

A phlebotomist centrifuges a lithium heparin (green top) plasma tube and prepares to aliquot the plasma. Upon inspection, the phlebotomist notices the plasma layer appears pink. What does this indicate and what should the phlebotomist do?

What happens if a serum specimen is not separated from the clot within the recommended timeframe?

A phlebotomist receives two specimens for centrifugation: one gold top SST and one green top lithium heparin tube. Can these be centrifuged together?

What is the purpose of adding sodium fluoride to a gray top collection tube?

A phlebotomist is centrifuging specimens and hears the centrifuge making an unusual vibrating noise. The phlebotomist checks the rotor and discovers that one tube holder is empty because a tube was accidentally left out. What should the phlebotomist do?

A phlebotomist collects a specimen for bilirubin testing and places the tube in a clear transport bag on the countertop near a window. A coworker advises that this specimen needs special handling. Which type of specimens must be protected from light during transport?

A phlebotomist collects a blood specimen for potassium testing and places it in the pneumatic tube system for transport to the laboratory. Upon arrival, the lab reports the specimen is hemolyzed. What is the most likely cause?

What is the standard temperature range for storing most routine blood specimens before processing?

A phlebotomist receives an arterial blood gas (ABG) specimen from a respiratory therapist for transport to the laboratory. What is the most critical handling requirement for this specimen?

A phlebotomist receives a call from the laboratory stating that a specimen was rejected with the code ‘QNS.’ The phlebotomist needs to explain this to the nurse and arrange a recollection. What does QNS mean?

A phlebotomist delivers a lavender top tube to the hematology department. The lab technician rejects the specimen because it is clotted. What is the most likely cause of the clot?

Which specimen appearance indicates lipemia?

A phlebotomist is transporting specimens from an outpatient clinic to the main laboratory, a 45-minute drive. The specimens include CBC tubes, chemistry panels, and a coagulation study. How should the specimens be transported?

What does icterus indicate when observed in a blood specimen?

A phlebotomist collects a coagulation specimen in a light blue top tube. The tube is only half-filled because the vein collapsed during the draw. Should this specimen be submitted for testing?

What is the primary cause of hemolysis in blood specimens?

A phlebotomist collects a CBC specimen at 8:00 AM. Due to a transport delay, the specimen does not arrive at the laboratory until 2:00 PM. The laboratory rejects the specimen, citing time-sensitive requirements. Why would a six-hour delay cause rejection?

A phlebotomist collects a specimen for cold agglutinin testing and places it in the regular specimen transport rack alongside other tubes at room temperature. A laboratory technician calls to say the specimen was received improperly. What special handling does a cold agglutinin specimen require?

A phlebotomist is preparing specimens for transport in a biohazard bag. The requisition forms are placed in the same bag as the specimen tubes. Is this correct?

What is the recommended action when a phlebotomist receives a specimen with no patient identification label?

A phlebotomist collects a specimen for ammonia testing. The laboratory protocol states the specimen must be placed on ice immediately and processed within 15 minutes. The phlebotomist places the specimen in the regular transport rack at room temperature. What is the consequence?

Which of the following is a common cause for specimen rejection by the laboratory?

A phlebotomist needs to send a urine specimen through the pneumatic tube system to the laboratory. What precaution should be taken?

What is the correct storage temperature for most refrigerated specimens?

A phlebotomist notices that a specimen tube in the processing area has condensation on the outside after being removed from the refrigerator. The label is becoming difficult to read due to moisture. What should the phlebotomist do?

What does LIS stand for in the laboratory setting?

A phlebotomist enters a patient’s specimen data into the LIS and notices that the system shows a duplicate order for the same test. What should the phlebotomist do?

What is a critical value in laboratory testing?

A phlebotomist performs a POC glucose test and obtains a result of 35 mg/dL. This falls below the laboratory’s critical low glucose threshold of 50 mg/dL. The phlebotomist calls the nurse to report the result but reaches voicemail. What should the phlebotomist do next?

Which federal regulation establishes quality standards for all laboratory testing performed on human specimens?

A phlebotomist receives a call from a patient’s spouse requesting the results of blood work drawn earlier that day. The results are available in the system. What should the phlebotomist do?

What documentation is required on a chain of custody form for forensic specimens processed in the laboratory?

A phlebotomist notices an error in the LIS: a specimen was accessioned under the wrong patient’s medical record number. The specimen has not yet been tested. What should the phlebotomist do?

A laboratory technician obtains a critical potassium result and asks the phlebotomist to help notify the ordering provider. The phlebotomist suggests sending an electronic alert through the LIS. The technician says this is not sufficient by itself. How should critical laboratory results be communicated?

A phlebotomist reports a critical potassium value of 6.8 mEq/L to the patient’s nurse at 10:15 AM. What must the phlebotomist document?

What is the purpose of entering specimen collection information into the laboratory information system at the time of collection?

A laboratory receives a specimen for glucose testing. The results are within normal range. Later, the ordering provider calls and requests that a hemoglobin A1c test also be performed on the same specimen. What should the laboratory do?

What is the laboratory’s responsibility when a specimen does not meet acceptance criteria?

A phlebotomist is updating a patient’s medical record in the EHR after collecting specimens. The phlebotomist notices that the patient’s allergy information shows ‘no known allergies,’ but during the draw, the patient mentioned a latex allergy. What should the phlebotomist do?

When must a phlebotomist contact a patient for specimen re-collection?

The laboratory information system is down for scheduled maintenance. A STAT specimen arrives for processing. What should the phlebotomist or laboratory staff do?

What type of CLIA certificate is required for a facility that performs only waived tests such as POC glucose and urine dipstick?

A phlebotomist receives a STAT order at 3:00 PM for a patient on the medical-surgical floor. The phlebotomist collects the specimen at 3:15 PM and delivers it to the lab at 3:25 PM. The result is available at 3:50 PM. The LIS shows the result has not been viewed by the ordering provider. What should the laboratory do?

What is the primary purpose of maintaining a database of specimen collection and processing information in the laboratory?

A phlebotomist discovers that two patients on the same nursing unit have very similar names: ‘John M. Smith’ and ‘John N. Smith.’ Both patients have blood draws ordered. What is the most important step to prevent a specimen labeling error?

What unit of measurement describes the speed at which a centrifuge rotor spins?

A phlebotomist needs to centrifuge five tubes of blood. When loading the centrifuge, how should the tubes be arranged?

After centrifugation, a phlebotomist needs to transfer serum from a red-top tube into a labeled aliquot tube. Which technique is correct?

In a serum separator tube (SST), what is the function of the gel barrier after centrifugation?

After centrifugation of an anticoagulated blood specimen, the thin whitish layer between the plasma and packed red blood cells is called the:

A laboratory test requires a frozen specimen. After centrifugation and aliquoting, at what temperature should the specimen typically be stored?

What is the standard temperature range for refrigerated specimen storage?

A phlebotomist receives a gold-top SST tube for chemistry testing. The tube was drawn 20 minutes ago. What is the next step in specimen preparation?

A phlebotomist draws blood for a bilirubin level on a newborn. What special handling is required for this specimen?

Amber-colored collection tubes are designed to protect specimens from which environmental factor?

A phlebotomist collects a specimen for a potassium level. The laboratory rejects the specimen two hours later due to hemolysis. Which handling error most likely caused this rejection?

Which of the following best describes specimen integrity in the preanalytical phase?

After centrifugation, a phlebotomist notices that a patient serum appears milky white instead of clear and pale yellow. What condition does this indicate?

A serum specimen that appears dark yellow or greenish-yellow likely indicates which condition?

A phlebotomist delivers a lavender-top EDTA tube to the hematology laboratory. The technologist reports that the specimen contains a visible clot. What is the most likely cause?

What is the term used when a specimen does not contain enough blood to perform the requested laboratory test?

When preparing a specimen for transport to a reference laboratory by courier, how should the phlebotomist package the specimen?

Which phase of laboratory testing includes specimen collection, handling, and transport?

A blood specimen for glucose testing is drawn in a gray-top tube. What preservative in this tube helps maintain specimen stability?

A phlebotomist is asked to collect specimens for a clinical research study. The research protocol specifies exact collection times and tube types. What is the phlebotomist primary responsibility?

When shipping specimens by air to a reference laboratory, which document must accompany the package to describe its contents for transport compliance?

A test requisition specifies that a specimen must be kept at room temperature during transport. The ambient temperature outside is 95 degrees Fahrenheit. How should the phlebotomist transport the specimen?

Under CLIA regulations, what is required of all facilities that perform laboratory testing on human specimens?

A phlebotomist receives a specimen labeled for vitamin B6 testing. The tube is a standard clear red-top tube and was transported in a regular specimen bag without light protection. The laboratory rejects the specimen. Why?

A phlebotomist scans a patient wristband and then scans each specimen tube at the bedside. Which system records this information to track the specimen from collection to result?

A laboratory technologist calls the nursing unit to report a critical potassium value of 6.8 mEq/L. What must the person receiving the result do to complete the reporting process?

Which federal regulation establishes quality standards for laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results?

When a forensic specimen arrives at the laboratory, the receiving technologist must document the transfer on the chain-of-custody form. Which information is required at this step?

Who is authorized to receive laboratory test results for a patient?

A STAT laboratory result is ready, but the ordering physician is not responding to pages. What should the laboratory do?

When laboratory results are finalized and verified, where are they permanently stored?

A laboratory rejects a specimen due to hemolysis and requests a recollection. For an outpatient who has already left the facility, what is the appropriate action?

What is the difference between an internal laboratory database and an external laboratory database?

A phlebotomist accessions a specimen by scanning its barcode into the laboratory information system. This process is an example of which data management function?

A nurse asks a phlebotomist to look up a patient laboratory results so she can discuss them with the patient. What should the phlebotomist do?

Where can a phlebotomist find the minimum blood volume required for a specific laboratory test?

What is the purpose of calibrating laboratory instruments on a regular schedule?

A phlebotomist notices that the laboratory temperature monitor shows the room is at 30 degrees Celsius, above the acceptable range. What is the correct action?

A phlebotomist retrieves a patient previous potassium results from the LIS and notices the current result is significantly different from the historical values. The specimen appears non-hemolyzed. What action should the phlebotomist take?

What is the primary function of a laboratory information system (LIS) in a clinical laboratory?

A phlebotomist obtains a potassium result of 6.8 mEq/L on a patient specimen. According to laboratory protocol, this value falls within the critical range. What is the phlebotomist’s most important next step?

Which federal regulation establishes quality standards and certification requirements for clinical laboratories?

A forensic blood alcohol specimen is collected from a patient involved in a motor vehicle accident. Which procedure is essential to maintain the legal validity of the specimen?

After completing laboratory testing, the technologist needs to send finalized results to the ordering physician’s office. Which process describes this action?

A laboratory receives a hemolyzed potassium specimen. The phlebotomist is instructed to update the patient’s medical record to reflect the recollection request. Where should this documentation be recorded?

A specimen is rejected due to insufficient volume, and the laboratory needs a new sample. The phlebotomist is asked to contact the patient for recollection. Which is the most appropriate action?

What is the difference between an internal database and an external database in a laboratory setting?

A phlebotomist needs to enter collection information into the LIS after drawing a patient’s blood. Which data must be accurately input at this step?

A nurse calls the laboratory requesting a patient’s CBC results from earlier in the day. The phlebotomist uses the LIS to look up the information. What function is the phlebotomist performing?

Which of the following best describes the role of non-laboratory personnel in accessing laboratory results?

The pathology department requests a stored specimen from the chemistry laboratory for additional testing. This communication between departments is an example of which process?

Which type of specimen tube is used to protect light-sensitive analytes such as bilirubin from degradation?

A phlebotomist collects a specimen that must reach the laboratory within 15 minutes of collection for valid results. This requirement is an example of which type of specimen handling concern?

A serum specimen appears milky white and turbid. What term describes this specimen appearance?

A serum specimen has a deep yellow or orange-brown color. What condition does this appearance suggest?

A phlebotomist centrifuges a green top tube and notices a clot in the plasma layer. What does this indicate, and what should be done?

A CBC is ordered, but the lavender top tube collected contains only 0.5 mL of blood instead of the required 3 mL minimum. What is the appropriate action?

A specimen must be shipped to a reference laboratory in another state. Which packaging requirement must be met for safe transport?

The phase of laboratory testing that occurs before the specimen is analyzed, including collection, handling, and transport, is referred to as what?

A phlebotomist collects a specimen for a glucose tolerance test that will not be centrifuged for two hours. Which tube type best preserves the glucose level during this delay?

A phlebotomist is collecting specimens for a clinical research study. The research protocol requires specimens to be processed within 30 minutes and stored at negative 70 degrees Celsius. What is the phlebotomist’s responsibility regarding this protocol?

Which environmental requirement must be maintained in the specimen processing area to ensure specimen integrity?

Under CLIA regulations, which requirement applies to all laboratories performing testing on human specimens?

A forensic blood alcohol specimen is collected at a hospital emergency department. Which documentation practice is essential for this specimen?

After reporting a critical laboratory value, what information should the phlebotomist document?

A phlebotomist receives a hemolyzed potassium specimen result that cannot be reported. What action should be taken?

When entering patient data into the laboratory information system, what is the minimum information required on a test requisition?

Which staff members may receive laboratory results from the phlebotomist or laboratory?