Special Collections — All Questions

When collecting blood cultures, which bottle should be inoculated first when using the direct draw method with a needle and syringe?

A phlebotomist is preparing to collect blood cultures from a patient with a suspected bloodstream infection. After applying the tourniquet and selecting the site, which antiseptic agent is most appropriate for skin preparation?

A physician orders blood cultures for a patient suspected of having a bloodstream infection. Which collection technique best helps the laboratory distinguish a true bacteremia from a skin contaminant?

A phlebotomist is preparing to inoculate blood culture bottles from an adult patient. The physician asks how much blood should go into each bottle. What is the minimum recommended volume per bottle?

A phlebotomist notices the blood culture bottle tops are dusty after being stored on a shelf. What should the phlebotomist do before inoculating the bottles?

When collecting blood cultures using an evacuated tube system with a winged collection set, which bottle should be filled first?

A phlebotomist is collecting blood cultures in the emergency department. The patient has an order for two sets drawn from two different sites. The phlebotomist completes the first set successfully. How long should the phlebotomist wait before collecting the second set?

A phlebotomist collects blood cultures but accidentally touches the venipuncture site with a gloved finger after applying antiseptic and before inserting the needle. What is the most appropriate action?

Which of the following is the primary purpose of collecting blood cultures from two separate venipuncture sites?

A phlebotomist prepares a blood culture site using chlorhexidine. The patient states they are allergic to chlorhexidine. Which alternative antiseptic should the phlebotomist use?

A phlebotomist applies chlorhexidine to a blood culture site and then begins fanning the area to speed up drying. A coworker stops the phlebotomist and explains that fanning is incorrect. Why is it important to allow the antiseptic to air dry naturally?

A phlebotomist is collecting blood cultures from a patient in the emergency department. Which collection practice is most important for ensuring accurate blood culture results?

While collecting blood cultures, the phlebotomist notices that only 3 mL of blood entered the aerobic bottle before the vein collapsed. What is the best course of action?

What color and type of blood culture bottle is typically designated for aerobic organisms?

A nurse asks the phlebotomist to collect blood cultures from the patient’s existing peripheral IV line. What is the phlebotomist’s best response?

How many sets of blood cultures are typically ordered for an adult patient with suspected sepsis?

A phlebotomist collects two sets of blood cultures. The first set is drawn at 8:00 AM and labeled. The phlebotomist realizes 30 minutes later that the second set was not labeled immediately after collection. Which action is most appropriate?

A phlebotomist is collecting blood cultures from a patient with very small, fragile veins. Which collection device is most appropriate for this situation?

Which of the following is a key reason blood culture bottles contain a nutrient broth medium?

During a blood culture collection, the phlebotomist accidentally sticks themselves with the contaminated needle. What is the first action the phlebotomist should take?

A phlebotomist is asked to collect a capillary blood specimen from a 2-week-old newborn. The phlebotomist selects the infant’s finger for the puncture. A supervising technician corrects this choice. What is the preferred site for capillary collection on an infant?

A phlebotomist is asked to collect blood from a 3-month-old infant for a complete blood count. The requisition calls for a venipuncture. The phlebotomist assesses the infant and cannot locate a suitable vein. What is the most appropriate alternative?

When performing a neonatal screening (newborn screen) for conditions such as PKU and galactosemia, where are the blood spots collected?

A phlebotomist is collecting a newborn screening specimen. After performing the heel stick, the phlebotomist applies the first drop of blood directly to the filter paper. Is this technique correct?

A phlebotomist is asked to draw blood from an 85-year-old patient with thin, fragile skin and rolling veins. After one failed attempt, the phlebotomist notices a small hematoma forming. What is the best next step?

At what age is it generally acceptable to perform finger stick capillary collections on pediatric patients?

A phlebotomist needs to collect blood from a 6-year-old child who is crying and pulling away. The parent is present. What is the most appropriate approach?

Why do phlebotomists use a shorter lancet when performing a heel stick on a premature or very small newborn compared to a full-term newborn?

A phlebotomist is drawing blood from an elderly patient receiving IV fluids in the left arm. The patient has a fistula in the right arm for dialysis. Which site should the phlebotomist select?

For blood donation screening, what is the minimum hemoglobin level typically required for a donor to be eligible?

A potential blood donor weighs 105 pounds. The minimum weight requirement for whole blood donation is 110 pounds. What should the phlebotomist do?

A phlebotomist is calculating the maximum safe blood draw volume for a 4 kg premature infant. Using the guideline that no more than 5% of total blood volume should be drawn at one time, and estimating total blood volume at 80 mL/kg, what is the maximum volume for this draw?

Which of the following conditions is included in standard newborn screening panels collected by heel stick on filter paper?

A phlebotomist is collecting a newborn screen. The blood spots on the filter paper appear thin and translucent rather than fully saturated. What should the phlebotomist do?

A phlebotomist is collecting a newborn screening specimen by heel stick. What is the most important requirement for properly filling the filter paper collection card?

An elderly patient tells the phlebotomist, ‘I bruise easily and the last time someone drew my blood, I had a bruise for two weeks.’ How should the phlebotomist modify the collection technique?

A phlebotomist arrives to draw blood from a 2-year-old patient. The requisition includes a CBC, BMP, and blood culture. The child weighs 12 kg. Considering pediatric volume limits, what is the phlebotomist’s primary concern?

What is the minimum hematocrit level typically required for a blood donor to be eligible for donation?

A phlebotomist needs to collect blood from a 78-year-old patient whose veins are visible but tend to roll when palpated. Which technique is most helpful to stabilize the vein during needle insertion?

A phlebotomist is preparing to collect blood from a 9-month-old infant for a bilirubin test. The nurse suggests performing a finger stick on the infant’s ring finger. What should the phlebotomist do?

Which of the following tests is classified as CLIA-waived and commonly performed by phlebotomy technicians at the point of care?

A phlebotomist performs a point-of-care glucose test on a patient and obtains a result of 450 mg/dL. The patient appears alert and oriented. What should the phlebotomist do with this result?

What does the abbreviation POC stand for in the context of laboratory testing?

Before performing a point-of-care hemoglobin test, the phlebotomist must run quality control (QC) on the device. The low control result is within the acceptable range, but the high control result is out of range. What should the phlebotomist do?

Which specimen is required for a standard urine pregnancy test performed at the point of care?

A phlebotomist is performing a gestational glucose tolerance test. The patient drank the 50-gram glucose beverage at 9:00 AM. At what time should the phlebotomist draw the blood specimen?

A phlebotomist performs a POC blood glucose test on a patient’s fingerstick specimen and obtains a reading of ‘Error.’ The phlebotomist wipes the finger and repeats the test with a new strip, and the device again reads ‘Error.’ What is the most appropriate next step?

What is the purpose of running quality control materials on a POC glucose meter?

A patient is scheduled for a two-hour post-prandial glucose test. The patient ate breakfast at 7:30 AM. When should the phlebotomist collect the blood specimen?

Which of the following is a CLIA-waived urinalysis test that can be performed at the point of care?

A phlebotomist is asked to perform a lactose tolerance test. The patient reports they have not fasted. What should the phlebotomist do?

A phlebotomist runs morning QC on two POC glucose meters. Meter A passes both levels of control. Meter B passes the normal control but fails the high control on two consecutive attempts. A patient needs a stat glucose test. What should the phlebotomist do?

During a glucose tolerance test, how many blood specimens are typically collected for a standard three-hour test?

A phlebotomist opens a new canister of glucose test strips and notices the expiration date was two days ago. What is the correct action?

What does CLIA stand for in the context of laboratory testing regulations?

A phlebotomist performs a POC hematocrit test by capillary collection. After centrifuging the capillary tube, the phlebotomist reads the hematocrit as 20%. What is the most appropriate action?

Which of the following specimens is typically used for a point-of-care hemoglobin test?

During a gestational glucose screening, the patient vomits 20 minutes after drinking the glucose beverage. What should the phlebotomist do?

A phlebotomist is responsible for POC testing at a small outpatient clinic. The clinic’s glucose meter QC log shows that controls have not been run in three days due to staff shortages. A provider orders a stat glucose test. What should the phlebotomist do?

A phlebotomist is performing a hemoglobin screening on a blood donor using a POC device. The first result reads 12.3 g/dL, which is below the 12.5 g/dL cutoff for female donors. The donor asks the phlebotomist to retest using the other hand. What is the correct response?

When collecting a blood specimen for blood alcohol testing, which antiseptic must be used for skin preparation?

A phlebotomist is collecting a specimen for a pre-employment drug screen. The donor provides the urine specimen, and the phlebotomist notices the temperature is outside the acceptable range of 90 to 100 degrees Fahrenheit. What should the phlebotomist do?

What is the primary purpose of a chain of custody form in forensic specimen collection?

A phlebotomist collects a urine drug screen specimen and places it in a specimen cup. Before sealing the cup with a tamper-evident seal, the phlebotomist is called away to respond to an emergency. When the phlebotomist returns five minutes later, what should be done with the specimen?

What is a tamper-evident seal used for in forensic specimen collection?

A law enforcement officer brings a suspect to the phlebotomy station for a court-ordered blood alcohol draw. The suspect refuses to cooperate and states they do not consent. What should the phlebotomist do?

During a witnessed urine collection for drug screening, what is the role of the witness?

A phlebotomist is performing a blood alcohol draw and reaches for an alcohol prep pad out of habit. The phlebotomist catches the error before opening the pad. What should the phlebotomist use instead?

A phlebotomist completes a DOT-regulated drug screening urine collection and realizes they forgot to initial the tamper-evident seal on the specimen bottle. The specimen is still in the phlebotomist’s direct observation and the seal has not been broken. What is the correct action per federal workplace drug testing protocols?

Which type of tube is typically used for a blood alcohol collection?

A phlebotomist finishes a drug screen collection and hands the sealed specimen to a courier for transport. What information must the phlebotomist document on the chain of custody form at this point?

What is the primary reason forensic blood and urine specimens require chain of custody documentation?

During a workplace drug screening, the donor requests to use the restroom before providing the urine specimen. The phlebotomist has already begun the collection process and completed the chain of custody paperwork. What should the phlebotomist do?

What is the acceptable temperature range for a urine drug screening specimen measured within four minutes of collection?

A phlebotomist collects a blood alcohol specimen using proper non-alcohol antiseptic and a gray top tube. However, the phlebotomist labels the tube with the wrong patient name and catches the error before sending it to the lab. The correct patient is still present. What should the phlebotomist do?

A phlebotomist is collecting a urine specimen for a DOT (Department of Transportation) drug test. The specimen volume collected is 25 mL, which is below the 45 mL minimum required. What should the phlebotomist do?

In drug screening collections, what is the purpose of adding a blue dye or bluing agent to the toilet water?

A phlebotomist receives a requisition for a legal blood draw from a patient involved in a motor vehicle accident. The patient is unconscious and cannot provide consent. A police officer is present with a warrant. What is the phlebotomist’s primary responsibility?

Which of the following is required on a chain of custody form for a urine drug screen?

A phlebotomist completes a drug screening collection and seals the specimen with a tamper-evident label. The donor then states they want to add more urine to the cup because they feel the volume is borderline. What should the phlebotomist do?

What is the common brand name for the povidone-iodine antiseptic sometimes used in blood culture preparation?

A phlebotomist applies chlorhexidine to the venipuncture site before a blood culture collection. What is the minimum time the site should be allowed to dry before needle insertion?

A blood culture collected from a patient grows coagulase-negative Staphylococcus in only one of two sets drawn from the same venipuncture. The phlebotomist is asked what likely occurred. Which explanation is most appropriate?

What is the typical recommended blood volume per bottle for an adult blood culture collection?

According to the standard order of draw, blood culture bottles are drawn at which position?

When collecting blood cultures using a winged infusion (butterfly) set, a phlebotomist first fills a discard tube before inoculating the culture bottles. What is the purpose of this discard tube?

Before inoculating blood culture bottles, the phlebotomist must prepare the bottle tops. Which action is required?

A phlebotomist needs to collect blood from a 2-year-old child for a CBC. The child has visible antecubital veins bilaterally. Which collection method is most appropriate?

An elderly patient reports that previous blood draws have caused significant bruising. Which technique modification should the phlebotomist use to reduce this risk?

When performing a heel puncture on an infant, which area of the heel is the correct puncture site?

Newborn metabolic screening specimens are collected by applying blood drops to a special filter paper card. What is this card commonly called?

A phlebotomist is collecting a newborn screening specimen on filter paper. After applying a blood drop to each circle, what should the phlebotomist do before submitting the specimen?

Before a blood donation, which screening test is performed on the donor to verify eligibility?

What is the minimum weight requirement for a standard whole blood donation?

A 6-month-old infant weighing 7 kg needs blood drawn for multiple laboratory tests. Estimated blood volume is approximately 80 mL/kg. What is the maximum volume that can safely be drawn from this infant?

What percentage of total blood volume is generally considered the maximum safe amount to draw from a pediatric patient at one time?

A phlebotomist is attempting to draw blood from a patient with small, difficult-to-access veins. After two unsuccessful venipuncture attempts, what should the phlebotomist do next?

Which type of central venous access device is surgically implanted and has a cuff that anchors it under the skin?

A non-tunneled central line is most commonly inserted into which anatomical location?

A nurse asks a phlebotomist to draw blood from a patient central venous catheter. The phlebotomist has not been trained in central line draws. What is the correct response?

Which term describes laboratory testing performed at or near the site of patient care rather than in a central laboratory?

What does CLIA waived mean in the context of point-of-care testing?

A phlebotomist is performing a blood glucose test using a handheld glucometer. The control solution result falls outside the acceptable range. What should the phlebotomist do?

A phlebotomist performs a microhematocrit test by filling a capillary tube with blood and placing it in a microhematocrit centrifuge. After centrifugation, what does the packed red cell layer represent?

When a phlebotomist performs a CLIA-waived urine dipstick test, which specimen type is generally preferred?

A pregnant patient arrives for a one-hour glucose tolerance test for gestational diabetes screening. She reports eating breakfast one hour ago. What should the phlebotomist do?

During a lactose tolerance test, what substance is measured in the patient blood specimens at timed intervals?

A physician orders a 2-hour postprandial glucose test. At what point does the phlebotomist draw the blood specimen?

When collecting a throat swab for a rapid strep test, which area should be swabbed?

A phlebotomist is asked to collect a nasal swab for a rapid influenza test. How should the swab be inserted?

When collecting a wound culture specimen, from which part of the wound should the swab be obtained?

Which of the following is an example of a non-blood specimen that a phlebotomist may be responsible for processing?

What is a key advantage of point-of-care testing compared to central laboratory testing?

A rapid strep test performed at the point of care returns a negative result, but the patient has symptoms strongly suggestive of streptococcal pharyngitis. What is the appropriate next step?

What does the abbreviation BAC stand for in the context of forensic blood collection?

A phlebotomist is preparing to draw a specimen for blood alcohol testing. Which antiseptic should be used for site preparation?

In a forensic or clinical toxicology blood draw, which tube is commonly used to collect specimens for drug and alcohol analysis?

A phlebotomist has completed a chain-of-custody urine drug screen collection. Before sealing the specimen, which information must be documented on the chain-of-custody form?

What is the purpose of applying a tamper-evident seal to a forensic specimen container?

Under what circumstance is a directly observed urine drug screen collection typically required?

A phlebotomist collects a blood specimen for a legal blood alcohol determination. After labeling and sealing the specimen, what must happen to maintain its admissibility as evidence?

What does the abbreviation UDS stand for in laboratory and forensic testing?

A phlebotomist is assigned to collect blood from a 3-year-old child. Which collection method and equipment are most appropriate for this patient?

When collecting blood from a geriatric patient with thin, fragile veins, which technique modification is most important?

A phlebotomist needs to collect blood from an infant under 1 year of age. Which collection method is preferred?

When performing a heel stick on a newborn for metabolic screening, which area of the heel should be punctured?

What is a dried blood spot specimen collected on filter paper for newborn screening also known as?

A potential blood donor arrives at the donation center. Before the donation can proceed, which screening test must be performed?