AAMA Phlebotomy and Specimen Collection 2 — Questions and Answers
Question 1: Which tube additive is found in a light blue-top (sodium citrate) tube and is used for coagulation studies?
- Sodium citrate (Correct answer)
- EDTA
- Sodium fluoride
- Lithium heparin
Correct answer: Sodium citrate
Light blue-top tubes contain sodium citrate, which chelates calcium to prevent clotting and is used for PT, aPTT, and other coagulation tests.
Question 2: A patient's arm veins are not visible. What is the BEST alternative site for venipuncture in an adult?
- Hand veins (Correct answer)
- Foot veins
- Femoral vein
- Jugular vein
Correct answer: Hand veins
Hand veins are the preferred alternative when antecubital veins are inaccessible, as they are accessible and relatively safe.
Question 3: What is the maximum angle recommended for needle insertion during a routine venipuncture?
- 45 degrees
- 30 degrees (Correct answer)
- 15 degrees
- 60 degrees
Correct answer: 30 degrees
A 15–30 degree angle is appropriate; 30 degrees is the maximum to avoid going through the vein.
Question 4: Which specimen collection technique is used to detect bacteremia or septicemia?
- Blood culture collection (Correct answer)
- Capillary puncture
- Urine midstream catch
- Sputum induction
Correct answer: Blood culture collection
Blood cultures are drawn to detect bacteria or fungi in the bloodstream, diagnosing bacteremia or septicemia.
Question 5: The order of draw for evacuated tubes places the SST (gold/tiger-top) immediately after:
- EDTA tube
- Light blue (citrate) tube
- Blood culture bottles (Correct answer)
- Gray-top tube
Correct answer: Blood culture bottles
Per CLSI guidelines, blood culture bottles are drawn first, followed by light blue, then SST/gold tubes.
Question 6: A hemoconcentrated specimen can result from which phlebotomy error?
- Leaving the tourniquet on for more than 1 minute (Correct answer)
- Using too large a needle gauge
- Drawing blood too slowly
- Inverting the tube immediately after collection
Correct answer: Leaving the tourniquet on for more than 1 minute
Prolonged tourniquet application (>1 minute) causes hemoconcentration, falsely elevating proteins, cells, and other large analytes.
Question 7: Which needle gauge is MOST commonly used for routine adult venipuncture?
- 18 gauge
- 21 gauge (Correct answer)
- 25 gauge
- 27 gauge
Correct answer: 21 gauge
21-gauge needles are standard for routine adult venipuncture, providing adequate flow without excessive vein trauma.
AAMA Phlebotomy and Specimen Collection 2
Which tube additive is found in a light blue-top (sodium citrate) tube and is used for coagulation studies?