ASPT Patient Preparation 2 — Questions and Answers
Question 1: A patient reports they have been fasting for 14 hours before a fasting glucose draw. What should the phlebotomist do?
- Proceed with the draw as the fast is sufficient
- Reject the specimen and reschedule for a shorter fast
- Notify the ordering physician before proceeding (Correct answer)
- Require the patient to eat and return in 2 hours
Correct answer: Notify the ordering physician before proceeding
An unusually prolonged fast (>12 hours) may affect some test results, so the physician should be notified before proceeding.
Question 2: Which instruction should be given to a patient preparing for a blood alcohol (BAC) test?
- Rinse mouth with water before the draw
- Avoid consuming alcohol for 24 hours prior
- No special preparation is needed before venipuncture for BAC (Correct answer)
- Fast for at least 8 hours before the test
Correct answer: No special preparation is needed before venipuncture for BAC
Venipuncture for BAC requires no special patient preparation; the blood sample directly reflects current blood alcohol concentration.
Question 3: Before performing a venipuncture, the phlebotomist should verify patient identity using at least:
- One unique identifier such as room number
- Two unique identifiers such as full name and date of birth (Correct answer)
- Three identifiers including the nurse's verbal confirmation
- The patient's verbal confirmation of their first name only
Correct answer: Two unique identifiers such as full name and date of birth
CLSI and The Joint Commission require two unique patient identifiers (e.g., full name and DOB) to be confirmed before specimen collection.
Question 4: A patient scheduled for a lipid panel asks if drinking black coffee (no cream or sugar) will affect the test results. The correct response is:
- Black coffee is fine and will not affect the results
- Black coffee contains compounds that can alter triglyceride levels (Correct answer)
- Only decaffeinated coffee is permitted during a fast
- Coffee of any type is permitted since it contains no calories
Correct answer: Black coffee contains compounds that can alter triglyceride levels
Black coffee can stimulate lipid metabolism and may elevate triglyceride levels, compromising the integrity of a fasting lipid panel.
Question 5: When collecting a 24-hour urine specimen, the patient should be instructed to:
- Collect the first morning void and include it in the container
- Discard the first morning void and begin timing from that point (Correct answer)
- Collect only evening and overnight specimens
- Refrigerate the specimen only during the final 4 hours
Correct answer: Discard the first morning void and begin timing from that point
The 24-hour urine collection begins after discarding the first morning void, with all subsequent urine collected for exactly 24 hours.
Question 6: Which of the following exercises performed the morning of blood collection can most significantly impact test results?
- Walking to the parking lot
- Strenuous jogging or aerobic exercise (Correct answer)
- Light stretching for 5 minutes
- Slow-paced walking up stairs
Correct answer: Strenuous jogging or aerobic exercise
Strenuous exercise can transiently elevate CK, LDH, potassium, and lactate levels, interfering with multiple analyte results.
Question 7: A patient taking warfarin asks how to prepare for a PT/INR blood draw. The phlebotomist should advise:
- Stop taking warfarin 48 hours before the draw
- Take warfarin at the usual scheduled time and come in as directed (Correct answer)
- Double the dose the night before for accurate baseline measurement
- Fast for 12 hours before the draw to reduce drug interactions
Correct answer: Take warfarin at the usual scheduled time and come in as directed
Patients on warfarin should continue their prescribed dose on schedule; the PT/INR is used to monitor therapeutic levels and should reflect current dosing.
ASPT Patient Preparation 2
A patient reports they have been fasting for 14 hours before a fasting glucose draw.
What should the phlebotomist do?