ASPT Patient Preparation 5 — Questions and Answers
Question 1: Which of the following is an acceptable alternative patient identifier when a wristband is not present?
- Room and bed number
- The nurse verbally confirming the patient's name
- A photo ID provided by the patient along with verbal confirmation of name and DOB (Correct answer)
- The patient's diagnosis listed on the chart
Correct answer: A photo ID provided by the patient along with verbal confirmation of name and DOB
When a wristband is absent, two independent identifiers such as a government-issued photo ID plus verbal name and date of birth confirmation meet identification requirements.
Question 2: Before drawing blood for a renin activity test, the patient should be instructed to:
- Fast overnight and avoid all medications
- Maintain a specified sodium intake and posture (supine or upright) as directed by the physician (Correct answer)
- Exercise for 30 minutes before the draw to stimulate renin release
- Drink 1 liter of water within the hour before collection
Correct answer: Maintain a specified sodium intake and posture (supine or upright) as directed by the physician
Renin levels are highly sensitive to sodium intake and body position; the physician specifies these conditions to ensure clinically interpretable results.
Question 3: A patient on heparin therapy requires a PTT draw. The phlebotomist should:
- Collect the specimen from the heparin lock line to save time
- Perform a venipuncture in the opposite arm and discard the first 5 mL if drawing from a line (Correct answer)
- Ask the nurse to discontinue the heparin infusion 30 minutes before collecting
- Collect the specimen using a serum separator tube instead of citrate
Correct answer: Perform a venipuncture in the opposite arm and discard the first 5 mL if drawing from a line
Drawing from a heparin lock or line introduces heparin contamination; if a line must be used, discarding an initial waste volume is required, but a clean venipuncture from the opposite arm is preferred.
Question 4: When collecting a specimen for cold agglutinin testing, which pre-analytical step is essential?
- Keep the specimen on ice until it reaches the lab
- Warm the tube to 37°C and transport it immediately in a warm container (Correct answer)
- Collect into an EDTA tube and refrigerate within 5 minutes
- Fast the patient for 12 hours before drawing the specimen
Correct answer: Warm the tube to 37°C and transport it immediately in a warm container
Cold agglutinins react at cooler temperatures, so the specimen must be kept at 37°C from collection to separation to prevent false-positive agglutination.
Question 5: Which statement best describes why patients are asked to avoid vigorous exercise before lipid panel testing?
- Exercise decreases LDL cholesterol to undetectable levels
- Strenuous activity can cause transient changes in lipid and enzyme levels that may not reflect a true baseline (Correct answer)
- Exercise promotes platelet aggregation that interferes with colorimetric assays
- Physical activity has no effect on lipid panels
Correct answer: Strenuous activity can cause transient changes in lipid and enzyme levels that may not reflect a true baseline
Exercise temporarily shifts lipoprotein fractions and elevates enzymes like CK, producing results that do not reflect the patient's true steady-state lipid profile.
Question 6: A patient's arm veins are not visible. Which preparatory step is appropriate to improve venous access before the draw?
- Apply ice to the antecubital area for 5 minutes
- Have the patient perform a few pumping motions with the fist and apply a warm compress (Correct answer)
- Aggressively tap the vein repeatedly with two fingers
- Immediately escalate to a fingerstick without further attempts
Correct answer: Have the patient perform a few pumping motions with the fist and apply a warm compress
Gentle fist pumping and warm compress application increase blood flow and venous dilation, making veins easier to palpate without causing hemoconcentration.
Question 7: Before a serum iron and TIBC draw, the patient should be advised to:
- Take iron supplements the morning of the draw to boost levels
- Avoid iron supplements and iron-rich meals for at least 24 hours before collection (Correct answer)
- Fast for only 2 hours since dietary iron absorbs slowly
- Collect the specimen in the afternoon for the highest iron values
Correct answer: Avoid iron supplements and iron-rich meals for at least 24 hours before collection
Dietary iron and supplement intake cause transient serum iron elevations that can falsely suggest adequate iron stores, so avoidance for at least 24 hours is required.
ASPT Patient Preparation 5
Which of the following is an acceptable alternative patient identifier when a wristband is not present?