ASPT Specimen Collection Techniques 5 — Questions and Answers
Question 1: Which of the following patient conditions is a contraindication for using the arm on a given side for venipuncture?
- Mild dehydration
- Recent mastectomy on that side (Correct answer)
- Patient age over 65
- Patient receiving oral medications
Correct answer: Recent mastectomy on that side
Venipuncture on the same side as a mastectomy risks lymphedema because lymph node removal impairs lymphatic drainage.
Question 2: A glucose specimen must be transported on ice to slow metabolism. Which tube is most commonly used for this purpose?
- Red-top plain tube
- Gray-top sodium fluoride/potassium oxalate tube (Correct answer)
- Lavender-top EDTA tube
- Yellow-top ACD tube
Correct answer: Gray-top sodium fluoride/potassium oxalate tube
Gray-top tubes contain sodium fluoride, which inhibits glycolysis and preserves glucose levels during transport.
Question 3: During a difficult draw, the phlebotomist repositions the needle slightly. This is acceptable when:
- The needle is completely withdrawn and reinserted
- Only minor forward or backward adjustment is made without lateral movement (Correct answer)
- The bevel is turned to face downward
- The tourniquet has been on for more than 2 minutes
Correct answer: Only minor forward or backward adjustment is made without lateral movement
Minor advancement or slight withdrawal is acceptable, but lateral (side-to-side) movements risk vein and nerve damage and are prohibited.
Question 4: For a timed specimen such as a 2-hour postprandial glucose, the collection time is measured from:
- When the patient first enters the clinic
- The start of the meal, not from the end
- When the fasting specimen was drawn
- When the patient finishes eating (Correct answer)
Correct answer: When the patient finishes eating
The 2-hour postprandial interval is timed from when the patient finishes the meal, reflecting the peak-and-recovery glucose curve.
Question 5: A phlebotomist is asked to collect an arterial blood gas (ABG). Which of the following is within the ASPT phlebotomist's standard scope of practice?
- Performing radial artery puncture independently
- Assisting with specimen labeling and transport after collection by authorized personnel (Correct answer)
- Interpreting ABG results at bedside
- Selecting the arterial site and performing the puncture
Correct answer: Assisting with specimen labeling and transport after collection by authorized personnel
In most states, arterial puncture is outside a phlebotomist's standard scope; phlebotomists may assist with handling and transporting ABG specimens.
Question 6: What is the rationale for warming the heel or finger before a capillary puncture?
- It sterilizes the puncture site
- It increases local blood flow (arterialization) for an adequate sample (Correct answer)
- It numbs the area to reduce pain
- It prevents clot formation in the microtainer
Correct answer: It increases local blood flow (arterialization) for an adequate sample
Warming the site dilates capillaries and increases arterial blood flow (arterialization), making it easier to obtain a sufficient blood volume.
Question 7: Which of the following BEST describes the correct labeling practice for a blood specimen?
- Label tubes in advance before the patient is identified
- Label tubes at the bedside immediately after collection, in front of the patient (Correct answer)
- Label tubes in the lab after transport to avoid smudging
- Label tubes before draw so the phlebotomist can focus on technique
Correct answer: Label tubes at the bedside immediately after collection, in front of the patient
Tubes must be labeled immediately after collection at the patient's side to ensure accurate patient identification and prevent specimen mix-ups.
ASPT Specimen Collection Techniques 5
Which of the following patient conditions is a contraindication for using the arm on a given side for venipuncture?