CCMA - Certified Clinical Medical Assistant Phlebotomy and Specimen Collection Questions and Answers 1 — Questions and Answers
Question 1: A medical assistant is preparing to draw blood for a coagulation study, a CBC, and a serum chemistry panel. Which of the following is the correct order of draw?
- Light Blue, Red, Lavender (Correct answer)
- Red, Light Blue, Lavender
- Lavender, Red, Light Blue
- Red, Lavender, Light Blue
Correct answer: Light Blue, Red, Lavender
The correct order of draw is critical to prevent cross-contamination of additives between tubes, which can alter test results. The sequence is: 1) Blood cultures (sterile), 2) Light Blue (for coagulation studies), 3) Red/Gold/Tiger Top (for serum tests), 4) Green (for plasma chemistry), 5) Lavender/Pink (for hematology), and 6) Gray (for glucose/lactate). Therefore, for the requested tests, the light blue top tube must be drawn first for the coagulation study, followed by the red top for the serum chemistry, and finally the lavender top for the CBC.
Question 2: While performing a venipuncture, the patient suddenly complains of a sharp, shooting pain radiating down their arm. What is the most appropriate immediate action for the medical assistant to take?
- Reassure the patient and continue the draw slowly
- Immediately withdraw the needle and apply pressure (Correct answer)
- Ask the patient to take a deep breath and relax
- Slightly reposition the needle to a different angle
Correct answer: Immediately withdraw the needle and apply pressure
A sharp, shooting, or electric-like pain during venipuncture is a sign of possible nerve damage. The needle should be removed immediately to prevent further injury. After removal, pressure should be applied to the site, and the incident must be documented and reported according to facility protocol.
Question 3: A medical assistant is performing a capillary puncture on a 6-month-old infant. Which of the following is the appropriate site for this procedure?
- The tip of the index finger
- The center of the plantar surface of the heel
- The medial or lateral aspect of the plantar surface of the heel (Correct answer)
- The earlobe
Correct answer: The medial or lateral aspect of the plantar surface of the heel
For infants under one year of age, the recommended site for a capillary puncture is the medial or lateral portion of the plantar surface (bottom) of the heel. Puncturing the center of the heel risks injury to the calcaneus (heel bone). The fingers are too small and have insufficient tissue depth, and the earlobe is no longer a recommended site due to lesser blood flow.
Question 4: Which of the following steps is essential to maintain the integrity of a specimen collected for a chain of custody drug screen?
- Leaving the specimen unsealed until it reaches the lab
- Having the patient label the specimen container themselves
- Ensuring the specimen is sealed in the presence of the donor (Correct answer)
- Allowing the donor to use the restroom in private without supervision
Correct answer: Ensuring the specimen is sealed in the presence of the donor
A key principle of the chain of custody process is to ensure the specimen's integrity and prevent tampering. The specimen must be sealed with a tamper-evident seal in the presence of the donor. This action is documented on the Chain of Custody Form (CCF) and shows that the specimen was secured immediately after collection.
Question 5: A medical assistant is instructing a patient on the collection of a clean-catch midstream urine specimen. Which of the following instructions is correct?
- Collect the first stream of urine directly into the sterile cup.
- Cleanse the genital area from back to front before urinating.
- Begin urinating into the toilet, then collect the middle portion of the stream in the cup. (Correct answer)
- Fill the collection cup to the very top to ensure a sufficient sample.
Correct answer: Begin urinating into the toilet, then collect the middle portion of the stream in the cup.
The clean-catch midstream technique is designed to minimize contamination from the urethra. The patient should first cleanse the area properly. They should then begin to urinate into the toilet, which flushes out initial contaminants, and then, without stopping the flow, move the sterile container into the stream to collect the 'midstream' portion.
Question 6: After a venipuncture procedure, the site begins to swell and form a hematoma. Which of the following is the most likely cause?
- The tourniquet was left on for less than one minute.
- The patient was properly hydrated before the draw.
- Pressure was applied to the site immediately after needle withdrawal.
- The needle penetrated completely through the vein. (Correct answer)
Correct answer: The needle penetrated completely through the vein.
A hematoma is a collection of blood outside the blood vessel. One common cause is the needle passing through the other side of the vein, allowing blood to leak into the surrounding tissue. Other causes include not removing the tourniquet before the needle, or not applying adequate pressure after needle removal.
CCMA - Certified Clinical Medical Assistant Phlebotomy and Specimen Collection Questions and Answers 1
A medical assistant is preparing to draw blood for a coagulation study, a CBC, and a serum chemistry panel.
Which of the following is the correct order of draw?