CCMA Phlebotomy and Specimen Collection 5 — Questions and Answers
Question 1: A patient is on anticoagulant therapy. Which complication is MOST likely after venipuncture?
- Hemoconcentration
- Prolonged bleeding (Correct answer)
- Hemolysis
- Petechiae only
Correct answer: Prolonged bleeding
Anticoagulants impair the blood's clotting ability, so patients on these medications are at increased risk for prolonged bleeding at the puncture site.
Question 2: Which condition would require a medical assistant to collect a capillary specimen rather than a venous specimen?
- Patient requires a CBC
- Neonate requiring glucose testing (Correct answer)
- Patient requires a BMP
- Adult requiring a lipid panel
Correct answer: Neonate requiring glucose testing
Neonates have very small, fragile veins, making capillary (heel stick) collection the preferred and safest method for routine testing.
Question 3: What does hemolysis in a specimen cause, and how can it be prevented?
- Falsely low potassium; use a larger needle
- Falsely elevated potassium; avoid vigorous mixing and use proper technique (Correct answer)
- Falsely low sodium; refrigerate immediately
- Falsely elevated WBC; use EDTA tubes only
Correct answer: Falsely elevated potassium; avoid vigorous mixing and use proper technique
Ruptured red blood cells release intracellular potassium, causing falsely elevated potassium results; gentle technique and proper needle size prevent hemolysis.
Question 4: When collecting a urine culture specimen, which collection method is MOST appropriate to minimize contamination?
- First morning void collected in any container
- Random catch in a standard cup
- Midstream clean-catch in a sterile container (Correct answer)
- Catheterized specimen only
Correct answer: Midstream clean-catch in a sterile container
A midstream clean-catch method minimizes contamination from skin flora and provides an accurate sample for culture and sensitivity testing.
Question 5: Which additive is found in a gray-top tube and what test is it primarily used for?
- Heparin; used for plasma chemistry tests
- EDTA; used for complete blood counts
- Sodium fluoride/potassium oxalate; used for glucose testing (Correct answer)
- Sodium citrate; used for coagulation studies
Correct answer: Sodium fluoride/potassium oxalate; used for glucose testing
Gray-top tubes contain sodium fluoride, which inhibits glycolysis, preserving glucose levels for accurate fasting glucose or GTT testing.
Question 6: A medical assistant notices a hematoma forming at the venipuncture site during the draw. What should they do?
- Continue drawing and document the hematoma
- Release the tourniquet only and continue
- Remove the needle immediately and apply firm pressure (Correct answer)
- Apply heat immediately to disperse the hematoma
Correct answer: Remove the needle immediately and apply firm pressure
A forming hematoma indicates blood is leaking into surrounding tissue; the needle must be removed immediately and pressure applied to stop the bleeding.
Question 7: What is the maximum time a tourniquet should remain in place during venipuncture to prevent hemoconcentration?
- 30 seconds
- 1 minute (Correct answer)
- 2 minutes
- 5 minutes
Correct answer: 1 minute
A tourniquet left in place longer than one minute causes hemoconcentration, which can falsely elevate results for proteins, cells, and other analytes.
CCMA Phlebotomy and Specimen Collection 5
A patient is on anticoagulant therapy.
Which complication is MOST likely after venipuncture?