MLS Patient Assessment & Documentation 3 — Questions and Answers
Question 1: A fasting glucose specimen is received, but the requisition does not indicate fasting status. What is the appropriate course of action?
- Run the specimen and report results as non-fasting
- Contact the patient or nursing unit to verify fasting status before reporting (Correct answer)
- Reject the specimen and order a recollection with fasting documentation
- Add a comment 'fasting status unknown' only if glucose is elevated
Correct answer: Contact the patient or nursing unit to verify fasting status before reporting
Fasting status must be verified and documented because it directly affects the interpretation of fasting glucose results.
Question 2: Which of the following is a pre-analytical variable that the MLS can identify from the patient assessment before collection?
- Instrument calibration error
- Incorrect reagent lot
- Patient exercise within 30 minutes of collection (Correct answer)
- Spectrophotometer wavelength drift
Correct answer: Patient exercise within 30 minutes of collection
Recent strenuous exercise is a pre-analytical variable affecting analytes like CK, potassium, and lactate that can be identified during patient assessment.
Question 3: When documenting a traumatic venipuncture in the patient's record, which information is MOST important to include?
- The gauge of needle used and phlebotomist's employee ID
- The site of collection, number of attempts, patient's response, and collector's identity (Correct answer)
- Only the number of attempts made
- The supervisor's approval of the deviation from protocol
Correct answer: The site of collection, number of attempts, patient's response, and collector's identity
Traumatic venipuncture documentation must include collection site, number of attempts, patient response, and the identity of the collector for complete incident tracking.
Question 4: A requisition is received for a drug level with no dose or last dose time listed. Why is this information critical?
- It determines which tube color to use for collection
- It is required only for controlled substances by federal law
- Trough vs. peak timing affects therapeutic range interpretation (Correct answer)
- It is needed for billing purposes under ICD-10 coding
Correct answer: Trough vs. peak timing affects therapeutic range interpretation
Knowing the last dose time determines whether a specimen is a trough or peak level, which directly affects whether the drug concentration is within therapeutic range.
Question 5: Which assessment finding should prompt the MLS to select an alternative collection site during phlebotomy?
- Patient anxiety about the procedure
- A mastectomy on the ipsilateral side of the intended draw arm (Correct answer)
- Patient preference for the left arm
- A faint scar from a previous venipuncture
Correct answer: A mastectomy on the ipsilateral side of the intended draw arm
Venipuncture on the same side as a mastectomy risks lymphedema and inaccurate results due to altered lymphatic drainage and should be avoided.
Question 6: An MLS observes that a pediatric patient's wristband is loose and has slipped off onto the crib rail. What should happen before specimen collection?
- Collect the specimen and tape the wristband to the outside of the collection tube
- Ask a parent or guardian to verbally confirm the child's name and date of birth
- Replace or reattach the wristband with nursing staff verification before collection (Correct answer)
- Proceed with collection using the crib card as the sole identifier
Correct answer: Replace or reattach the wristband with nursing staff verification before collection
The wristband must be properly placed on the patient and verified with nursing staff before proceeding to maintain a reliable two-identifier check.
Question 7: When assessing a patient for a glucose tolerance test (GTT), which pre-test instruction is MOST important to verify?
- That the patient avoided caffeine for 24 hours
- That the patient fasted for 8–12 hours and avoided strenuous exercise (Correct answer)
- That the patient consumed a high-carbohydrate meal the night before
- That the patient took insulin within 2 hours of the test
Correct answer: That the patient fasted for 8–12 hours and avoided strenuous exercise
An 8–12 hour fast and avoidance of strenuous exercise are essential preconditions for a valid GTT, as both can significantly alter glucose metabolism.
MLS Patient Assessment & Documentation 3
A fasting glucose specimen is received, but the requisition does not indicate fasting status.
What is the appropriate course of action?