List of Lessons
1. To obtain valid blood test results, specimens must be properly:
- a. Collected.
- b. Processed.
- c. Recorded.
- d. a and c.
- e. a, b, and c.
2. Blood counts on venous and capillary blood are nearly the same if the capillary puncture is:
- a. Shallow.
- b. Sterile.
- c. Free-flowing.
- d. Located on the finger.
3. Valid blood counts cannot be made when:
4. Venous samples are preferred over capillary samples because they:
- a. Capillary specimens are not taken from a free-flowing sample.
- b. When capillary specimens are obtained from cyanotic or calloused areas.
- c. When sources vary as much as 150 to 1550 cells per cu mm from the real value.
- d. a and b.
- a. Allow for several and repeated hematological examinations.
- b. Provide a sufficient amount of blood to perform the various laboratory tests needed.
- c. Provide for less chance of error because operations are made under better conditions and repeated operations are possible.
- d. a, b, and c.
5. Which blood count method would be performed if blood from an extensive burn victim was needed?
- a. Venous vacutainer collection.
- b. Capillary (micro quantitative) collection method.
- c. Syringe method.
- d. Arterial blood collection.
6. When collecting blood for white blood cell counts, blood obtained from free-flowing areas or areas of local stasis sources can vary as much as:
- a. 400-1000 cells per cu mm from their real value.
- b. 800-1200 cells per cu mm from their real value.
- c. 1000-1300 cells per cu mm from their real value.
- d. 1000-1500 cells per cu mm from their real value.
7. For adults, which veins should be used for venipuncture?
8. For the elderly or debilitated persons, or those who may have sclerosed or fragile veins, what should you do for the venipuncture?
- a. Veins located in the distal forearm or antecubital space.
- b. Veins located in the proximal forearm or antecubital space.
- c. The jugular vein.
- d. The femoral vein or antecubital space.
- a. Consult with a physician concerning the procedure.
- b. Take blood from the veins located in the proximal forearm or antecubital space.
- c. Use the jugular vein.
- d. Select the femoral vein.
9. If blood is needed from infants, which veins should be used for the venipuncture?
- a. Sagittal sinus area.
- b. Veins located in the proximal forearm or antecubital space.
- c. The collapsed vein.
- d. The jugular or femoral vein. The vein selected should be large, readily accessible, and sufficiently close to the surface to be seen and palpated.
10. If venipuncture poses a problem due to the age of the patient, sclerotization due to repeated venipuncture, or any other unusual circumstance, what procedure is to be followed?
11. Which of the following is normally used for the collection of blood specimens?
- a. Under some circumstances the technician should withdraw blood from a sagittal sinus, jugular vein, or femoral vein.
- b. Under no circumstances should a technician withdraw blood from a sagittal sinus, jugular vein, or femoral vein.
- c. The technician may withdraw blood from a sagittal sinus, jugular vein, or femoral vein.
- d. Withdraw blood from a sagittal sinus, jugular vein, or femoral vein.
- a. Isopropyl alcohol, 40 percent.
- b. Gauze pads, 6 x 6 inches.
- c. Needle, 1 to 1 1/2 inches, 19-23 gauge.
- d. Needle, large bevel.
12. Veins are made easier to enter if:
- a. The site of puncture is gently slapped.
- b. The vein is massaged toward the heart.
- c. a and b.
- d. The arm hangs down for 4 to 6 minutes.
13. Generally speaking, veins from which group of people tend to collapse more easily; and, therefore, greater care may be needed to select and puncture the vein?
- a. Children.
- b. Middle-aged adult.
- c. Elderly.
- d. Hypertensive people.
14. Blood collection instruments should be:
15. The syringe and needle for venipuncture must be dry to avoid _____ of the red blood cells.
- a. Glass and disposable.
- b. Plastic and calibrated.
- c. Sterile and disposable.
- d. Aseptic and anticoagulated.
- a. Hemolysis.
- b. Coagulation.
- c. Contamination.
- d. Hemoglobin reduction.
16. What must the technician do to prevent an possibly fatal injection of air into the vein?
- a. Use a longer plunger than the syringe.
- b. Use a shorter plunger than the syringe.
- c. It makes no difference.
- d. The plunger must match the syringe.
17. If latex tubing is used as a tourniquet, how far above the venipuncture site should it be secured?
18. Prolonged application of a tourniquet may change the concentration of many blood components. The maximum period over which a tourniquet should be applied for a venipuncture is:
- a. 1 inch.
- b. 2 inches.
- c. 3 inches.
- d. 4 inches.
- a. 1 minute.
- b. 2 minutes.
- c. 4 minutes.
- d. 6 minutes.
19. Besides inspecting and palpating to locate the desired vein for venipuncture, on what other items should you focus?
- a. Direction of vein course and estimate its size and depth.
- b. Direction of vein course and estimate its length and color.
- c. Direction of vein course and estimate its position and elasticity.
- d. The veinís thickness, length, and size.
20. When preparing for the venipuncture, what should be done with the needle?
- a. Keep the cap on until ready to stick.
- b. Place it on a sterile pad.
- c. Dispose in sharps container.
- d. Sterilize it with alcohol.
21. What are the reasons for inspecting a possible puncture site?
22. What may NOT be done once the puncture area is cleansed and excess alcohol wiped off?
- a. Estimate the size and depth of the vein (some may be too small or shallow).
- b. Determine the direction of the veinís course (puncture with the grain, so to speak).
- c. Palpate the vein (for resiliency).
- d. All of the above.
- a. Grasp the forearm with the left hand.
- b. Straighten the arm.
- c. Contaminate the area.
- d. Have the patient make a clenched fist.
23. Puncture of the Vacutainer stopper is completed immediately:
- a. Before the needle enters the vein.
- b. After the needle enters the vein.
- c. Before withdrawal of the needl.
- d. After withdrawal of the needle.
24. Which way is the needle bevel supposed to be and how is it to be situated at time of entry?
- a. Bevel side down; parallel with and alongside the vein.
- b. Bevel side up; adjunct with and alongside the vein.
- c. Bevel side perpendicular; perpendicular to and close to the vein.
- d. Bevel side up; parallel with, and alongside the vein.
25. After the needle for a venipuncture is withdrawn, what must the patient do?
26. Which of the following is an important vacutainer procedure?
- a. Take an iron compound.
- b. Lie down for 10 minutes.
- c. Keep his fist clenched for 5 minutes.
- d. Maintain light pressure on the gauze pad over the site.
- a. The short needle should be embedded in the stopper, but the needle must not break the vacuum.
- b. Any needle should be embedded in the stopper, but the needle must not break the vacuum.
- c. The long needle should be embedded in the stopper, but the needle must not break the vacuum.
- d. The first needle should be embedded in the stopper, but the needle must not break the vacuum.
27. If the multiple needle is used or more than one tube is required for venipuncture, which of the following is to be followed?
- a. Tighten the tourniquet after the first tube is filled; remove the filled tube and insert the next one.
- b. Loosen the tourniquet after the first tube is filled; remove the filled tube.
- c. Release the tourniquet after the first tube is filled; remove the filled tube and insert the next one.
- d. Tighten the tourniquet after the first tube is filled and insert the next one.
28. Why must you be careful not to remove the needle while tubes are being changed?
- a. The blood will continue to flow.
- b. The skin may rip.
- c. a and b may occur separately or at one tine.
- d. All the above.
- 29. Why is it most important that correct venipuncture technique be practiced?
- a. Avoid unnecessary pain to the patient.
- b. Prevent tissue damage.
- c. Secure a good representative blood specimen.
- d. Prevent contamination of the specimen or infection of the patient.
- e. All of the above.
30. What may occur to the donor if the tourniquet is not removed as early as possible once the blood starts flowing well?
- a. Coagulation of the blood.
- b. Changes in the quantitative values of the blood components.
- c. Hemolysis of the blood specimen.
- d. All of the above.
31. The blood count should be performed within _____ once the blood is collected.
- a. 30 minutes.
- b. 3 hours.
- c. 24 hours.
- d. 48 hours.
32. The site of a capillary puncture should be:
33. When is the tourniquet released and removed?
- a. Warm.
- b. Cold.
- c. Hot.
- d. 24ļ C.
- a. When a hematoma begins to form, the first drop of blood appears, or when it is hard to enter the vein.
- b. When it is hard to enter the vein, a hematoma begins to form, or the first drop of blood appears, aspiration occurs.
- c. When a hematoma begins to form, or it is hard to enter the vein.
- d. All of the above.
34. What will occur if blood is squeezed from a capillary puncture?
- a. Infections.
- b. Unnecessary pain.
- c. Free- flowing punctures.
- d. Inaccurate test results.
35. Which aspect of the fingertip should be used as the site for a capillary puncture?
- a. Dorsal.
- b. Ventral.
- c. Frontal.
- d. Lateral.
36. Sodium citrate is a good anticoagulant for coagulation studies because:
37. Which of the following is true of heparin?
- a. A concentration of one part 0.2 M sodium citrate is used to 9 parts of whole blood.
- b. It binds the calcium of the blood into a soluble complex to prevent coagulation.
- c. It combines cellular constituents in the plasma.
- d. A concentration of one part 0.1 M sodium citrate is used to 15 parts of whole blood.
- a. It does not alter the size of cellular components.
- b. It dissolves more rapidly than double oxalate salts.
- c. It is least expensive.
- d. It can be used in excessive amounts.
38. EDTA ammonium-potassium oxalate, and heparin are commonly used:
- a. Stains.
- b. Buffers.
- c. Fixatives.
- d. Anticoagulants.
39. What are the two basic methods for the preparation of blood smears?
- a. Cover slip and polychromic stains.
- b. Slide and acid dye.
- c. Slide and cover slip.
- d. Methylene blue and slide.
40. How many solutions are needed to perform a Wright's stain buffer?
41. Before staining, what should be done?
- a. 1.
- b. 2.
- c. 3.
- d. 4.
- a. Dip in Esoin stain for 30 seconds.
- b. Fix in methanol for 30 seconds.
- c. Rinse in deionized water.
- d. Dip in Polychrome stain.
42. On a dried blood smear, where is the name or identification of the patient written?
- a. Side.
- b. Middle.
- c. Thin area.
- d. Frosted end.
43. When smears for a differential leukocyte count contain a low concentration of white blood cells, but marked leukopenia, they can be prepared from the _____ layer by slowly centrifuging the blood specimen in a _____ tube.
- a. Top; volumetric.
- b. Buffy coat; Wintrobe hematocrit.
- c. Plasma layer; test.
- d. Red blood cell layer; Vacutainer.
44. If areas of a blood smear are still wet when staining is to begin, they will:
45. What is indicated if, when staining the slide, the RBCs are bluish or green?
- a. Hemolyze.
- b. Wash away.
- c. Stain well.
- d. Stain too heavily.
- a. The stain is too acidic.
- b. The WOC stains very lightly.
- c. Insufficient staining.
- d. The film is too thick.
46. Why should slides be stained quickly after preparation?
- a. So buffers will appear unequal.
- b. WBC distort and disintegrate quickly.
- c. Lines and ridges will appear.
- d. Acid fumes will develop.
47. Which is an error that should be avoided when staining slides?
- a. Routinely transferring of blood to the slide.
- b. Using an oil cover slide.
- c. Using clean, dust free, and smooth slides.
- d. Using thin films of blood and placing on slides.
Solutions to Exercises for Lesson 3
- 2. c