Øvingsprøve i blodprøvetaking

Alle quizer i Sykepleie og helse

• Øvingsprøve · 15 spørsmål

  CNA øvingsprøve

• Øvingsprøve · 15 spørsmål

  Medical assistant øvingsprøve

• Flashcard-sett · 20 kort

  Flashcards i medisinsk terminologi

Se alle →

Lag din egen

Last opp boka, lysbildene eller notatene dine, eller si bare til Bo hva du vil lære. Du trenger ikke et dokument for å komme i gang.

Lag min egen øvingsprøve

Alle 15 spørsmål i oversikt

Vil du heller lese før du spiller? Alle spørsmålene i smakebiten står listet under. Svar og forklaringer er skjult til du åpner dem.

1. 1. Following the standard order of draw, which tube is collected immediately after the light blue sodium citrate tube?

   • A. The lavender EDTA tube
   • B. The gray sodium fluoride tube
   • C. The red or gold serum tube
   • D. The green heparin tube
   Vis svar og forklaring

   Svar: C. The red or gold serum tube

   The standard sequence is blood cultures first, then the light blue citrate tube, then serum tubes with or without a gel separator, then heparin, then EDTA, then the glycolytic inhibitor tube. The citrate tube comes early because coagulation testing depends on an exact ratio of blood to additive, and it must be filled to the mark for that ratio to hold.

2. 2. Why does the order of draw exist?

   • A. To keep additive from one tube from carrying over into the next through the needle
   • B. To keep the total time of the draw under a fixed limit
   • C. To fill the largest tubes while the vein is still full
   • D. To match the order in which the laboratory runs the tests
   Vis svar og forklaring

   Svar: A. To keep additive from one tube from carrying over into the next through the needle

   Blood in the needle and the holder can carry a trace of additive backward into the following tube, and a trace is enough to ruin a result. EDTA carried into a chemistry tube is the classic example, because the potassium in the salt makes potassium read falsely high and the chelated calcium makes calcium read falsely low.

3. 3. Complete the sentence.

   The lavender top tube contains _____, which stops the specimen from clotting by binding _____.

   Alternativer for luke 1: sodium citrate, EDTA, lithium heparin, sodium fluoride

   Alternativer for luke 2: calcium, potassium, sodium, iron

   Vis svar og forklaring

   Svar: EDTA, calcium

   EDTA binds calcium, and the clotting cascade cannot run without it. It also preserves cell shape better than the other anticoagulants, which is why it is the tube for a complete blood count and a blood smear. The tube has to be filled to the marked volume, because leftover EDTA in an underfilled tube shrinks the red cells and skews the count.

4. 4. In the antecubital fossa, which vein is usually the first choice for venipuncture?

   • A. The cephalic vein
   • B. The median cubital vein
   • C. The basilic vein
   • D. The brachial artery
   Vis svar og forklaring

   Svar: B. The median cubital vein

   The median cubital vein sits toward the middle of the antecubital fossa, is generally large and well anchored so it rolls less, and lies farthest from the major nerve and artery. The cephalic vein on the thumb side is the usual second choice. Vein patterns differ from person to person, so palpate first rather than assuming a textbook layout.

5. 5. Why is the basilic vein the last choice among the antecubital veins?

   • A. It is too small to accept a standard needle
   • B. It collapses as soon as the tourniquet is released
   • C. It carries arterial blood rather than venous blood
   • D. It lies close to the brachial artery and the median nerve
   Vis svar og forklaring

   Svar: D. It lies close to the brachial artery and the median nerve

   The basilic vein runs on the little finger side of the arm, and the brachial artery and the median nerve sit just under it. Puncturing either is the reason this vein is used only when the others are unavailable. It is also less anchored in the tissue, so it tends to roll away from the needle.

6. 6. Which of the following make hemolysis more likely?

   Velg alle som passer.

   • A. Drawing through a needle that is too small for the vacuum of the tube
   • B. Pushing blood from a syringe through the tube stopper under pressure
   • C. Shaking the tubes hard instead of inverting them gently
   • D. Letting the alcohol dry fully before the puncture
   • E. Filling each tube to the volume the vacuum draws
   Vis svar og forklaring

   Svar: A. Drawing through a needle that is too small for the vacuum of the tube, B. Pushing blood from a syringe through the tube stopper under pressure, C. Shaking the tubes hard instead of inverting them gently

   Hemolysis is red cells breaking open, and it happens when the cells are forced through too narrow an opening, pushed under pressure, or shaken. It matters because the contents of the cells spill into the plasma, so potassium, LDH, magnesium and phosphate all read falsely high, and a visibly pink or red sample is usually rejected. Letting alcohol dry and filling tubes properly both reduce the risk rather than raise it.

7. 7. An inpatient is scheduled for a draw. Which identification step meets the standard?

   • A. Ask the patient whether they are Mrs. Alvarez and draw if they say yes
   • B. Match the name posted on the door of the room to the requisition
   • C. Ask the patient to state their full name and date of birth, then compare both with the armband and the requisition
   • D. Confirm the patient's name with the nurse assigned to the room
   Vis svar og forklaring

   Svar: C. Ask the patient to state their full name and date of birth, then compare both with the armband and the requisition

   Identification has to be active, using two identifiers the patient supplies rather than ones you offer. A yes or no question invites the wrong answer from someone who is drowsy, hard of hearing or confused. Room numbers and bed numbers are never identifiers, because patients get moved.

8. 8. Complete the sentence.

   The gray top tube contains _____, which slows glycolysis so that the _____ result does not drift downward while the specimen waits to be tested.

   Alternativer for luke 1: EDTA, sodium citrate, sodium fluoride, a clot activator

   Alternativer for luke 2: potassium, glucose, hemoglobin, albumin

   Vis svar og forklaring

   Svar: sodium fluoride, glucose

   Red cells keep consuming glucose after the blood leaves the arm, so an untreated sample reads lower the longer it sits. Sodium fluoride blocks an enzyme in the glycolytic pathway and holds the value steady, which is why this tube is used for glucose and for alcohol testing. It is usually paired with potassium oxalate, which handles the anticoagulation.

9. 9. Which anticoagulant prevents clotting by blocking thrombin rather than by binding calcium?

   • A. Sodium citrate
   • B. EDTA
   • C. Potassium oxalate
   • D. Heparin
   Vis svar og forklaring

   Svar: D. Heparin

   Heparin works further along the cascade. It boosts antithrombin, which shuts down thrombin and factor Xa, so fibrin never forms. Citrate, EDTA and oxalate all work the other way, by tying up the calcium the cascade needs. Because heparin leaves the sample's chemistry closest to untouched, heparin tubes are common for chemistry panels.

10. 10. During a draw the patient reports a sharp, shooting, electric pain running down the forearm. What should the phlebotomist do?

    • A. Release the tourniquet, withdraw the needle right away, and stop the draw
    • B. Continue, since brief pain is expected during venipuncture
    • C. Rotate the needle to a shallower angle and continue
    • D. Loosen the tourniquet and collect the remaining tubes quickly
    Vis svar og forklaring

    Svar: A. Release the tourniquet, withdraw the needle right away, and stop the draw

    Shooting or electric pain, tingling or numbness suggests the needle is near or in a nerve, and that is one of the few injuries from a blood draw that can last. The response is to stop rather than to reposition. Ordinary venipuncture stings briefly at the puncture and then settles, which is different from pain that travels down the limb.

11. 11. Which of these are correct sharps and infection control practices during venipuncture?

    Velg alle som passer.

    • A. Activate the needle safety device as soon as the needle leaves the arm
    • B. Discard the needle and the tube holder together as a single unit
    • C. Recap the needle with two hands before disposing of it
    • D. Perform hand hygiene and put on clean gloves before every patient
    • E. Fill the sharps container to the very top before it is replaced
    Vis svar og forklaring

    Svar: A. Activate the needle safety device as soon as the needle leaves the arm, B. Discard the needle and the tube holder together as a single unit, D. Perform hand hygiene and put on clean gloves before every patient

    Most needlestick injuries happen between the arm and the container, so the safety device goes on immediately and the needle is not handled again. Recapping with two hands points a contaminated needle at your own fingers. An overfilled sharps container is a puncture hazard on its own, which is why containers are replaced at the marked fill line rather than when they stop closing.

12. 12. A swelling appears at the site during a draw and the blood flow slows. What is the most likely cause?

    • A. The tourniquet was applied too loosely
    • B. The needle went through the far wall of the vein
    • C. The additive in the tube had expired
    • D. The patient's arm was held above the level of the heart
    Vis svar og forklaring

    Svar: B. The needle went through the far wall of the vein

    That swelling is a hematoma, blood leaking out of the vessel into the surrounding tissue. It usually means the needle passed through the back wall, or that the bevel is only partly in the vein, or that a nearby vessel was nicked. Release the tourniquet, remove the needle and hold firm pressure, and do not try to save the draw by pushing the needle deeper.

13. 13. Which statements about capillary, or dermal, collection are correct?

    Velg alle som passer.

    • A. The first drop is wiped away because it is diluted with tissue fluid
    • B. The EDTA tube is filled before the other additive tubes
    • C. On an infant, the puncture is made on the medial or lateral plantar surface of the heel
    • D. Repeated hard squeezing of the site is used to speed up the flow
    • E. A capillary sample is the preferred specimen for blood cultures
    Vis svar og forklaring

    Svar: A. The first drop is wiped away because it is diluted with tissue fluid, B. The EDTA tube is filled before the other additive tubes, C. On an infant, the puncture is made on the medial or lateral plantar surface of the heel

    Capillary collection reverses the venipuncture order because platelets start clumping at the puncture within seconds, so the hematology tube is filled first. Hard squeezing, sometimes called milking, forces tissue fluid into the sample and breaks red cells. On an infant the puncture stays on the sides of the plantar surface to keep away from the heel bone. Blood cultures need a larger sterile volume than a fingerstick can give.

14. 14. Complete the sentence.

    A specimen collected for _____ is wrapped in foil or collected in an amber tube, because that substance breaks down when the sample sits in the light.

    Alternativer for luke 1: potassium, glucose, bilirubin, hemoglobin

    Vis svar og forklaring

    Svar: bilirubin

    Bilirubin is light sensitive, so even a short spell on a sunny counter can drop the value and make a jaundiced newborn look better than they are. Light protection is one of three special handling rules worth knowing together. Some specimens travel chilled, some have to stay near body temperature until they are processed, and the requisition or the laboratory manual says which.

15. 15. When should a blood collection tube be labeled?

    • A. Back in the laboratory, once the specimen has been checked in
    • B. Before the draw, so the tube is ready when it fills
    • C. At the end of the round, together with the rest of the batch
    • D. At the patient's side, right after the tubes are filled and before leaving
    Vis svar og forklaring

    Svar: D. At the patient's side, right after the tubes are filled and before leaving

    Labeling at the bedside, with the patient still in front of you, is what keeps a tube tied to the right person. Prelabeled tubes can end up on the wrong patient, and labeling later relies on memory. The label carries the patient's full name, a second unique identifier, and the date and time of collection, plus whatever else your facility requires, such as the collector's initials.

Dette dekker en prøve i blodprøvetaking faktisk

Det finnes ingen enkelt nasjonal prøve i blodprøvetaking i USA. Flere organisasjoner sertifiserer phlebotomists, blant dem National Healthcareer Association, American Society for Clinical Pathology, American Medical Technologists og National Center for Competency Testing. Hver av dem setter sitt eget antall spørsmål, sin egen tidsgrense, grense for bestått, vei inn og regler for resertifisering, og de detaljene blir revidert, så den eneste pålitelige kilden er den gjeldende kandidathåndboka til organet du tar prøven hos. Noen delstater setter i tillegg sitt eget krav om lisens eller sertifisering for å ta blodprøver, oppå et eventuelt nasjonalt sertifikat. De reglene settes delstat for delstat og ikke nasjonalt, så sjekk helsemyndigheten i din egen delstat også.

Det innholdsoversiktene har til felles er selve arbeidet. Nesten alle forventer at du kan trekkrekkefølgen og grunnen bak den, hvilket tilsetningsstoff som sitter i hvilket glass og hvordan det virker, venene i albuegropen og hvordan du velger stikkested, hvordan du identifiserer en pasient og merker en prøve, de vanlige komplikasjonene og hva som forårsaker hver av dem, kapillærprøver og hvordan de skiller seg fra venepunksjon, spesialhåndtering som kjøling og lysbeskyttelse, og smittevern og sikker håndtering av skarpe gjenstander. De fleste tester også litt prøvebehandling, yrkesetikk og pasientens personvern.

To ting veier tyngre enn nybegynnere venter. Det første er rekkefølge. Prøvene spør hva du gjør først, hva som kommer etterpå og hva du gjør i det øyeblikket noe går galt, for i denne jobben er rekkefølgen selve ferdigheten. Det andre er sikkerhet, både din og pasientens, så vent spørsmål om nålutstyr, avfallshåndtering av skarpt og situasjonene der du avbryter en prøvetaking framfor å fullføre den.

Slik bruker du smakebiten

Disse 15 spørsmålene lener seg på hvorfor framfor på navn. De spør hva et tilsetningsstoff faktisk gjør med blodet, hvorfor glassene settes på nåla i en fast rekkefølge, hvorfor vena mediana cubiti velges framfor vena basilica, og hva en hevelse eller en stikkende smerte under prøvetakingen forteller deg. Det resonnementet er det som får de pugga listene til å sitte, for en regel du kan forklare er en du ikke roter til under tidspress.

Ta den i én økt uten notater, og les så forklaringen til hvert spørsmål, også de du fikk riktig. Behandle et galt svar som et tema framfor som et faktum. Bommet du på spørsmålet om trekkrekkefølgen og spørsmålet om tilsetningsstoffet, les glass og tilsetningsstoffer sammen som én tabell, siden det er den samme kunnskapen spurt om fra to kanter.

Én ting skal være klar. Dette er eksamensøving, ikke medisinsk veiledning. Ingenting på denne siden forteller deg hvordan du skal behandle en pasient. Når du tar prøver på ekte, følg arbeidsgiverens skriftlige prosedyre, læreren eller veilederen din, og produsentens bruksanvisning for de glassene og det sikkerhetsutstyret du faktisk bruker.

Slik bygger StudyPDF fullengdes øvingsprøver fra ditt eget materiale

Femten spørsmål kan vise deg hvor du er svak. De gjør deg ikke klar alene, og en generell spørsmålsbank treffer sjelden det ditt eget studieløp eller arbeidsgiverens sjekkliste for kompetanse legger vekt på.

StudyPDF jobber fra ditt materiale i stedet. Du laster opp læreboka i blodprøvetaking, laboratoriehåndboka eller heftene studieløpet ditt ga deg, så bygger Bo, studieagenten, fullengdes øvingsprøver fra akkurat de sidene. Hvert spørsmål er forankret i ditt materiale, og hver forklaring viser hvor svaret kommer fra, så du kan gå rett til kilden når noe ser rart ut. Du kan lage nye prøver så ofte du vil, snevre dem inn til ett område som trekkrekkefølge eller komplikasjoner, og følge med på hvilke begreper du stadig bommer på.

Du må ikke laste opp noe for å komme i gang. Har du ingen fil for hånden, oppgi et tema i stedet, for eksempel tilsetningsstoffer i prøveglass eller kapillærprøver, så skriver Bo en øvingsprøve fra det. Gratis å komme i gang.