ASCP Domain 2: Specimen Collection Welcome to your ASCP Domain 2: Specimen Collection 1. ASCP: Specimen Collection When collecting a blood specimen for a coagulation test, which of the following tubes is the most appropriate to use? A. Red-top tube B. Lavender-top tube C. Light blue-top tube D. Green-top tube None 2. ASCP: Specimen Collection A phlebotomist needs to collect a blood culture, a CBC, and a PT/PTT. Which of the following is the correct order of draw? A. Blood culture, CBC, PT/PTT B. CBC, blood culture, PT/PTT C. PT/PTT, CBC, blood culture D. Blood culture, PT/PTT, CBC None 3. ASCP: Specimen Collection What is the most critical aspect to ensure the accuracy of a point-of-care glucose test? A. The patient's fasting status B. The amount of blood applied to the test strip C. The expiration date of the test strips D. The time of day when the test is performed None 4. ASCP: Specimen Collection When performing a dermal puncture on an infant, which site is preferred? A. The tip of the finger B. The heel C. The earlobe D. The big toe None 5. ASCP: Specimen Collection In a patient with a left-sided mastectomy, where should the phlebotomist perform venipuncture? A. The left arm B. The right arm C. Either arm, it does not matter D. Avoid venipuncture altogether None 6. ASCP: Specimen Collection What is the recommended maximum time a tourniquet should be applied to a patient's arm during venipuncture? A. 1 minute B. 2 minutes C. 3 minutes D. 5 minutes None 7. ASCP: Specimen Collection If a patient is prone to syncope during venipuncture, what is the most appropriate action for the phlebotomist to take? A. Proceed with the draw as quickly as possible B. Have the patient lie down or sit in a reclining chair C. Tell the patient to hold their breath during the procedure D. Skip the tourniquet None 8. ASCP: Specimen Collection When collecting a specimen for a therapeutic drug monitoring test, what is essential to verify with the patient? A. The patient's age B. The time and date of the last dose of medication C. The patient's fasting status D. The patient's allergy history None 9. ASCP: Specimen Collection When drawing blood from a patient with difficult veins, which of the following techniques is NOT recommended? A. Using a smaller gauge needle B. Slapping the skin to make the vein more prominent C. Applying a warm compress to the area D. Asking the patient to make a fist None 10. ASCP: Specimen Collection For a patient receiving intravenous therapy in the right arm, where should the phlebotomist collect the blood sample? A. The same arm above the IV site B. The same arm below the IV site C. The opposite arm D. Any available vein in the right arm None 11. ASCP: Specimen Collection What is the most appropriate action if a blood specimen tube appears underfilled? A. Proceed with testing as usual B. Add saline to fill the tube C. Discard the tube and collect a new specimen D. Mix the tube longer to compensate None 12. ASCP: Specimen Collection When a phlebotomist observes petechiae after applying a tourniquet, what should be the next course of action? A. Tighten the tourniquet to prevent further petechiae B. Proceed with the draw as petechiae are not a concern C. Loosen the tourniquet slightly and reassess D. Remove the tourniquet and select a different site None 13. ASCP: Specimen Collection In the context of blood specimen collection, what is the significance of the 'order of draw'? A. It ensures the most painful draws are done last B. It prevents carryover of additives between tubes C. It determines which tests are prioritized D. It indicates the order of patient processing None 14. ASCP: Specimen Collection When should a phlebotomist use a syringe for blood collection instead of a vacuum tube system? A. When the patient requests it B. For arterial blood gas collections C. In cases of difficult or fragile veins D. When larger volumes of blood are needed None 15. ASCP: Specimen Collection What is a critical consideration when performing a capillary blood collection on a finger? A. Wipe away the first drop of blood B. Use the first drop of blood for the test C. Apply heavy pressure to the finger D. Collect blood from the side of the fingertip None 16. ASCP: Specimen Collection Which of the following is an appropriate action if a patient has a syncope episode during a blood draw? A. Continue the draw while monitoring the patient's condition B. Stop the draw, remove the needle, and ensure the patient's safety C. Elevate the patient's legs while continuing the draw D. Immediately apply a cold compress to the patient's forehead None 17. ASCP: Specimen Collection For a glucose tolerance test, how should the phlebotomist instruct the patient regarding preparation? A. Fast for 8 hours, but drink plenty of water B. Consume a high-sugar meal before the test C. No specific preparation is required D. Fast for 12 hours and avoid water None 18. ASCP: Specimen Collection What is the best practice for labeling a blood specimen collection tube? A. Label the tube before drawing the blood B. Label the tube immediately after filling it, in front of the patient C. Label the tube at the end of the day with collected specimens D. Label the tube once you return to the laboratory None 19. ASCP: Specimen Collection If a blood sample is required to be chilled immediately after collection, which of the following is the best method to achieve this? A. Place the tube in a freezer B. Surround the tube with ice packs C. Hold the tube under cold running water D. Store the tube in a refrigerator None 20. ASCP: Specimen Collection Which of the following is NOT a recommended practice for ensuring vein preservation and patient comfort during phlebotomy? A. Rotate puncture sites B. Use the smallest gauge needle possible for the blood volume C. Use a single vein for all draws whenever possible D. Anchor the vein firmly before insertion None 21. ASCP: Specimen Collection When performing a venipuncture, how should the needle be positioned relative to the skin and the vein? A. At a 45-degree angle with the bevel facing up B. At a 15 to 30-degree angle with the bevel facing down C. Parallel to the vein with the bevel facing sideways D. At a 15 to 30-degree angle with the bevel facing up None 22. ASCP: Specimen Collection In blood collection, what is the significance of the anticoagulant EDTA? A. It preserves glucose in the blood sample B. It prevents the blood from clotting C. It enhances the coagulation process D. It increases the serum separation time None 23. ASCP: Specimen Collection What precaution should be taken when collecting a blood specimen from a patient undergoing anticoagulant therapy? A. Use a larger gauge needle B. Apply extended pressure after collection C. Avoid using a tourniquet D. Collect a smaller volume of blood None 24. ASCP: Specimen Collection What is the primary reason for inverting tubes after collection? A. To mix the blood with the additive B. To increase the blood flow C. To check for clots D. To aerate the blood None 25. ASCP: Specimen Collection When is it appropriate to use a butterfly needle for venipuncture? A. When the patient is extremely obese B. For arterial blood gas collections C. In pediatric patients or those with small or fragile veins D. When a large volume of blood is needed None 26. ASCP: Specimen Collection Which of the following is a crucial step to avoid hemolysis when drawing blood from a patient with fragile veins? A. Use a tourniquet as tightly as possible B. Select the largest gauge needle available C. Avoid vigorous mixing of the blood tube D. Fill the tube rapidly to ensure quick collection None 27. ASCP: Specimen Collection What is the primary purpose of requesting a patient to make a fist during venipuncture? A. To reduce the pain of the needle insertion B. To help locate and stabilize the vein C. To check the patient's reflexes D. To increase blood pressure for a better draw None 28. ASCP: Specimen Collection When is it necessary to use a "chain of custody" protocol during specimen collection? A. For all blood draws B. When collecting a routine CBC C. For drug testing or forensic samples D. During pediatric collections None 29. ASCP: Specimen Collection How should a phlebotomist handle a needlestick injury immediately after it occurs? A. Ignore the injury and continue with the draw B. Wash the area with antiseptic and return to work C. Wash the area with soap and water and report the incident D. Apply a bandage and assess the injury later None 30. ASCP: Specimen Collection What is the most appropriate action if a patient reports a history of feeling faint during blood draws? A. Proceed with the draw while standing B. Have the patient stand and stretch beforehand C. Use a smaller gauge needle D. Have the patient lie down or sit in a reclining chair None 31. ASCP: Specimen Collection Which tube should be drawn first when collecting a blood culture and a CBC? A. The tube for CBC B. The tube for blood culture C. Any tube can be drawn first D. Tubes should be drawn simultaneously None 32. ASCP: Specimen Collection What is the recommended course of action if a phlebotomist notices signs of infection at a proposed venipuncture site? A. Cleanse the site more thoroughly with antiseptic B. Proceed with the draw, using a larger gauge needle C. Select an alternative site for the venipuncture D. Use an antibiotic ointment on the site before the draw None 33. ASCP: Specimen Collection Why is it important to invert anticoagulant tubes immediately after blood collection? A. To prevent clot formation B. To enhance the color of the plasma C. To increase the blood volume D. To cool down the blood sample None 34. ASCP: Specimen Collection What is the recommended procedure when a patient has an intravenous (IV) line on both arms? A. Draw blood from the arm with the slower IV drip B. Draw blood from the arm with the clearer IV fluid C. Draw below the IV site on the arm with less swelling D. Coordinate with the patient's nurse to temporarily halt the IV and draw distal to the IV site None 35. ASCP: Specimen Collection In pediatric blood collection, why is it important to use a smaller volume collection tube? A. To minimize the discomfort from the tourniquet B. To reduce the risk of anemia from blood loss C. To speed up the collection process D. To ensure faster clotting in the tube None 36. ASCP: Specimen Collection When collecting a specimen for a lipid panel, why is fasting important? A. Fasting stabilizes the patient's blood pressure B. Non-fasting can lead to hemolysis of the sample C. Nutrient intake can alter the lipid levels in the blood D. It ensures the patient is hydrated None 37. ASCP: Specimen Collection What is the primary reason for performing an Allen test before arterial blood collection? A. To assess the pain tolerance of the patient B. To determine the appropriate needle size C. To check the arterial blood flow to the hand D. To ensure the vein is suitable for puncture None 38. ASCP: Specimen Collection Why is it important to allow the alcohol to dry completely before performing a venipuncture? A. To reduce the sensation of pain B. To prevent contamination of the sample with alcohol C. To enhance the visibility of the veins D. To make the puncture site less slippery None 39. ASCP: Specimen Collection What is the significance of using an evacuated tube system for blood collection? A. It eliminates the need for a tourniquet B. It provides a pre-measured vacuum for consistent blood volume C. It allows for blood collection without a needle D. It automatically separates the plasma from the cells None 40. ASCP: Specimen Collection What is the best approach when a phlebotomist needs to collect a blood sample from a patient with a history of vasovagal syncope? A. Perform the draw while the patient is seated in a chair with armrests B. Have the patient stand up to increase blood flow C. Conduct the draw with the patient lying down D. Quickly perform the draw while the patient is distracted None 41. ASCP: Specimen Collection During a blood draw, if the blood flow stops suddenly, what should the phlebotomist initially attempt? A. Immediately remove the needle and apply pressure B. Adjust the angle of the needle slightly C. Ask the patient to pump their fist D. Change the needle and try a different vein None 42. ASCP: Specimen Collection For which type of test is it most critical to avoid the use of a tourniquet when collecting a blood sample? A. Hemoglobin A1c B. Lactic acid measurement C. Complete blood count (CBC) D. Serum electrolytes None 43. ASCP: Specimen Collection When drawing blood from a patient with a fistula, what is the essential precaution? A. Use the arm with the fistula for blood draw B. Apply the tourniquet above the fistula C. Never use the arm with the fistula for blood draws D. Use a larger gauge needle for the draw None 44. ASCP: Specimen Collection How should the phlebotomist proceed if the requested volume of blood exceeds the patient's safe blood draw volume? A. Proceed with the draw as requested B. Consult with the patient's healthcare provider for prioritization of tests C. Draw only the amount that is safe, regardless of the test requirements D. Substitute with a less volume-intensive test None 45. ASCP: Specimen Collection What is the recommended action if a phlebotomist inadvertently collects the wrong tube type for a test? A. Label the tube correctly and send it to the lab B. Re-label the tube with the correct test C. Discard the incorrect tube and redraw the sample D. Send the tube to the lab with a note explaining the error None 46. ASCP: Specimen Collection What is the proper course of action if a patient develops a hematoma during venipuncture? A. Continue the draw until the required volume is collected B. Apply more pressure to the site to stop the bleeding C. Stop the draw, remove the needle, and apply pressure D. Immediately apply a cold compress to the site None 47. ASCP: Specimen Collection In the event of a needlestick injury to a phlebotomist after collecting a sample from a high-risk patient, what is the first action that should be taken? A. Continue with the next patient to maintain workflow B. Wash the affected area with soap and water immediately C. Apply an antibiotic cream to the injury site D. Cover the wound with a bandage and report at the end of the shift None 48. ASCP: Specimen Collection When collecting a blood sample for erythrocyte sedimentation rate (ESR) testing, why is it important to avoid vigorous mixing of the sample? A. Vigorous mixing can cause hemolysis B. It can lead to activation of clotting factors C. Vigorous mixing can artificially lower the ESR D. It can cause air bubbles that may affect the test result None 49. ASCP: Specimen Collection What is the primary reason for avoiding the use of an alcohol swab when collecting a specimen for an alcohol level test? A. The alcohol from the swab can dilute the sample B. It can cause irritation at the puncture site C. The residual alcohol on the skin can contaminate the sample D. Alcohol swabs can cause hemolysis None 50. ASCP: Specimen Collection Why is it necessary to fill a blood culture bottle to the recommended volume? A. To ensure adequate pressure for the culture media B. To provide sufficient sample for multiple tests C. To avoid dilution of the specimen with the culture medium D. To ensure an optimal ratio of blood to culture medium for bacterial growth None 1 out of 50 Time is Up! Time's up
