Patient Preparation practice questions

Answer: A) Contact the supervisor right away, following facility call-in policy, and give an estimated arrival time.

Professionalism includes punctuality and integrity. When lateness can't be avoided, notify the supervisor right away according to policy. Never falsify time records or cut corners on patient care.

• ACorrect. Giving notice right away lets the supervisor reassign the morning draws so that timed and fasting specimens are not delayed. This shows reliability and accountability.
• BIncorrect. Waiting until arrival leaves the team without warning, and draws may be missed or delayed. Notice should be given as soon as the problem is known.
• CIncorrect. Having someone else clock you in falsifies time records. This violates integrity and facility policy.
• DIncorrect. Rushing draws risks skipping identification and other steps, which harms patient safety and specimen quality. It also does nothing to notify the team.

Answer: A) Patient identifiers, tests ordered, priority and special instructions

Before a draw, check the requisition for patient identifiers, the tests ordered, the priority and any special instructions. Together these tell the phlebotomist who to draw, which tubes to use, and when and how to collect.

• ACorrect. The identifiers are matched to the patient. The tests determine which tubes to use. The priority (for example STAT or routine) sets the timing, and special instructions cover things like fasting or timed draws and how to handle the specimen.
• BIncorrect. Billing details are handled elsewhere and don't tell the phlebotomist who to draw, what to draw or when.
• CIncorrect. Provider contact details may appear on the form, but they don't identify the patient or tell the phlebotomist how to collect the specimen.
• DIncorrect. A room or bed number is not an acceptable patient identifier. Unless a special instruction calls for it, the meal schedule doesn't define what to collect.

Answer: A) Implied consent

• ACorrect. The patient's actions show agreement.
• BIncorrect. Nothing was signed.
• CIncorrect. The patient's actions indicate consent.
• DIncorrect. The patient consented for themselves.

Answer: C) Stop, step back to a safe distance, and notify the patient's nurse so trained staff can assist

With a combative patient, the phlebotomist should not attempt the draw alone. Step away safely and notify the nurse so trained staff can assist or decide how to proceed.

• AIncorrect. A butterfly does not make a draw safe on a combative patient. Sudden movement can still cause a needlestick or injure the patient.
• BIncorrect. Family members are not trained to restrain patients and could be hurt or hurt the patient. Restraint decisions belong to the nursing and medical staff under facility policy.
• CCorrect. Everyone's safety comes first. The phlebotomist should not go ahead alone and should bring in the nurse, who knows the patient's condition and can arrange help or decide how to proceed.
• DIncorrect. Leaving paperwork without speaking to the nurse does not properly communicate a safety event. The nurse needs to be told directly so the care team can respond and the draw can be rescheduled or assisted.

Answer: B) Do not collect; notify the nurse or provider and document the refusal

A competent adult may refuse a blood draw. The phlebotomist does not collect, notifies the nurse or provider, and documents the refusal.

• AIncorrect. A provider's order does not override a competent patient's refusal. Drawing blood after a refusal can amount to assault and battery.
• BCorrect. A competent patient may refuse a test at any time before sampling. The phlebotomist does not collect, tells the nurse or ordering provider so care can be adjusted, and documents the refusal according to facility policy.
• CIncorrect. A family member cannot override the decision of a competent adult. Surrogate consent applies only when the patient lacks decision-making capacity and the surrogate is legally authorized.
• DIncorrect. Returning the requisition to the lab is not enough. The nurse or provider must be told directly, because the test may be needed for patient care.

Answer: D) Fibrinogen

Thrombin converts soluble fibrinogen into insoluble fibrin, which forms the meshwork of a blood clot.

• AIncorrect. Prothrombin is the inactive precursor that is activated into thrombin, the enzyme that does the conversion. It does not become the clot's strands.
• BIncorrect. Plasminogen is involved in fibrinolysis, the breakdown of a clot, not in building the clot's mesh.
• CIncorrect. Albumin is a plasma protein that helps maintain oncotic pressure and transports substances. It does not form clot strands.
• DCorrect. Fibrinogen is a soluble, liver-made protein that thrombin converts into insoluble fibrin strands, which form the clot's mesh. This is why serum, the fluid left after clotting, contains no fibrinogen.

Answer: A) The right arm

• ACorrect. The arm on the mastectomy side is generally avoided.
• BIncorrect. The affected side is generally avoided.
• CIncorrect. The affected side should be avoided.
• DIncorrect. The unaffected arm can usually be used.

Answer: C) Have the patient state full name and date of birth; match to ID band and requisition

For an alert inpatient, the patient states at least two identifiers (full name and date of birth). The phlebotomist matches them to the ID band and the requisition before collecting.

• AIncorrect. Door and bed labels can be out of date when patients are moved. They are not attached to the patient.
• BIncorrect. A leading yes/no question can draw a mistaken 'yes' from a patient who is confused or hard of hearing. The patient should state the identifiers instead.
• CCorrect. The patient states two unique identifiers, and the phlebotomist checks them against the ID band and the requisition at the bedside.
• DIncorrect. Identity must be confirmed at the bedside with the patient and the ID band, not by a verbal check away from the patient.

Answer: D) Use a qualified interpreter

• AIncorrect. Children should not interpret medical information.
• BIncorrect. Volume does not overcome a language barrier.
• CIncorrect. The patient must understand the procedure.
• DCorrect. A qualified interpreter ensures accurate communication and informed consent.

Answer: A) Wait or come back, unless the draw is STAT or timed

• ACorrect. Don't interrupt routine care.
• BIncorrect. Routine draws can wait.
• CIncorrect. Return later.
• DIncorrect. Return later.