1What is another name for the red-top tube?
Plain tube or serum tube
2What does a glass red-top tube contain?
No additive
3How does the glass surface of a red-top tube initiate clotting?
It activates the clotting sequence
4Is inversion required for a glass red-top tube?
No
5What specimen is obtained from a red-top tube?
Serum
6What is the clotting time for a plastic red-top tube?
60 minutes
7How many inversions are required for a plastic red-top tube?
5 full inversions
8Why must a plastic red-top tube be inverted?
To mix the sample with the clot activator and initiate clotting
9How long should blood in a red-top tube clot before centrifugation?
30–60 minutes
10What is the proper position of a red-top tube while the blood clots?
Upright
11Enumerate the laboratory uses of the red-top tube.
Serum determinations in chemistry, routine blood donor screening (crossmatching), diagnostic testing for infectious diseases
12Enumerate the laboratory sections that use red-top tubes.
Clinical Chemistry, Blood Banking, Immunoserology
13What does a gold-top or mottled red-gray top tube contain?
Clot activator and gel
14What is another name for the gold-top tube?
Serum Separator Tube (SST)
15How many inversions are required for a gold-top tube?
5 full inversions
16What is the proper position of a gold-top tube?
Upright
17At what temperature should a gold-top tube be kept?
Room temperature
18What is the clotting time for a gold-top tube?
30 minutes
19What specimen is obtained from a gold-top tube?
Serum
20Enumerate the laboratory uses of the gold-top tube.
Serum determination in chemistry, blood donor screening (crossmatching), serum testing for infectious diseases
21Enumerate the laboratory sections that use gold-top tubes.
Blood Banking, Clinical Chemistry, Immunology and Serology
22What anticoagulant is present in a light blue-top tube?
3.2% sodium citrate
23Why is sodium citrate used in a light blue-top tube?
It preserves coagulation or clotting factors
24What specimen is obtained from a light blue-top tube?
Plasma
25How does sodium citrate prevent blood clotting?
It binds calcium
26How many inversions are required for a light blue-top tube?
3–4 full gentle inversions
27Which tube differs in the number of inversions required?
Light blue-top tube
28What can vigorous inversion of a light blue-top tube cause?
Hemolyzed blood and microclot formation
29What is the blood-to-anticoagulant ratio for a light blue-top tube?
9:1
30When can a light blue-top tube be centrifuged?
Immediately after collection
31Enumerate the laboratory uses of the light blue-top tube.
Clot-based/coagulation studies (PT and APTT), mixing studies, ethanol gelation test
32Which laboratory section uses the light blue-top tube according to the notes?
Hematology
33Does the light blue-top tube have a microtainer counterpart?
No
34What is the anticoagulant in a green-top tube?
Heparin
35Enumerate the three formulations of heparin used in green-top tubes.
Lithium heparin, ammonium heparin, sodium heparin
36What specimens can be collected in a green-top tube?
Plasma and whole blood
37How does heparin prevent coagulation?
It inhibits thrombin formation
38How many inversions are required for a green-top tube?
8 full inversions
39Which tube is the exception to the inversion rule for anticoagulant tubes?
Light blue-top tube
40How should a green-top tube be handled for pH, pO₂, and ionized calcium analysis?
It must be full and transported on ice if needed
41What is the laboratory use of a green-top tube?
Plasma determinations in chemistry
42What type of blood sample is specified for the green-top tube?
Arterial blood
43What anticoagulant is used in a purple-top tube?
K₃EDTA or K₂EDTA
44Which form of EDTA is used in glass purple-top tubes?
Spray-coated K₃EDTA
45Which form of EDTA is used in plastic purple-top tubes?
Liquid K₂EDTA
46What specimens can be collected in a purple-top tube?
Plasma or whole blood
47How does EDTA prevent coagulation?
It binds calcium through chelation
48How many inversions are required for a purple-top tube?
8 full inversions
49How many additional inversions are required when using the hemoanalyzer?
2 additional inversions
50Enumerate the laboratory uses of a purple-top tube.
Hematology determinations (CBC), routine immunohematology testing, blood donor screening (crossmatching)
51What is the anticoagulant in the tube containing potassium oxalate monohydrate?
Potassium oxalate monohydrate
52How does potassium oxalate prevent coagulation?
By precipitating calcium
53What specimens can be collected in the potassium oxalate tube?
Plasma and whole blood
54What is the antiglycolytic agent used in the potassium oxalate tube?
Sodium fluoride
55What is the function of sodium fluoride in the tube?
Maintains plasma glucose levels
56How long does sodium fluoride preserve glucose according to the notes?
Up to 3 days
57What additional effect does sodium fluoride have?
It inhibits bacterial growth
58How many inversions are required for the potassium oxalate and sodium fluoride tube?
8–10 full inversions
59Enumerate the laboratory uses of the potassium oxalate and sodium fluoride tube.
Glucose determinations, lactic acid level determination
60What is the purpose of lactic acid level determination according to the notes?
Testing for stress response
61What does ACD stand for in a yellow-top tube?
Acid Citrate Dextrose
62Enumerate the laboratory uses of ACD.
Blood bank studies, HLA phenotyping, paternity testing, DNA testing
63What does SPS stand for?
Sodium Polyanethol Sulfonate
64What is the use of SPS in a yellow-top tube?
Special blood culture studies
65What effect does SPS have on certain antibiotics?
It inhibits certain antibiotics
66What is the common function of ACD and SPS?
Both bind calcium
67How many inversions are required for a yellow-top tube?
8 full inversions
68What specimens can be collected in a yellow-top tube?
Plasma and whole blood
69What is the correct order of draw for evacuated tubes?
Blood culture/sterile tube, coagulation tube, serum tube, heparin tube, black-top tube, EDTA tube, oxalate/fluoride tube
70What is the first tube collected in the order of draw?
Blood culture or sterile tube
71What is the stopper color of blood culture or sterile tubes?
Yellow
72What is the second tube collected in the order of draw?
Coagulation tube
73What is the stopper color of a coagulation tube?
Light blue
74What is the third tube collected in the order of draw?
Serum tube with or without clot activator or gel
75What are the stopper colors of serum tubes?
Red, gold, or red-gray marbled
76What is the fourth tube collected in the order of draw?
Heparin tube
77What are the stopper colors of heparin tubes?
Green or light green
78Where is the black-top tube placed in the order of draw?
After the heparin tube; it may be placed before or after the EDTA tube
79What is the stopper color of the EDTA tube?
Lavender
80What is the last tube in the order of draw?
Oxalate/fluoride tube
81What is the stopper color of the oxalate/fluoride tube?
Gray
82Enumerate the importance of the order of draw.
Prevents cross-contamination of samples, transfer of tissue thromboplastin, additive carry-over, and contamination with microorganisms
83What is the purpose of antiseptics in blood collection?
To prevent sepsis and clean the site before blood collection
84Enumerate the antiseptics used in blood collection.
70% ethyl alcohol, 70% isopropyl alcohol, benzalkonium chloride, chlorhexidine gluconate, hydrogen peroxide, povidone-iodine, tincture of iodine
85Which alcohol is commonly used in blood collection?
70% isopropyl alcohol (isopropanol)
86When is povidone-iodine used in blood collection?
During blood donor bleeding and blood culture collection
87What is the purpose of povidone-iodine in blood collection?
To prevent contamination by normal flora
88How should the venipuncture site be disinfected?
In a concentric fashion
89What is the recommended gauze pad size for blood collection?
2 × 2-inch gauze pads folded into fourths
90What is the purpose of gauze pads after blood collection?
To hold over the puncture site
91Why are cotton balls not recommended after blood collection?
Because of their fiber material
92What is the purpose of a sharps disposal container?
To contain used needles, lancets, and other sharp objects used in blood collection
93What type of ink should a phlebotomist's pen use?
Indelible (permanent), non-smear ink
94What is the purpose of the phlebotomist's pen?
To label tubes and record patient information
95What type of pen is preferably avoided for blood collection documentation?
Sign pen
96What type of watch is preferred for blood collection?
A watch with a sweep second hand or timer
97Why is a watch used during blood collection?
To accurately determine specimen collection times and time certain tests
98Why should collection times be labeled with AM or PM?
Some test levels increase or decrease depending on the time of day
99What are vein-locating devices also called?
Portable illumination devices or vein viewers
100What is the purpose of vein-locating devices?
To locate veins that are difficult to see or feel
101How do vein-locating devices highlight veins?
They use high-intensity LED or infrared light through the patient's subcutaneous tissue
102What is the principle of vein-locating devices?
Infrared light absorption
103What is a tourniquet?
A device applied or tied around the patient's arm before venipuncture to restrict blood flow
104How should a tourniquet be fastened?
So it can be easily released with one hand during blood collection or emergencies
105What is the most common type of tourniquet?
Strap tourniquet
106Enumerate the types of tourniquets.
Elastic tourniquet, buckle quick-release tourniquet, Velcro tourniquet
107How tightly should a tourniquet be applied?
Tightly enough to restrict venous flow but not arterial flow
108How far above the specimen collection site should a tourniquet be placed?
3–4 inches
109What may happen if the tourniquet is placed too near the collection site?
Hemolysis of the sample may occur
110When should a tourniquet be discarded?
If it has been dropped on the floor or is visibly contaminated with blood
111What are the characteristics of phlebotomy needles?
Sterile, disposable, and designed for single use only
112Enumerate the types of phlebotomy needles.
Multisample needles, hypodermic needles, winged infusion (butterfly) needles
113What type of blood collection uses multisample needles?
Evacuated Tube System (ETS) only
114How are phlebotomy needles identified by gauge?
They are color-coded for easy identification
115What is the gauge of a yellow needle?
20 gauge
116What is the gauge of a green needle?
21 gauge
117What is the gauge of a black needle?
22 gauge
118What is the gauge of a blue needle?
23 gauge
119What is the relationship between needle gauge and needle size?
The higher the gauge, the smaller the needle
120What criteria are used to choose a needle gauge?
Size and condition of the vein, type of blood collection procedure, and equipment being used
121What is the typical use of a 15–17 gauge special needle attached to a collection bag?
Collection of donor units, autologous blood donation, and therapeutic phlebotomy
122When is a 20-gauge multisample hypodermic needle used?
Sometimes used with large-volume syringes on patients with normal-sized veins
123What is the standard needle gauge for routine venipuncture on patients with normal veins?
21-gauge multisample hypodermic needle
124What needle gauge is used for syringe blood culture collection?
21-gauge multisample hypodermic needle
125When is a 22-gauge multisample hypodermic needle used?
For older children and adults with small veins or syringe draws on difficult veins
126When is a 23-gauge butterfly needle used?
For infants and children, and for difficult or hand veins of adults
127What is the typical length of multisample needles?
1 or 1.5 inches
128What is the typical length of hypodermic needles?
1 or 1.5 inches
129What is the typical length of butterfly needles?
½ to ¾ inch
130What is another name for a winged infusion set?
Butterfly
131What is the purpose of a winged infusion set?
To collect blood from small or difficult veins, such as the hand veins of elderly and pediatric patients
132What is the most commonly used needle gauge for a winged infusion set?
23 gauge
133What needle gauge is specifically used to collect blood from the scalp or other tiny veins of premature infants and neonates?
25 gauge
134What collection methods can be used with a winged infusion set?
A syringe or an evacuated tube system (ETS) tube holder
135Which is faster when using a winged infusion set: syringe or ETS?
ETS
136What is a tube holder?
A clear, plastic, disposable cylinder used to hold the collection tube and connect it to the needle
137What is the small threaded opening of a tube holder called?
Hub
138Where is the needle attached to the tube holder?
The small threaded opening or hub
139Where is the collection tube placed in the tube holder?
The large opening
140What are evacuated tubes used for?
Obtaining blood specimens using both the evacuated tube system (ETS) and syringe method
141What are the available materials of evacuated tubes?
Plastic or glass
142What is the volume range of evacuated tubes?
1.8–15 mL
143How do evacuated tubes automatically fill with blood?
Through a vacuum artificially created by removing air from the tube
144What determines the volume of blood collected in an evacuated tube?
The pre-measured vacuum
145Enumerate the circumstances that may cause an evacuated tube to lose its vacuum.
Improper storage, opening the tube, dropping the tube, advancing the tube too far onto the needle before venipuncture, and partial withdrawal of the needle bevel from the skin during venipuncture
146What may indicate that the needle bevel is partially out of the skin during venipuncture?
A hissing sound