Which of the following is the correct order of collection?
Citrate, heparin, EDTA, fluoride
Citrate, EDTA, heparin, fluoride
Fluoride, EDTA, heparin, citrate
Fluoride, heparin, EDTA, citrate
The Correct Answer is B
Choice A reason:
The order of citrate, heparin, EDTA, and fluoride is not the correct sequence for blood collection. The correct order is essential to prevent cross-contamination of additives between tubes, which could interfere with test results. Citrate tubes should be drawn first to ensure that the blood does not clot prematurely, but heparin should not follow immediately after citrate.
Choice B reason:
Citrate tubes, which contain sodium citrate, are used for coagulation tests and must be drawn first to ensure the proper blood-to-additive ratio. EDTA tubes are drawn next because EDTA binds calcium and prevents clotting, making it ideal for complete blood counts and other hematology studies. Heparin tubes, which prevent clotting by inhibiting thrombin and thromboplastin, are drawn after EDTA. Lastly, fluoride tubes, which contain a glycolysis inhibitor, are drawn to preserve glucose levels and are typically used for glucose and lactate testing.
Choice C reason:
Starting with fluoride is not recommended as it could lead to contamination of the EDTA and heparin tubes with fluoride, which could affect the results of certain tests, such as calcium determinations in heparin tubes. The order of draw is designed to minimize such risks.
Choice D reason:
This sequence is incorrect because fluoride tubes are not drawn before EDTA and heparin tubes. The presence of fluoride could potentially contaminate the subsequent tubes and alter the results of the tests that require heparin or EDTA as an anticoagulant.
In phlebotomy, following the correct order of draw is crucial. The order is established based on the type of additive in each tube and its potential to interfere with tests conducted in subsequent tubes. The standard order is: blood cultures, citrate tubes, serum tubes with or without clot activator and gel, heparin tubes with or without gel, EDTA tubes, and lastly, fluoride tubes. This sequence helps prevent cross-contamination and ensures the accuracy of laboratory results, which are critical for patient diagnosis and treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Immunization schedules are not regulated by OSHA. They are typically overseen by public health agencies such as the Centers for Disease Control and Prevention (CDC) in the United States. These agencies provide guidelines on when and which vaccines should be administered to various populations.
Choice B reason:
Patient privacy is primarily regulated by the Health Insurance Portability and Accountability Act (HIPAA), not OSHA. HIPAA sets the standard for protecting sensitive patient health information from being disclosed without the patient's consent or knowledge.
Choice C reason:
The accuracy of laboratory results falls under the purview of the Clinical Laboratory Improvement Amendments (CLIA), which are federal regulatory standards that apply to all clinical laboratory testing performed on humans in the United States, except for clinical trials and basic research.
Choice D reason:
Universal precautions are indeed regulated by OSHA. These are a set of infection control practices used to prevent transmission of diseases that can be acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. These precautions are designed to protect workers from exposure to diseases spread by blood and certain body fluids.
Correct Answer is C
Explanation
Choice A Reason:
A multipart requisition involves multiple copies of a paper form, which can be prone to errors due to manual entry, misplacement, or illegible handwriting. While it provides physical copies for various departments, it is not the most accurate method compared to digital solutions.
Choice B Reason:
A manual requisition is similar to a multipart requisition but typically consists of a single form. It carries the same risks of human error and does not offer the benefits of automated tracking and data entry that come with electronic systems.
Choice C Reason:
An automated requisition is considered the most accurate method for receiving orders for specimen collection. It reduces the risk of human error associated with manual data entry and allows for better tracking and integration with laboratory information systems. Automated systems can also provide immediate feedback if there is an issue with the order, such as a missing patient identifier or a test code.
Choice D Reason:
A verbal requisition is the least reliable method as it depends on the memory and communication skills of the individuals involved. It lacks the documentation and verification steps present in written or automated methods, making it susceptible to misunderstandings and errors.
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