Which of the following specimens has a phlebotomist appropriately prepared for transport?
A red-top tube that is being shipped after clotting for 15 minutes and being centrifuged
A tube containing serum that is being shipped after separation from a lavender-top tube
A tiger-top tube for bilirubin testing that is being shipped in a clear biohazard bag
A green-top tube for ammonia testing that is being shipped in an icy water mixture
The Correct Answer is D
Choice A Reason:
A red-top tube is used for serum determinations in chemistry and should be allowed to clot completely, typically for 30 minutes, before centrifugation. Shipping after only 15 minutes may result in incomplete clotting and potentially inaccurate test results.
Choice B Reason:
Serum should not be separated from a lavender-top tube, as this type of tube contains EDTA and is used for whole blood tests, not serum. This indicates a misunderstanding of the tube's purpose and could lead to compromised test results.
Choice C Reason:
A tiger-top tube, also known as a serum separator tube, is used for various chemistry tests. However, bilirubin is light-sensitive, and specimens for bilirubin testing should be protected from light, not shipped in a clear bag. This could lead to degradation of the bilirubin and inaccurate results.
Choice D Reason:
A green-top tube contains heparin and is used for plasma determinations. Ammonia testing requires the plasma to be placed on ice immediately after collection to inhibit the continued production of ammonia from red blood cells. Therefore, shipping in an icy water mixture is the correct procedure to ensure accurate ammonia levels.
In conclusion, the proper preparation and transport of blood specimens are crucial for the accuracy of laboratory tests. The green-top tube for ammonia testing, shipped in an icy water mixture, is the only option that follows the correct protocol for specimen handling and transport.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Anchoring the vein does not eliminate the need for a tourniquet. The tourniquet is applied to engorge the veins, making them more prominent and easier to puncture. Anchoring is a technique used after the tourniquet has already accomplished this task.
Choice B Reason:
While anchoring the vein can provide a more stable area for needle insertion, which might indirectly reduce pain, its primary purpose is not pain reduction. Pain during needle insertion is more directly influenced by the needle gauge, angle of insertion, and the phlebotomist's technique.
Choice C Reason:
Improving vein identification is not the direct purpose of anchoring. Vein identification is typically done visually and by palpation before the application of the tourniquet and before anchoring the vein. Anchoring is performed to stabilize the vein once it has been identified.
Choice D Reason:
The primary purpose of anchoring the vein is to minimize its movement during venipuncture. This is important because it helps prevent the needle from slipping out of or through the vein, which can cause discomfort and bruising, and may require another puncture attempt.
Correct Answer is D
Explanation
Choice A Reason:
Inverting the tube 5 to 7 times may not be sufficient to mix the blood thoroughly with the EDTA. This could lead to partial clotting and potentially inaccurate test results. The EDTA anticoagulant works by binding calcium ions, which are necessary for blood clotting. Without adequate mixing, the EDTA may not be evenly distributed, leaving some areas of the blood sample able to clot.
Choice B Reason:
Inverting the tube only 2 to 4 times is inadequate for proper mixing. This minimal agitation would likely result in clot formation because the anticoagulant would not be sufficiently mixed with the blood. Clots can interfere with the accuracy of hematological tests by trapping cells and altering the specimen's composition.
Choice C Reason:
Inverting the tube 1 to 3 times is clearly insufficient and would almost certainly lead to clotting. The purpose of inverting the tube is to ensure that the EDTA coats all the blood cells, preventing coagulation. Such a low number of inversions would not allow for the anticoagulant to perform its function effectively.
Choice D Reason:
Inverting the tube 8 to 10 times is the recommended practice. This number of inversions ensures that the blood is fully mixed with the EDTA, preventing clot formation and preserving the integrity of the sample for accurate laboratory analysis. It is important to perform these inversions gently to avoid hemolysis, which can also affect test results. Hemolysis occurs when red blood cells are damaged and their contents leak out, which can happen if the blood is shaken too vigorously.
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