Which of the following tube additives promotes clot formation?
Heparin
Oxalate
Citrate
Silica
The Correct Answer is D
Choice A reason:
Heparin is an anticoagulant, not a clot activator. It works by inhibiting thrombin and preventing the conversion of fibrinogen to fibrin, thus preventing clot formation. It is commonly found in green-top tubes and is suitable for collecting plasma samples for tests like electrolyte levels and coagulation studies.
Choice B reason:
Oxalate is also an anticoagulant that prevents clotting by precipitating calcium. It is not used to promote clot formation but rather to maintain a blood sample in a non-coagulated state for various tests.
Choice C reason:
Citrate functions similarly to heparin and oxalate as an anticoagulant. It chelates calcium ions in the blood, inhibiting the coagulation process. Citrate is often used in blue-top tubes and is ideal for collecting plasma samples for coagulation studies.
Choice D reason:
Silica is a clot activator. It is commonly used in serum separator tubes (SSTs) with a gold or red speckled top. The silica particles provide a surface for the rapid formation of the clot, allowing for the separation of serum from the blood cells. This is essential when serum is needed for testing.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
While informing the patient of the procedure is important, it is not the immediate next step after greeting. The technician should first ensure the patient's safety and comfort before proceeding with the details of the blood draw.
Choice B Reason:
Asking if the patient has a latex allergy is crucial as it directly pertains to patient safety. Many medical supplies, including gloves and tourniquets used during phlebotomy, may contain latex, which can cause allergic reactions in sensitive individuals. Identifying an allergy before any contact ensures that the technician can take necessary precautions to prevent an allergic reaction.
Choice C Reason:
Stating the technician's name to the patient helps build rapport but is not as critical as ensuring the patient's safety. It is a part of good communication and patient care practices but should follow after confirming any potential allergies or other immediate health concerns.
Choice D Reason:
Asking the patient which arm they prefer for the blood draw is a part of the procedure that involves patient preference and comfort. However, this should come after ensuring there are no allergies that could lead to complications during the draw.
Correct Answer is B
Explanation
Choice A Reason:
Prepping the site with povidone iodine is not typically associated with hemoconcentration. Povidone iodine is used as an antiseptic to clean the skin before venipuncture to prevent infection. While it's important to allow it to dry to avoid sample contamination, it does not cause hemoconcentration.
Choice B Reason:
Leaving the tourniquet in place for more than 2 minutes can lead to hemoconcentration. A tourniquet is applied to engorge the veins, making them easier to puncture. However, prolonged application can result in fluid being forced out of the vein into the tissue, increasing the concentration of cells and larger molecules in the blood. This can affect certain laboratory test results by artificially increasing the levels of cellular components.
Choice C Reason:
Not refrigerating the specimen within 30 minutes does not cause hemoconcentration. However, it can affect the stability of certain analytes in the blood sample. Refrigeration is necessary for preserving the integrity of certain components of the blood until analysis, but it is unrelated to the concentration of cells within the sample at the time of collection.
Choice D Reason:
Removing the needle before the tourniquet is released does not cause hemoconcentration. This action might lead to other complications, such as hematoma formation, but it does not affect the concentration of cellular elements in the collected sample.

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