NCE PRACTICE EXAM

The circulatory system carries all the necessary nutrients to the parts of the body. The heart receives and pumps the blood out. Veins return deoxygenated blood from the tissues back to the heart.

The circulatory system is responsible for circulating nutrients throughout the body to help the other organs do their job. The cardiovascular system (the heart) pumps the blood throughout the body and the lymphatic system is responsible for cleaning the blood.

The average person has about 5 Liters (5.3 quarts) of blood in their body.

Venous blood is the most common way to collect blood from a patient. Capillary blood is commonly used for finger sticks (glucose) or heel sticks of an infant (bilirubin). Arterial blood is used for certain tests such as Arterial Blood Gas.

The method of transport is a main factor that can impact the integrity of a blood specimen.

With a Venous blood draw, the flow of the blood is steady, and easily controlled when done. The blood is also dark red.

Hemolyzed samples are when the Red Blood Cells (RBCs) are lysed and release hemoglobin into the serum. The serum will become pink or red in color.

A lipemic specimen means that there is an increase of fats or lipids in the blood. After centrifuging the specimen (sometimes before) the serum will be a milky white, and hazy. The level of haziness is determined by the amount of fats in the blood.

Yellow (blood cultures) will always go first due to their sensitivity. Blue, red (SST), orange, green, pink, white, and gray are the remaining order. Contamination of the tubes can drastically determine the results of the test.

The lavender tubes must be inverted 8-10 times to properly mix the blood and the EDTA (ethylenediamine tetra acetic acid) to prevent clotting. Clotting in these tubes can affect the specimen integrity and may result in a redraw.

The specimen must be placed in a vertical position for a minimum of 30 minutes to allow for clotting. If the specimen is not fully-clotted before spinning, it can affect the integrity of the specimen.

1 minute is the maximum amount of time a tourniquet can remain on a patient's arm. Any longer and it can affect the integrity of the specimen.

Incorrect order of draw can result in contamination of the tubes. Contaminated tubes can lead to inaccurate results. Inaccurate results can lead to incorrect treatment.

Citrate tubes are always blue or light-blue and must be inverted 3-4 times for the proper mix. These tubes help determine coagulation in the patient's blood and must not clot.

After being spun, an SST (Serum Separator Tube) produces serum and Lavender tubes produce plasma. Serum and plasma are the part of the specimen that is actually being tested.

You are preventing hemolysis. A hemolyzed specimen may mean that the sample cannot be tested and a redraw is necessary. Hemolysis means that the red blood cells have burst and released hemoglobin into the serum or plasma, turning it a pink or red color.

Some tests require frozen or refrigerated transportation. Room temp samples are samples that do not require specific methods or conditions for transportation.

A specimen must have two main patient identifiers. Patient name and date of birth are the two main identifiers.

Waived testing produces no reasonable harm to the patient when the test is performed incorrectly. An example of this testing is glucometers for diabetic patients that can be performed bedside or at home.

POCT stands for Point of Care Testing, meaning that the test can be done near the site of treatment. POCT is usually done in a hospital setting and is done at bedside.

Point of Care Testing has been proven to reduce hospital stays because results are monitored in real time instead of waiting for results. It is convenient for the patient and requires small samples.

The types of urine collection are random, first morning, clean catch, mid-stream, and timed. Each type has its own purpose.

A sputum sample is fluid from the lungs. It is usually collected first thing in the morning by the patient at home.

The patient must come to the lab to get a stool card. Fecal Occult Blood Tests (FOBTs) are done at home and test for blood in the stool. Results from this test can detect lesions or cancer in the GI tract.

Streptococcal infections are in the throat. The patient is to open the mouth wide and the inflamed area is swabbed.

Universal precautions is an approach to infection control. Gloves, gowns, and goggles are all a part of universal precautions. They help to protect people from blood borne pathogens in human body fluids.

NAACLS is the National Accrediting Agency for Clinical Laboratory Science. This agency does peer reviews to grant public recognition to educational agencies, and holds those agencies to defined educational standards.

Safety data sheets (SDS)include everything you need to know about a specific chemical. They list properties of each chemical, environmental health hazards, and safety precautions for handling, storing, and transportation.

The Environmental Protection Agency (EPA) is a federal government agency whose mission is to protect the health and the environment by implementing and enforcing environmental laws. They also sponsor and conduct research on environmental issues.

When collecting a non-blood specimen, the Phlebotomist is responsible for accepting the specimen when it is dropped off, describing collection instructions when the patient comes in to collect the containers, labeling and transportation, as well as administration of the test.