Q: What are the primary responsibilities of a phlebotomist?
A: The primary responsibilities of a phlebotomist include drawing blood
from patients, labeling and handling blood specimens, ensuring proper
patient identification, maintaining a sterile environment, and following
protocols to prevent contamination and ensure the integrity of the
specimens.
Q: What are the key steps in the venipuncture procedure?
A: Key steps include verifying patient identity, selecting an appropriate
vein, cleaning the site with an antiseptic, applying a tourniquet, inserting
the needle, collecting the blood, releasing the tourniquet, removing the
needle, and applying pressure to the site.
Q: Why is it important to correctly identify a patient before drawing
blood?
A: Correct identification ensures that the blood specimen is accurately
linked to the right patient, which is crucial for accurate diagnosis and
treatment.
Q: What is the role of antiseptics in phlebotomy?
A: Antiseptics are used to clean the skin before needle insertion to
prevent infection and contamination of the blood specimen.
Q: How do you select an appropriate vein for venipuncture?
A: The selection involves assessing the veins in the antecubital fossa
(usually the median cubital vein) by palpation and considering factors
like vein size, condition, and accessibility.
Q: What complications can arise from improper tourniquet application?
A: Complications include hemoconcentration, petechiae, nerve damage,
and prolonged venous stasis, which can affect the accuracy of test results.
Q: Describe the correct method for labeling blood specimens.
A: Labels should be applied immediately after collection and include the
patient's name, date of birth, unique identifier, date and time of collection,
and the phlebotomist's initials.
Q: What are the common types of blood collection tubes and their uses?
A: Common tubes include red-top (serum), lavender-top (EDTA for
CBC), blue-top (sodium citrate for coagulation tests), and green-top
(heparin for plasma).
Q: How do you handle a patient who is afraid of needles?
A: Use a calm and reassuring manner, explain the procedure, engage in
distraction techniques, and consider using smaller needles if appropriate.
Q: What are the steps for handling and processing a blood specimen after
collection?
A: Steps include proper labeling, ensuring the specimen is transported at
the right temperature, centrifuging if necessary, and timely delivery to the
laboratory.
Q: How do you ensure the integrity of a blood specimen during
transportation?
A: Use appropriate containers, maintain required temperatures, avoid
excessive agitation, and follow specific transport protocols.
Q: What is the importance of using the correct order of draw?
A: It prevents cross-contamination of additives between tubes, which can
affect test results.
Q: How do you manage a difficult venipuncture?
A: Reassess the site, consider using a smaller needle, warm the area to
increase blood flow, or seek assistance from a more experienced
phlebotomist.
Q: What is the significance of using personal protective equipment (PPE)
in phlebotomy?
A: PPE protects both the phlebotomist and the patient from exposure to
bloodborne pathogens and other contaminants.
Q: How do you prevent hemolysis during blood collection?
A: Use proper technique, avoid excessive suction, allow alcohol to dry
completely, and handle the specimen gently.
Q: What are the signs of nerve damage during venipuncture?
A: Signs include sharp pain, numbness, tingling, or burning sensations.
Q: How do you handle a needle stick injury?
A: Follow the protocol for immediate washing of the area, reporting the
incident, and seeking medical evaluation and follow-up.
Q: What are the criteria for rejecting a blood specimen in the laboratory?
A: Criteria include improper labeling, hemolysis, clotting in
anticoagulated samples, insufficient volume, and contamination.
Q: How do you perform a capillary puncture?
A: Clean the site, puncture with a lancet, wipe away the first drop, and
collect the subsequent drops into a capillary tube.
Q: What are the indications for using a butterfly needle?
A: Indications include difficult venous access, small or fragile veins, and
pediatric or geriatric patients.
Q: How do you ensure patient confidentiality during the phlebotomy
process?
A: Follow HIPAA guidelines, use secure systems for patient information,
and discuss patient details discreetly.
Q: What is the impact of prolonged tourniquet application on blood test
results?
A: It can lead to hemoconcentration, falsely elevated potassium levels,
and altered blood gas values.
Q: How do you prepare a patient for a fasting blood test?
A: Instruct the patient to fast for the required period, usually 8-12 hours,
and avoid certain activities or medications as advised.
Q: What are the steps for collecting a blood culture specimen?
A: Use aseptic technique, clean the site with antiseptic, collect the
specimen in the correct order, and avoid contamination.
Q: How do you manage a patient who experiences syncope during
venipuncture?
A: Stop the procedure, ensure the patient is safe, lower their head,
provide fresh air, and monitor vital signs.
Q: What are the quality control measures in phlebotomy?
A: Measures include regular equipment calibration, proper training,
adherence to protocols, and participation in proficiency testing.
Q: How do you handle specimens that need to be kept cold?
A: Use ice packs or refrigerate immediately, and follow specific transport
guidelines for temperature-sensitive specimens.
Q: What are the signs of an adverse reaction to venipuncture?
A: Signs include swelling, bruising, infection, and allergic reactions to
adhesive or antiseptics.
Q: How do you perform a blood draw on a patient with a central line?
A: Follow strict aseptic technique, obtain proper training, and ensure
orders specify drawing from a central line.
Q: What is the role of the phlebotomist in maintaining patient records?
A: Ensure accurate entry of collection details, specimen labeling, and
documentation of any incidents or variations from standard procedure.
Q: How do you manage a patient with a bleeding disorder during
phlebotomy?
A: Use gentle technique, apply prolonged pressure after needle removal,
and monitor for excessive bleeding.
Q: What are the common causes of hemolysis in blood specimens?
A: Causes include improper needle size, vigorous shaking of the tube,
drawing blood too quickly, and traumatic venipuncture.
Q: How do you handle a pediatric blood draw?
A: Use age-appropriate communication, distraction techniques, smaller
needles, and possibly a butterfly needle or capillary puncture.
Q: What is the significance of proper specimen mixing?
A: Ensures even distribution of additives, preventing clotting or
incomplete anticoagulation, which can affect test results.
Q: How do you identify and address pre-analytical errors?
A: Identify errors through quality control measures, proper training, and
adherence to standard operating procedures. Address them by retraining
staff and implementing corrective actions.
Q: What are the differences between plasma and serum?
A: Plasma is the liquid portion of blood with anticoagulants, while serum
is the liquid portion after clotting has occurred, without clotting factors.
Q: How do you handle a specimen that requires immediate processing?
A: Prioritize transport to the lab, use appropriate transport containers, and
follow any specific handling instructions.
Q: What are the guidelines for drawing blood from a patient with IV
therapy?
A: Draw from a site below the IV, use a different arm if possible, or stop
the IV for a few minutes before drawing.
Q: How do you manage a specimen that needs protection from light?
A: Wrap the tube in foil or use light-protective containers and transport
promptly.
Q: What are the steps for handling and processing a urine specimen?
A: Label the container, ensure proper collection, transport at the correct
temperature, and process according to test requirements.
Q: How do you ensure accurate point-of-care testing (POCT)?
A: Calibrate equipment regularly, follow manufacturer instructions, and
participate in quality control and proficiency testing.
Q: What are the indications for performing a heel stick on an infant?
A: Indications include newborn screening tests and situations where
venipuncture is difficult or impractical.
Q: How do you manage a patient with a latex allergy during phlebotomy?
A: Use non-latex gloves and equipment, and ensure the environment is
free of latex products.
