Samplex 2nd Year MLS

Principles in Medical Laboratory Sciences 2

Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa

7. A blood condition wherein variation of size among

UNDERSTANDING PHLEBOTOMY red blood cells is observed.
A. Anisocytosis
B. Poikilocytosis
C. Hemochromatosis
1. Which of the following is not included among the D. Hemolysis
choices?
A. Mean Corpuscular Volume BLOOD COLLECTION, EQUIPMENT,
B. Platelet Count ADDITIVES, AND ORDER OF DRAW
C. Red Blood Distribution Width
D. Alanine Aminotransferase Test

2. The following statements are true, EXCEPT: 8. A plastic red-top tube undergoes ____ inversions,
A. Humans during the stone age era used crude while a glass red-top tube is mixed by inverting the
tools to cut blood vessels and drain blood from tube ___ times
the body. A. 0, 8
B. In 17th and 18th century, phlebotomy was B. 5,8
viewed to be a major surgery C. 0,0
C. Honey or blood is dropped on the skin of the D. 5, 0
patient before introducing Hirudo medicinalis
D. According to Hippocrates, excess humor should 9. The following statements are true EXCEPT
be removed through the procedure of I. Neoprene gloves and non-sterile gloves are among
bloodletting the approved gloves that a phlebotomist can use
during routine venipuncture.
3. It is the meaning of the Greek word tenmein. II. An Evacuated Tube System is considered to be
A. to cut more efficient and preferred method of collecting
B. to trim blood specimens 
C. to puncture III. Sodium fluorite is an antiglycolytic agent, in which
D. to scratch are substances that prevents glycolysis
IV. A light blue top tube is a trace element-free tube and
4. It is the variation of shape among red blood cells. is usually utilized for toxicology studies or nutrient
A. Anisocytosis determination.
B. Poikilocytosis
C. Hemochromatosis A. none of the above
D. Hemolysis B. III and I
C. III and IV
5. This practice is strictly prohibited if a blood sample is D. I,III, and IV
not yet collected and inside the tube.
A. Labelling samples 10. Which of the following is true regarding the needles
B. Pre-labelling used in venipuncture.
C. Centrifugation of samples A. The diameter of the bevel is used to classify the
D. Transport of samples gauge of the needle
B. A lower gauge number indicates a bigger
6. It is a section in the clinical analysis area where diameter
blood typing and cross-matching procedures are C. The recommended length of the needle used in
performed. venipuncture is 1-1.5 in 
A. Blood Bank and Immunohematology D. A and C
B. Hematology and Coagulation
C. Clinical Chemistry 11. The type of needle/s being used in Evacuated Tube
D. Immunology and Serology System
A. Hypodermic Needle
B. Multi-sample Needle
 Samplex 2nd Year MLS
Principles in Medical Laboratory Sciences 2
Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa

C. a and b
D. None of the above
12. These are used in killing microorganisms on the 18. It is a liquid component of blood that is separated
body surface. from cells after centrifugation and is treated with an
A. Disinfectants anticoagulant
B. Antiseptics A. Serum
C. both a and b B. Plasma
D. none of the above C. Fibrinogen
D. Platelets
13. It is the most commonly used needle in venipuncture
A. gauge 20 needle with a yellow colored hub 19. A type of precaution that identifies patients to be
B. gauge 21 needle with a yellow colored hub potentially infected with blood-borne pathogens.
C. gauge 20 needle with a green colored hub A. Universal Precautions
D. gauge 21 needle with a green colored hub B. Standardized Safety Precautions
C. Universal Health Precautions
14. Which of the following statements is correct about D. Standard Precautions
K2EDTA
A. spray-dried and in powdered form, inside glass 20. Which among the choices are the most common
tubes volumes used for collecting blood?
B. spray-dried and in powdered form, inside plastic A. 21 gauge
tubes B. 23 gauge 
C. in liquid form inside glass tubes C. 2, 5, and 10 mL
D. in liquid form inside plastic tubes D. 2.5 and 10 mL

15. Which of the following statements is correct about 21. Which of the following are NOT included in the
K3EDTA analytical phase of blood collection?
A. spray-dried and in powdered form, inside glass A. Identifying the patient and the test requested for
tubes them 
B. spray-dried and in powdered form, inside plastic B. Placing the needed equipment at a safe and
tubes easily accessible place such as a tray or a
C. It is in liquid form inside glass tubes trolley. 
D. It is in liquid form inside plastic tub C. Reassuring and positioning the patient. 
D. Labelling of blood collection tubes immediately
16. The supposed amount of time the tourniquet should after extracting the blood. 
be left tied to the patient.
A. Only for 30 seconds 22. Which of the following is not included among the
B. none, you can leave the tourniquet on and choices?
remove it until you are done withdrawing blood A. Bevel
C. for at least 1 minute B. Shaft
D. for at most 1 minute C. Plunger
D. Hub
17. The extreme immune response of the body against
infection caused by bacteria in the blood 23. The following statements are true, except:
A. Septicemia I. The median cubital vein is the vein of choice
B. Sepsis because it is the most stable. 
C. Bacteremia II. Winged infusion set lessens one’s exposure to
D. Aseptic blood as compared to the syringe method. 
III. Slight hemolysis may be observe when the
serum displays a pink color.
IV. Hematoma formation can be caused by using a
needle that is too small for venipuncture. 

A. only I
 Samplex 2nd Year MLS
Principles in Medical Laboratory Sciences 2
Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa

B. I and IIV
C. II and III
INFECTION CONTROL,
D. SAFETY,
II and I FIRST AID,
AND PERSONAL WELLNESS

29. Which of the following is not included among the

24. What are the proper sequence in removing gloves? choices?
I. The non-gloved fingers are slipped under the wrist A. Eyes
of the remaining glove to completely remove it. B. Nose
II. The non-gloved hand holds the removed glove C. Hands 
III. The glove is pulled inside out and out of the hand D. Mouth
IV. The wrist part of one hand is grasped by the
opposite hand 30. The following statements are true except:
A. Collection of data should be done to those who
A. IV, III, I, are at risk of infection.
B. IV, II, III B. Trans placenta is the portal of exit for hereditary
C. IV, II, I, III diseases.
D. IV, III, II, I C. NICU stands for Neonatal Intensive Care Unit. 
D. The best defense for Hepatitis B is HBV
vaccination.
25. It reduces the possibility of further transmission of
disease between patients and health care staff by 31. What biohazard exposure route can be associated
separating the patient with disease. with needle-stick injuries?
A. Wearing PPE A. Non-intact skin
B. Quarantine B. Permucosal
C. Isolation C. Percutaneous
D. Private Room D. Ingestion
26. Which of the corresponding biosafety levels can 32. Which of the following statements are true?
contain an infectious agent like Coxiella? I. The B in the ABCs of CPR is “Breathe”
A. BSL-1 II. After 30 chest compressions, one must give two
B. BSL-2 rescue breaths.
C. BSL-3 III. The minimum detectable dose for a body badge
D. BSL-4 is 20 millirems.
IV. Class A fires can be extinguished with water. 
27. The following statements are true, except:
A. I, II, III, IV
A. Biosafety protects people from germs. B. I, II, III 
B. Biosecurity protects germs from people. C. II and III
C. BSL-2 contains Human immunodeficiency virus. D. II and IV
D. The biohazard symbol was created by Charles
L. Baldwin, an environmental engineer at Dow
Chemical Company in 1966. 

28. Which of the following diseases can be acquired

through zoonosis?
A. Urinary tract infection
B. Schistosomiasis
C. Tuberculosis
D. Hay fever
 Samplex 2nd Year MLS
Principles in Medical Laboratory Sciences 2
Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa

B. Sinoatrial (SA) node

C. Systole
D. Electrocardiogram
CIRCULATORY SYSTEM
39. The following statements are true, except:
A. Aortic stenosis is when the heart produces a
murmuring sound because the aortic leaflet fails
to fully open during diastole.  
B. The average heart rate is 72 beats per minute
(bpm).
33. What is the outermost layer of the heart? C. Digoxin is administered to treat rapid or irregular
A. Pericardium heartbeat. 
B. Endocardium D. Myoglobin is always present in the bloodstream.
C. Myocardium
D. Epicardium
40. Which of the following is not included among the
choices:
34. Where do thermoreceptors report sudden changes A. Hodgkin’s diseases
in the body’s temperature? B. Splenomegaly
A. Hypothalamus C. Lymphosarcoma
B. Thalamus D. Angina pectoris
C. Midbrain
D. Lymphatic system
41. It refers to the fluid portion separated by
centrifugation from the red blood cells, white blood
35. Which of the following statements is true? cells, and platelets. 
A. Vasodilation refers to decreasing the blood A. Serum
vessel’s diameter in order to decrease blood B. Plasma
pressure.  C. Whole blood
B. Vasodilation is the body’s mechanism when D. Buffy coat
there is a sudden decrease from the body’s
normal temperature range. 
42. Which of the following statements are true?
C. The smooth muscles around the arteries are
A. Blood type O can receive any blood type in case
stimulated to either dilate or constrict to regain
there is a need for blood transfusion. 
optimal body temperature.
B. The ABO Blood Group System classifies human
D. Vasoconstriction results in a decrease in blood
blood by the presence of antibodies. 
flow. 
C. Blood type AB is the only group without the
presence of antibodies in its plasma
36. Which of the following valves of the heart prevents D. The RH Blood Group Sytem is classified by the
backflow to the right atrium? presence of the C antigen.
A. Tricuspid valve
B. Bicuspid valve
43. Which of the following are classified as a secondary
C. Pulmonary valve 
lymphoid organ
D. Aortic valve
I. Bone Marrow
II. Lymph nodes
37. It refers to the shortage of oxygen in the blood due III. Spleen 
to poor circulation IV. Thymus
A. Myocardial infarction
B. Hemochromatosis  A. I, II, III, IV
C. Ischemia B. I, II, III
D. Congestive heart failure C. I and IV
D. II and III
38. It is considered the pacemaker of the heart and
generates electrical impulses for the heart to beat. 44. It refers to the increased number of white blood cells
A. Diastole in the blood due to illness
 Samplex 2nd Year MLS
Principles in Medical Laboratory Sciences 2
Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa

A. Leukemia diagnosed as anemic. The following diagnostic tests

B. Leukocytosis that were done to this patient, EXCEPT:
C. Polycythemia A. Complete Blood Count (CBC)
D. Leukopenia B. Reticulocyte count (retic count)
C. Ferritin test
45. Which among the following is not included among D. Arterial Blood Gas test
the choices?
A. Hodgkin’s disease
B. Lymphadenitis 
C. Lymphoma
D. Lymphosarcoma

46. The body process refers to the breakdown of blood

clots formed in the body as a sign of healing.
A. Fibrinolysis
B. Hemolysis
C. Hemostasis
D. Homeostasis

47. Where does the pulmonary vein transport the

oxygenated blood? 
A. Left AV valve
B. Left atrium
C. Right AV valve
D. Right atrium

48. After going through certain blood tests, the results of

the patient showed that there is an absence of
antibodies but showed the presence of antigens A,
B, and D. Which among the following is the patient’s
blood type?
A. A Rh positive (A+)
B. AB Rh positive (AB+)
C. B Rh negative (B-)
D. O Rh positive (O+)

49. Faced with an emergency in the battlefield, the war

doctor needs to make an urgent decision on which
blood to transfuse to the soldier who lost a
significant amount of blood. Unfortunately, the
materials needed for blood typing have not yet
arrived. Luckily there are few bags left, O+, O-, AB+
and AB-. Which among the remaining blood bags
should the doctor use?
A. O-
B. O+
C. AB-
D. AB+

50. A woman exhibited symptoms of dizziness, fatigue,

weakness, and pale skin. Later on, she was
 Samplex 2nd Year MLS
Principles in Medical Laboratory Sciences 2
Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa
ANSWER KEY
1. D. Alanine Aminotransferase Test
WHY? ALT Test is a procedure done under the
Clinical Chemistry Section (Clinical Analysis Area)
2. C. Honey or blood is dropped on the skin of the
patient before introducing Hirudo medicinalis
WHY? Milk or blood is used to introduce the medicinal
leeches to start bloodletting.
3. A. to cut
WHY? Phlebotomy is derived from the Greek work
Phlebos meaning vein and tenmein meaning to cut
4. B. Poikilocytosis
WHY? Variation of sizes among red blood cells is
called poikilocytosis and the variation in the shapes of
red blood cells is called anisocytosis
5. B. Pre-labelling
WHY? Pre-labelling is strictly prohibited to avoid
misidentification of blood samples. Labelling must be
done after there is a blood sample within the tube
6. A. Blood Bank and Immunohematology
WHY? Blood banking is the section of the clinical
analysis laboratory where blood is screened before
transfusion.
7. A. Anisocytosis
WHY? Variation of sizes among red blood cells is
called poikilocytosis and the variation in the shapes of
red blood cells is called anisocytosis
8. D. 5, 0
WHY? A plastic red top tube is inverted 5 times to mix
it with the clot activator and a glass red top tube is
inverted 0 times.
9. C. III and IV
WHY?
o Sodium fluoride is an antiglycolytic agent, in which
are substances that prevents glycolysis
o A royal blue top tube is a trace element-free tube
and is usually utilized for toxicology studies or
nutrient determination.
10. C. The recommended length of the needle used in
venipuncture is 1-1.5-inch
WHY?
A. The diameter of the lumen is used to
classify the gauge of the needle
B. A lower gauge number indicates a smaller
diameter
C. The recommended length of the needle
used in venipuncture is 1-1.5 in - TRUE
11. B. Multi-sample Needle
WHY? The Evacuated Tube System (ETS) utilizes a
multi-sample needle for blood collection.
Hypodermic needles are only used in a syringe
system.
12. B. Antiseptics
WHY? Both are used for the purpose of killing
microorganisms, but Disinfectants are applied on
non-living surfaces, such as table-tops, while
antiseptics are primarily applied on the body.
 
13. B. gauge 21 needle with a yellow colored hub
WHY? Gauges 20-21 are the appropriate needles
used in venipuncture but the most commonly used
gauge is 21. It is color coded with a green hub for
easier identification
14. B. spray-dried and in powdered form, inside plastic
tubes
 Samplex 2nd Year MLS
Principles in Medical Laboratory Sciences 2
Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa
WHY? K2EDTA is a powdered anticoagulant that are
spray-dried and contained inside plastic tubes.
15. C. It is in liquid form inside glass tubes
WHY? K3EDTA is a liquid anticoagulant contained
inside glass tubes.
16. D. for at most 1 minute
WHY? The tourniquet should only be tied within 1
minute to prevent hemoconcentration
17. B. Sepsis
WHY? It is the extreme response of the body from
the infection caused by the bacteria’s endotoxins
18. B. Plasma
WHY? It is a liquid component in blood that is a
straw-colored  substance which is separated from
other blood cells after centrifugation.
19. A. Universal Precautions
WHY? According to CDC, Universal precautions
assume that any patient has the potential of being
infected with blood-borne pathogens.
20. C. 2, 5, and 10 mL
WHY?  2 mL, 5 mL, and 10 mL, are the most
commonly used volumes used for phlebotomy.
Gauge is used to measure a needle’s size and not
the blood volume.
21. A. Identifying the patient and the test requested for
them  Baldwin, an environmental engineer at Dow
WHY? Patient identification and securing the request
form before blood collection is a part of the pre-
analytical phase
22. C. Plunger
WHY? All of the choices are parts of the needle
except for plunger, which is a rod-like part of the
syringe that pulls fluids into the syringe when drawn
back and forces fluids out when drawn in.
23. D. II and IV
WHY?  WHY? All of the following are considered mucous
I. The median cubital vein is the vein of
choice because it is the most stable. –
TRUE
II. Evacuated Tube System (ETS) lessens
one’s exposure to blood as compared to
the syringe method.
III. Slight hemolysis may be observed when
the serum displays a pink color. - TRUE
IV. Hemolysis can be caused by using a
needle that is too small for venipuncture.
24. A. IV, III, I,
WHY? The proper sequence of removing your used
gloves are:
1. The wrist part of one glove is grasped by the
opposite hand.
2. The glove is pulled inside out and off the hand
3. The gloved hand holds the removed glove from
the other hand.
4. The non-gloved fingers are slipped under the wrist
of the remaining glove to and pulled inside out until
completely removed.
25. D. Private Room
WHY? Private rooms can reduce transmission of
infectious diseases by separating the infected
patient from other patients and healthcare staff
26. C. BSL-3
WHY? Laboratories that are under BSL-3 mainly
handle indigenous exotic agents (or Risk Group 3)
like Coxiella.
27. D. The biohazard symbol was created by Charles L.
Chemical Company in 1966. 
WHY? Charles L. Baldwin was an environmental
HEALTH engineer.
28. B. Schistosomiasis
WHY? Zoonosis is an infectious disease wherein it
can be transmitted from animals to humans under
natural conditions. Schistosomiasis is zoonotic
because it can be transmitted by the parasitic blood
flukes of the genus Schistosoma, with snails as its
intermediate hosts.
29. C. Hands
membranes except for hands. 
 Samplex 2nd Year MLS
Principles in Medical Laboratory Sciences 2
Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa

30. A. Collection of data should be done to those who D. Vasoconstriction constricts the blood
are at risk of infection. vessels which result in a decrease in blood
flow. - TRUE
WHY? Collection of data should be done to those
who were already exposed to the risk.
36. A. Tricuspid valve
WHY? The tricuspid valve, also known as the right
atrioventricular valve, closes as the right ventricle
contracts to avoid backflow to the right atrium.

31. C. Percutaneous
WHY? Needle-stick injuries are an example of
37. C. Ischemia
percutaneous biohazard exposure route because it
is an injury that goes through the skin.  WHY? Ischemia is defined as the inadequate supply
of oxygen in the blood. 
32. D. II and IV
38. B. Sinoatrial (SA) node
WHY? 
I. The B in the ABCs of CPR is “Breathing”  WHY?  The Sinoatrial (SA) node is the heart’s
II. After 30 chest compressions, one must give two natural pacemaker and is included in its electrical
rescue breaths. - TRUE conduction system. 
III. The minimum detectable dose for a body badge
is 10 millirems.  39. A. Aortic stenosis is when the heart produces a
IV. Class A fires can be extinguished with water. – murmuring sound because the aortic leaflet fails to
TRUE fully open during diastole.  
WHY? Aortic stenosis occurs when the aortic leaflet
33. A. Pericardium fails to fully open during systole. 
WHY? Pericardium encloses the heart and the roots
of the great vessels. It is then followed by 40. D. Angina pectoris
epicardium.
WHY? All of the choices are disorders of the
lymphatic system except for Angina pectoris which is
34. A. Hypothalamus
a heart disorder characterized by chest pain due to
WHY? Once the hypothalamus reports the reduced blood flow to the heart. 
temperature changes to the hypothalamus, it will
initiate certain mechanisms to regain the safe 41. B. Plasma
temperature range.
WHY?  The plasma is the yellowish liquid that is
35. D. Vasoconstriction results in a decrease in blood separated from the whole blood. It is seen to sit on
flow.  top of the buffy coat. 

WHY? 42. C. Blood type AB is the only group without the

A. Vasodilation refers to increasing the blood
vessel’s diameter in order to decrease
blood pressure.  WHY?
B. Vasodilation is the body’s mechanism when
there is a sudden increase from the body’s
normal temperature range. (since
vasodilation is used as a cooling
mechanism)
C. The smooth muscles around the arterioles
are stimulated to either dilate or constrict to
regain optimal body temperature.
presence of antibodies in its plasma
 
A. Blood type O can donate any blood type in
case there is a need for blood transfusion. 
B. The ABO Blood Group System classifies
human blood by the presence of antigens. 
C. Blood type AB is the only group without the
presence of antibodies in its plasma -
TRUE
D. The RH Blood Group SyStem is classified
by the presence of the D antigen.
 Samplex 2nd Year MLS
Principles in Medical Laboratory Sciences 2
Topic: Understanding Phlebotomy, Blood Collection, Infection Control Safety and First Aid, Circulatory System,
Equipment, Additives, and Order of Draw,
Prepared by: Charlemagne Mojica & Nataly Nakazawa

remaining tests namely, complete blood count,

reticulocyte count, and ferritin test, are able to
43. D. II and III confirm the possible diagnosis of anemia.
WHY? The secondary lymphoid organs are the
lymph nodes and spleen while the primary lymphoid “THE SECRET OF GETTING AHEAD IS GETTING
organs are the bone marrow and thymus.  STARTED” –MARK TWAIN
For comments and suggestions, please email:
cmlssc.acadcomm.dlshsi@gmail.com

44. B. Leukocytosis
WHY? Leukocytosis is a blood disorder that causes
the body to have too much white blood cells during
an infection and is also considered as an
inflammatory response.

45. B. Lymphadenitis 
WHY? Lymphadenitis is an inflammatory disease
affecting the lymph nodes while the remaining
choices are considered as cancers of the lymphatic
system.

46. A. Fibrinolysis
WHY? Fibrinolysis removes previously formed blood
clots from the bloodstream to prevent blockage and
reopen intact vessels. 

47. B. Left atrium

WHY? After receiving oxygen from the lungs, the
pulmonary vein transports the oxygenated blood
back to the heart, specifically to the left atrium.

48. B. AB Rh positive (AB+)

WHY?  The patient has blood type AB due to the
absence of antibodies in his plasma and is Rh
positive because the blood contains the D antigen. 

49. A. O-
WHY? O negative is the universal blood type that
can be received by anyone, as it does not contain
any proteins that can cause agglutination.

50. D. Arterial Blood Gas test

WHY? Arterial Blood Gas test was not exhibited to
this patient because it is only used to assess lung
and kidney function by measuring the oxygen,
carbon dioxide, and pH levels in the blood. The