Phlebotomy and Laboratory Management SAMPLEX/ REVIEWER
• Which blood specimen additive can inhibit the • What is the advantage of collecting STAT chemistries
metabolism of glucose by the cells?- NaF
• Which of the following items is unnecessary when
performing a routine venipuncture?- Disinfectant
• A serum specimen is requested. Which of the following
evacuated tubes can be used to- SST
• Which of the following are all anticoagulants that
remove calcium from the specimen by forming
insoluble calcium salts and therefore prevent
coagulation?- Sodium citrate, EDTA, oxalate
• In a successful venipuncture, evacuated tubes fit
automatically as soon as the tube stopper is pierced
because of- Premeasured vacuum in each tube
• Lavender stopper tubes are most commonly used to
collect- hematology tests
• Which of the following is one reason the evacuated
tube system (ETS) is the preferred blood collection
system?- Exposure of the blood to contaminants is
avoided
• Lithium heparin is a suitable anticoagulant for which of
the following tests?- lytes
• Which of the following additives can be found in a
royal blue-top collection tube?- EDTA
• Measurements of copper, trace element, requires blood
collection in a tube with a- Royal blue top
• The blood to additive ratio is most critical for a
specimen collected in this tube.- light blue top
• If phlebotomists have dermatitis, they should- see if
wearing glove liners will help
• Decontamination of hands after glove removal is
essential because- Hand contamination might not be
visible to the naked eye
• Which of the following is a disinfectant?- Household
bleach
• Which disinfectant is preferred by the HICPAC for use
on surfaces and instruments?- EPA-registered sodium
hypochlorite product
• After a blood spill, a disinfectant is applied and must
have at least_________________of contact time for
cleanup to be effective.- 10 minutes
• If hands are heavily contaminated with organic material
and a sink is not available, the phlebotomist should
clean them with?- detergent-containing wipes followed
by a sanitizer
• The purpose of a transillumination device is to- Locate
veins for venipuncture
• Which statement is incorrect? A properly applied
tourniquet should- Restrict venous and arterial blood
flow
• The needle gauge is used for autologous blood
collection.- 15 to 17
• Needle safety features work by- All of the
above...Covering or shielding the needle, retracting the
needle after the use, using a device to blunt the needle
• OSHA regulations require that after use- Tube holders
with needles attached be disposed of as a unit
• The headspace in an evacuated tube is- a consistent
amount of air space left when a tube is filled properly
• Tubes designed by the manufacturer to be "short draw"
are:- made to fill only partially
• Types of ETS tube additives include- anticoagulants,
clot activators, separator gels
• Plastic red-top tubes used to collect blood specimens
usually contain:- clot activators
• improper handling of lab specimens can result in-
additive integrity, shape of the tube, vacuum of a tube
• This would be the best tube for collecting a STAT test
that must be performed on serum.- RST
• Which additive is used to collect donor units of blood?-
CPD
• A specimen collected in this type of additive will
separate if allowed to stand.- Citrate, Heparin, Oxalate
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in a green top tube?- Plasma specimens can be
centrifuged right away, The turnaround time for results
is much shorter, Whole blood tests can be performed
right away
• This antiseptic has been traditionally used to obtain the
high degree of skin antisepsis required when collecting
blood cultures.- povidone-iodine
• Which of the following is the preferred solution to use
to clean up blood spills?- An EPA-approved bleach
product
• Antiseptics are- Safe for use on human skin
• A solution used to clean the site before routine
venipuncture is- 70% isopropyl alcohol
• Why are gauze pads a better choice than cotton balls
for covering the site and holding pressure following
venipuncture?- Cotton ball fibers can stick to the site
• CLSI standards advise against using these on infants
and children under 2 years old:- adhesive bandages
• Which of the following should be deleted from a list of
required characteristics of a sharps container?- red in
color
• It is best if tourniquets are- Used once and then
discarded
• Wearing gloves during phlebotomy procedures is
mandated by the following agency:- OSHA
• What criterion is used to decide which needle gauge to
use for venipuncture?- Size and condition of the vein
• To what does the "gauge" of a needle relate?- diameter
• Which needle gauge has the largest bore or lumen?- 18
• Multisample needles are typically available in these
gauges.- 20-22
• The slanted tip of a needle is called the:- bevel
• The purpose of the rubber sleeve that covers the tube
end of a multiple-sample needle is to- prevent leakage
of blood during tube changes
• A phlebotomy needle that does not have a safety
feature- Must be used with a holder that has a safety
feature
• Which of the following plays no role in deciding what
size tubes to use for ETS blood collection?- Patient's
allergy to antiseptics
• Mixing additive tubes involves:- Slowly rocking them
back and forth
• Which of the following stopper colors identifies a tube
used for coagulation testing?- light blue
• Which of the following tubes will yield a serum
sample?- Red top
• The cleaning agent in hand sanitizers used in healthcare
is?- alcohol based
• Which of the following tube stopper colors indicates
something other than the presence (or absence) and
type of additive in the tube?- royal blue
• Heparin prevents blood from clotting by- inhibiting
thrombin
• Which department would most likely perform the test
on a specimen collected in an SPS tube?- Microbiology
• A royal blue-top tube with green color coding on the
label contains- Heparin
• Which one of the following substances is an
anticoagulant?- Oxalate
• It is important to fill oxalate tubes to the stated fill
capacity because oxalate- cause hemolysis of blood
specimens
• Which of the following substances is continued in a
serum separator tube?- Thixotropic gel
• what is the purpose of an antiglycolytic-agent?-
preserve glucose
• Glass particles present in serum separator tubes-
activate clotting
• Which is the best tube for collecting an ETOH
(ethanol) specimen?- Gray top
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 Phlebotomy and Laboratory Management SAMPLEX/ REVIEWER
• Identify the tubes needed to collect a CBC, PTT, &
STAT potassium by color and in the proper order of
collection for a multi-tube draw:- light blue top, green
top, lavender top
• During venipuncture the tourniquet should not be left
on longer than- 1 minute
• Which one of the following tubes is filled first when
multiple tubes are filled from a syringe?- Blood culture
tube
• This test is collected in a light blue top tube-
prothrombin time
• Which of the following STAT tests is typically collected
in a lithium heparin tube?- Electrolyte panel
• This tube stopper color indicates that the tube contains
EDTA:- lavender
• What anticoagulant is contained in a PST?- Heparin
• The purpose of sodium citrate in a specimen collection
is to:- protect coagulation factors
• The part of a syringe that shows measurements in cc or
ml is called the:- barrel
• This part of the evacuated tube holder is meant to aid
in smooth tube removal:- flange
• The best choice of equipment for drawing difficult
veins is a:- Butterfly and ETS holder
• Mixing equipment from different manufacturers can
result in- Improper fit of the needle
• You are most likely to increase the chance of
hemolyzing a specimen if you use a- 25 gauge butterfly
needle to collect a specimen from a small child
• The purpose of a tourniquet in the venipuncture
procedure is to:- Enlarge veins so they are easier to find
and enter
• If a blood pressure cuff is used for venipuncture in
place of a tourniquet, the pressure used must be- Below
the patient's diastolic pressure
• In general, an anticoagulant is unable to- Inhibit the
metabolism of glucose
• Needle safety devices must- Create a barrier between a
user's hand and the needle after use.
• This gel separator tube contains EDTA:- PPT
• Which additive contains a substance that inhibits
phagocytosis of bacteria by white blood cells?- sodium
polyanethol sulfonate
• Which type of test can potentially be affected by tissue
thromboplastin contamination- coagulation
• Which of the following tests would be most affected by
carryover of K2EDTA?- Potassium
• Carryover from this tube has a greater potential to
negatively affect the specimen in the next tube drawn.-
Underfilled EDTA tube
• A trace element specimen tube should be collected-
Separately or by syringe
• A pink-top tube containing EDTA is primarily used
for:- Blood bank tests
• Identify the tubes needed to collect a PT, STAT lytes,
and BC in the proper order of collection- Yellow, light
blue, PST
• Which one of the following tubes is additive free?- BD
clear/red
• Which chemistry tube could contain either of two
different forms of an anticoagulant because both have
the same stopper color?- Green
• Which additive can be found in four separate tubes
with different stopper colors?- EDTA
• Which stopper color is the same for two completely
different types of additives used by two different
departments? - yellow
• Due to allergic reactions, which type of glove is not
recommended to be used in healthcare facilities?- Latex
• Which of the following additives is most commonly
used for chemistry tests?- Heparin
• An ETS holder and a syringe transfer device look very
similar. What is the difference between the two?- There
Gabriel, GC
is a permanently attached needle with a sleeve inside
the transfer device
• A prothrombin time (PT) and platelet count are
ordered on an 80 yr old female patient. Deciding to use
a butterfly and "short draw" evacuated tubes on the
tiny cephalic vein on the dorsal side of her right arm,
the phlebotomist collects one light blue top and then a
lavender top. Why would you suspect that the PT test
be incorrect and the platelet count unaffected?- No
tube was drawn to remove air in the butterfly tubing.
• A home care phlebotomist had a requisition to collect a
complete blood count (CBC), plasma K, partial
thromboplastin time (PTT), and prothrombin time
(PT). He collected the tubes from the client, who was
lying on the sofa with her arm elevated above her
shoulder on a table next to the sofa. As he collected the
tests in the following order-CBC, K, & finally the PT &
PTT-he was careful to invert the tubes as required.
Later that day, the lab called the phlebotomist to say
that three of the tests would have to be redrawn.
Which three test most likely had questionable results
and needed to redrawn?-Potassium, PTT, and PT
• While collecting a STAT blood culture and electrolytes
on a child in the emergency room, the physician asked
the phlebotomist to get an extra tube of blood to check
for metal poisoning. Which one of the following tubes
would the phlebotomist add to the ones already being
collected?- royal blue
• Which one of the following tubes/additives would be
used to collect a DNA test?- yellow, ACD
• Electrolytes should never be collected in a- Gray top
• iodine solution- when drawing blood cultures, a
medical assistant should prepare a patients skin using
which of the following products?
• remove the tourniquet before 1 min has elapsed- to
avoid hemoconcentration during venipuncture, which
of the following actions should the medical assistant
take?
• Yellow- which of the following tubes should a medical
assistant select first when adhering to the proper order
of draw?
• Fourth- which of the following digits is the preferred
site for capillary puncture on an adult patient ?
• dispose of the needle- A medical assistant removes a
needle from the antecubital space of a patient following
a phlebotomy procedure and applies pressure. which of
the following steps should the medical assistant take
next?
• 45min- A medical assistant should allow a red-top or
serum-separator tube (SST) to stand for which of the
following lengths of time prior to centrifuge
• before the patient is discharged- at which point during
a venipuncture process should a medical assistant label
the blood specimen tube?
• verify that the requisition form has been completed- A
medical assistant has completed a blood collection.
which of the following actions should the medical
assistant take to ensure proper specimen processing?
• notify the patients provider of the results- when
reviewing blood work results, a medical assistant
notices fasting blood glucose of 200 mg/dL. which of
the following actions should the medical assistant take?
• have a provider review the lab results- after receiving
blood test results from the reference laboratory , which
of the following actions should the medical assistant
take?
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 Phlebotomy and Laboratory Management SAMPLEX/ REVIEWER
✓ Yellow Tube
o Blood Culture Tube.
o Collected first, right after skin
decontamination.
o Additives: Sodium polyanethal sulfonate
(SPS),
o Acid citrate dextose (ACD) preserves blood
for donations
o Used for specialty blood banking such as
leukocyte antigen typing and DNA testing.
(paternity & organ donor compatibility
testing)
o Invert 8 times
o .Vacuum vials can be purchased with various
culture media
o unplugged venting unit for aerobic (involving
free oxygen) incubation
o plugged venting unit for anaerobic (absence
of free oxygen) incubation.
✓ Light Blue Tubes
o Used for coagulation procedures. (PT, APTT)
o Additives: sodium citrate at 3.2% to 3.8%
concentration.
o Underfilling causes erroneously prolonged
coagulation results
o Invert 3-4 times
✓ Mottled, speckled, & gold Tubes
o Serum separation tubes.
o (incudes BD VACUTAINER + SST or
Greiner Bio-One VACUETTE serum tube)
o Contains polymer barrier at bottom of tube
(specific gravity lies between blood clot and
serum)
o Invert 5 - 8 times.
o Set aside for 30 min prior to centrifugation.
o Orange & gray/yellow tubes conatain
Thrombin and are used for STAT collections.
o (Glass non-additive serum tubes or plastic
tubes with no clot activator may be used
before coagulation tube.)
✓ Red Tube
o No anticoagulant
o No polymer barrier
o Used for Serum collections
o Clot takes 30 mins to form
✓ Green Tube
o Contains Anticoagulants: Sodium heparin,
ammonium heparin, lithium heparin
o Used for plasma & whole blood testing;
chemistry tests.
o Used for STAT and provides a fast TAT.
o Used for potassium measurements
o Use lithium heparin tubes for;
o Glucose, Blood urea nitrogen (BUN), Ionized
calcium, Creatinine, Electrolyte studies
o Do not use this tube for collections to be
used on microscopes stained with Wright's
stain.
o Light green & green/gray tubes have gel to
separate plasma from red blood cells. Used
for assays requiring herparinized plasma.
o Invert 8 times
✓ Purple (lavender) tube
o Contains EDTA
o used for hematology procedures; complete
blood count, RBCs, WBCs, Platelets,
Hematocrit, differentials (DIFF), hemoglobin,
and mean tests, molecular diagnostic testing,
immunology, hemoglobin A1c.
o Can be ordered as K2 spray-dried potassium
attached to EDTA or K3 liquid potassium
attached to EDTA.
o invert 8 - 10 times
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✓ Pink Tubes
o Contains EDTA with Spray-dried K2
o Used for blood bank collections
o Invert 8 - 10 times
Anticoagulants
✓ Acid Citrate Dextrose - additive used in specimens for
blood donations to prevent clotting and to ensure
RBCs maintain their oxygen-carrying capacity.
✓ Oxalates - anticoagulants that prevent blood-clotting
sequence by removing calcium and forming calcium
salts.
✓ Citrates - anticoagulant additive for blood collection
tubes; prevents the blood from clotting sequence by
removing calcium and forming calcium salts.
✓ sodium citrate - anticoagulant, a collection tube additive
used in specimen collections of whole blood, plasma,
and molecular diagnositics.
✓ EDTA - anticoagulant additive used to prevent blood-
clotting sequence by removing calcium and forming
calcium salts. Prevents platelet aggregation and is useful
for platelet counts and platelet function tests.Useful for
making blood films and microscopic slides as there is
minimal distortion of platelets and WBCs.
✓ heparin - anticoagulant that prevents blood-clotting by
inactivating thrombin and thromboplastin, the blood-
clotting chemicals in the body.
Yellow Tube Additive: SPS OR ACD.
Tests: Blood cultures,
Paternity, DNA and tissue
typing
Light Blue Tube Additive: Sodium Citrate.
Tests: PT, PTT, Coagulation
Tests.
Red Tube Additive: None
Tests: Gluclose, Rubella,
group And Rh.
Tiger Top/ SST Tube Additive: SST and
Anticoagulant.
Tests: Gluclose and Bun
Green Tube Additive Sodium Heparin.
Tests: Gluclose, Electrolytes,
and Ammonia
Lavender Tube Additive: EDTA.
Tests: CBC and HGB
Gray Tube Additive Sodium Flouride or
Potassium Oxalate.
Tests: Fasting Blood Sugar,
Alcohol Levels, and Lactic
Acid.
• Sodium citrate- found in light blue stopper tubes. Used
for coagulation tests because it is the best at preserving
the coagulation factors
• EDTA- found in lavender or pink stopper tubes. These
are mostly uses for hematology and some blood
banking tests,respectively, because they help preserve
the shape of the cells and reduce platelet clumping
• Heparin- Found in green stopper tubes and used for
most chemistry tests that require plasma or whole
blood and STAT chemistry tests. Heparin separator gel
that is found in light green or black and green mottled
stopper tubes are used fr chemistry testing as well
• ACD- Found in the light yellow stopped tube and used
for DNA testing because the additive has little impact
on platelets and cells
• SPS- Found in yellow stopped tubes and are used to
draw cultures for microrganisms
• Potassium oxalte- Found in the gray stopper tube and
used for testing blood glucose levels because combined
with sodium fluoride it helps prevent glucose
deterioration
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 Phlebotomy and Laboratory Management SAMPLEX/ REVIEWER
• Sterile bottles • PT Test
✓ Additive: nutrient broth o Prothrombin Time (LIGHT BLUE):
✓ Lab: Microbiology evaluates extrinsic system of the coagulation
✓ Tests: Blood cultures (Culture and Sensitivity) cascade
• Light Blue Vacutainer o therapeutic drug monitoring requires patient
✓ Additive: Sodium Citrate to be on coumadin regimen
✓ Yield: Plasma • PTT Test
✓ Lab: Coagulation o Partial Thromboplastin Time (LIGHT
✓ Tests: PT, PTT, APPT, PTINR, D-Dimer, BLUE): evaluates intrinsic system of
DVT, PE coagulation cascade
• Red Vacutainer o therapeutic drug montoring requires patient to
✓ Additive: None be on heparin regimen
✓ Yield: Serum • APTT Test
✓ Lab: Chemistry o Activated Partial Thromboplastin Time
✓ Tests: Storage or Backup (LIGHT BLUE): same as PTT but activator is
added to increase coagulation
• Tiger-Top/Gold/SST Vacutainer
✓ Additive: Silica and Thixotropic Gel • PTINR Test
✓ Yield: Serum o (LIGHT BLUE) evaluates extrinsic system of
coagulation cascade for patients on blood
✓ Lab: Chemistry
thinners (e.g. warfarin)
✓ Tests: BMP, CMP
• D-Dimer Test
• Mint Green Vacutainer
o (LIGHT BLUE) helps to rule out the
✓ Additive: Lithium Heparin and gel
presence of an inappropriate blood clot
✓ Yield: Plasma
• DVT Test
✓ Lab: Chemistry
o (LIGHT BLUE) evaluates presence of deep
✓ Tests: STAT (lytes), hCG
vein thrombosis
(qualitative/quantitative)
• PE Test
• Dark Green Vacutainer
o (LIGHT BLUE) evaluates presence of
✓ Additive: Sodium Heparin
pulmonary embolism
✓ Yield: Plasma
• Basic Metabolic Panel (BMP)
✓ Lab: Chemistry
o (TIGERTOP) group of tests ordered together
✓ Tests: Ammonia
that provides generl information about a
• Lavender/Dark Purple Vacutainer
patient's metabolism, kidney function,
✓ Additive: EDTA (Ethylenediaminetetraacetic electrolytes, and fluid balance
Acid)
• Complete Metabolic Panel (CMP)
✓ Yield: Plasma
o (TIGERTOP) similar to BMP but more
✓ Lab: Hematology
comprehensive - also includes information
✓ Tests: ESR, Sickle Cell, CBC about liver function and performance
• Pink Vacutainer
• LYTES Test
✓ Additive: K2 EDTA o (MINT) STAT Electrolytes - measures
✓ Yield: Plasma electrolytes for the diagnoses and treatment of
✓ Lab: Blood Bank renal and endocrine conditions
✓ Tests: TSR, Cross-match o low = arrhythmia and tachycardia
• Gray Vacutainer o high = heart failure
✓ Additive: Sodium Fluoride and Potassium • hCG Test
Oxalate o (MINT) measures Human Chorionic
✓ Yield: Plasma Gonadotropin in the body (if present then
✓ Lab: Chemistry qualitative, if measuring amount then
✓ Tests: OGTT, Lactic Acid, A1C quantitative)
• Royal Blue Vacutainer (Red Stripe) • Ammonia test
✓ Additive: None o (GREEN) measures ammonia in the blood -
✓ Yield: Serum high volume is an indication that liver is not
✓ Drawn after Light Blue functioning properly
✓ Lab: Toxicology • ESR Test
✓ Tests: Lead Poisoning, Heavy Metal o (LAVENDER) Erythrocyte Sedimentation
Toxicology Rate - measures inflammation in the body due
• Royal Blue Vacutainer (Blue Stripe) to infection, cancer, etc.
✓ Additive: EDTA • Sickle Cell Screening
✓ Yield: Plasma o (LAVENDER) evaluates amount of
✓ Drawn after Lavender/Purple hemoglobin S to determine whether a patient
✓ Lab: Toxicology has sickle cell anemia or may be a carrier
✓ Tests: Lead Poisoning, Heavy Metal • CBC Test
Toxicology o Complete Blood Count (LAVENDER) -
• BCX Test extensive test that evaluates cellular elements
o Blood Cultures/Culture and Sensitivity of the blood including: wbc count, wbc
(BOTTLES): differential, hematocrit, hemoglobin, platelets,
o ordered in sets of two (aerobic and anaerobic) and differential
o most common cause of contamination is • TSR Test
improper site preparation o Type and Screen (PINK) - provides basic
o venipuncture site cleansed with iodine understanding of blood type and antibodies
o can only be drawn using butterfly so no broth present in the blood (hematocrit and
is introduced into the bloodstream hemoglobin)

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 Phlebotomy and Laboratory Management SAMPLEX/ REVIEWER
• Cross-match
o (PINK) used to determine if donor blood is a
compatible "match" to the recipient (required
before blood influsion)
• OGTT Test
o Glucose tolerance test (GRAY) - performed
on both blood and urine samples and used to
evaluate blood sugar
o 3hr used to test hyperglycemia and diagnose
diabetes mellitus
o 5hr used to evaluate hypoglycemia for
disorders of carb metabolism
• Lactic Acid Test
o (GRAY) measures lactic acid in the blood -
abnormal levels are an indication the body is
not receiving proper oxygenation (NO
TOURNIQUET)
• Hemoglobin A1C Test
o (GRAY) evaluates an individuals three month
average plasma glucose concentration to
monitor diabetes
• ABG Test
o Arterial Blood Gas - used to determine blood
pH and blood gas levels, including carbon
dioxide, oxygen, and bicarbonate (MUST be
run within 15 minutes of collection and
delivered on ice)
o obtained from radial artery by a respiratory
therapist, nurse, or physician
• PKU Test
o Phenylketonuria - ordered for infants to
detect a genetic disease that causes mental
retardation and brain damage

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