Venipuncture Review Questions

1. Which solvents can be used as surface cleaners in the in house lab?

2. Can blood samples be kept in the same fridge as injectables such as B12?
3. Which type of blood sample (whole blood, serum, plasma)
a. Is allowed to clot?
b. Is never centrifuged?
c. Uses an SST tube?
d. Is collected for a CBC?
e. Is collected for hormone testing?
f. Is collected for INR testing?
g. Is collected for a cholesterol panel?
h. Is collected for heavy metal testing?
4. How many mL are adult and pediatric collection tubes?
5. Which solvents are contained in the following tubes
a. Grey?
b. Green?
c. Lavender?
d. Light blue?
e. Red?
f. Royal blue?
g. Brown?
h. Black?
i. Yellow?
j. SST? (mottled top)
k. Pink?
6. Which of the tubes listed above must be filled to avoid false results?
7. Which tube listed above is used to test for lead poisoning?
8. Which tube listed above is used for blood typing?
9. What is the correct order the tubes should be used to prevent sample
contamination?
10. Which gage of needle is used to
a. Donate blood?
b. In a butterfly?
c. For IM injections?
11. At what distance from the injection site should the tourniquet be placed?
12. Which tests could be altered by the tourniquet?
13. If a patient faints during a blood draw, how long should they remain resting
afterwards? How long before they can drive?
14. What is the protocol followed at CCNM following a broken needle?
15. If hemolysis occurs during a blood draw, how will the following tests be altered
a. RBC number?
b. MCV?
c. MCH?
d. Ferritin?
 e. Biliruben?
f. RBC magnesium?
g. RBC potassium?
h. Serum protein?
i. Serum ammonia?
j. Lactate dehydrogenase?
16. Under which conditions are RBCs more likely to lyse during blood draws?
17. Why is there an increased risk of vessel collapse in the elderly?
18. Which blood tests require patients to fast?
19. How does exercise before drawing blood affect the following
a. Liver enzymes?
b. CRP?
c. Lactic acid?
d. Cortisol?
e. Protein?
f. Albumin?
g. Amino acids?
h. Coagulation factors?
i. Electrolytes?
20. What condition can cause a patient to have increased WBC, albumin, serum
glucose, insulin, cholesterol and decreased iron?
21. What happens to a newborn’s blood work if drawn while crying?
22. Which factors can change DHEA values?
23. Which blood values decrease in the afternoon?
24. Which blood values increase in the afternoon?
25. Which patient posture causes an increase in triglycerides, cholesterol and HDL?
26. Which values will be increased with a tourniquet?
27. Which situation requires the use of Provodone?
28. What is the maximum daily dose of diphenhydramine?
29. When is diphenhydramine contraindicated? When should it be used with caution?
30. What are the side effects of diphenhydramine?
31. Which medications does diphenhydramine interact with?
32. When is epinephrine contraindicated?
33. What are the side effects of epinephrine?
34. What is the treatment for acute magnesium toxicity?
35. What are the signs and symptoms of hypercalcemia?
36. What is the treatment for hypercalcemia, at what dose?
37. What causes hypoglycemia during IV treatment?
38. If a patient has an allergic reaction during and IV treatment, what should be done
with the needle in their arm?
39. What does the ‘gage’ of the needle actually describe?
40. What considerations should be made when drawing blood/using IV if a patient
has had a mastectomy?
41. What changes are made during IV treatment if a patient has a permanent pic-line?
42. Define hemoconcentration.
43. What is the difference between extravasation and infiltration?
44. What complication causes an absent bleed back, blistering and a significant
amount of pain?
45. At which injection site is there an increased risk of thrombous formation?
46. Which complication causes streaking and cord like veins?
47. What is a veni-spasm, what causes it?
48. What is the treatment for a veni-spasm?
49. What could be occurring if a patient suddenly experiences edema of the face and
ankles?
50. What predisposition puts a patient at an increased risk for circulatory overload
during and IV?
51. What are the signs and symptoms of speed shock, what causes it?
52. What is the treatment for speed shock?
53. Which medications increase the risk of syncope during IV treatments?
54. What are the mEq/kg for isotonic, hypotonic and hypertonic solutions?
55. Which osmolality causes cell damage?
56. Which osmolality causes irritation of the vein wall?
57. Which osmolality is used most commonly during IV treatments?
58. Which osmolality is contraindicated in renal failure or congestive heart failure?
59. Which injections need intradermal administration?
60. Which injections need subcutaneous administration?
61. Which injections need intramuscular administration?
62. What could IV hydrochloric acid be used for?
63. When is IV HCl contraindicated?
64. What are the side effects of HCl toxicity?
65. What should be monitored when using IV vitamin D and why?
66. What equipment needs to be used with oil based vitamin E?
67. What should be monitored when using IV vitamin E and why?
68. When is vitamin E indicated?
69. When is vitamin K1 given IV or IM?
70. What are the risks of giving K1 IM?
71. What symptoms indicate a biotin deficiency?
72. What does biotin require as a cofactor in the body?
73. What is the relationship between biotin and insulin?
74. What are the symptoms of a vitamin B1 deficiency?
75. Under what conditions are large amounts of B2 secreted?
76. What are the symptoms of a vitamin B3 deficiency?
77. Is B3 safely administered during pregnancy and lactation?
78. What should be monitored when administering B3?
79. When is B5 contraindicated?
80. What are the potential uses for B5 post-surgery?
81. What are the symptoms that indicate a B5 deficiency?
82. Which pharmaceutical drugs cause a B6 deficiency?
83. What are the symptoms of a B6 deficiency?
84. What does B6 require as a cofactor in the body?
85. What are the potential toxicity symptoms of B6?
86. Which other injectable compounds is folic acid incompatible with?
87. Is folic acid included in TPN therapy?
88. Which drugs interfere with folic acid absorption?
89. What are the three types of B12 commonly used for injection?
90. When is cyanocobalamin used?
91. What are the signs and symptoms of a B12 deficiency?
92. What is mixed with vitamin C intended for intravenous use as a preservative?
93. What are the sources of vitamin C used for intravenous treatments?
94. Which amino acid in collagen does vitamin C help with the formation of?
95. Which blood values could intravenous vitamin C falsely elevate in some patients?
96. Which pharmaceutical drugs can deplete vitamin C levels?
97. How does vitamin C enter cancer cells?
98. What are the potential side effects of intravenous vitamin C?
99. What are the potential side effects if calcium is pushed intravenously too quickly?
100.Caution should be used with intravenous calcium when patients are on which
pharmaceutical drugs?
101.Which medical conditions should intravenous calcium be used with caution?
102.What is the standard diagnostic test for depleted calcium levels? What could
render this test inaccurate?
103.What are the signs and symptoms of a calcium deficiency?
104.How is calcium for intravenous use stored in the laboratory?
105.Which blood values can intravenous calcium potentially affect?
106.When should iron be supplemented with caution?
107.When is iron supplementation contraindicated?
108.What are the potential side effects of intravenous/intramuscular iron?
109.How does intravenous magnesium cause hypothermia as a potential side effect?
110.What are the contraindications for intravenous magnesium therapy?
111.Which laboratory test is used to determine if a magnesium deficiency exists?
112.What are the potential side effects of intravenous magnesium?
113.What are the signs and symptoms of a magnesium deficiency?
114.What are the signs and symptoms of a zinc deficiency?
115.Where in the body is zinc most concentrated?
116.What are the signs and symptoms of Wilson’s disease?
117.Which mineral is inappropriately stored in Wilson’s disease?
118.What are the signs and symptoms of a copper deficiency?
119.How does chromium supplementation affect insulin?
120.What factors affect chromium absorption?
121.What are the signs and symptoms of a molybdenum deficiency?
122.Which minerals does molybdenum cause the excretion of?
123.What is molybdenum a cofactor in the excretion of?
124.What does molybdenum supplementation decrease the incidence of?
125.When should molybdenum be supplemented with caution?
126.What are the uses of strontium in the body?
127.What are the signs and symptoms of excess strontium?
128.What areas of the body does manganese have an affinity for?
129.What are the signs and symptoms of manganese toxicity?
130.How is manganese excreted from the body?
131.Which mineral does manganese (and zinc) affect the absorption of?
132.Which conditions would manganese treatment be indicated for?
133.What type of disease could benefit from boron supplementation?
134.What are the signs and symptoms of boron toxicity?
135.Which cancer is boron contraindicated for, and why?
136.How does vanadium affect insulin?
137.Which type of diabetes is vanadium useful for?
138.What metabolic processes is vanadium linked to?
139.What are the signs and symptoms of a vanadium deficiency?
140.What are the potential side effects of vanadium supplementation?
141.What are the normal serum values for potassium? What are considered dangerous
levels?
142.With which technique should potassium be administered intravenously?
143.What are the potential side effects if potassium is pushed, rather than slowly
dripped?
144.What are the signs and symptoms of hypokalemia?
145.What are the signs and symptoms of hyperkalemia?
146.Which drugs can increase serum levels of potassium?
147.Which drugs can decrease serum levels of potassium?
148.What are potential side effects from receiving intravenous iodine?
149.Which tissues is iodine most concentrated in?
150.Sodium bicarbonate is used as a buffer in most IV solutions except for which
solution?
151.What can sodium bicarbonate increase the excretion of from the body?
152.What are the signs and symptoms of increased serum sodium bicarbonate?
153.What effect does glutathione treatment have in HIV+ patients?
154.What types of cancers can glutathione treatment be used for?
155.Which substances should not be co-administered with glutathione?
156.How is decreased glutathione related to diabetes?
157.What can be a potential side effect of nebulized glutathione?
158.What response does ozone therapy have in patients with asthma?
159.How does ozone therapy change hemoglobin saturation?
160.Why does selenium need to be co-administered with ozone therapy?
161.Which cytokines are produced with ozone therapy?
162.What are the contraindications for ozone therapy?
163.Which vitamin in the blood is decreased following ozone therapy?
164.What are the reported effects felt after ozone treatments?
165.Which gage needle is used during ozone treatments?
166.What are the uses of ozone treatment?
167.When is hydrogen peroxide treatment contraindicated?
168.What is the Herxheimer reaction?
169.What are the potential side effects of hydrogen peroxide treatment?
170.Which pharmaceutical drug decreases the effectiveness of ultraviolet treatment?
171.What is the mechanism of action of colchicine treatment?
172.What does colchicine interfere with the absorption of?
173.Which laboratory values should be assessed before beginning EDTA treatments?
174.What modifications can be made if a patient’s lab work in question 173 is
suboptimal?
175.What is the recommended treatment schedule for EDTA?
176.What are the potential side effects of EDTA therapy?
177.What type of EDTA chelates calcium?, lead?
178.In which conditions would it be beneficial to chelate calcium?
179.What is the relationship between EDTA and osteoporosis?
180.What is the half life of EDTA?
181.What effect would EDTA treatment have on cardiac patients?
182.Which other chelator is DPTA similar to and in which respects?
183.Which minerals does DPTA chelate?
184.Which minerals should be supplemented with patients receiving either EDTA or
DPTA therapy?
185.Which metals does LIHOPO chelate?
186.Which metals does BAL chelate?
187.How is BAL excreted from the body?
188.What is the half life of BAL?
189.With which genetic condition should BAL be given with caution?
190.How common are side effects from BAL? What are they?
191.What are the signs and symptoms of arsenic poisoning?
192.If comparing DMPS and DMSA which of the two:
a. Is orally administered?
b. Is more toxic?
c. Has a half life of 2 hours?
d. Crosses the blood brain barrier?
e. Causes skin rashes?
f. Is used more commonly as a ‘challenge’ rather than treatment?
193.Which genetic condition should DMSA be used with caution?
194.What are the potential side effects of DMSA and DMPS?
195.What are the signs and symptoms of mercury poisoning?
196.What is the most common mercury chelator? Which other minerals/metals does
this treatment chelate?
197.What are the potential side effects of using deferoxamine?
198.What are the potential side effects of using deferiprone?
199.For which medical conditions is deferiprone use contraindicated?
200.What are the uses of D-penicillamine?
201.What is the half life of D-penicillamine?
202.How is D-penicillamine excreted?
203.How is D-penicillamine taken?
204.Which vitamin and mineral should be supplemented when D-penicillamine
treatment is used?
205.Where in the body is excess copper usually stored?
206.What is the alternative chelator used if patients have a sensitivity to D-
penicillamine?
207.How is trinetine administered and excreted?
208.What are the potential side effects of trinetine?
209.What minerals/metals does ditocarb sodium chelate?
210.When would ditocarb sodium be contraindicated?
211.What effects does cadmium have in the body?
212.How is ditocarb sodium administered and excreted?
213.What are the potential side effects of ditocarb sodium? What is the half life?