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AMCA EXAM REVIEW PART 2 QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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AMCA EXAM REVIEW PART 2 QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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AMCA EXAM REVIEW PART 2 QUESTIONS ANDANSWERS WITH SOLUTIONS 2024
4.03 Identify the circumstances that can interfere in clinical analysis of blood constituents. -
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ANSWER It is important to always work accurately and efficiently. With respect to specimen collection, t
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he phlebotomy technician should take proper measures to prevent interference in the clinical analysis of
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blood constituents. The presence of certain substances in the blood specimen can alter test results, dep
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ending on the types of tests being performed. To prevent interference, the phlebotomy technician shoul
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d be mindful of the following variables:
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• Type of antiseptic -
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The type of antiseptic used in specimen collection is determined by the tests being ordered.
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➢ Isopropyl alcohol- The most common antiseptic used for cleaning a puncture site.
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➢ Iodine -
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QWhen drawing samples for blood cultures, iodine is used to prevent contamination of the sample by ski
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n flora. Likewise, povidone-
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iodine is used as an alternative to alcohol when prepping a puncture site for blood-
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alcohol testing. Iodine is never used for dermal punctures because it will contaminate the sample and in
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terfere with results of certain tests, such as bilirubin, uric acid, and phosphorous tests.
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• Site selection -
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The site from which a specimen is collected may cause interference as well. The following sites should b
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e avoided when performing venipunctures:
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Part 2 of 4.03 - ANSWER Hematomas -
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Test results may be altered cause blood drawn from a hematoma not as fresh as venous blood.
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➢ The side of the body that has undergone mastectomy - lymph stasis here can affect test results
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➢ IV sites -
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Qwhen possible, avoid drawing blood from an arm that has an IV in place. If no alternate site is available,
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Qbe sure to perform specimen collection from a site that is distal to (or below) the IV. The 5 mL of blood
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should be discarded to prevent interference by the IV medications and fluids.
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• Specimen Collection -
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QCollecting specimens in the correct tubes and following the proper order of draw will help to prevent c
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ontamination or interference. It is also important to ensure correct sample volume and to invert tubes p
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roperly.
• Tourniquet application -
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QTying a tourniquet too tightly can result in hemoconcentration, or an increase in the proportion of cells
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to plasma. This can affect many results, including plasma proteins, enzymes, RBC counts, iron, and potas
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sium levels, among others. To prevent is, release the tourniquet as soon as blood begins to flow in the fi
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rst tube, and never leave it in place for longer than 1 minute.
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, 4.04 Select proper antiseptic agents for the test. -
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QANSWER Before routine venipuncture selection, the patient's skin is cleaned with antiseptic to prevent
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contamination by normal skin flora. Most commonly, 70% isopropyl alcohol is used. The antiseptic shoul
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d remain on the skin for 30-
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60 seconds and allowed to dry before proceeding with the venipuncture. Do not fan, blow on, or touch t
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he site, as this may introduce more bacteria.
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In certain situations, such as blood cultures or arterial punctures, Povidine-
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iodine may be used. It is important not to use iodine for all venipuncture procedures, as it can interfere
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with some chemistry test results. For patients older than 2 months of age with iodine sensitivity, Chlorh
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exidine gluconate or benzalkonium chloride (Zephiran Chloride).
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4.05 Select proper venipuncture equipment for the test and the size and the condition of veins. -
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ANSWER The following supplies are needed to perform venipuncture:
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• Phlebotomy tray containing vacutainers, holders, needles, and syringes. *
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• Tourniquet.
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• Specimen labels.
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• Disposable gloves.
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• Sharp's container.
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• 70% isopropyl alcohol.
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• Gauze pads.
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• Bandages.
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*While evacuated tubes are more commonly used when drawing blood from veins, in some patients, es
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pecially those with fragile veins, the strong vacuum of these tubes may cause the vein to collapse. To av
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oid such complications, a syringe is used in place of the evacuated tubes. A smaller gauge needle is usua
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lly used for these types of draws and discarding once the draw is complete. The blood is then transferre
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d from the syringe to the evacuated tubes through use of a needleless blood transfer device.
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Part2 of 4.05 - ANSWER Needles
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Parts of a multi-sample needle:
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• Bevel
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• Shaft
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• Threaded hub
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