NHA CCMA Study Guide, questions and answers 2026 graded a+
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Needle Adapters -answer-Also called the tube holder. One end has a small opening that
connects the needle, and the other end has a wide opening to hold the collection tube.
Winged Infusion Sets -answer--Used for venipuncture on small veins such as those in
the hand. They are also used for venipuncture in the eldery and pediatric patients.
-The most common size is 23 gauge, 1/2 to 3/4 inch long.
Sterile Syringes and Needles -answer-10-20ml syringe is used when the Vacutainer
method cannot be used.
Tourniquets -answer--Prevents the venous outflow of blood from the arm causing the
veins to bulge thereby making it easier to locate the veins.
-The most common is a latex strip
-Blood pressure cuffs may also be used
Chux -answer-An impermeable pad used to protect the patient's clothing and bedding.
Specimen Labels -answer-To be placed on each tube collected after venipuncture.
Gloves -answer-Must be always be worn when collecting blood specimen.
Needle Disposal Container -answer-Must be clearly marked puncture-resistant
biohazard disposal containers.
NEVER RECAP!
The medical assistant uses 3 skills when contacting patients for phlebotomy: -answer--
Social
-Clerical
,-Technical
Blood Request forms should include the following: -answer--Patient's name and age
from ID plate or wristband
-Identification #
-Date and time the specimen is obtained
-Name or initials of person who obtains the specimen
-Accessioning #
-Physician's name
-Department for which work is being done
-Other useful info.
Fasting -answer-Some test such as those for glucose, cholesterol, and triglycerides
require that the patient abstain from eating for at least 12 hours.
Edema -answer-Is the accumulation of fluid in the tissues. Collection from edematous
tissue alters test results.
Fistula -answer-Is the permanent surgical connection between an artery and a vein. Are
used for dialysis procedures and must never be used for venipuncture's due to the
possibility of infection.
Common causes of Failure to Obtain Blood: -answer--The tube has lost its vacuum
-Improperly positioned needle.
-Collapsed Vein
Hematoma -answer-The most common complication of phlebotomy procedure.
Hemoconcentration -answer-The increase in proportion of formed elements to plasma
caused by the tourniquet being left too long.
Phlebitis -answer-Inflammation of a vein as a result of repeated venipuncture on that
vein.
Petechiae -answer-These are tiny non-raised red spots that appear on the skin from
rupturing of the capillaries due to the tourniquet being left on too long or too tight.
Thrombus -answer-This is a blood clot usually a consequence of insufficient pressure
applied after the withdrawal of the needle.
Thrombophlebitis -answer-Inflammation of a vein with formation of a clot.
Septicemia -answer-This is a systemic infection associated with the presence of
pathogenic organism introduced during a venipuncture.
Trauma -answer-This is an injury to underlying tissues caused by probing of the needle.
,Two-Hour Postprandial Test -answer-This is used to evaluate diabetes mellitus. Fasting
glucose level is compared with the level 2 hours after eating a full meal or ingesting a
measured amount of glucose.
Oral Glucose Tolerance Test (OGTT) -answer-This test is used to diagnose diabetes
mellitus and evaluate patients with frequent low blood sugar.
Fasting Specimens -answer-This requires collection of blood while the patient is in the
basal state, that is, the patient has fasted and refrained for strenuous exercise for 12
hours prior to the drawing.
Time Specimens -answer--To determine blood levels of medications
-To monitor changes in a patients conditions
-to measure blood levels of substances exhibiting diurnal variation
Therapeutic Drug Monitoring -answer-This test is used to monitor the blood levels of
certain medication to ensure patient safety and also maintain a plasma level.
Blood Cultures (BC) -answer-They are ordered to detect presence of microorganisms in
the patient's blood. Usually ordered STAT or as a timed specimen.
Cold Agglutinins -answer-Are antibodies produced in response to Mycoplasma
pneumoniae infection (atypical pneumonia). The antibodies formed may attach to red
blood cells at temperatures below body temperature, and as such, the specimen must
be kept warm until the serum is separated from the cells.
Chilled Specimens -answer-Some tests require that the specimen collected by chilled
immediately after collection in crushed ice or ice and water mixture.
Some of the tests that require chilled specimen are: -answer--Arterial Blood Gases
-Ammonia
-Lactic Acid
-Pyruvate
-ACTH
-Gastrin
-Parathyroid Hormone
Light-Sensitive Specimens -answer-Specimens are protected from light by wrapping the
tubes in aluminum foil immediately after they are drawn.
Exposure to light could alter the test results for: -answer--Bilirubin
-Beta-carotene
-Vitamins A & B6
-Porphyrins
, Dermal Punctures (Microcapillary Collection) -answer-May be done on both pediatric
and adult patients.
Dermal Punctures (Infants) -answer-The heel is used. Areas recommended are the
medical and lateral areas of the plantar surface of the foot.
Precautions when performing a dermal puncture: -answer--Do not puncture deeper than
2.0mm
-Do not perform dermal punctures on previous puncture sites
-Do not use the back of the heel or arch of the foot
-Use the medial and lateral areas of the plantar surface of the heel
Dermal Punctures (Older children and adults) -answer-The distal segment of the 3rd or
4th finger of the non-dominant hand is recommended site.
Lavender Top Tube -answer-Contains the anticoagulant ethylenediaminetetraacetic acid
(EDTA). EDTA inhibits coagulation by binding to calcium present in the specimen. The
tubes must be filled at least two-third full and inverted eight times.
Lavender Top Tube Common Test: -answer-CBC (Complete Blood Count) Included:
RBC count, WBC count and Platelet count; WBC differential count; Hemoglobin and
Hematocrit determinations; ESR (Erythrocyte Sedimentation Rate); Sickle Cell
Screening.
Light-Blue Top Tube -answer-Contains the anticoagulant Sodium Citrate, which also
prevents coagulation by binding to calcium in the specimen. The tube must be filled
completely to maintain the ratio of nine parts blood to one part sodium citrate, and
should be inverted 3 to 4 times.
Light-Blue Top Tube Common Test -answer-Coagulation Studies-Prothrombin Time
(PT)-evaluates the extrinsic; system of the coagulation cascade and monitors;
Coumadin therapy; Activated Partial Thromboplastin Time (APTT, PTT) - Evaluates the
intrinsic system of the coagulation cascade and monitors Heparin therapy. Fibrinogen
Degradation Products (FDP) Thrombin Time (TT); Factor assays, Bleeding Time (BT)
Green Top Tube -answer-Contains the anticoagulant Heparin combined with sodium,
lithium, or ammonium ion. Heparin works by inhibiting thrombin in the coagulation
cascade. It is not used for hematology because heparin interferes with the Wright's
stained blood smear. This tube should be inverted eight times.
Green Top Tube Common Test -answer-Chemistry test: performed on plasma such as
Ammonia, carboxyhemoglobin & STAT electrolytes.
Gray Top Tube -answer-Contains additives and anticoagulants. Contains glucose
preservative (antiglycolytic agent): sodium fluoride - preserves glucose for 3 days; or
lithium iodoacetate-preserves glucose for 24 hours.
(verified)\\pass!!!
Needle Adapters -answer-Also called the tube holder. One end has a small opening that
connects the needle, and the other end has a wide opening to hold the collection tube.
Winged Infusion Sets -answer--Used for venipuncture on small veins such as those in
the hand. They are also used for venipuncture in the eldery and pediatric patients.
-The most common size is 23 gauge, 1/2 to 3/4 inch long.
Sterile Syringes and Needles -answer-10-20ml syringe is used when the Vacutainer
method cannot be used.
Tourniquets -answer--Prevents the venous outflow of blood from the arm causing the
veins to bulge thereby making it easier to locate the veins.
-The most common is a latex strip
-Blood pressure cuffs may also be used
Chux -answer-An impermeable pad used to protect the patient's clothing and bedding.
Specimen Labels -answer-To be placed on each tube collected after venipuncture.
Gloves -answer-Must be always be worn when collecting blood specimen.
Needle Disposal Container -answer-Must be clearly marked puncture-resistant
biohazard disposal containers.
NEVER RECAP!
The medical assistant uses 3 skills when contacting patients for phlebotomy: -answer--
Social
-Clerical
,-Technical
Blood Request forms should include the following: -answer--Patient's name and age
from ID plate or wristband
-Identification #
-Date and time the specimen is obtained
-Name or initials of person who obtains the specimen
-Accessioning #
-Physician's name
-Department for which work is being done
-Other useful info.
Fasting -answer-Some test such as those for glucose, cholesterol, and triglycerides
require that the patient abstain from eating for at least 12 hours.
Edema -answer-Is the accumulation of fluid in the tissues. Collection from edematous
tissue alters test results.
Fistula -answer-Is the permanent surgical connection between an artery and a vein. Are
used for dialysis procedures and must never be used for venipuncture's due to the
possibility of infection.
Common causes of Failure to Obtain Blood: -answer--The tube has lost its vacuum
-Improperly positioned needle.
-Collapsed Vein
Hematoma -answer-The most common complication of phlebotomy procedure.
Hemoconcentration -answer-The increase in proportion of formed elements to plasma
caused by the tourniquet being left too long.
Phlebitis -answer-Inflammation of a vein as a result of repeated venipuncture on that
vein.
Petechiae -answer-These are tiny non-raised red spots that appear on the skin from
rupturing of the capillaries due to the tourniquet being left on too long or too tight.
Thrombus -answer-This is a blood clot usually a consequence of insufficient pressure
applied after the withdrawal of the needle.
Thrombophlebitis -answer-Inflammation of a vein with formation of a clot.
Septicemia -answer-This is a systemic infection associated with the presence of
pathogenic organism introduced during a venipuncture.
Trauma -answer-This is an injury to underlying tissues caused by probing of the needle.
,Two-Hour Postprandial Test -answer-This is used to evaluate diabetes mellitus. Fasting
glucose level is compared with the level 2 hours after eating a full meal or ingesting a
measured amount of glucose.
Oral Glucose Tolerance Test (OGTT) -answer-This test is used to diagnose diabetes
mellitus and evaluate patients with frequent low blood sugar.
Fasting Specimens -answer-This requires collection of blood while the patient is in the
basal state, that is, the patient has fasted and refrained for strenuous exercise for 12
hours prior to the drawing.
Time Specimens -answer--To determine blood levels of medications
-To monitor changes in a patients conditions
-to measure blood levels of substances exhibiting diurnal variation
Therapeutic Drug Monitoring -answer-This test is used to monitor the blood levels of
certain medication to ensure patient safety and also maintain a plasma level.
Blood Cultures (BC) -answer-They are ordered to detect presence of microorganisms in
the patient's blood. Usually ordered STAT or as a timed specimen.
Cold Agglutinins -answer-Are antibodies produced in response to Mycoplasma
pneumoniae infection (atypical pneumonia). The antibodies formed may attach to red
blood cells at temperatures below body temperature, and as such, the specimen must
be kept warm until the serum is separated from the cells.
Chilled Specimens -answer-Some tests require that the specimen collected by chilled
immediately after collection in crushed ice or ice and water mixture.
Some of the tests that require chilled specimen are: -answer--Arterial Blood Gases
-Ammonia
-Lactic Acid
-Pyruvate
-ACTH
-Gastrin
-Parathyroid Hormone
Light-Sensitive Specimens -answer-Specimens are protected from light by wrapping the
tubes in aluminum foil immediately after they are drawn.
Exposure to light could alter the test results for: -answer--Bilirubin
-Beta-carotene
-Vitamins A & B6
-Porphyrins
, Dermal Punctures (Microcapillary Collection) -answer-May be done on both pediatric
and adult patients.
Dermal Punctures (Infants) -answer-The heel is used. Areas recommended are the
medical and lateral areas of the plantar surface of the foot.
Precautions when performing a dermal puncture: -answer--Do not puncture deeper than
2.0mm
-Do not perform dermal punctures on previous puncture sites
-Do not use the back of the heel or arch of the foot
-Use the medial and lateral areas of the plantar surface of the heel
Dermal Punctures (Older children and adults) -answer-The distal segment of the 3rd or
4th finger of the non-dominant hand is recommended site.
Lavender Top Tube -answer-Contains the anticoagulant ethylenediaminetetraacetic acid
(EDTA). EDTA inhibits coagulation by binding to calcium present in the specimen. The
tubes must be filled at least two-third full and inverted eight times.
Lavender Top Tube Common Test: -answer-CBC (Complete Blood Count) Included:
RBC count, WBC count and Platelet count; WBC differential count; Hemoglobin and
Hematocrit determinations; ESR (Erythrocyte Sedimentation Rate); Sickle Cell
Screening.
Light-Blue Top Tube -answer-Contains the anticoagulant Sodium Citrate, which also
prevents coagulation by binding to calcium in the specimen. The tube must be filled
completely to maintain the ratio of nine parts blood to one part sodium citrate, and
should be inverted 3 to 4 times.
Light-Blue Top Tube Common Test -answer-Coagulation Studies-Prothrombin Time
(PT)-evaluates the extrinsic; system of the coagulation cascade and monitors;
Coumadin therapy; Activated Partial Thromboplastin Time (APTT, PTT) - Evaluates the
intrinsic system of the coagulation cascade and monitors Heparin therapy. Fibrinogen
Degradation Products (FDP) Thrombin Time (TT); Factor assays, Bleeding Time (BT)
Green Top Tube -answer-Contains the anticoagulant Heparin combined with sodium,
lithium, or ammonium ion. Heparin works by inhibiting thrombin in the coagulation
cascade. It is not used for hematology because heparin interferes with the Wright's
stained blood smear. This tube should be inverted eight times.
Green Top Tube Common Test -answer-Chemistry test: performed on plasma such as
Ammonia, carboxyhemoglobin & STAT electrolytes.
Gray Top Tube -answer-Contains additives and anticoagulants. Contains glucose
preservative (antiglycolytic agent): sodium fluoride - preserves glucose for 3 days; or
lithium iodoacetate-preserves glucose for 24 hours.
