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Quizzes > High School Quizzes > Career

Order of Draw Practice Quiz

Practice correct blood draw sequence and techniques

Difficulty: Moderate
Grade: Grade 12
Study OutcomesCheat Sheet
Paper art themed trivia quiz about The Order of Draw Challenge for nursing and phlebotomy students.

Which tube should be drawn first during a multi-tube blood collection?
EDTA Tube
Heparin Tube
Serum Tube
Blood Culture Tube
Blood culture tubes are drawn first to minimize the risk of contaminating the specimen with additives from subsequent tubes. This ensures the accuracy of culture results.
What is the primary reason for following the correct order of draw in blood sample collection?
To prevent additive carryover between tubes
To speed up the blood collection process
To ensure accurate labeling of specimens
To reduce patient discomfort
Following the correct order minimizes the risk of additive carryover between tubes, which can interfere with test results. This protocol is essential for maintaining specimen integrity.
Which tube is typically used for coagulation studies?
Blue top tube with sodium citrate
Red top tube with clot activators
Green top tube with heparin
Lavender top tube with EDTA
The blue top tube contains sodium citrate, an anticoagulant that prevents clotting, which is essential for coagulation studies. Its use early in the draw process avoids contamination from other additives.
Which tube is most commonly associated with EDTA as an anticoagulant?
Lavender top tube
Blue top tube
Gray top tube
Red top tube
The lavender (or purple) top tube contains EDTA, which is used to preserve blood cells for tests like a complete blood count. Drawing it later in the sequence prevents contamination of earlier tubes.
Which tube is typically drawn last in a multi-tube collection for tests requiring glycolysis inhibition?
Gray top tube
Red top tube
Lavender top tube
Blue top tube
The gray top tube contains sodium fluoride, a glycolytic inhibitor, and is drawn last to avoid additive contamination. This order ensures that the glycolytic process is properly halted for accurate test results.
After drawing blood culture tubes, which tube is drawn next when a coagulation test is ordered?
Red top serum tube
Lavender top EDTA tube
Blue top tube with sodium citrate
Green top heparin tube
Once the blood culture tube is drawn first, the blue top tube for coagulation studies is drawn next to avoid interference from additives in other tubes. This order ensures the coagulation test is not compromised.
What potential issue may arise if the order of draw is not strictly followed?
Cross contamination of additives between tubes
Delayed sample processing
Improper storage temperature
Incorrect patient identification
Failing to follow the correct order of draw can lead to cross contamination of tube additives. This contamination may alter test results and impact patient diagnoses.
Which tube is primarily used for serum collection in routine chemistry tests?
Lavender top tube
Blue top tube
Green top tube
Red top tube or gold top tube
Serum tubes, typically red or gold, are used to collect blood for chemistry tests after clotting occurs. These tubes are drawn following coagulation tubes to ensure proper sample integrity.
What is the correct sequence when drawing tubes for blood culture, coagulation, serum, heparin, and EDTA tests?
Blood culture, Sodium citrate (blue), Serum, Heparin, EDTA
Heparin, Serum, EDTA, Blood culture, Sodium citrate
Serum, Blood culture, EDTA, Heparin, Sodium citrate
EDTA, Heparin, Serum, Sodium citrate, Blood culture
The proper order of draw starts with blood culture tubes to prevent contamination, followed by the sodium citrate tube for coagulation, then the serum tube for chemistry, followed by the heparin tube, and finally the EDTA tube. This systematic sequence preserves sample integrity.
When collecting samples for both a coagulation test and a heparin test, which tube should be drawn immediately before the heparin tube?
Serum tube
EDTA tube
Sodium citrate tube
Blood culture tube
In the proper order of draw, the serum tube follows the sodium citrate tube and is drawn right before the heparin tube. This positioning avoids cross contamination from additives present in the heparin tube.
Which tube is associated with lithium heparin as the anticoagulant?
Green top tube
Gray top tube
Blue top tube
Lavender top tube
The green top tube contains lithium heparin which is used as an anticoagulant for plasma chemistry tests. Drawing it in the correct sequence prevents its additives from affecting adjacent samples.
Drawing an EDTA tube before a serum tube can lead to which potential problem?
Chelation of calcium affecting clotting tests
Incorrect tube labeling
Delayed sample processing
Inadequate blood volume for testing
EDTA is a calcium chelator; if drawn before a serum tube, its presence can interfere with clot formation and affect clotting test results. Maintaining the correct order is crucial for accurate test outcomes.
For blood glucose measurement, which tube is typically used due to its glycolytic inhibitor additive?
Gray top tube
Red top tube
Lavender top tube
Blue top tube
The gray top tube contains sodium fluoride, a glycolytic inhibitor that helps preserve blood glucose levels. It is drawn later in the sequence to prevent contamination from additives in earlier tubes.
What is the primary purpose of the order of draw in phlebotomy?
To speed up the blood collection process
To avoid needle stick injuries
To prevent additive interference between tubes
To reduce patient anxiety
The order of draw is designed to prevent the carryover of additives from one tube to another, which could interfere with laboratory results. This protocol is critical for ensuring accurate diagnostics.
Which tube is most appropriate for a complete blood count (CBC) analysis?
Blue top tube (sodium citrate)
Green top tube (heparin)
Lavender top tube (EDTA)
Gray top tube (sodium fluoride)
The lavender top tube contains EDTA, which is ideal for preserving cellular components used in a complete blood count. Its placement in the draw order is devised to avoid interference from other additives.
A patient requires tests including blood culture, coagulation, serum chemistries, and complete blood count. Which of the following sequences adheres to the proper order of draw?
Blood culture, Blue top (sodium citrate), Red/Gold top (serum), Lavender top (EDTA)
Lavender top (EDTA), Blood culture, Blue top (sodium citrate), Red/Gold top (serum)
Blue top (sodium citrate), Blood culture, Lavender top (EDTA), Red/Gold top (serum)
Red/Gold top (serum), Lavender top (EDTA), Blood culture, Blue top (sodium citrate)
The correct sequence starts with the blood culture tube to avoid contamination, followed by the blue top tube for coagulation tests, then the serum tube, and finally the lavender top tube for CBC. This order is critical for ensuring that no additives interfere with subsequent tests.
In a scenario where multiple tubes are drawn and a sample for coagulation is drawn after a serum tube, what is the likely impact on the coagulation test?
No impact if the blood volume is sufficient
Enhanced clotting due to additional factors
Improved test accuracy
Contamination from clot activators can lead to false results
Drawing a serum tube before the coagulation tube may introduce clot activators into the coagulation specimen, leading to inaccurate test outcomes. This error can result in falsely altered clotting times.
During a multi-tube blood draw, if the order is not followed correctly and the heparin tube is drawn immediately after the blood culture tube, what potential error can occur in subsequent tests?
The blood culture may be compromised
Glucose levels may become unstable
EDTA contamination may occur
Heparin contamination may affect serum tests
Drawing the heparin tube too early can lead to its additive contaminating subsequent samples, particularly those meant for serum analysis. This emphasizes the importance of respecting the proper order of draw to avoid interference.
If a phlebotomist inadvertently mixes up the order and draws the EDTA tube before the blue top tube, which type of laboratory test is most likely to yield erroneous results?
Glucose measurements
Plasma chemistry tests
Blood culture results
Coagulation studies
EDTA acts as a calcium chelator; if drawn before the sodium citrate tube used for coagulation studies, it may compromise clotting tests by altering calcium levels. This misorder can lead to significant errors in coagulation results.
In a complex blood draw involving tests for CBC, coagulation, and chemistry, why is it critical to follow the specific order of draw rather than relying solely on proper mixing of tubes?
It ensures that the patient remains comfortable
To avoid additive carryover that cannot be corrected by mixing
It speeds up the overall collection process
Mixing is sufficient to eliminate all additive effects
The order of draw is designed to prevent the carryover of additives from one tube to the next, which mixing cannot reverse. Maintaining the correct sequence is crucial for ensuring that each specimen remains uncontaminated and yields accurate results.
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Study Outcomes

  1. Understand the rationale behind the proper sequence for blood sample collection.
  2. Identify the correct order of draw for different laboratory tests.
  3. Apply best practices to maintain sample integrity during phlebotomy.
  4. Analyze common errors in blood sample collection and their potential effects.
  5. Evaluate clinical scenarios to determine appropriate blood collection methods.

Order of Draw Quiz Review Cheat Sheet

  1. Understanding the order of draw - Knowing the correct sequence for tube collection is your first line of defense against contaminated samples and false lab results. Think of it like following a recipe: skip a step and the whole batch could be ruined! Master this, and you'll be a lab ninja in no time. phlebotomy.com
  2. Standard order of draw - Follow the classic lineup: blood culture, sodium citrate (light blue), serum (red or gold), heparin (green), EDTA (lavender), then glycolytic inhibitors (gray). Each tube has a special role, and jumping around can mix additives in ways that wreck your test data. Stick to the script to keep results rock-solid. phlebotomy.com
  3. Use mnemonic devices - Memory tricks like "Young Bodies Really Should Get Large Grains" can turn a daunting list into a catchy jingle. When you belt it out, each tube color and order sticks in your head like a favorite tune. Before you know it, you're recalling the sequence faster than you can say "phlebotomy." phlebotomyu.com
  4. Know your additives - From sodium citrate in light blue tubes for coagulation to EDTA in lavender for hematology, every tube's chemistry matters. Mix the wrong additive into your sample and you could throw off entire panels of blood work. Get to know what's inside each tube, and you'll never mix up your tests again. phlebotomyinfo.com
  5. Proper tube inversion - Gentle mixing is key - think "no shake, just roll." For example, sodium citrate tubes need about 3 - 4 gentle inversions to blend blood and additive without forming clots. Master the swirl and you'll avoid hemolysis or clotting mishaps that can invalidate results. phlebotomyinfo.com
  6. Minimize additive carryover - Skipping or reordering tubes can transfer tiny traces of chemicals that throw off sensitive assays. Imagine sugar in your salt - it just doesn't work! By staying disciplined, you'll slash the risk of cross-contamination and keep your data pristine. phlebotomy.com
  7. Follow CLSI guidelines - The Clinical and Laboratory Standards Institute sets the gold standard for phlebotomy practices. These rules are designed to harmonize procedures worldwide, so labs everywhere speak the same "tube language." Trust the experts and your draw technique will be globally recognized. clinicaldiagnotics.com
  8. Blood culture tubes first - Drawing these before anything else ensures microbial cultures aren't tainted by other additives. It's like putting on fresh gloves before handling a sterile tray. Start strong to nail your microbiology analysis every time. phlebotomy.com
  9. Serum tubes without additives - Plain red-top tubes come before clot-activator tubes to avoid accidental clotting inside the sample. This simple order tweak preserves the purity of serum you need for many chemistry tests. Keep unadulterated serum samples on your A-game checklist. phlebotomy.com
  10. Practice makes perfect - Regularly reviewing and rehearsing the draw sequence cements your skills under pressure. Turn each venipuncture into a mini training session, and pretty soon you'll breeze through complex panels without blinking. Confidence grows with every successful stick! phlebotomyu.com
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