NHA Phlebotomy Certification Practice Exam

Which of the following would result in a grossly hemolyzed specimen?

1. Incorrect order of draw

2. Incorrect needle gauge

3. Applying tourniquet too close to the draw site

4. Failure to invert tube

The correct answer is: Incorrect needle gauge

A grossly hemolyzed specimen is primarily caused by the destruction of red blood cells, which can happen due to several factors during the collection process. The choice that correctly identifies a reason for this is applying an incorrect needle gauge. Using a needle that is too small, such as a 23-gauge or smaller needle for drawing blood from a vein, can lead to hemolysis. The small lumen can create turbulence in the blood, causing red blood cells to break apart as they are drawn into the tube. This is particularly relevant for patients with fragile veins or when a significant volume of blood is drawn quickly, as the shear stress on the cells is increased. It is important to select the appropriate needle gauge based on the patient's vein size and the procedure to be performed to minimize the risk of hemolysis. Understanding this aspect of phlebotomy practice ensures that specimens are collected correctly and remain viable for laboratory analysis.