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| Section | Weight | Objectives |
|---|---|---|
| Routine Blood Collections | 28% | - Tourniquet use & vein assessment - Venipuncture techniques & equipment - Post-collection care & labeling - Capillary puncture procedures - Order of draw & tube selection |
| Special Collections | 12% | - Blood alcohol & legal collections - Blood cultures & sterile collection - Therapeutic drug monitoring - Glucose tolerance & dynamic tests - Pediatric & geriatric collections |
| Safety and Compliance | 26% | - HIPAA & patient confidentiality - PPE & sharps disposal - Quality control & error prevention - Bloodborne pathogens & exposure control - Infection control & OSHA standards |
| Specimen Processing & Handling | 14% | - Documentation & tracking - Processing & centrifugation - Transport & storage requirements - Specimen rejection criteria - Aliquoting & preservation |
| Patient Preparation | 20% | - Patient identification & verification - Site selection & preparation - Requisition review & test verification - Informed consent & communication - Patient positioning & comfort |
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25. Frage
A phlebotomist is preparing a container for a 24-hr urine collection when a chemical splash occurs. The phlebotomist should find information about this chemical from which of the following sources?
Antwort: A
Begründung:
The correct source is the Safety Data Sheet. An SDS provides chemical-specific information about hazards, exposure controls, personal protective equipment, first aid, spill response, handling, storage, and disposal. During a chemical splash, the phlebotomist must follow facility policy immediately, use the eyewash or shower if indicated, notify appropriate personnel, and consult the SDS for the exact chemical involved. Current Procedural Terminology is a medical coding system and has no role in chemical exposure response. The CDC provides infection-control guidance, but it is not the primary document for a specific chemical's hazard and first-aid requirements. OSHA establishes workplace safety regulations, including hazard communication expectations, but the SDS is the actual document used at the point of exposure for chemical-specific instructions. NHA CPT safety content includes workplace safety regulations, exposure control protocols, reporting requirements, PPE, and biohazard or chemical safety practices. OSHA also describes SDSs as documents containing chemical properties, hazards, protective measures, and safety precautions. Reference topics: Safety and Compliance; chemical exposure; SDS; OSHA hazard communication.
26. Frage
Which of the following should a sharps container have?
Antwort: D
Begründung:
A sharps container should have a leakproof lid or leak-resistant closure to prevent contaminated blood or fluid from escaping during handling, storage, or transport. Sharps containers must also be puncture-resistant, closable, upright and stable during use, and properly labeled or color-coded as biohazardous. A "room temperature" label is used for certain specimen storage or transport conditions, not for sharps disposal. A 1-gallon capacity is not a universal requirement; sharps containers come in multiple approved sizes depending on the setting and volume of use. Dual openings are not required and could increase risk if poorly designed. The essential safety standard is containment: the device must prevent puncture injury and leakage while allowing safe disposal at the point of use. The phlebotomist must never overfill a sharps container, reach into it, shake it, force items into it, or dispose of sharps in regular trash or soft biohazard bags. Reference topics: Safety and Compliance; sharps container requirements; biohazard disposal; OSHA bloodborne pathogen safety; needlestick prevention.
27. Frage
A phlebotomist is performing a glucose tolerance test. Which of the following actions should the phlebotomist take after the patient drinks the glucose solution?
Antwort: A
Begründung:
After the patient drinks the glucose solution, the phlebotomist should start timing according to the test protocol. Glucose tolerance testing depends on strict timed specimen collection after ingestion of a measured glucose load. If timing is inaccurate, the results may be invalid or misleading. The patient should not eat crackers because additional food intake can alter glucose results. Exercise should also be avoided unless specifically directed because physical activity can affect glucose metabolism. Collecting all remaining specimens immediately defeats the purpose of the timed test, which evaluates the body's glucose response over defined intervals. The phlebotomist must verify fasting status, collect the baseline specimen if required, ensure the patient consumes the glucose solution within the allowed time, document the time finished, and collect subsequent specimens at exact ordered intervals. If the patient vomits, eats, leaves, or misses a timed draw, the phlebotomist should follow facility policy and notify appropriate personnel. Reference topics: Special Collections; glucose tolerance testing; timed specimens; patient preparation; test protocol compliance.
28. Frage
A phlebotomist is collecting a blood culture set. Which of the following actions helps reduce contamination?
Antwort: B
Begründung:
Allowing the antiseptic to dry before puncture helps reduce blood culture contamination. Blood cultures require strict aseptic technique because skin organisms can enter the specimen and produce false-positive results. Repalpating the site after antisepsis with an ungloved finger contaminates the prepared area and should not be done. If repalpation is absolutely necessary, facility policy may require sterile technique or repeat antisepsis. A gray-top tube is not collected before culture bottles; blood cultures are collected first in the order of draw to maintain sterility. Cleaning only the bottle cap is incomplete because both the patient's skin and bottle access surfaces must be prepared according to procedure. Blood culture quality depends on correct skin antisepsis, adequate drying time, correct bottle order, sufficient volume, separate collection sites when ordered, and accurate documentation. Contaminated cultures can lead to unnecessary antibiotics, longer hospitalization, additional testing, and patient harm. Reference topics: Special Collections; blood cultures; contamination prevention; antiseptic drying; aseptic technique.
29. Frage
Which of the following sites should a phlebotomist use as the second choice to perform venipuncture on an adult patient?
Antwort: B
Begründung:
The cephalic vein is the second-choice vein for routine adult venipuncture. The median cubital vein is preferred first because it is usually large, well anchored, superficial, and located away from major nerves and arteries. If the median cubital vein is unavailable or unsuitable, the cephalic vein is typically selected next because it is generally accessible and safer than the basilic vein. The basilic vein is usually the last choice in the antecubital area because it lies closer to the brachial artery and median nerve, increasing the risk of serious complications if the needle placement is poor. The median antebrachial vein may be visible in the forearm but is not the standard second-choice site for routine venipuncture. Proper site selection is not cosmetic; it is risk control. The phlebotomist must evaluate vein size, depth, resilience, direction, and surrounding anatomy while avoiding sites with edema, hematoma, burns, scarring, IV lines, infection, or mastectomy restrictions. Reference topics: Routine Blood Collections; antecubital vein selection; median cubital, cephalic, and basilic veins; site safety.
30. Frage
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