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| Section | Weight | Objectives |
|---|---|---|
| Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Capillary puncture procedures - Order of draw & tube selection - Tourniquet use & vein assessment - Post-collection care & labeling |
| Patient Preparation | 20% | - Informed consent & communication - Patient identification & verification - Patient positioning & comfort - Site selection & preparation - Requisition review & test verification |
| Safety and Compliance | 26% | - HIPAA & patient confidentiality - Infection control & OSHA standards - Quality control & error prevention - Bloodborne pathogens & exposure control - PPE & sharps disposal |
| Special Collections | 12% | - Pediatric & geriatric collections - Therapeutic drug monitoring - Blood alcohol & legal collections - Blood cultures & sterile collection - Glucose tolerance & dynamic tests |
| Specimen Processing & Handling | 14% | - Aliquoting & preservation - Documentation & tracking - Specimen rejection criteria - Transport & storage requirements - Processing & centrifugation |
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NEW QUESTION # 16
Which of the following actions should a phlebotomist take before palpating a vein?
Answer: D
Explanation:
The phlebotomist should put on gloves before palpating a vein. Gloves are required because the phlebotomist is preparing for an invasive procedure with potential blood exposure. Palpation helps assess vein size, depth, direction, resilience, and suitability, but it must occur after hand hygiene and glove application. Removing the needle cap before site selection is unsafe because it exposes the needle unnecessarily and increases needlestick risk. Labeling collection tubes before collection is improper because tubes must be labeled after collection in the presence of the patient to prevent misidentification. Asking the patient to bend the arm is not appropriate for vein palpation and is especially unsafe after needle removal because bending the arm can cause hematoma formation. The correct sequence is patient identification, hand hygiene, gloves, position patient, apply tourniquet, select/palpate vein, release/reapply tourniquet as needed, clean site, allow antiseptic to dry, anchor, and perform venipuncture. Reference topics: Routine Blood Collections; glove use; vein palpation; venipuncture sequence; patient safety.
NEW QUESTION # 17
A patient starts convulsing during a blood collection. Which of the following actions should the phlebotomist take?
Answer: C
Explanation:
If a patient begins convulsing during blood collection, the phlebotomist's priority is patient safety and prevention of injury. From the choices provided, allowing the patient's limbs to move freely is correct because the phlebotomist should not restrain the patient during a seizure. Restraining can cause musculoskeletal injury and does not stop the seizure. In actual procedure, the phlebotomist should immediately stop the draw when safe, remove the tourniquet and needle, activate the safety device, call for help, protect the patient from surrounding hazards, and follow emergency protocol. Continuing the collection is unsafe because seizure activity can cause needle movement, vein trauma, needlestick exposure, and specimen compromise. A cold compress is more relevant to swelling, bruising, or selected local complications, not active convulsions. Orange juice may be appropriate only for a conscious patient with suspected hypoglycemia who can swallow safely; it is unsafe during convulsions. The NHA CPT outline includes recognizing seizures and other complications during routine blood collection, discontinuing the draw if needed, emergency response, and first aid. Reference topics: Safety and Compliance; Routine Blood Collections; seizure response; emergency care during collection.
NEW QUESTION # 18
Which of the following conditions is a reason for specimen rejection?
Answer: B
Explanation:
A clotted lavender-top specimen is a reason for specimen rejection. Lavender-top tubes contain EDTA anticoagulant and are used for tests such as CBCs, which require anticoagulated whole blood. If the specimen clots, the cellular components are trapped in the clot, platelet counts can be falsely low, and automated hematology analysis becomes unreliable. Properly labeled specimens, correctly filled light-blue tubes, and specimens transported upright are acceptable practices, not rejection causes. A clotted lavender specimen usually results from failure to mix the tube properly immediately after collection, delayed inversion, underfilling or collection difficulty, or drawing blood slowly and allowing clotting to begin before the specimen contacts the additive. The correct prevention is to fill the tube to the required volume and gently invert it the recommended number of times immediately after collection. The phlebotomist should never shake the tube, because vigorous agitation can cause hemolysis. Reference topics: Processing Specimens; specimen rejection; EDTA tube mixing; clotted specimens; hematology testing.
NEW QUESTION # 19
A phlebotomist completes a venipuncture procedure and activates the safety mechanism on the winged infusion set up to discard it into the sharps container. Which of the following actions should the phlebotomist take if the sharps container is locked?
Answer: D
Explanation:
If the sharps container is locked and cannot accept the used winged infusion set, the phlebotomist should obtain a new sharps container. A contaminated needle or winged infusion set must be discarded immediately into an approved sharps container that is puncture-resistant, leak-resistant, properly labeled or color-coded, closable, and accessible at the point of use. Unlocking or forcing a container is unsafe and may expose the technician to contaminated sharps. A trash container is never acceptable for needle disposal because it creates risk for housekeeping staff, patients, and other personnel. A biohazard bag is also incorrect because bags are for regulated soft biohazard waste, not sharps; needles can puncture the bag and cause injury. The correct action is to maintain control of the activated device safely and use an appropriate replacement sharps container. This is a direct OSHA and standard-precaution issue. Reference topics: Safety and Compliance; sharps disposal; safety-engineered devices; needlestick prevention; OSHA bloodborne pathogen precautions.
NEW QUESTION # 20
A phlebotomist in an emergency department is obtaining a blood sample from a patient who asks the purpose of the test. Which of the following responses should the phlebotomist give?
Answer: C
Explanation:
The phlebotomist should respond, "It's best that you ask the provider." A phlebotomist may explain the collection procedure, identify themselves, verify the patient, and answer process-related questions, but the clinical purpose, diagnosis, treatment rationale, and interpretation of ordered tests belong to the ordering provider or authorized clinical personnel. Saying the test screens for communicable diseases is unsafe because it may be inaccurate and could mislead or alarm the patient. Saying "I'm not sure" is weak communication and does not guide the patient to the correct source. Saying the purpose can be explained after completion is also inappropriate because it delays the patient's right to ask clinical questions before the procedure. The correct professional response maintains scope of practice, avoids unauthorized interpretation, and directs the patient to the person responsible for the order. NHA CPT patient-preparation content includes communication with patients, explaining the phlebotomy procedure, receiving consent, complying with ethical standards, and respecting scope of practice. Reference topics: Patient Preparation; scope of practice; patient communication; consent and procedure explanation.
NEW QUESTION # 21
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