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| Section | Objectives |
|---|---|
| Topic 1: Special Collections | - Pediatric and geriatric considerations - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) |
| Topic 2: Routine Blood Collections | - Order of draw - Venipuncture procedures - Equipment selection and use |
| Topic 3: Specimen Processing and Handling | - Quality assurance procedures - Specimen transport and storage - Common errors and rejection criteria |
| Topic 4: Safety and Compliance | - OSHA regulations and patient safety - Infection control and standard precautions - HIPAA and patient confidentiality |
| Topic 5: Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
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質問 # 12
A phlebotomist observes that the lid of a sharps container will not close. Which of the following actions should the phlebotomist take?
正解：C
解説：
The sharps container should be replaced. A sharps container must be closable, puncture-resistant, leak-resistant, and properly labeled or color-coded. If the lid will not close, the container no longer provides safe containment and creates a needlestick or exposure hazard. Continuing to use it is unsafe even if it has not reached the fill line. Emptying sharps into another container is strictly inappropriate because it requires handling contaminated needles and increases exposure risk. Taping the opening closed is not an approved correction and does not restore the container's designed safety function. The phlebotomist should obtain an approved replacement container and report the defective container according to facility protocol. This is not a minor housekeeping issue; sharps disposal is an engineering-control requirement designed to prevent occupational exposure to bloodborne pathogens. Phlebotomy technicians must dispose of needles immediately after use, never recap used needles, and never place sharps in regular trash or soft biohazard bags. Reference topics: Safety and Compliance; sharps disposal; engineering controls; needlestick prevention.
質問 # 13
A phlebotomist is preparing to perform a phlebotomy procedure on a hospitalized patient. Which of the following steps should the phlebotomist take for the initial introduction?
正解：B
解説：
The best initial introduction is to knock on the door, greet the patient, and introduce themselves. This sequence respects privacy, establishes professional presence, and begins communication before any technical identification or collection step. Entering quietly without first knocking may be inappropriate in a patient-care environment because the patient has a right to privacy and dignity. Turning on lights immediately can be abrupt, especially for hospitalized patients who may be resting, anxious, or ill. Checking the ID band is essential, but it follows professional entry and introduction. Checking the provider's prescription or order is important before collection, but it is not the interpersonal "initial introduction" step at bedside. The correct approach supports patient cooperation, consent, and safety. After introduction, the phlebotomist should verify the order, use two identifiers, explain the procedure, assess patient readiness, and obtain consent according to facility policy. Reference topics: Patient Preparation; therapeutic communication; patient rights; bedside approach; patient identification; consent. NHA's CPT test plan includes patient communication and preparation as a major domain.
質問 # 14
A phlebotomist should avoid using a site with burned skin during venipuncture for which of the following reasons?
正解：B
解説：
Burned skin should be avoided for venipuncture because the tissue barrier is compromised and the site carries an increased risk of infection. A venipuncture intentionally breaches the skin, so selecting tissue that is already injured, inflamed, fragile, or poorly healed increases the chance of introducing microorganisms and worsening local tissue damage. Burned areas can also have altered circulation, scarring, tenderness, edema, and impaired healing, making vein assessment and needle control less reliable. Although damaged skin elasticity can make puncture technically difficult, the best clinical reason in this item is infection risk. Inaccuracy of laboratory results is more directly associated with sites such as IV arms, edematous tissue, hematomas, or improperly handled specimens. Vein sclerosis is associated with repeated venipuncture, medication irritation, or diseased veins, not simply the use of burned skin. The NHA CPT test plan includes venipuncture site selection, contraindicated collection sites, infection control, and patient safety under routine blood collection and safety competencies. Reference topics: Routine Blood Collections; Safety and Compliance; site selection; infection prevention.
質問 # 15
A patient's recent consumption of fatty substances could result in which of the following elevated analytes?
正解：B
解説：
Recent consumption of fatty substances can elevate lipid-related analytes and can also produce lipemia, a milky or turbid appearance in serum or plasma. Therefore, the correct answer is lipid. This is why fasting status is important for certain chemistry tests, especially lipid panels or triglyceride-related testing. If the patient has not followed fasting requirements, the specimen may not reflect basal-state values and can produce misleading results. Bilirubin is primarily associated with hemoglobin breakdown and liver or biliary function; it is not directly elevated simply because the patient recently ate fatty food. Albumin is a plasma protein reflecting liver synthesis, nutrition, inflammation, or fluid status, not immediate dietary fat intake. Lipase is a pancreatic enzyme used mainly in the evaluation of pancreatic disorders and is not the same as lipids. The phlebotomist's responsibility is to verify patient compliance with fasting, medication, timing, and basal-state requirements before collection and proceed according to facility policy. Reference topics: Patient Preparation; fasting requirements; medication and basal-state compliance; preanalytical variables.
質問 # 16
A patient refuses a blood draw after the phlebotomist explains the procedure. Which of the following actions should the phlebotomist take?
正解：B
解説：
The phlebotomist should notify the nurse or provider according to facility policy. A competent adult patient has the right to refuse a blood draw, even when the test is ordered. Proceeding against the patient's refusal is unethical and can constitute battery. Asking a family member to pressure the patient is inappropriate because consent must come from the patient or legally authorized representative when applicable, not from coercion. Using a smaller needle does not address refusal unless the patient specifically refused because of needle size and then gives consent after discussion. The phlebotomist should remain professional, clarify the patient's concern within scope, avoid arguing, document or report the refusal as required, and allow authorized clinical personnel to follow up. This question tests patient rights, consent, communication, and scope of practice. Phlebotomy is invasive, so consent is not optional. The technician's authority ends where patient refusal begins unless a specific emergency or legal policy applies through authorized medical personnel. Reference topics: Patient Preparation; patient refusal; consent; patient rights; communication; documentation.
質問 # 17
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