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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Safety and Compliance | 26% | - PPE & sharps disposal - Bloodborne pathogens & exposure control - Infection control & OSHA standards - HIPAA & patient confidentiality - Quality control & error prevention |
| Topic 2: Patient Preparation | 20% | - Requisition review & test verification - Patient identification & verification - Patient positioning & comfort - Site selection & preparation - Informed consent & communication |
| Topic 3: Special Collections | 12% | - Blood cultures & sterile collection - Therapeutic drug monitoring - Blood alcohol & legal collections - Pediatric & geriatric collections - Glucose tolerance & dynamic tests |
| Topic 4: Specimen Processing & Handling | 14% | - Aliquoting & preservation - Specimen rejection criteria - Processing & centrifugation - Transport & storage requirements - Documentation & tracking |
| Topic 5: Routine Blood Collections | 28% | - Capillary puncture procedures - Order of draw & tube selection - Tourniquet use & vein assessment - Post-collection care & labeling - Venipuncture techniques & equipment |
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NEW QUESTION # 23
Which of the following agencies is responsible for setting guidelines for bloodborne exposure incidents?
Answer: C
Explanation:
The Occupational Safety and Health Administration is responsible for workplace safety regulation, including requirements related to bloodborne pathogen exposure. In phlebotomy, bloodborne exposure incidents include needlesticks, blood splashes, mucous membrane exposure, and contact with non-intact skin. OSHA's Bloodborne Pathogens Standard requires employers to maintain exposure control plans, provide training, use engineering controls such as safety needles and sharps containers, support appropriate PPE, and establish procedures for exposure reporting and follow-up. CMS is primarily linked to Medicare, Medicaid, and healthcare payment/quality oversight, not direct bloodborne exposure incident standards. The FDA regulates medical devices, drugs, biologics, and related safety approvals. CLIA governs laboratory testing quality standards, not occupational blood exposure response. The option wording on the screen says "Occupational Safety of Health Administration," but the correct agency is OSHA: Occupational Safety and Health Administration. NHA CPT safety content includes OSHA, bloodborne pathogens, sharps disposal, biohazards, exposure control protocols, needlestick reporting, and workplace safety regulations. Reference topics: Safety and Compliance; OSHA; Bloodborne Pathogens Standard; exposure control protocols.
NEW QUESTION # 24
Which of the following types of medication is an indication for an INR draw?
Answer: C
Explanation:
An anticoagulant is the medication type most directly associated with an INR draw. INR, or international normalized ratio, is used to evaluate clotting time and is especially important for monitoring patients who take warfarin or other anticoagulant therapy. These medications reduce the blood's ability to clot, so laboratory monitoring helps determine whether the patient is within the therapeutic range or at risk for bleeding or clotting complications. Anti-inflammatory medications may affect bleeding risk in some situations, but they are not the primary indication for an INR draw. Antihistamines are used for allergic symptoms, and antiemetics are used for nausea or vomiting; neither is routinely monitored by INR. From a phlebotomy standpoint, anticoagulant therapy also alerts the technician to apply pressure longer after venipuncture and observe for prolonged bleeding. Reference topics: Special Collections; coagulation testing; point-of-care INR; medication-related collection considerations; hemostasis. The NHA CPT test plan includes special collections, waived testing, and coagulation/hemostasis-related competencies.
NEW QUESTION # 25
Which of the following actions should a phlebotomist take if blood flow stops during an evacuated tube collection?
Answer: C
Explanation:
If blood flow stops during an evacuated tube collection, the phlebotomist may gently adjust the needle position. Blood flow can stop if the bevel rests against the vein wall, the needle partially exits the vein, the needle passes through the vein, or the tube vacuum is defective. Small, controlled adjustments are acceptable, but aggressive probing is not. Rotating the needle 360 degrees is dangerous and can injure the vein, surrounding tissue, or nerves. Removing the tube and shaking it does not correct needle placement and can hemolyze the specimen. Pulling the needle almost completely out is unsafe because it can leave the vein, cause hematoma, or create a needlestick risk. If gentle adjustment does not restore flow, the phlebotomist should discontinue the attempt according to facility policy and consider recollection. Patient safety and specimen quality are more important than forcing a failed draw. Reference topics: Routine Blood Collections; troubleshooting venipuncture; blood flow failure; needle adjustment; complications prevention.
NEW QUESTION # 26
A phlebotomist is instructing a patient who has a prescription for a 24-hr urine collection. Which of the following instructions should the phlebotomist include?
Answer: D
Explanation:
For a 24-hour urine collection, the patient should discard the first urine on the day of collection, record the start time, and then collect all urine passed during the next 24 hours, including the final specimen at the end time. Discarding the first void empties the bladder and establishes a clean starting point for the timed collection. Keeping the specimen at room temperature is usually incorrect because many 24-hour urine specimens require refrigeration, ice, or preservatives depending on the ordered test. Urinating directly into the large collection container may be unsafe or impractical, especially if the container contains preservative; patients are commonly given a separate collection device and then transfer urine as instructed. Doubling fluid intake is incorrect because it can dilute analytes and alter test results unless specifically ordered by the provider. The phlebotomist must explain timing, storage, missed specimens, labeling, and return instructions clearly because incomplete collection is a major preanalytical error. NHA CPT competencies include non-blood specimen collection, patient instructions, timed urine collection, specimen storage, and specimen integrity. Reference topics: Special Collections; 24-hour urine; non-blood specimens; patient preparation.
NEW QUESTION # 27
Which of the following pathologies requires a phlebotomist to use an N95 respirator?
Answer: C
Explanation:
Tuberculosis requires airborne precautions, including use of a properly fitted N95 respirator or equivalent respiratory protection when indicated by facility protocol. Tuberculosis can spread through airborne droplet nuclei, so a simple surgical mask is not the same level of respiratory protection for healthcare personnel entering a TB-risk environment. Lyme disease is transmitted through tick exposure, not routine airborne patient contact. Heart disease is cardiovascular pathology and does not require an N95 respirator as a transmission-based precaution. Thrombocytopenia is a low platelet count and affects bleeding risk, not respiratory isolation. The phlebotomist must follow posted isolation signage, perform hand hygiene, use required PPE, and avoid entering isolation rooms without proper protection and training. This question tests transmission-based precautions and recognition of airborne disease hazards. Reference topics: Safety and Compliance; PPE; airborne precautions; infection control; respiratory protection; isolation signage. CDC guidance specifically identifies respiratory protection programs for healthcare personnel using respirators to protect against Mycobacterium tuberculosis exposure.
NEW QUESTION # 28
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