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| Section | Objectives |
|---|---|
| Patient Preparation | - Patient identification and communication - Explaining procedures and obtaining consent - Site selection and preparation |
| Professional Practice | - Communication and professionalism - Ethics and patient confidentiality (HIPAA) |
| Specimen Collection | - Order of draw and tube handling - Venipuncture techniques - Capillary puncture procedures |
| Specimen Processing and Handling | - Specimen transport and storage - Quality control and rejection criteria - Labeling and documentation |
| Safety and Compliance | - Infection control and PPE usage - OSHA standards and safety protocols - Needlestick prevention and biohazard disposal |
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NEW QUESTION # 73
A phlebotomist is performing a glucose tolerance test. Which of the following actions should the phlebotomist take after the patient drinks the glucose solution?
Answer: C
Explanation:
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.
NEW QUESTION # 74
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 # 75
A phlebotomist centrifuges a serum specimen before it has fully clotted. Which of the following is most likely to occur?
Answer: C
Explanation:
If a serum specimen is centrifuged before it has fully clotted, fibrin strands can form in the serum. These strands can interfere with testing instruments, cause sample aspiration problems, and lead to inaccurate results or specimen rejection. Serum specimens must be allowed to clot for the required time before centrifugation. Centrifugation does not increase specimen volume, neutralize additives, or sterilize blood. Blood specimens remain potentially infectious regardless of processing. This question tests the difference between serum and plasma. Serum is the liquid portion after clotting; plasma is the liquid portion of anticoagulated blood. If the phlebotomist rushes serum processing, the specimen may look separated but still contain fibrin. The correct workflow includes observing required clot time, balancing centrifuge tubes, using the correct speed and duration, and removing specimens promptly after centrifugation when required. Speed is not quality; specimen integrity is quality. Reference topics: Processing Specimens; clotting time; serum processing; centrifugation; fibrin formation.
NEW QUESTION # 76
Which of the following conditions is a reason for specimen rejection?
Answer: A
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 # 77
A phlebotomist is scheduled to perform a venipuncture on a patient who had a bilateral radical mastectomy. Which of the following actions should the phlebotomist take?
Answer: B
Explanation:
The phlebotomist should contact the provider for approval. After a mastectomy, especially radical mastectomy with lymph node involvement, venipuncture on the affected side is generally avoided because impaired lymphatic drainage can increase risk for lymphedema, infection, delayed healing, and patient complications. With a bilateral radical mastectomy, both arms may be restricted, so the phlebotomist should not independently choose an alternate arm vein. Drawing from an ulnar vein is not a standard solution and could still be in a restricted extremity. Requesting surgical outpatient records is not the immediate collection action and does not provide authorization to proceed. Obtaining a specimen from the subclavian vein is outside the phlebotomist's routine scope and would be a provider-level invasive procedure. The correct approach is to pause, follow facility policy, notify the nurse or provider, and obtain explicit direction for an approved site or alternate collection method. Reference topics: Routine Blood Collections; site contraindications; mastectomy precautions; provider communication; patient safety.
NEW QUESTION # 78
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