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| Section | Objectives |
|---|---|
| Routine Blood Collections | - Venipuncture procedures - Order of draw - Equipment selection and use |
| Special Collections | - Non-routine specimen collection methods - Pediatric and geriatric considerations - Capillary puncture (fingerstick/heel stick) |
| Specimen Processing and Handling | - Quality assurance procedures - Common errors and rejection criteria - Specimen transport and storage |
| Patient Preparation | - Site selection and preparation - Specimen labeling procedures - Patient identification and communication |
| Safety and Compliance | - HIPAA and patient confidentiality - Infection control and standard precautions - OSHA regulations and patient safety |
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NEW QUESTION # 110
Which of the following specimens should a phlebotomist protect from light immediately after collection?
Answer: D
Explanation:
Bilirubin specimens should be protected from light immediately after collection because bilirubin is photosensitive. Exposure to light can degrade bilirubin and produce falsely decreased results. The phlebotomist should follow facility procedure, which may include wrapping the tube in foil or using an amber transport container. Blood urea nitrogen is not classically light-sensitive; it is generally handled as a routine chemistry analyte unless special facility requirements apply. Sodium testing does not require light protection. Hemoglobin A1c reflects long-term glycemic exposure through glycated hemoglobin and is not light-sensitive in the same way bilirubin is. The broader technical principle is that specimen handling requirements are test-specific. Some specimens require chilling, some must remain warm, some require rapid transport, some must avoid light, and some require timed collection. Failure to follow these requirements creates preanalytical error even when the venipuncture itself was performed correctly. Reference topics: Special Collections; Processing Specimens; light-sensitive specimens; bilirubin handling; specimen integrity.
NEW QUESTION # 111
Which of the following is a possible complication of venipuncture collection for a patient who has been on warfarin therapy?
Answer: D
Explanation:
Prolonged bleeding is the expected complication for a patient on warfarin therapy. Warfarin is an anticoagulant, meaning it interferes with normal clot formation and can increase bleeding time after venipuncture. The phlebotomist should be alert for delayed hemostasis, apply firm pressure after needle removal, avoid having the patient bend the arm sharply, and confirm that bleeding has stopped before applying a bandage and leaving the patient. Blood clotting is the opposite of the expected medication effect. Hemostasis is the normal stopping of bleeding, not a complication. Petechiae can occur from tourniquet pressure, fragile capillaries, or platelet-related issues, but in this question the medication-specific risk is prolonged bleeding. Proper technique reduces complications: release the tourniquet, withdraw the needle smoothly, activate the safety device, apply pressure, and monitor the puncture site. Reference topics: Routine Blood Collections; post-procedure care; anticoagulant therapy; bleeding complications; hemostasis; patient observation. NHA includes routine venipuncture complications and post-collection care within the CPT test plan.
NEW QUESTION # 112
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: C
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 # 113
Which of the following sites should a phlebotomist use as the second choice to perform venipuncture on an adult patient?
Answer: A
Explanation:
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.
NEW QUESTION # 114
A phlebotomist observes that the lid of a sharps container will not close. Which of the following actions should the phlebotomist take?
Answer: B
Explanation:
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.
NEW QUESTION # 115
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