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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Specimen Processing & Handling | 14% | - Documentation & tracking - Specimen rejection criteria - Transport & storage requirements - Aliquoting & preservation - Processing & centrifugation |
| Topic 2: Special Collections | 12% | - Blood cultures & sterile collection - Pediatric & geriatric collections - Therapeutic drug monitoring - Glucose tolerance & dynamic tests - Blood alcohol & legal collections |
| Topic 3: Patient Preparation | 20% | - Site selection & preparation - Patient identification & verification - Informed consent & communication - Requisition review & test verification - Patient positioning & comfort |
| Topic 4: Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Post-collection care & labeling - Order of draw & tube selection - Capillary puncture procedures - Tourniquet use & vein assessment |
| Topic 5: Safety and Compliance | 26% | - PPE & sharps disposal - HIPAA & patient confidentiality - Bloodborne pathogens & exposure control - Quality control & error prevention - Infection control & OSHA standards |
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질문 # 120
Which of the following transmission-based precautions should a phlebotomist follow when performing collections for a patient who has a Clostridium difficile infection?
정답：A
설명：
Clostridium difficile infection requires contact precautions because the organism is transmitted primarily by the fecal-oral route through contaminated hands, surfaces, equipment, and patient-care environments. A phlebotomist entering the room must follow posted isolation instructions, use appropriate PPE, and perform meticulous hand hygiene. For C. difficile, soap-and-water handwashing is especially important because alcohol-based hand rubs do not reliably destroy spores. Airborne precautions are used for diseases transmitted by small droplet nuclei, such as tuberculosis. Droplet precautions are used for organisms spread through respiratory droplets, such as influenza or pertussis. Reverse isolation is used to protect severely immunocompromised patients from external contamination, not to protect staff and other patients from C. difficile. Contact precautions directly address the transmission route. The phlebotomist should also avoid bringing unnecessary supplies into the room, disinfect reusable equipment according to policy, and prevent cross-contamination during specimen handling. Reference topics: Safety and Compliance; infection control; transmission-based precautions; PPE; isolation procedures; hand hygiene.
질문 # 121
Which of the following should a phlebotomist do if a specimen must remain warm during transport?
정답：C
설명：
If a specimen must remain warm during transport, the phlebotomist should use an approved warming device according to facility policy. Some tests, such as cold agglutinin-related specimens or specific specialized assays, may require warm handling to prevent analyte or cellular changes. Placing the specimen on ice or refrigerating it would violate warm-transport requirements and could compromise results. Leaving it near a sunny window is uncontrolled, unsafe, and may expose the specimen to light or excessive heat. Temperature requirements must be controlled and documented when required. The phlebotomist should not improvise with unapproved heat sources because overheating can also damage specimens. Proper specimen handling means knowing whether the specimen should be transported at room temperature, chilled, frozen, protected from light, or kept warm. Failure to follow special handling instructions creates preanalytical error and may require recollection. Reference topics: Processing Specimens; warm specimens; transport requirements; temperature control; specimen integrity.
질문 # 122
Which of the following actions is required before using a new lot number of point-of-care testing strips?
정답：C
설명：
Quality control testing should be performed before using a new lot number of point-of-care testing strips. Lot-to-lot variation can affect test performance, and QC confirms that the strips, controls, meter, and operator process are producing acceptable results before patient testing begins. Freezing strips is incorrect unless a manufacturer specifically requires a storage condition, and most reagent strips have controlled storage requirements that must not be improvised. Mixing old and new lots is unsafe because it creates traceability problems and can invalidate quality control. Using strips only for "control patients" is meaningless; patient specimens should not be used to validate unverified supplies. For waived testing and point-of-care testing, the phlebotomist must follow manufacturer instructions, document QC results, check expiration dates, store materials properly, and stop patient testing when controls fail. If QC is outside range, patient results should not be reported until corrective action is completed. Reference topics: Safety and Compliance; Special Collections; point-of-care testing; quality control; reagent lot verification.
질문 # 123
Which of the following sites should a phlebotomist use as the second choice to perform venipuncture on an adult patient?
정답：B
설명：
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.
질문 # 124
Which of the following complications is associated with a dermal puncture?
정답：D
설명：
Osteomyelitis is the correct complication associated with dermal puncture, especially when puncture depth or site selection is improper in infants. Osteomyelitis is infection of bone, and it can occur if a lancet penetrates too deeply or if a puncture is performed over an unsafe area where soft tissue is thin and bone is close to the skin. This is why infant heel punctures must be performed only on the medial or lateral plantar surface and never on the posterior curvature or central heel. Osteoarthritis is degenerative joint disease and is not caused by dermal puncture. Osteoporosis is reduced bone density and is unrelated to capillary collection technique. Osteosarcoma is a malignant bone tumor and is not a procedural complication of phlebotomy. Proper dermal puncture requires correct lancet depth, appropriate site selection, aseptic technique, and avoidance of repeated punctures in the same area. NHA CPT content includes dermal puncture procedures, capillary collection, complications, site selection, and patient risk reduction. Reference topics: Routine Blood Collections; dermal puncture; capillary collection; pediatric site safety.
질문 # 125
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