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| Section | Objectives |
|---|---|
| Topic 1: Safety and Compliance | - Needlestick prevention and biohazard disposal - Infection control and PPE usage - OSHA standards and safety protocols |
| Topic 2: Specimen Collection | - Venipuncture techniques - Order of draw and tube handling - Capillary puncture procedures |
| Topic 3: Professional Practice | - Communication and professionalism - Ethics and patient confidentiality (HIPAA) |
| Topic 4: Patient Preparation | - Site selection and preparation - Patient identification and communication - Explaining procedures and obtaining consent |
| Topic 5: Specimen Processing and Handling | - Quality control and rejection criteria - Labeling and documentation - Specimen transport and storage |
>> Phlebotomy-Technician参考書内容 <<
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質問 # 111
A phlebotomist notices that a serum separator tube has not clotted before centrifugation. Which of the following actions should the phlebotomist take?
正解：A
解説：
The phlebotomist should allow the serum separator tube to clot completely before centrifugation. Serum specimens require clot formation before centrifugation so the liquid serum can separate properly from the clot. Centrifuging before clotting is complete can cause fibrin strands, incomplete separation, instrument issues, and possible specimen rejection. Shaking the tube vigorously is incorrect because it can hemolyze the specimen and disrupt cellular integrity. Transferring the specimen into a plasma tube is unsafe and invalid because the specimen was not collected with the correct anticoagulant at the correct blood-to-additive ratio. Proper processing means respecting the requirements of the tube collected: serum tubes must clot for the required time, additive tubes must be gently inverted, and specimens must be centrifuged according to time, speed, and temperature requirements. This item tests processing discipline, not speed. A phlebotomist must protect specimen integrity from collection through transport and processing. Reference topics: Processing Specimens; serum separation; clotting time; centrifugation; specimen rejection.
質問 # 112
Which of the following should a phlebotomist review on a requisition prior to collection for an outpatient draw?
正解：D
解説：
Before collecting an outpatient specimen, the phlebotomist must review the requisition to confirm what test is ordered and what specimen requirements apply. Specimen requirements include tube type, additive, minimum volume, handling conditions, fasting status, timing, temperature, light protection, and whether the specimen requires special processing or transport. This step prevents preanalytical errors such as collecting the wrong tube, insufficient volume, wrong timing, or improperly handled specimens. Medications and allergies can be clinically relevant during patient interview, but they are not the primary item reviewed on the requisition for collection accuracy unless the test requirement specifically involves medication timing or patient compliance. Insurance authorization is administrative and should not drive the technical collection step. The requisition is the controlling document for collection, because it links patient identification, ordering provider, diagnosis or test code, test priority, and ordered tests. The NHA CPT outline includes obtaining, reviewing, and verifying orders or requisitions, confirming testing requirements, and understanding requisition field requirements. Reference topics: Patient Preparation; requisition review; testing requirements; specimen requirements; outpatient collection workflow.
質問 # 113
Which of the following laboratory departments performs a CBC and ESR?
正解：D
解説：
CBC and ESR testing are performed in the hematology department. A complete blood count evaluates formed elements of blood, including red blood cells, white blood cells, hemoglobin, hematocrit, platelet count, and sometimes differential cell counts. ESR, or erythrocyte sedimentation rate, is also a hematology procedure because it measures the rate at which red blood cells settle in anticoagulated blood over a defined time. Chemistry handles serum or plasma analytes such as glucose, electrolytes, enzymes, renal markers, liver markers, and metabolic panels. Serology focuses on immune reactions, antibodies, antigens, and infectious or immunologic testing. Microbiology deals with organisms, cultures, stains, and susceptibility testing. Knowing laboratory departments helps the phlebotomist route specimens correctly, answer workflow questions accurately, and understand tube selection and specimen handling requirements. For CBC and ESR, anticoagulated whole blood is typically required, commonly collected in lavender-top EDTA tubes depending on the laboratory's procedure. NHA CPT competencies include laboratory departments, blood components, specimen processing, specimen transport, and communication of laboratory information. Reference topics: Processing Specimens; hematology department; CBC; ESR; specimen routing.
質問 # 114
Which of the following is the life span of an erythrocyte?
正解：C
解説：
The life span of an erythrocyte, or red blood cell, is approximately 120 days. Erythrocytes are specialized cells that transport oxygen through hemoglobin and support carbon dioxide transport from tissues back to the lungs. Because mature erythrocytes lack nuclei and many organelles, they cannot repair themselves indefinitely; they gradually lose membrane flexibility and are removed primarily by the spleen and reticuloendothelial system. A 14-day lifespan is far too short for normal red blood cells and is more consistent with certain abnormal disease states or other cellular turnover concepts. Eighty days and 160 days are not the standard lifespan used in basic hematology. This knowledge matters in phlebotomy because blood collection, CBC interpretation context, hemolysis awareness, and specimen quality all depend on understanding blood components. The phlebotomist is not diagnosing anemia or hemolytic disease, but must understand formed elements and their general characteristics. Reference topics: Phlebotomy Fundamentals; blood composition; erythrocytes; hematology basics; CBC-related concepts. MedlinePlus states that red blood cells live about 120 days.
質問 # 115
Which of the following actions should the phlebotomist take after filling the last tube of a venipuncture procedure?
正解：A
解説：
After the last tube has filled, the phlebotomist must complete the venipuncture termination sequence safely. The correct action from the choices is to withdraw the needle from the puncture site. In routine venipuncture, the tourniquet is released before needle removal, then the needle is withdrawn smoothly, the safety device is activated, and pressure is applied with clean gauze or cotton only after the needle is out. Applying cotton while the needle is still inserted can cause the needle to cut or traumatize the vein. Cleaning the site with antiseptic occurs before puncture, not after collection. A warm compress is not part of routine completion; it may be used only for selected complications or difficult venous access before collection. The NHA CPT outline specifically includes standard tourniquet removal, needle removal, safety-device use, post-procedural care, and bandaging as routine blood collection competencies. Reference topics: Routine Blood Collections; removing tourniquet, tubes, and needle; post-procedural patient care.
質問 # 116
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