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| Section | Objectives |
|---|---|
| Special Collections | - Pediatric and geriatric considerations - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) |
| Specimen Processing and Handling | - Common errors and rejection criteria - Quality assurance procedures - Specimen transport and storage |
| Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
| Routine Blood Collections | - Venipuncture procedures - Order of draw - Equipment selection and use |
| Safety and Compliance | - Infection control and standard precautions - OSHA regulations and patient safety - HIPAA and patient confidentiality |
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NEW QUESTION # 75
Which of the following actions should a phlebotomist take to prevent reflux during venipuncture?
Answer: C
Explanation:
To prevent reflux, the patient's arm should be kept in a downward position so the collection tube remains below the puncture site. Reflux occurs when blood or tube additive flows backward from the tube into the patient's vein. Keeping the tube below the venipuncture site and allowing tubes to fill properly reduces this risk. Holding the tube above the puncture site increases the chance of backflow. Removing the tube before it fills can create incorrect blood-to-additive ratios and does not prevent reflux. Inserting the needle bevel down is incorrect technique; venipuncture needles are inserted bevel up to enter the vein smoothly and reduce trauma. Reflux prevention also includes using proper tube position, avoiding excessive movement, not pushing tube contents toward the patient, and releasing the tourniquet appropriately. This is especially important with additive tubes because additive contamination of the patient's circulation, while uncommon, is a preventable safety concern. Reference topics: Routine Blood Collections; reflux prevention; evacuated tube technique; arm positioning; tube handling.
NEW QUESTION # 76
Which of the following actions should a phlebotomist take when a specimen requires immediate processing?
Answer: B
Explanation:
A specimen requiring immediate processing should be delivered or processed according to stat or time-sensitive protocol. Some analytes degrade rapidly, some cells change after collection, and some tests depend on strict timing. Leaving the specimen until the next courier pickup may cause inaccurate results or rejection. Marking it routine ignores the priority and may delay care. Refrigerating it overnight is inappropriate unless specifically required, and even then it would not satisfy immediate processing. The phlebotomist must recognize priority indicators such as STAT, timed, fasting, peak/trough, chilled, protected-from-light, and immediate-spin requirements. The responsibility does not end when blood enters the tube. Specimen integrity depends on timely transport, correct temperature, proper centrifugation, and accurate documentation. If a delay occurs, the phlebotomist should communicate it according to facility policy rather than silently submitting a compromised specimen. Reference topics: Processing Specimens; stat specimens; time-sensitive processing; transport priority; specimen stability.
NEW QUESTION # 77
A phlebotomist is preparing to perform venipuncture on a patient who has had a right-sided mastectomy. Which of the following collection sites should the phlebotomist select?
Answer: C
Explanation:
The phlebotomist should select the left antecubital area because the patient has had a right-sided mastectomy. Venipuncture should generally be avoided on the side of a mastectomy due to the risk of impaired lymphatic drainage, lymphedema, infection, and delayed healing. The right cephalic and right basilic veins are on the affected side and should not be used unless a provider specifically authorizes collection from that side. The left femoral artery is not an appropriate routine phlebotomy site and arterial collection is outside standard venipuncture practice unless performed under specialized authorization and scope. The left antecubital area is the safest option listed because it uses the unaffected arm and provides standard venipuncture access. The technician should still assess vein suitability, avoid sites with IVs, edema, scarring, hematoma, or infection, and follow facility policy if no acceptable site is available. This question tests contraindicated sites and safe site selection, not simply vein-name recall. Reference topics: Routine Blood Collections; mastectomy precautions; venipuncture site selection; contraindicated sites; patient safety.
NEW QUESTION # 78
A phlebotomist is preparing to collect a CBC and a basic metabolic panel using evacuated tubes. Which of the following tubes should the phlebotomist collect first?
Answer: C
Explanation:
For a CBC and basic metabolic panel, the green-top tube should be collected before the lavender-top tube when following the standard order of draw after sterile/blood culture tubes and coagulation tubes. A basic metabolic panel is commonly collected in a green-top heparin tube or serum tube depending on facility protocol, while a CBC requires a lavender-top EDTA tube. Additive carryover is the key concept. EDTA from a lavender tube can contaminate later specimens and falsely elevate potassium while lowering calcium because EDTA binds calcium. This makes lavender-top collection before chemistry specimens technically unsafe when chemistry testing is also ordered. Gray-top tubes are generally used for glucose or lactate testing and are collected later. Yellow SPS tubes are used for blood cultures and would be collected first only if blood cultures were ordered. The phlebotomist must know order of draw, tube additives, and the clinical consequence of additive contamination. Reference topics: Routine Blood Collections; order of draw; tube additives; CBC; chemistry specimen collection.
NEW QUESTION # 79
A patient's recent consumption of fatty substances could result in which of the following elevated analytes?
Answer: D
Explanation:
Recent consumption of fatty substances can elevate lipid-related analytes and can also produce lipemia, a milky or turbid appearance in serum or plasma. Therefore, the correct answer is lipid. This is why fasting status is important for certain chemistry tests, especially lipid panels or triglyceride-related testing. If the patient has not followed fasting requirements, the specimen may not reflect basal-state values and can produce misleading results. Bilirubin is primarily associated with hemoglobin breakdown and liver or biliary function; it is not directly elevated simply because the patient recently ate fatty food. Albumin is a plasma protein reflecting liver synthesis, nutrition, inflammation, or fluid status, not immediate dietary fat intake. Lipase is a pancreatic enzyme used mainly in the evaluation of pancreatic disorders and is not the same as lipids. The phlebotomist's responsibility is to verify patient compliance with fasting, medication, timing, and basal-state requirements before collection and proceed according to facility policy. Reference topics: Patient Preparation; fasting requirements; medication and basal-state compliance; preanalytical variables.
NEW QUESTION # 80
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