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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Special Collections | 12% | - Glucose tolerance & dynamic tests - Blood alcohol & legal collections - Pediatric & geriatric collections - Blood cultures & sterile collection - Therapeutic drug monitoring |
| Topic 2: Specimen Processing & Handling | 14% | - Transport & storage requirements - Specimen rejection criteria - Processing & centrifugation - Aliquoting & preservation - Documentation & tracking |
| Topic 3: Routine Blood Collections | 28% | - Order of draw & tube selection - Capillary puncture procedures - Tourniquet use & vein assessment - Venipuncture techniques & equipment - Post-collection care & labeling |
| Topic 4: Safety and Compliance | 26% | - HIPAA & patient confidentiality - PPE & sharps disposal - Bloodborne pathogens & exposure control - Quality control & error prevention - Infection control & OSHA standards |
| Topic 5: Patient Preparation | 20% | - Patient identification & verification - Patient positioning & comfort - Site selection & preparation - Requisition review & test verification - Informed consent & communication |
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NEW QUESTION # 63
A phlebotomist receives a specimen without a patient identifier on the tube. Which of the following actions should the phlebotomist expect?
Answer: D
Explanation:
The laboratory should reject an unlabeled specimen. A specimen without patient identification cannot be reliably linked to the correct patient, even if a requisition is nearby or a provider verbally confirms the order. Labeling a tube later from the requisition is unsafe because it breaks the chain between patient, collection event, and specimen. Testing based only on an order number does not meet safe identification practice. Verbal confirmation after the fact cannot correct an unlabeled specimen because the tube's identity was not secured at the bedside or collection site. Proper labeling should occur immediately after collection in the presence of the patient, using required identifiers such as full name, date of birth, medical record number, date/time of collection, and collector identity according to facility policy. Mislabeling and unlabeled specimens are serious preanalytical errors that can cause wrong diagnosis, wrong treatment, transfusion risk, and patient harm. Reference topics: Processing Specimens; specimen labeling; patient identification; rejection criteria; preanalytical error.
NEW QUESTION # 64
Which of the following situations increases a phlebotomist's risk for a needlestick?
Answer: D
Explanation:
A nearly full sharps container increases the risk for a needlestick because contaminated needles or other sharps may protrude, rebound, or be difficult to place safely into the container. Sharps containers must be puncture-resistant, leak-resistant, properly labeled or color-coded, kept upright, and replaced before they become overfilled. OSHA specifically warns not to allow sharps containers to overfill and requires routine replacement to reduce sharps injury risk. A tight tourniquet can cause patient discomfort, hemoconcentration, or venous obstruction, but it is not the best answer for needlestick risk. A 22-gauge needle is commonly used for routine venipuncture, especially for smaller veins, and is not inherently unsafe. A transfer device used with the syringe method is actually a safety control because it prevents the phlebotomist from manually pushing blood through a needle into evacuated tubes. NHA CPT safety content includes bloodborne pathogens, sharps safety, OSHA standards, exposure control, and safe disposal of contaminated equipment. Reference topics: Safety and Compliance; OSHA Bloodborne Pathogens Standard; sharps disposal; needlestick prevention.
NEW QUESTION # 65
Which of the following transmission-based precautions should a phlebotomist follow when performing collections for a patient who has a Clostridium difficile infection?
Answer: B
Explanation:
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.
NEW QUESTION # 66
Which of the following actions should a phlebotomist take after removing gloves?
Answer: A
Explanation:
The phlebotomist should perform hand hygiene after removing gloves. Gloves reduce contamination but do not replace hand hygiene. Hands can become contaminated during glove removal, and gloves may have microscopic defects. Putting used gloves in a lab coat pocket is a contamination hazard. Sanitizing gloves for reuse is incorrect because medical gloves used during patient care are single-use items and should be discarded appropriately. Touching clean supplies immediately after glove removal without hand hygiene can contaminate the clean supply area and spread organisms to future patients. Proper glove workflow includes performing hand hygiene before gloving when indicated, wearing gloves for blood collection, avoiding unnecessary surface contact while gloved, removing gloves without contaminating the hands, discarding them properly, and performing hand hygiene afterward. This question tests routine infection-control behavior. Many healthcare-associated contamination events happen through simple missed hand hygiene after glove removal. Reference topics: Safety and Compliance; hand hygiene; glove removal; standard precautions; contamination prevention.
NEW QUESTION # 67
A phlebotomist must recollect a blood sample after the initial sample was rejected by the laboratory. Which of the following factors might have caused the sample to be rejected?
Answer: A
Explanation:
An underfilled collection tube is a common reason for laboratory rejection because many tests require a specific blood-to-additive ratio. This is especially critical for coagulation specimens, where insufficient blood relative to anticoagulant can falsely prolong clotting results. Underfilling can also produce inadequate specimen volume for testing, repeat analysis, or instrument requirements. A hematoma at the puncture site is a patient complication and may indicate procedural difficulty, but it does not automatically require specimen rejection unless it affected specimen quality. Use of a multiple-sample needle is a standard venipuncture method and is not a rejection criterion by itself. The cephalic vein is an acceptable antecubital vein when selected appropriately, so using it does not invalidate the specimen. Processing accuracy begins at collection: correct tube, correct volume, correct mixing, correct labeling, and correct transport. The NHA CPT outline identifies preanalytical errors, minimum and maximum volume requirements, fill levels and ratios, maintaining specimen integrity, and recollection as core processing and collection competencies. Reference topics: Processing Specimens; preanalytical errors; tube fill level; specimen rejection and recollection.
NEW QUESTION # 68
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