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| Section | Objectives |
|---|---|
| Topic 1: Safety and Compliance | - Needlestick prevention and biohazard disposal - OSHA standards and safety protocols - Infection control and PPE usage |
| Topic 2: Patient Preparation | - Site selection and preparation - Explaining procedures and obtaining consent - Patient identification and communication |
| Topic 3: Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
| Topic 4: Specimen Collection | - Order of draw and tube handling - Venipuncture techniques - Capillary puncture procedures |
| Topic 5: Specimen Processing and Handling | - Specimen transport and storage - Labeling and documentation - Quality control and rejection criteria |
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NEW QUESTION # 31
Which of the following actions should the phlebotomist take after filling the last tube of a venipuncture procedure?
Answer: B
Explanation:
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 In routine venipuncture, the tourniquet is released before needle removal, then the needle is withdrawn smoothly, the safety device is activated, and pressure is applied with clean gauze or cotton only after the needle is out.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.
NEW QUESTION # 32
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 # 33
Which of the following should a sharps container have?
Answer: A
Explanation:
A sharps container should have a leakproof lid or leak-resistant closure to prevent contaminated blood or fluid from escaping during handling, storage, or transport. Sharps containers must also be puncture-resistant, closable, upright and stable during use, and properly labeled or color-coded as biohazardous. A "room temperature" label is used for certain specimen storage or transport conditions, not for sharps disposal. A 1-gallon capacity is not a universal requirement; sharps containers come in multiple approved sizes depending on the setting and volume of use. Dual openings are not required and could increase risk if poorly designed. The essential safety standard is containment: the device must prevent puncture injury and leakage while allowing safe disposal at the point of use. The phlebotomist must never overfill a sharps container, reach into it, shake it, force items into it, or dispose of sharps in regular trash or soft biohazard bags. Reference topics: Safety and Compliance; sharps container requirements; biohazard disposal; OSHA bloodborne pathogen safety; needlestick prevention.
NEW QUESTION # 34
Which of the following types of testing requires chain of custody documentation for specimens?
Answer: B
Explanation:
Drug testing requires chain of custody documentation when the specimen is collected for legal, employment, forensic, or regulatory purposes. Chain of custody tracks the specimen from collection through transport, receipt, testing, storage, and final disposition. It documents who collected the specimen, who handled it, when transfers occurred, whether seals were intact, and whether the specimen remained secure. This protects the legal defensibility of the result by reducing the possibility of substitution, tampering, contamination, or misidentification. Blood typing requires strict patient identification and specimen labeling because of transfusion risk, but it is not the classic chain-of-custody specimen in this question. HIV testing requires confidentiality and consent requirements according to policy, but not forensic custody tracking in routine care. Tuberculosis testing requires correct collection or test procedure, infection-control precautions, and documentation, not legal custody control. For drug screening, the phlebotomist must follow collection kit instructions exactly, verify identity, seal the specimen properly, complete all required documentation, and maintain specimen security. Reference topics: Processing Specimens; chain of custody; toxicology testing; forensic specimens; legal documentation.
NEW QUESTION # 35
Which of the following is the purpose of applying a tourniquet for venipuncture?
Answer: D
Explanation:
The purpose of applying a tourniquet is to enlarge veins. A properly applied tourniquet partially restricts venous return while arterial flow continues briefly, causing the selected vein to become more prominent, easier to palpate, and easier to access. This improves site selection and helps establish blood flow into the collection device. The tourniquet must not be applied too tightly or left on too long because prolonged stasis can cause hemoconcentration, discomfort, petechiae, or altered laboratory values. "To solidify veins" is incorrect because veins do not become solid; they become distended. "To shrink veins" is the opposite of the intended effect. "To roll veins" is also incorrect; rolling veins are a collection problem controlled by proper anchoring, not an intended effect of tourniquet use. The phlebotomist should apply the tourniquet above the intended site, palpate appropriately, remove it within accepted time limits, and release it before needle withdrawal. NHA CPT routine collection content includes standard tourniquet application and removal procedures, palpation, site selection, anchoring, and procedural steps for removing the tourniquet, tubes, and needle. Reference topics: Routine Blood Collections; tourniquet application; vein palpation; venipuncture preparation.
NEW QUESTION # 36
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