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| Section | Objectives |
|---|---|
| Topic 1: Safety and Compliance | - Infection control and standard precautions - OSHA regulations and patient safety - HIPAA and patient confidentiality |
| Topic 2: Routine Blood Collections | - Venipuncture procedures - Equipment selection and use - Order of draw |
| Topic 3: Specimen Processing and Handling | - Common errors and rejection criteria - Quality assurance procedures - Specimen transport and storage |
| Topic 4: Special Collections | - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) - Pediatric and geriatric considerations |
| Topic 5: Patient Preparation | - Patient identification and communication - Site selection and preparation - Specimen labeling procedures |
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NEW QUESTION # 90
Which of the following actions should a phlebotomist take if a patient develops a rapidly forming hematoma during venipuncture?
Answer: B
Explanation:
If a rapidly forming hematoma develops, the phlebotomist should remove the needle and apply pressure. A hematoma occurs when blood leaks into surrounding tissue, often because the needle has gone through the vein, partially exited the vein, or the vein wall has been injured. Continuing the collection can worsen bleeding, increase pain, and compromise the specimen. Asking the patient to pump their fist increases venous pressure and can worsen leakage or alter some test results. Inserting the needle deeper is unsafe because it may worsen vessel injury or strike nearby structures. The correct response is to release the tourniquet, remove the needle, activate the safety device, apply firm pressure, and monitor the site. A bandage should be applied only after bleeding has stopped. The phlebotomist should document or report the complication according to facility policy and avoid recollecting from the affected site. Reference topics: Routine Blood Collections; hematoma; venipuncture complications; needle removal; post-procedure care.
NEW QUESTION # 91
Which of the following transmission-based precautions should a phlebotomist follow when performing collections for a patient who has a Clostridium difficile infection?
Answer: C
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 # 92
Which of the following should a sharps container have?
Answer: C
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 # 93
Which of the following sites should a phlebotomist use for collecting a capillary blood specimen from an adult patient?
Answer: A
Explanation:
For an adult capillary blood specimen, the third digit with the cut perpendicular to the fingerprint grooves is the best answer. The third digit is the middle finger, one of the preferred fingers for dermal puncture because it usually has adequate tissue depth and blood flow. The incision should be made perpendicular to the fingerprint lines so blood forms a rounded drop instead of running along the fingerprint grooves, which improves collection efficiency and reduces specimen smearing. The second digit, or index finger, is generally avoided because it may be more calloused or sensitive and is used frequently for touch. The fifth digit should be avoided because it has less tissue depth and greater risk of bone injury. A cut parallel to fingerprint grooves is technically poor because blood can track along the grooves and make collection more difficult. Correct adult capillary collection requires site warming when needed, antisepsis, complete drying, appropriate lancet depth, wiping away the first drop when required, and avoiding excessive squeezing. Reference topics: Routine Blood Collections; dermal puncture; adult capillary site selection; lancet orientation; microcollection technique.
NEW QUESTION # 94
Which of the following laboratory departments performs a CBC and ESR?
Answer: B
Explanation:
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.
NEW QUESTION # 95
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