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| Section | Objectives |
|---|---|
| Specimen Processing and Handling | - Specimen transport and storage - Labeling and documentation - Quality control and rejection criteria |
| Patient Preparation | - Site selection and preparation - Patient identification and communication - Explaining procedures and obtaining consent |
| Specimen Collection | - Venipuncture techniques - Capillary puncture procedures - Order of draw and tube handling |
| Safety and Compliance | - Infection control and PPE usage - Needlestick prevention and biohazard disposal - OSHA standards and safety protocols |
| Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
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64. Frage
Which of the following actions is required before using a new lot number of point-of-care testing strips?
Antwort: B
Begründung:
Quality control testing should be performed before using a new lot number of point-of-care testing strips. Lot-to-lot variation can affect test performance, and QC confirms that the strips, controls, meter, and operator process are producing acceptable results before patient testing begins. Freezing strips is incorrect unless a manufacturer specifically requires a storage condition, and most reagent strips have controlled storage requirements that must not be improvised. Mixing old and new lots is unsafe because it creates traceability problems and can invalidate quality control. Using strips only for "control patients" is meaningless; patient specimens should not be used to validate unverified supplies. For waived testing and point-of-care testing, the phlebotomist must follow manufacturer instructions, document QC results, check expiration dates, store materials properly, and stop patient testing when controls fail. If QC is outside range, patient results should not be reported until corrective action is completed. Reference topics: Safety and Compliance; Special Collections; point-of-care testing; quality control; reagent lot verification.
65. Frage
Which of the following actions should a phlebotomist take immediately after blood splashes into their eye?
Antwort: B
Begründung:
The phlebotomist should immediately flush the eye with water at an eyewash station. Blood exposure to mucous membranes is a bloodborne pathogen exposure incident and requires immediate decontamination before administrative steps. Wiping the eye with gauze is inadequate and can irritate tissue or fail to remove infectious material. Continuing patient collections delays treatment and increases occupational risk. Applying antibiotic ointment is outside the phlebotomist's role and does not replace proper exposure response. After flushing, the phlebotomist must report the incident according to facility policy, complete required documentation, and obtain occupational health follow-up. This may include source-patient evaluation, baseline testing, and post-exposure prophylaxis assessment when indicated. The correct professional sequence is decontaminate first, report immediately, document accurately, and follow the exposure-control plan. This question tests standard precautions, exposure control, OSHA-related safety obligations, and emergency response in the phlebotomy environment. Reference topics: Safety and Compliance; bloodborne pathogen exposure; mucous membrane exposure; eyewash use; incident reporting.
66. Frage
A phlebotomist is instructing a patient who has a prescription for a 24-hr urine collection. Which of the following instructions should the phlebotomist include?
Antwort: A
Begründung:
For a 24-hour urine collection, the patient should discard the first urine on the day of collection, record the start time, and then collect all urine passed during the next 24 hours, including the final specimen at the end time. Discarding the first void empties the bladder and establishes a clean starting point for the timed collection. Keeping the specimen at room temperature is usually incorrect because many 24-hour urine specimens require refrigeration, ice, or preservatives depending on the ordered test. Urinating directly into the large collection container may be unsafe or impractical, especially if the container contains preservative; patients are commonly given a separate collection device and then transfer urine as instructed. Doubling fluid intake is incorrect because it can dilute analytes and alter test results unless specifically ordered by the provider. The phlebotomist must explain timing, storage, missed specimens, labeling, and return instructions clearly because incomplete collection is a major preanalytical error. NHA CPT competencies include non-blood specimen collection, patient instructions, timed urine collection, specimen storage, and specimen integrity. Reference topics: Special Collections; 24-hour urine; non-blood specimens; patient preparation.
67. Frage
At which of the following angles should a phlebotomist insert an antecubital venipuncture needle?
Antwort: D
Begründung:
For antecubital venipuncture, the needle is inserted bevel up at approximately a 15° to 30° angle, with 30° commonly used as the upper accepted standard for routine venous access. From the options provided, 30° is the best answer. A 10° angle is usually too shallow for antecubital venipuncture and may cause the needle to skim the skin surface or fail to enter the vein lumen. A 45° angle is too steep and increases the risk of passing through the vein, causing hematoma, pain, or arterial/nerve injury depending on site depth and anatomy. A 25° angle can be clinically workable in some routine venipunctures, but this item is asking for the standard recognized insertion angle, and 30° is the expected test answer. Proper angle must be combined with vein anchoring, bevel-up orientation, stable equipment control, and avoidance of excessive probing. The NHA CPT outline specifically includes needle insertion, angle of needle insertion and withdrawal, and routine venipuncture technique. Reference topics: Routine Blood Collections; antecubital venipuncture; angle of needle insertion; needle withdrawal and safety.
68. Frage
Which of the following actions can cause hemolysis during venipuncture?
Antwort: D
Begründung:
Using a needle with a gauge that is too small can cause hemolysis. A small-bore needle can create excessive mechanical force as blood passes through the lumen, damaging red blood cells and releasing intracellular contents into serum or plasma. Hemolysis can alter test results, especially potassium, lactate dehydrogenase, and other analytes affected by red-cell rupture. Allowing alcohol to dry before puncture is correct practice because it reduces stinging and helps prevent contamination. Releasing the tourniquet before needle removal is also correct because it reduces pressure and supports safer needle withdrawal. Mixing additive tubes by gentle inversion is required; the danger occurs when tubes are shaken vigorously. Additional hemolysis causes include probing, drawing through a hematoma, forcing blood from a syringe into a tube, rough transport, incorrect centrifugation, and delayed processing. A phlebotomist must choose equipment appropriate to the patient's vein while maintaining specimen quality. Reference topics: Routine Blood Collections; hemolysis; needle gauge selection; specimen integrity; preanalytical error.
69. Frage
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