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| Section | Objectives |
|---|---|
| Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
| Specimen Processing and Handling | - Common errors and rejection criteria - Quality assurance procedures - Specimen transport and storage |
| Special Collections | - Non-routine specimen collection methods - Pediatric and geriatric considerations - Capillary puncture (fingerstick/heel stick) |
| Routine Blood Collections | - Equipment selection and use - Venipuncture procedures - Order of draw |
| Safety and Compliance | - HIPAA and patient confidentiality - Infection control and standard precautions - OSHA regulations and patient safety |
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NEW QUESTION # 113
Which of the following actions should a phlebotomist take when transporting specimens to an outside laboratory?
Answer: A
Explanation:
The phlebotomist should use appropriate leakproof transport packaging when specimens are transported to an outside laboratory. Specimen transport must protect the patient sample, courier, laboratory personnel, and documentation from leakage, breakage, contamination, and temperature-related instability. Requisitions should be kept separate from the specimen container, usually in an outer pouch, so paperwork is not contaminated if leakage occurs. Removing labels is never acceptable because identification must remain intact from collection through testing. Freezing all specimens is incorrect because temperature requirements are test-specific; freezing some specimens can destroy cells, alter analytes, or make the sample unsuitable. Proper transport includes correct labeling, biohazard identification, absorbent material when required, secure closure, upright positioning when appropriate, and compliance with time, light, and temperature requirements. The phlebotomist must know the difference between routine transport, chilled transport, frozen transport, and protected-from-light transport. Reference topics: Processing Specimens; specimen transport; leakproof packaging; biohazard handling; specimen integrity.
NEW QUESTION # 114
Which of the following pathologies requires a phlebotomist to use an N95 respirator?
Answer: B
Explanation:
Tuberculosis requires airborne precautions, including use of a properly fitted N95 respirator or equivalent respiratory protection when indicated by facility protocol. Tuberculosis can spread through airborne droplet nuclei, so a simple surgical mask is not the same level of respiratory protection for healthcare personnel entering a TB-risk environment. Lyme disease is transmitted through tick exposure, not routine airborne patient contact. Heart disease is cardiovascular pathology and does not require an N95 respirator as a transmission-based precaution. Thrombocytopenia is a low platelet count and affects bleeding risk, not respiratory isolation. The phlebotomist must follow posted isolation signage, perform hand hygiene, use required PPE, and avoid entering isolation rooms without proper protection and training. This question tests transmission-based precautions and recognition of airborne disease hazards. Reference topics: Safety and Compliance; PPE; airborne precautions; infection control; respiratory protection; isolation signage. CDC guidance specifically identifies respiratory protection programs for healthcare personnel using respirators to protect against Mycobacterium tuberculosis exposure.
NEW QUESTION # 115
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: C
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 # 116
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 # 117
A phlebotomist needs assistance in explaining a venipuncture procedure to a patient who speaks a different language than the phlebotomist. Which of the following people should the phlebotomist contact?
Answer: B
Explanation:
The phlebotomist should contact a medical interpreter. A patient who speaks a different language must receive clear, accurate information about the procedure, identification process, collection requirements, and consent in a language they understand. A qualified medical interpreter is trained to communicate healthcare information accurately while preserving confidentiality and minimizing misinterpretation. A charge nurse may help coordinate care but is not automatically qualified to interpret. A unit coordinator or office manager may assist administratively, but they are not the appropriate person to explain a clinical procedure in another language unless they are formally authorized and qualified as interpreters. Family members or untrained staff should not be used for medical interpretation when a qualified interpreter is available because errors can affect consent, safety, and patient rights. The phlebotomist should pause the procedure until communication is adequate, then explain the process, verify identity, confirm understanding, and obtain appropriate consent. Reference topics: Patient Preparation; communication barriers; medical interpretation; patient rights; informed/expressed/implied consent; cultural competence.
NEW QUESTION # 118
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