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| Section | Objectives |
|---|---|
| Topic 1: Patient Preparation | - Site selection and preparation - Specimen labeling procedures - Patient identification and communication |
| Topic 2: Special Collections | - Capillary puncture (fingerstick/heel stick) - Non-routine specimen collection methods - Pediatric and geriatric considerations |
| Topic 3: Routine Blood Collections | - Venipuncture procedures - Order of draw - Equipment selection and use |
| Topic 4: Safety and Compliance | - OSHA regulations and patient safety - HIPAA and patient confidentiality - Infection control and standard precautions |
| Topic 5: Specimen Processing and Handling | - Specimen transport and storage - Quality assurance procedures - Common errors and rejection criteria |
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NEW QUESTION # 35
A phlebotomist has just performed quality control measurements on a glucose monitor. The values exceed the acceptable limits. Which of the following actions should the phlebotomist take?
Answer: C
Explanation:
When glucose monitor quality control values exceed acceptable limits, the phlebotomist should perform the manufacturer's recommended actions. Out-of-range QC means the instrument, strips, controls, operator technique, storage conditions, or environmental factors may be unreliable. Patient testing should not proceed until the problem is corrected and QC results return to acceptable range according to the device instructions and facility procedure. Cleaning the monitor may be part of troubleshooting, but it is not automatically the complete or correct response unless the manufacturer's protocol identifies contamination as the cause. Replacing batteries may be appropriate only if the device indicates low power or the manufacturer's instructions direct it. Documenting the values is necessary, but documentation alone does not correct the failed QC or validate patient results. The correct professional action is to follow the device-specific troubleshooting and QC procedure, repeat controls when indicated, remove defective materials from use, and notify the appropriate supervisor if unresolved. NHA CPT competencies include point-of-care testing, quality control, CLIA-waived testing, equipment maintenance, and accurate documentation. Reference topics: Special Collections; point-of-care glucose testing; quality control; manufacturer instructions.
NEW QUESTION # 36
At the completion of a routine venipuncture, a phlebotomist incurs a needlestick to their finger. Which of the following information should the phlebotomist include on the incident report for this situation?
Answer: D
Explanation:
The incident report should include the type of blood collection device used. For a needlestick or contaminated sharps injury, the device involved is central to exposure documentation because the facility must evaluate whether safer devices, training, handling, or disposal procedures failed. OSHA states that a sharps injury log must include, at minimum, the type and brand of device involved when known, the department or work area, and an explanation of how the incident occurred. The number and color of tubes collected may matter for specimen documentation but does not explain the exposure mechanism. The employee's primary care provider information is not the key occupational exposure detail. Proof of biohazard container fill-line adherence may be relevant only if the injury involved sharps disposal, but the broader required incident-report item is the collection device involved. The phlebotomist should immediately wash the area, report the injury, follow exposure-control policy, document the event, and obtain occupational health evaluation. Reference topics: Safety and Compliance; needlestick injury; exposure control; OSHA sharps injury log; incident reporting.
NEW QUESTION # 37
Which of the following is an example of a postanalytical error?
Answer: A
Explanation:
Failing to report a critical value promptly is a postanalytical error because it occurs after testing has produced a result. Postanalytical processes include result reporting, documentation, communication, verification, and delivery to the appropriate provider or clinical team. Collecting the wrong tube, underfilling a citrate tube, and hemolyzing a specimen during collection are preanalytical errors because they occur before laboratory analysis. These preanalytical errors may lead to specimen rejection or inaccurate results. Critical values require urgent communication because they may indicate an immediate threat to patient safety. The phlebotomist's role depends on facility policy; if performing point-of-care testing, the technician may be responsible for documenting and reporting results through a defined workflow. A delayed critical result can be just as dangerous as an incorrect specimen because the patient may not receive timely intervention. This question tests the three phases of laboratory testing: preanalytical, analytical, and postanalytical. Reference topics: Processing Specimens; postanalytical error; critical value reporting; documentation; laboratory workflow.
NEW QUESTION # 38
Which of the following specimens should be collected before antibiotics are administered when ordered for suspected bloodstream infection?
Answer: B
Explanation:
Blood cultures should be collected before antibiotics are administered when ordered for suspected bloodstream infection. Antibiotics can reduce or inhibit microbial growth in the specimen, potentially producing false-negative results. Blood cultures are used to detect bacteria or fungi in the bloodstream and require careful timing, strict antisepsis, adequate volume, and correct bottle handling. A lipid panel, hemoglobin A1c, and electrolyte panel do not depend on organism recovery and are not the priority before antibiotic therapy in this context. The phlebotomist must follow facility policy for collection order, number of sets, collection sites, bottle order, skin preparation, and documentation. If antibiotics have already been started, the phlebotomist should not cancel the test independently; they should collect according to order and document or communicate relevant timing if required. Blood culture contamination is a serious quality problem, but delayed collection after antibiotic administration can also reduce diagnostic value. Reference topics: Special Collections; blood cultures; timing before antibiotics; bloodstream infection; aseptic technique.
NEW QUESTION # 39
Which of the following actions should a phlebotomist take when transporting specimens to an outside laboratory?
Answer: C
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 # 40
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