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| Section | Objectives |
|---|---|
| Topic 1: Specimen Processing and Handling | - Specimen transport and storage - Quality control and rejection criteria - Labeling and documentation |
| Topic 2: Safety and Compliance | - Infection control and PPE usage - OSHA standards and safety protocols - Needlestick prevention and biohazard disposal |
| Topic 3: Patient Preparation | - Site selection and preparation - Patient identification and communication - Explaining procedures and obtaining consent |
| Topic 4: Professional Practice | - Communication and professionalism - Ethics and patient confidentiality (HIPAA) |
| Topic 5: Specimen Collection | - Order of draw and tube handling - Venipuncture techniques - Capillary puncture procedures |
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質問 # 53
Which of the following tests is most likely to require collection in a chilled specimen tube?
正解：A
解説：
Ammonia is most likely to require collection in a chilled specimen tube and rapid transport, depending on facility protocol. Ammonia is unstable and can be affected by delayed processing, temperature, and cellular metabolism after collection. Chilling slows metabolic activity and helps preserve specimen integrity. Total cholesterol is generally a routine chemistry test and does not usually require immediate chilling. Hemoglobin A1c is collected to evaluate long-term glycemic control and is not typically a chilled specimen. Blood cultures require aseptic technique, correct culture bottles, adequate volume, and timely incubation or transport, not chilling. The broader lesson is that special handling requirements are analyte-specific. Some specimens must be chilled, some kept warm, some protected from light, and some delivered immediately. The phlebotomist must review the requisition, laboratory directory, or facility procedure before collection. Improper temperature handling can produce inaccurate results even if the specimen was collected in the correct tube. Reference topics: Special Collections; chilled specimens; ammonia handling; specimen stability; transport requirements.
質問 # 54
A phlebotomist is preparing to perform venipuncture on a patient who has had a right-sided mastectomy. Which of the following collection sites should the phlebotomist select?
正解：A
解説：
The phlebotomist should select the left antecubital area because the patient has had a right-sided mastectomy. Venipuncture should generally be avoided on the side of a mastectomy due to the risk of impaired lymphatic drainage, lymphedema, infection, and delayed healing. The right cephalic and right basilic veins are on the affected side and should not be used unless a provider specifically authorizes collection from that side. The left femoral artery is not an appropriate routine phlebotomy site and arterial collection is outside standard venipuncture practice unless performed under specialized authorization and scope. The left antecubital area is the safest option listed because it uses the unaffected arm and provides standard venipuncture access. The technician should still assess vein suitability, avoid sites with IVs, edema, scarring, hematoma, or infection, and follow facility policy if no acceptable site is available. This question tests contraindicated sites and safe site selection, not simply vein-name recall. Reference topics: Routine Blood Collections; mastectomy precautions; venipuncture site selection; contraindicated sites; patient safety.
質問 # 55
Which of the following agencies is responsible for setting guidelines for bloodborne exposure incidents?
正解：A
解説：
The Occupational Safety and Health Administration is responsible for workplace safety regulation, including requirements related to bloodborne pathogen exposure. In phlebotomy, bloodborne exposure incidents include needlesticks, blood splashes, mucous membrane exposure, and contact with non-intact skin. OSHA's Bloodborne Pathogens Standard requires employers to maintain exposure control plans, provide training, use engineering controls such as safety needles and sharps containers, support appropriate PPE, and establish procedures for exposure reporting and follow-up. CMS is primarily linked to Medicare, Medicaid, and healthcare payment/quality oversight, not direct bloodborne exposure incident standards. The FDA regulates medical devices, drugs, biologics, and related safety approvals. CLIA governs laboratory testing quality standards, not occupational blood exposure response. The option wording on the screen says "Occupational Safety of Health Administration," but the correct agency is OSHA: Occupational Safety and Health Administration. NHA CPT safety content includes OSHA, bloodborne pathogens, sharps disposal, biohazards, exposure control protocols, needlestick reporting, and workplace safety regulations. Reference topics: Safety and Compliance; OSHA; Bloodborne Pathogens Standard; exposure control protocols.
質問 # 56
Which of the following methods should a phlebotomist use to anchor a vein?
正解：A
解説：
The vein is anchored by placing the thumb of the free hand below the intended puncture site and gently pulling the skin taut. This stabilizes the vein, reduces rolling, creates a firmer puncture surface, and supports accurate needle entry. Anchoring above the site is unsafe because it places the phlebotomist's hand in the direction of needle travel and increases needlestick risk. Using two fingers instead of the thumb provides less controlled traction and may interfere with the venipuncture angle or contaminate the prepared site. The phlebotomist should avoid touching the cleansed puncture site after antisepsis unless the site is re-cleansed. Proper anchoring is especially important for superficial or mobile veins because failure to stabilize the vein can cause missed access, hematoma formation, probing, patient discomfort, or specimen collection failure. The NHA CPT outline identifies anchoring the vein below the venipuncture site and knowledge of anchoring techniques as routine venipuncture competencies. Reference topics: Routine Blood Collections; site selection; anchoring below venipuncture site; venous anatomy and safe insertion technique.
質問 # 57
Which of the following actions should a phlebotomist take when obtaining a throat culture?
正解：A
解説：
When obtaining a throat culture, the phlebotomist should swab the tonsillar area and the back of the throat because these are the clinically relevant sites for detecting organisms associated with pharyngitis, such as group A Streptococcus. The swab should avoid the tongue, cheeks, teeth, and lips because contact with those surfaces can contaminate the specimen with normal oral flora and reduce diagnostic value. Swabbing the buccal areas collects cheek-cell or oral flora material, not a proper throat specimen. Swabbing visible mucus in the oral cavity is unreliable because mucus may not represent the infected pharyngeal area. Leaving the swab in the sublingual area is inappropriate because the area under the tongue is not the target site for a throat culture. Correct technique includes explaining the procedure, positioning the patient, using a tongue depressor if needed, quickly swabbing the tonsillar pillars and posterior pharynx, placing the swab in the correct transport medium, and labeling the specimen accurately. Reference topics: Special Collections; non-blood specimen collection; throat culture technique; specimen integrity; patient instructions.
質問 # 58
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