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| Section | Objectives |
|---|---|
| Safety and Compliance | - Infection control and PPE usage - OSHA standards and safety protocols - Needlestick prevention and biohazard disposal |
| Specimen Collection | - Venipuncture techniques - Order of draw and tube handling - Capillary puncture procedures |
| Specimen Processing and Handling | - Specimen transport and storage - Quality control and rejection criteria - Labeling and documentation |
| Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
| Patient Preparation | - Patient identification and communication - Explaining procedures and obtaining consent - Site selection and preparation |
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118. Frage
Which of the following is the maximum allowed time for a tourniquet application before possibly affecting test results?
Antwort: C
Begründung:
The maximum recommended tourniquet application time before results may be affected is 60 seconds. A tourniquet is applied to increase venous filling and make the vein easier to locate and access, but prolonged application causes venous stasis and hemoconcentration. When blood remains trapped below the tourniquet too long, fluid shifts from the vascular space into surrounding tissue, concentrating cells, proteins, and protein-bound analytes. This can falsely elevate results such as potassium, calcium, proteins, and other chemistry values. It can also increase patient discomfort and make the collection more difficult. Thirty and forty-five seconds are acceptable but are not the maximum allowed time. Ninety seconds is too long and increases the risk of altered test values. Correct practice is to apply the tourniquet only long enough to select the site and establish blood flow, then release it promptly, especially before removing the needle. Reference topics: Routine Blood Collections; tourniquet application; hemoconcentration; venipuncture preanalytical variables.
119. Frage
Which of the following should a phlebotomist review on a requisition prior to collection for an outpatient draw?
Antwort: B
Begründung:
Before collecting an outpatient specimen, the phlebotomist must review the requisition to confirm what test is ordered and what specimen requirements apply. Specimen requirements include tube type, additive, minimum volume, handling conditions, fasting status, timing, temperature, light protection, and whether the specimen requires special processing or transport. This step prevents preanalytical errors such as collecting the wrong tube, insufficient volume, wrong timing, or improperly handled specimens. Medications and allergies can be clinically relevant during patient interview, but they are not the primary item reviewed on the requisition for collection accuracy unless the test requirement specifically involves medication timing or patient compliance. Insurance authorization is administrative and should not drive the technical collection step. The requisition is the controlling document for collection, because it links patient identification, ordering provider, diagnosis or test code, test priority, and ordered tests. The NHA CPT outline includes obtaining, reviewing, and verifying orders or requisitions, confirming testing requirements, and understanding requisition field requirements. Reference topics: Patient Preparation; requisition review; testing requirements; specimen requirements; outpatient collection workflow.
120. Frage
Which of the following tube colors is commonly used for coagulation testing?
Antwort: C
Begründung:
Light-blue tubes are commonly used for coagulation testing because they contain sodium citrate. Citrate binds calcium reversibly, preventing clotting while preserving the specimen for coagulation analysis such as PT, INR, and aPTT. The tube must be filled to the required level because coagulation testing depends on a precise blood-to-anticoagulant ratio. Underfilling a light-blue tube can falsely prolong clotting results and cause specimen rejection. Lavender tubes contain EDTA and are commonly used for hematology tests such as CBC. Gray tubes often contain sodium fluoride and potassium oxalate and are used for glucose or lactate testing depending on facility protocol. Red tubes are generally serum tubes without anticoagulant or with clot activator depending on manufacturer. The phlebotomist must collect light-blue tubes in the correct order of draw and inspect for proper fill. This is a high-yield NHA-style concept because it combines tube color, additive, test department, and specimen acceptability. Reference topics: Routine Blood Collections; coagulation tubes; sodium citrate; fill volume; order of draw.
121. Frage
Which of the following actions should a phlebotomy technician take upon withdrawing a winged infusion needle?
Antwort: B
Begründung:
Upon withdrawing a winged infusion needle, the phlebotomy technician should activate the safety device. Winged infusion sets have a built-in safety mechanism designed to shield or retract the needle after use, reducing the risk of needlestick injury and bloodborne pathogen exposure. The device should be activated immediately according to the manufacturer's instructions and then disposed of in an appropriate sharps container. Disposing of a 16-gauge needle is not the best answer because winged sets for routine phlebotomy are not typically described as 16-gauge, and disposal occurs after safety activation. Placing a capillary pipette in clay relates to microhematocrit tube sealing, not venipuncture completion. Depressing a syringe plunger is unrelated to winged needle removal and could create exposure or specimen-handling problems if done incorrectly. The critical safety action is engineering-control use: activate the safety feature without recapping or unnecessary handling. Reference topics: Routine Blood Collections; Safety and Compliance; winged infusion sets; needle withdrawal; sharps safety; needlestick prevention. NHA CPT domains include equipment selection, needle removal, safety-device use, and exposure-control procedures.
122. Frage
Which of the following tests is most likely to require collection in a chilled specimen tube?
Antwort: A
Begründung:
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.
123. Frage
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