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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Safety and Compliance | 26% | - PPE & sharps disposal - HIPAA & patient confidentiality - Infection control & OSHA standards - Quality control & error prevention - Bloodborne pathogens & exposure control |
| Topic 2: Patient Preparation | 20% | - Informed consent & communication - Patient identification & verification - Requisition review & test verification - Patient positioning & comfort - Site selection & preparation |
| Topic 3: Routine Blood Collections | 28% | - Tourniquet use & vein assessment - Post-collection care & labeling - Order of draw & tube selection - Capillary puncture procedures - Venipuncture techniques & equipment |
| Topic 4: Special Collections | 12% | - Pediatric & geriatric collections - Glucose tolerance & dynamic tests - Therapeutic drug monitoring - Blood cultures & sterile collection - Blood alcohol & legal collections |
| Topic 5: Specimen Processing & Handling | 14% | - Documentation & tracking - Transport & storage requirements - Specimen rejection criteria - Aliquoting & preservation - Processing & centrifugation |
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22. Frage
OSHA requires employers to provide which of the following to employees who are at risk for bloodborne pathogen exposure?
Antwort: D
Begründung:
OSHA requires employers to offer the hepatitis B vaccine to employees who have occupational exposure risk to bloodborne pathogens. Phlebotomists routinely handle blood, contaminated needles, sharps, and potentially infectious materials, so they fall into the category of workers who require bloodborne pathogen protection under workplace safety standards. Hepatitis B is a bloodborne viral infection that can be transmitted through needlestick injuries, mucous membrane exposure, or contact with contaminated blood. The vaccine is an important preventive measure and must be offered according to employer exposure-control procedures. Medical insurance and life insurance are employee benefit issues, not OSHA bloodborne-pathogen requirements. Phenylketonuria screening is a newborn metabolic screening test and has no connection to employee exposure prevention. In practice, the phlebotomist must also follow standard precautions, use PPE, activate safety devices, dispose of sharps immediately, report exposures, and comply with the facility exposure-control plan. Reference topics: Safety and Compliance; OSHA Bloodborne Pathogens Standard; hepatitis B vaccination; occupational exposure; needlestick prevention.
23. Frage
A laboratory is scheduled for a routine annual inspection with primary focus on equipment maintenance logs. Which of the following areas will be the focus of the inspection?
Antwort: C
Begründung:
The focus is mechanical safety because equipment maintenance logs document whether laboratory equipment is being inspected, maintained, calibrated, and monitored properly. In a phlebotomy or clinical laboratory setting, mechanical safety includes safe use and maintenance of centrifuges, refrigerators, freezers, analyzers, timers, and other equipment used in specimen collection and processing. Maintenance logs demonstrate that the facility follows required quality-control procedures and that equipment problems are reported and corrected. Chemical safety would focus on chemical labeling, SDS access, storage compatibility, spill response, and exposure controls. Radiation safety would apply to radioactive materials or imaging-related hazards, not routine phlebotomy equipment logs. Electrical safety would involve cords, plugs, grounding, and electrical hazards, which may be inspected separately but are not the primary focus when the question specifically identifies equipment maintenance logs. NHA CPT safety content includes performing quality control for laboratory equipment, maintaining logs for equipment inspection, reporting and troubleshooting equipment issues, and following manufacturer recommendations for equipment maintenance and calibration. Reference topics: Safety and Compliance; equipment maintenance logs; quality control; mechanical safety.
24. Frage
A patient calls about their laboratory results, which the phlebotomist has just retrieved from the office fax machine. Which of the following actions should the phlebotomist take?
Antwort: A
Begründung:
The phlebotomist should give the report to the requesting provider to review and notify the patient. Laboratory results are protected health information and often require clinical interpretation. A phlebotomist should not independently review, interpret, or communicate diagnostic results unless facility policy specifically authorizes a defined action. Telling the patient the results directly can create legal, privacy, and clinical risks, especially if the result is abnormal or requires medical explanation. Asking a laboratory supervisor to interpret and report the results is also inappropriate unless that person is the authorized provider or designated reporting professional. Telling the patient to pick up results may violate release-of-information procedures and still bypass provider review. The safe workflow is to route the report to the ordering provider or authorized clinical team for interpretation, documentation, and patient notification. Reference topics: Processing Specimens; communication of results; confidentiality; HIPAA; scope of practice; postanalytical handling. NHA CPT competencies include legal responsibilities, patient confidentiality, documentation, and result communication workflows.
25. Frage
Which of the following actions should a phlebotomist take before palpating a vein?
Antwort: D
Begründung:
The phlebotomist should put on gloves before palpating a vein. Gloves are required because the phlebotomist is preparing for an invasive procedure with potential blood exposure. Palpation helps assess vein size, depth, direction, resilience, and suitability, but it must occur after hand hygiene and glove application. Removing the needle cap before site selection is unsafe because it exposes the needle unnecessarily and increases needlestick risk. Labeling collection tubes before collection is improper because tubes must be labeled after collection in the presence of the patient to prevent misidentification. Asking the patient to bend the arm is not appropriate for vein palpation and is especially unsafe after needle removal because bending the arm can cause hematoma formation. The correct sequence is patient identification, hand hygiene, gloves, position patient, apply tourniquet, select/palpate vein, release/reapply tourniquet as needed, clean site, allow antiseptic to dry, anchor, and perform venipuncture. Reference topics: Routine Blood Collections; glove use; vein palpation; venipuncture sequence; patient safety.
26. Frage
A phlebotomist is collecting a blood culture from a 6-month-old infant who has no known allergies. Which of the following disinfectants should the phlebotomist use?
Antwort: D
Begründung:
Chlorhexidine gluconate is the best answer for blood culture skin antisepsis in this 6-month-old infant with no known allergies. Blood cultures require stricter skin disinfection than routine venipuncture because contamination can produce false-positive culture results, unnecessary antibiotics, repeat testing, and delayed diagnosis. Sodium polyanethol sulfonate is not a skin disinfectant; it is an anticoagulant/additive used in blood culture media to support organism recovery. Sodium hypochlorite is a bleach-type disinfectant used for environmental decontamination, not patient skin preparation for venipuncture. Hydrogen peroxide is not the standard blood culture skin antiseptic. Chlorhexidine is widely used for effective skin antisepsis, and CDC guidance recognizes chlorhexidine-containing agents in healthcare infection-control contexts when age, skin maturity, and clinical risk are considered. For collection technique, the phlebotomist should cleanse the site properly, allow the antiseptic to dry, avoid repalpating unless sterile technique is used, collect adequate volume, and label/document accurately. Reference topics: Special Collections; blood culture collection; pediatric skin preparation; contamination prevention.
27. Frage
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