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| Section | Objectives |
|---|---|
| Specimen Processing and Handling | - Common errors and rejection criteria - Quality assurance procedures - Specimen transport and storage |
| Routine Blood Collections | - Order of draw - Equipment selection and use - Venipuncture procedures |
| Patient Preparation | - Site selection and preparation - Specimen labeling procedures - Patient identification and communication |
| Special Collections | - Non-routine specimen collection methods - Pediatric and geriatric considerations - Capillary puncture (fingerstick/heel stick) |
| Safety and Compliance | - OSHA regulations and patient safety - HIPAA and patient confidentiality - Infection control and standard precautions |
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48. Frage
Which of the following actions should a phlebotomy technician take upon withdrawing a winged infusion needle?
Antwort: C
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.
49. Frage
Which of the following patient positions is safest for a patient who reports a history of fainting during blood draws?
Antwort: D
Begründung:
A patient with a history of fainting should be positioned reclining or lying down before collection. Syncope is a common phlebotomy complication and can lead to falls, head injury, needle injury, or specimen loss if the patient is not positioned safely. Standing is never appropriate for venipuncture because a fainting patient can collapse. Sitting on an unsupported exam table is also unsafe because the patient may fall from a height. Sitting with legs crossed can affect circulation and does not protect against syncope. The phlebotomist should ask about prior fainting, observe the patient's color and behavior, explain the procedure calmly, and stop the draw if the patient becomes pale, diaphoretic, dizzy, nauseated, or unresponsive. If syncope occurs, the phlebotomist should remove the needle when safe, activate the safety device, call for assistance, lower the patient's head or follow facility policy, and monitor the patient until help arrives. Reference topics: Patient Preparation; syncope prevention; patient positioning; adverse reactions; venipuncture safety.
50. Frage
A phlebotomist should immediately report which of the following to a supervisor?
Antwort: D
Begründung:
A needlestick injury must be reported immediately to a supervisor because it is an occupational exposure incident involving potential transmission of bloodborne pathogens. Immediate reporting triggers the facility's exposure-control plan, which may include wound cleansing, documentation, source-patient evaluation when permitted, employee health assessment, post-exposure prophylaxis consideration, and required follow-up testing. Delayed reporting can compromise medical management and regulatory documentation. Outdated blood collection supplies should be removed from use and handled according to inventory or quality-control policy, but they do not carry the same immediate occupational exposure urgency. An allergic reaction must be managed clinically and reported according to severity and facility procedure, but the most direct supervisor-reporting requirement in this item is the needlestick injury. Patient noncompliance with dietary requirements should be documented or communicated as required because it may affect test validity, but it is not an occupational exposure emergency. NHA CPT safety content specifically includes following exposure control plans for needle sticks, notification requirements, needle stick protocols, bloodborne pathogen standards, and reporting requirements. Reference topics: Safety and Compliance; needlestick injury; exposure control protocols; reporting requirements.
51. Frage
Which of the following veins is usually the last choice for antecubital venipuncture?
Antwort: B
Begründung:
The basilic vein is usually the last choice for antecubital venipuncture. The median cubital vein is preferred because it is typically large, well anchored, superficial, and less likely to roll. The cephalic vein is commonly the second choice when the median cubital is unavailable. The basilic vein is used cautiously because it lies closer to the brachial artery and median nerve, creating greater risk if the needle is inserted too deeply or inaccurately. The dorsal metacarpal veins are hand veins, not antecubital veins, and may be used when antecubital access is unavailable, often with a butterfly needle and shallow angle. This question tests anatomical risk control. A phlebotomist must not simply pick the most visible vein; they must evaluate vein safety, depth, direction, resilience, patient history, and contraindications such as IV sites, edema, burns, scars, hematomas, fistulas, and mastectomy restrictions. Proper site selection reduces pain, nerve injury, arterial puncture, hematoma, and recollection risk. Reference topics: Routine Blood Collections; antecubital anatomy; vein selection; basilic vein risk.
52. Frage
Which of the following questions should a phlebotomist ask to verify fasting status?
Antwort: A
Begründung:
The phlebotomist should ask, "When was the last time you had anything to eat or drink other than water?" This question directly verifies fasting status and avoids a vague yes/no answer. Patients may misunderstand fasting and think coffee, juice, gum, candy, or a small snack does not count. Asking about medication is important for some tests, but it does not verify fasting. Asking why the provider ordered the test is outside the phlebotomist's interpretive role and may lead to unauthorized clinical discussion. Asking whether the patient has had the test before does not confirm current preparation. Accurate fasting verification is part of patient preparation and preanalytical quality control. If the patient has not fasted as required, the phlebotomist should follow facility policy, notify appropriate personnel, document noncompliance if collection proceeds, or reschedule if instructed. Poor preparation can produce misleading chemistry results and unnecessary repeat testing. Reference topics: Patient Preparation; fasting verification; patient interview; basal-state requirements; preanalytical variables.
53. Frage
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