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| Section | Weight | Objectives |
|---|---|---|
| Special Collections | 12% | - Glucose tolerance & dynamic tests - Therapeutic drug monitoring - Blood cultures & sterile collection - Pediatric & geriatric collections - Blood alcohol & legal collections |
| Safety and Compliance | 26% | - Infection control & OSHA standards - HIPAA & patient confidentiality - Bloodborne pathogens & exposure control - PPE & sharps disposal - Quality control & error prevention |
| Specimen Processing & Handling | 14% | - Documentation & tracking - Processing & centrifugation - Transport & storage requirements - Aliquoting & preservation - Specimen rejection criteria |
| Patient Preparation | 20% | - Requisition review & test verification - Informed consent & communication - Patient identification & verification - Patient positioning & comfort - Site selection & preparation |
| Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Order of draw & tube selection - Post-collection care & labeling - Capillary puncture procedures - Tourniquet use & vein assessment |
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NEW QUESTION # 15
Which of the following actions should a phlebotomist take when transporting specimens to an outside laboratory?
Answer: D
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 # 16
A phlebotomist is preparing for a blood alcohol level test that will be admitted as evidence in a court of law. Which of the following preparations should the phlebotomist document?
Answer: C
Explanation:
For a forensic blood alcohol level, the phlebotomist should document use of a non-alcohol-based preparation, represented here by chlorhexidine preparation rather than ethanol or isopropyl alcohol. The critical issue is legal defensibility: using an alcohol-containing skin antiseptic can create a challenge that the collection process contaminated or affected the blood alcohol evidence. Ethanol and isopropyl alcohol are both inappropriate choices for this context because they are alcohols. The direction of rubbing ethanol-up and down or circular-is irrelevant; the problem is the substance itself. Chlorhexidine is the only non-ethanol/non-isopropyl option listed and is therefore the correct answer, assuming the facility's forensic kit or protocol specifies an acceptable non-alcohol preparation. The phlebotomist must also maintain chain of custody, identify the patient/donor correctly, use the proper tube, seal the specimen, document collection time, and transfer the specimen according to legal procedure. Reference topics: Special Collections; blood alcohol collection; forensic specimens; chain of custody; documentation. NHA's CPT outline includes forensic studies and chain-of-custody collection requirements.
NEW QUESTION # 17
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?
Answer: A
Explanation:
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.
NEW QUESTION # 18
A phlebotomist is instructing a patient who has a prescription for a 24-hr urine collection. Which of the following instructions should the phlebotomist include?
Answer: A
Explanation:
For a 24-hour urine collection, the patient should discard the first urine on the day of collection, record the start time, and then collect all urine passed during the next 24 hours, including the final specimen at the end time. Discarding the first void empties the bladder and establishes a clean starting point for the timed collection. Keeping the specimen at room temperature is usually incorrect because many 24-hour urine specimens require refrigeration, ice, or preservatives depending on the ordered test. Urinating directly into the large collection container may be unsafe or impractical, especially if the container contains preservative; patients are commonly given a separate collection device and then transfer urine as instructed. Doubling fluid intake is incorrect because it can dilute analytes and alter test results unless specifically ordered by the provider. The phlebotomist must explain timing, storage, missed specimens, labeling, and return instructions clearly because incomplete collection is a major preanalytical error. NHA CPT competencies include non-blood specimen collection, patient instructions, timed urine collection, specimen storage, and specimen integrity. Reference topics: Special Collections; 24-hour urine; non-blood specimens; patient preparation.
NEW QUESTION # 19
OSHA requires employers to provide which of the following to employees who are at risk for bloodborne pathogen exposure?
Answer: D
Explanation:
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.
NEW QUESTION # 20
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