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| Section | Objectives |
|---|---|
| Patient Preparation | - Patient identification and communication - Explaining procedures and obtaining consent - Site selection and preparation |
| Professional Practice | - Communication and professionalism - Ethics and patient confidentiality (HIPAA) |
| Specimen Processing and Handling | - Specimen transport and storage - Quality control and rejection criteria - Labeling and documentation |
| Safety and Compliance | - OSHA standards and safety protocols - Needlestick prevention and biohazard disposal - Infection control and PPE usage |
| Specimen Collection | - Venipuncture techniques - Order of draw and tube handling - Capillary puncture procedures |
>> Phlebotomy-Technician模擬解説集 <<
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質問 # 122
Which of the following actions can cause hemolysis during venipuncture?
正解：B
解説：
Using a needle with a gauge that is too small can cause hemolysis. A small-bore needle can create excessive mechanical force as blood passes through the lumen, damaging red blood cells and releasing intracellular contents into serum or plasma. Hemolysis can alter test results, especially potassium, lactate dehydrogenase, and other analytes affected by red-cell rupture. Allowing alcohol to dry before puncture is correct practice because it reduces stinging and helps prevent contamination. Releasing the tourniquet before needle removal is also correct because it reduces pressure and supports safer needle withdrawal. Mixing additive tubes by gentle inversion is required; the danger occurs when tubes are shaken vigorously. Additional hemolysis causes include probing, drawing through a hematoma, forcing blood from a syringe into a tube, rough transport, incorrect centrifugation, and delayed processing. A phlebotomist must choose equipment appropriate to the patient's vein while maintaining specimen quality. Reference topics: Routine Blood Collections; hemolysis; needle gauge selection; specimen integrity; preanalytical error.
質問 # 123
Which of the following actions should a phlebotomist take when using a syringe for venipuncture?
正解：C
解説：
When using a syringe for venipuncture, the phlebotomist should transfer blood into tubes using a safety transfer device. A syringe may be used for fragile veins or situations where vacuum pressure could collapse the vein, but it introduces additional handling risk. Pulling the plunger forcefully can cause vein collapse, pain, and hemolysis. Removing tube stoppers and pouring blood into tubes is unsafe because it exposes the specimen and staff to blood, increases contamination risk, and disrupts additive ratios. Attaching a used needle to fill evacuated tubes is dangerous and creates needlestick risk. A safety transfer device allows blood to move from the syringe into evacuated tubes while maintaining a closed system and preserving order of draw. The phlebotomist should also avoid excessive force, fill tubes correctly, mix additive tubes gently, activate safety features, and discard sharps immediately. Reference topics: Routine Blood Collections; syringe method; blood transfer device; hemolysis prevention; sharps safety.
質問 # 124
Which of the following angles should a phlebotomist use when inserting a butterfly needle into a patient's dorsal hand veins?
正解：C
解説：
A butterfly needle inserted into dorsal hand veins should be introduced at a shallow angle, and from the options provided, 10° is the best answer. Hand veins are usually superficial, smaller, and more mobile than antecubital veins, so a steep angle increases the risk of passing through the vein, causing infiltration, hematoma formation, pain, or failed collection. A winged infusion set gives better control for fragile or difficult veins, but the phlebotomist must still anchor the vein, insert bevel up, and keep the angle low. A 25° or 30° angle is more consistent with routine antecubital venipuncture rather than shallow hand-vein access. A 45° angle is excessive for venous collection and creates unnecessary tissue trauma. The NHA CPT test plan places this under routine blood collection skills, including equipment selection, winged collection sets, hand vascular anatomy, site selection, and angle of needle insertion and withdrawal. Reference topics: Routine Blood Collections; winged collection set; hand veins; angle of needle insertion.
質問 # 125
Which of the following is the minimum amount of time required to perform vigorous handwashing according to standard precaution guidelines?
正解：C
解説：
The minimum time for vigorous handwashing is 20 seconds. Proper handwashing requires wetting the hands, applying soap, rubbing all surfaces vigorously, cleaning between fingers and under nails, rinsing, and drying with a clean towel or approved drying method. Ten seconds is too short to reliably remove transient microorganisms. Two or three minutes is excessive for routine handwashing under standard precautions and is more consistent with extended surgical scrub concepts, not ordinary clinical hand hygiene before and after patient contact. In phlebotomy, hand hygiene is required before patient contact, after glove removal, after contact with blood or body fluids, after touching contaminated surfaces, and whenever hands are visibly soiled. Gloves do not replace hand hygiene; they are an additional barrier. Correct hand hygiene reduces healthcare-associated infection risk and protects both the patient and the phlebotomist. Reference topics: Safety and Compliance; standard precautions; hand hygiene; infection prevention; PPE. CDC guidance states that healthcare personnel should wash hands with soap and water for at least 20 seconds in indicated situations.
質問 # 126
Which of the following actions should a phlebotomist take when a specimen requires immediate processing?
正解：A
解説：
A specimen requiring immediate processing should be delivered or processed according to stat or time-sensitive protocol. Some analytes degrade rapidly, some cells change after collection, and some tests depend on strict timing. Leaving the specimen until the next courier pickup may cause inaccurate results or rejection. Marking it routine ignores the priority and may delay care. Refrigerating it overnight is inappropriate unless specifically required, and even then it would not satisfy immediate processing. The phlebotomist must recognize priority indicators such as STAT, timed, fasting, peak/trough, chilled, protected-from-light, and immediate-spin requirements. The responsibility does not end when blood enters the tube. Specimen integrity depends on timely transport, correct temperature, proper centrifugation, and accurate documentation. If a delay occurs, the phlebotomist should communicate it according to facility policy rather than silently submitting a compromised specimen. Reference topics: Processing Specimens; stat specimens; time-sensitive processing; transport priority; specimen stability.
質問 # 127
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