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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Specimen Processing & Handling | 14% | - Specimen rejection criteria - Documentation & tracking - Aliquoting & preservation - Transport & storage requirements - Processing & centrifugation |
| Topic 2: Special Collections | 12% | - Therapeutic drug monitoring - Blood cultures & sterile collection - Glucose tolerance & dynamic tests - Pediatric & geriatric collections - Blood alcohol & legal collections |
| Topic 3: Safety and Compliance | 26% | - Infection control & OSHA standards - PPE & sharps disposal - Bloodborne pathogens & exposure control - HIPAA & patient confidentiality - Quality control & error prevention |
| Topic 4: Routine Blood Collections | 28% | - Order of draw & tube selection - Venipuncture techniques & equipment - Post-collection care & labeling - Tourniquet use & vein assessment - Capillary puncture procedures |
| Topic 5: Patient Preparation | 20% | - Informed consent & communication - Patient positioning & comfort - Requisition review & test verification - Patient identification & verification - Site selection & preparation |
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NEW QUESTION # 81
Which of the following is the maximum allowed time for a tourniquet application before possibly affecting test results?
Answer: A
Explanation:
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.
NEW QUESTION # 82
Which of the following is the purpose of applying a tourniquet for venipuncture?
Answer: A
Explanation:
The purpose of applying a tourniquet is to enlarge veins. A properly applied tourniquet partially restricts venous return while arterial flow continues briefly, causing the selected vein to become more prominent, easier to palpate, and easier to access. This improves site selection and helps establish blood flow into the collection device. The tourniquet must not be applied too tightly or left on too long because prolonged stasis can cause hemoconcentration, discomfort, petechiae, or altered laboratory values. "To solidify veins" is incorrect because veins do not become solid; they become distended. "To shrink veins" is the opposite of the intended effect. "To roll veins" is also incorrect; rolling veins are a collection problem controlled by proper anchoring, not an intended effect of tourniquet use. The phlebotomist should apply the tourniquet above the intended site, palpate appropriately, remove it within accepted time limits, and release it before needle withdrawal. NHA CPT routine collection content includes standard tourniquet application and removal procedures, palpation, site selection, anchoring, and procedural steps for removing the tourniquet, tubes, and needle. Reference topics: Routine Blood Collections; tourniquet application; vein palpation; venipuncture preparation.
NEW QUESTION # 83
Which of the following actions should a phlebotomist take if a patient develops a rapidly forming hematoma during venipuncture?
Answer: C
Explanation:
If a rapidly forming hematoma develops, the phlebotomist should remove the needle and apply pressure. A hematoma occurs when blood leaks into surrounding tissue, often because the needle has gone through the vein, partially exited the vein, or the vein wall has been injured. Continuing the collection can worsen bleeding, increase pain, and compromise the specimen. Asking the patient to pump their fist increases venous pressure and can worsen leakage or alter some test results. Inserting the needle deeper is unsafe because it may worsen vessel injury or strike nearby structures. The correct response is to release the tourniquet, remove the needle, activate the safety device, apply firm pressure, and monitor the site. A bandage should be applied only after bleeding has stopped. The phlebotomist should document or report the complication according to facility policy and avoid recollecting from the affected site. Reference topics: Routine Blood Collections; hematoma; venipuncture complications; needle removal; post-procedure care.
NEW QUESTION # 84
Which of the following actions is required before using a new lot number of point-of-care testing strips?
Answer: B
Explanation:
Quality control testing should be performed before using a new lot number of point-of-care testing strips. Lot-to-lot variation can affect test performance, and QC confirms that the strips, controls, meter, and operator process are producing acceptable results before patient testing begins. Freezing strips is incorrect unless a manufacturer specifically requires a storage condition, and most reagent strips have controlled storage requirements that must not be improvised. Mixing old and new lots is unsafe because it creates traceability problems and can invalidate quality control. Using strips only for "control patients" is meaningless; patient specimens should not be used to validate unverified supplies. For waived testing and point-of-care testing, the phlebotomist must follow manufacturer instructions, document QC results, check expiration dates, store materials properly, and stop patient testing when controls fail. If QC is outside range, patient results should not be reported until corrective action is completed. Reference topics: Safety and Compliance; Special Collections; point-of-care testing; quality control; reagent lot verification.
NEW QUESTION # 85
Which of the following conditions is a reason for specimen rejection?
Answer: A
Explanation:
A clotted lavender-top specimen is a reason for specimen rejection. Lavender-top tubes contain EDTA anticoagulant and are used for tests such as CBCs, which require anticoagulated whole blood. If the specimen clots, the cellular components are trapped in the clot, platelet counts can be falsely low, and automated hematology analysis becomes unreliable. Properly labeled specimens, correctly filled light-blue tubes, and specimens transported upright are acceptable practices, not rejection causes. A clotted lavender specimen usually results from failure to mix the tube properly immediately after collection, delayed inversion, underfilling or collection difficulty, or drawing blood slowly and allowing clotting to begin before the specimen contacts the additive. The correct prevention is to fill the tube to the required volume and gently invert it the recommended number of times immediately after collection. The phlebotomist should never shake the tube, because vigorous agitation can cause hemolysis. Reference topics: Processing Specimens; specimen rejection; EDTA tube mixing; clotted specimens; hematology testing.
NEW QUESTION # 86
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