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| Section | Objectives |
|---|---|
| Specimen Collection | - Capillary puncture procedures - Venipuncture techniques - Order of draw and tube handling |
| Specimen Processing and Handling | - Labeling and documentation - Specimen transport and storage - Quality control and rejection criteria |
| Safety and Compliance | - Infection control and PPE usage - Needlestick prevention and biohazard disposal - OSHA standards and safety protocols |
| Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
| Patient Preparation | - Patient identification and communication - Site selection and preparation - Explaining procedures and obtaining consent |
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NEW QUESTION # 80
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: B
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 # 81
Which of the following should a phlebotomist review on a requisition prior to collection for an outpatient draw?
Answer: C
Explanation:
Before collecting an outpatient specimen, the phlebotomist must review the requisition to confirm what test is ordered and what specimen requirements apply. Specimen requirements include tube type, additive, minimum volume, handling conditions, fasting status, timing, temperature, light protection, and whether the specimen requires special processing or transport. This step prevents preanalytical errors such as collecting the wrong tube, insufficient volume, wrong timing, or improperly handled specimens. Medications and allergies can be clinically relevant during patient interview, but they are not the primary item reviewed on the requisition for collection accuracy unless the test requirement specifically involves medication timing or patient compliance. Insurance authorization is administrative and should not drive the technical collection step. The requisition is the controlling document for collection, because it links patient identification, ordering provider, diagnosis or test code, test priority, and ordered tests. The NHA CPT outline includes obtaining, reviewing, and verifying orders or requisitions, confirming testing requirements, and understanding requisition field requirements. Reference topics: Patient Preparation; requisition review; testing requirements; specimen requirements; outpatient collection workflow.
NEW QUESTION # 82
Which of the following additives is commonly found in a gray-top tube used for glucose testing?
Answer: A
Explanation:
Sodium fluoride is commonly found in gray-top tubes used for glucose testing. Sodium fluoride inhibits glycolysis, which helps preserve glucose concentration after collection by slowing cellular glucose consumption. Many gray-top tubes also contain potassium oxalate as an anticoagulant. Sodium citrate is found in light-blue tubes used for coagulation studies because it binds calcium reversibly. EDTA is found in lavender-top tubes and is commonly used for hematology testing such as CBC. SPS is sodium polyanethol sulfonate, an additive used in blood culture bottles or yellow SPS tubes because it supports organism recovery by reducing certain inhibitory effects. Tube additives are not trivia; they determine specimen type and test validity. A glucose specimen collected in the wrong tube or processed late may produce inaccurate results because cells continue metabolizing glucose after collection. The phlebotomist must match test, tube, additive, order of draw, fill volume, and handling requirements. Reference topics: Special Collections; glucose testing; gray-top tube; sodium fluoride; additive function.
NEW QUESTION # 83
Which of the following types of medication is an indication for an INR draw?
Answer: D
NEW QUESTION # 84
Which of the following is a possible complication of venipuncture collection for a patient who has been on warfarin therapy?
Answer: D
Explanation:
Prolonged bleeding is the expected complication for a patient on warfarin therapy. Warfarin is an anticoagulant, meaning it interferes with normal clot formation and can increase bleeding time after venipuncture. The phlebotomist should be alert for delayed hemostasis, apply firm pressure after needle removal, avoid having the patient bend the arm sharply, and confirm that bleeding has stopped before applying a bandage and leaving the patient. Blood clotting is the opposite of the expected medication effect. Hemostasis is the normal stopping of bleeding, not a complication. Petechiae can occur from tourniquet pressure, fragile capillaries, or platelet-related issues, but in this question the medication-specific risk is prolonged bleeding. Proper technique reduces complications: release the tourniquet, withdraw the needle smoothly, activate the safety device, apply pressure, and monitor the puncture site. Reference topics: Routine Blood Collections; post-procedure care; anticoagulant therapy; bleeding complications; hemostasis; patient observation. NHA includes routine venipuncture complications and post-collection care within the CPT test plan.
NEW QUESTION # 85
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