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| Section | Objectives |
|---|---|
| Safety and Compliance | - Infection control and standard precautions - HIPAA and patient confidentiality - OSHA regulations and patient safety |
| Routine Blood Collections | - Venipuncture procedures - Equipment selection and use - Order of draw |
| Patient Preparation | - Specimen labeling procedures - Patient identification and communication - Site selection and preparation |
| Specimen Processing and Handling | - Quality assurance procedures - Common errors and rejection criteria - Specimen transport and storage |
| Special Collections | - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) - Pediatric and geriatric considerations |
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33. Frage
Which of the following needle gauges can be used for blood donation collection?
Antwort: C
Begründung:
Blood donation collection requires a large-bore needle because a full unit of blood must be collected efficiently while minimizing hemolysis and maintaining adequate flow into the collection bag. An 18-gauge needle is the correct option from the list. Blood donor collections commonly use larger needles than routine diagnostic venipuncture because donor collection volume is much greater than routine tube collection. A 25-gauge or 27-gauge needle is too small; it would slow flow excessively, increase mechanical stress on cells, and be inappropriate for donor collection. A 21-gauge needle is common for routine adult venipuncture but is not the best answer for blood donation collection because donor procedures require faster sustained flow. The phlebotomist must also confirm donor eligibility, follow blood bank protocol, use correct equipment, maintain aseptic technique, and monitor the donor for adverse reactions. The NHA CPT outline includes phlebotomy for blood donations and blood donation standards such as hemoglobin/hematocrit screening, weight, and complete screening. Reference topics: Special Collections; blood donation; needle gauge selection; donor collection standards.
34. Frage
A phlebotomist should immediately report which of the following to a supervisor?
Antwort: B
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.
35. Frage
Using outdated supplies can result in which of the following?
Antwort: A
Begründung:
Using outdated supplies can result in specimen rejection because expired collection materials may fail to preserve the specimen correctly or meet laboratory acceptance criteria. Expired evacuated tubes may have inadequate vacuum, degraded additives, compromised sterility, or incorrect blood-to-additive performance. These problems are preanalytical errors, meaning they occur before testing and can make results unreliable. The laboratory may reject the specimen rather than risk reporting inaccurate data. Stat processing refers to urgent priority handling and is unrelated to supply expiration. Postanalytical error occurs after testing, such as reporting or result-delivery mistakes, not from using expired collection supplies during acquisition. Claim rejection is a billing or insurance issue, not a specimen integrity issue. A competent phlebotomist prevents rejection by checking tube expiration dates, inspecting supplies, confirming required specimen type, filling tubes properly, mixing additives correctly, and following transport requirements. NHA CPT processing and routine collection content covers specimen integrity, preanalytical errors, equipment quality control, expiration checks, and recollection when required. Reference topics: Processing Specimens; preanalytical error; specimen rejection; equipment quality control.
36. Frage
Which of the following actions should a phlebotomist take when administering first aid?
Antwort: C
Begründung:
The correct first-aid action is to apply direct pressure to a patient who is hemorrhaging. Direct pressure is the immediate basic intervention to control external bleeding because it compresses the injured vessel and supports clot formation. Inserting anything into the mouth of a patient who is seizing is dangerous; it can damage teeth, obstruct the airway, or injure the responder. A fainting patient should be protected from injury, placed safely, monitored, and assisted according to facility protocol; a warm compress to the neck is not the correct primary response. A patient in shock should not be offered water because altered consciousness, nausea, or urgent medical instability creates aspiration risk and delays proper emergency care. In phlebotomy, first aid is not optional "nice-to-know" material; blood collection can trigger syncope, seizures, excessive bleeding, allergic reactions, or shock-like symptoms. The technician must stop the draw when needed, protect the patient, call for help, and follow emergency procedures. Reference topics: Safety and Compliance; first aid; hemorrhage control; emergency response; patient complications.
37. Frage
A phlebotomist completes a venipuncture procedure and activates the safety mechanism on the winged infusion set up to discard it into the sharps container. Which of the following actions should the phlebotomist take if the sharps container is locked?
Antwort: A
Begründung:
If the sharps container is locked and cannot accept the used winged infusion set, the phlebotomist should obtain a new sharps container. A contaminated needle or winged infusion set must be discarded immediately into an approved sharps container that is puncture-resistant, leak-resistant, properly labeled or color-coded, closable, and accessible at the point of use. Unlocking or forcing a container is unsafe and may expose the technician to contaminated sharps. A trash container is never acceptable for needle disposal because it creates risk for housekeeping staff, patients, and other personnel. A biohazard bag is also incorrect because bags are for regulated soft biohazard waste, not sharps; needles can puncture the bag and cause injury. The correct action is to maintain control of the activated device safely and use an appropriate replacement sharps container. This is a direct OSHA and standard-precaution issue. Reference topics: Safety and Compliance; sharps disposal; safety-engineered devices; needlestick prevention; OSHA bloodborne pathogen precautions.
38. Frage
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