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| Section | Weight | Objectives |
|---|---|---|
| Special Collections | 12% | - Blood alcohol & legal collections - Pediatric & geriatric collections - Therapeutic drug monitoring - Blood cultures & sterile collection - Glucose tolerance & dynamic tests |
| Routine Blood Collections | 28% | - Order of draw & tube selection - Tourniquet use & vein assessment - Capillary puncture procedures - Venipuncture techniques & equipment - Post-collection care & labeling |
| Safety and Compliance | 26% | - Quality control & error prevention - Infection control & OSHA standards - PPE & sharps disposal - HIPAA & patient confidentiality - Bloodborne pathogens & exposure control |
| Patient Preparation | 20% | - Informed consent & communication - Requisition review & test verification - Patient positioning & comfort - Patient identification & verification - Site selection & preparation |
| Specimen Processing & Handling | 14% | - Specimen rejection criteria - Documentation & tracking - Processing & centrifugation - Transport & storage requirements - Aliquoting & preservation |
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NEW QUESTION # 80
Which of the following veins is usually the last choice for antecubital venipuncture?
Answer: A
Explanation:
The basilic vein is usually the last choice for antecubital venipuncture. The median cubital vein is preferred because it is typically large, well anchored, superficial, and less likely to roll. The cephalic vein is commonly the second choice when the median cubital is unavailable. The basilic vein is used cautiously because it lies closer to the brachial artery and median nerve, creating greater risk if the needle is inserted too deeply or inaccurately. The dorsal metacarpal veins are hand veins, not antecubital veins, and may be used when antecubital access is unavailable, often with a butterfly needle and shallow angle. This question tests anatomical risk control. A phlebotomist must not simply pick the most visible vein; they must evaluate vein safety, depth, direction, resilience, patient history, and contraindications such as IV sites, edema, burns, scars, hematomas, fistulas, and mastectomy restrictions. Proper site selection reduces pain, nerve injury, arterial puncture, hematoma, and recollection risk. Reference topics: Routine Blood Collections; antecubital anatomy; vein selection; basilic vein risk.
NEW QUESTION # 81
A blood specimen is rejected by the laboratory for testing. Which of the following actions should the phlebotomist take?
Answer: D
Explanation:
The phlebotomist should contact the patient to repeat the venipuncture collection, following facility policy and provider notification procedures. A rejected specimen cannot be tested reliably, so the practical correction is recollection using the proper tube, volume, labeling, handling, and transport requirements. Waiting until the next yearly visit is unacceptable because the ordered test was needed for current clinical care. Shredding documentation is improper unless performed under approved records-management procedures, and it does not solve the missing valid specimen. Sending laboratory results by mail is impossible or inappropriate when the specimen was rejected and no valid result exists. Specimen rejection usually results from preanalytical problems such as wrong tube, insufficient volume, hemolysis, clotting in an anticoagulant tube, unlabeled or mislabeled specimen, expired supplies, improper temperature, or delayed transport. The phlebotomist's job is to correct the collection failure promptly and prevent recurrence. Reference topics: Processing Specimens; specimen rejection; recollection; preanalytical error; specimen integrity.
NEW QUESTION # 82
Which of the following agencies enforces workplace standards related to bloodborne pathogens?
Answer: A
Explanation:
OSHA enforces workplace standards related to bloodborne pathogens. In phlebotomy, OSHA's Bloodborne Pathogens Standard is central because technicians routinely handle blood, sharps, contaminated equipment, and potentially infectious materials. OSHA requirements support exposure-control plans, engineering controls, sharps safety, PPE, hepatitis B vaccination access, training, and post-exposure follow-up. The FDA regulates drugs, biologics, and medical devices, but it does not enforce employer bloodborne pathogen workplace standards in the same way OSHA does. CMS administers Medicare and Medicaid and oversees certain healthcare quality and laboratory-related regulatory structures, but it is not the primary workplace bloodborne pathogen enforcement agency. DEA regulates controlled substances, which is unrelated to routine phlebotomy safety. A phlebotomist does not need to be a legal scholar, but they must know which agencies govern common safety and compliance issues. This knowledge supports correct behavior during needlesticks, sharps disposal, PPE use, exposure reporting, and infection-control practice. Reference topics: Safety and Compliance; OSHA; bloodborne pathogens; exposure-control plan; workplace safety.
NEW QUESTION # 83
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: C
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 # 84
Which of the following conditions is a reason for specimen rejection?
Answer: C
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 # 85
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