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| Section | Weight | Objectives |
|---|---|---|
| Routine Blood Collections | 28% | - Capillary puncture procedures - Post-collection care & labeling - Order of draw & tube selection - Tourniquet use & vein assessment - Venipuncture techniques & equipment |
| Specimen Processing & Handling | 14% | - Specimen rejection criteria - Transport & storage requirements - Processing & centrifugation - Aliquoting & preservation - Documentation & tracking |
| Safety and Compliance | 26% | - HIPAA & patient confidentiality - PPE & sharps disposal - Bloodborne pathogens & exposure control - Quality control & error prevention - Infection control & OSHA standards |
| Special Collections | 12% | - Therapeutic drug monitoring - Blood cultures & sterile collection - Blood alcohol & legal collections - Pediatric & geriatric collections - Glucose tolerance & dynamic tests |
| Patient Preparation | 20% | - Informed consent & communication - Patient identification & verification - Requisition review & test verification - Site selection & preparation - Patient positioning & comfort |
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NEW QUESTION # 60
Which of the following collection sites is appropriate for a dermal puncture on an infant?
Answer: A
Explanation:
The appropriate dermal puncture site on an infant is the medial or lateral plantar surface of the heel. These areas reduce the risk of puncturing bone and provide suitable capillary blood flow for neonatal testing. The posterior curvature of the heel should be avoided because the bone may be close to the surface, increasing risk of osteomyelitis or injury. The arch of the foot is not an approved puncture site and may damage nerves, tendons, or deeper structures. The tip of the index finger is inappropriate for infants because there is insufficient tissue depth and greater risk of bone injury. Correct infant dermal puncture also requires using an age-appropriate lancet depth, warming the site if needed, cleaning and drying the skin, wiping away the first drop when required, avoiding excessive squeezing, and collecting specimens in the correct order. Infant blood volume is limited, so collection volume must be minimized. Reference topics: Special Collections; infant heel puncture; dermal puncture sites; neonatal safety; osteomyelitis prevention.
NEW QUESTION # 61
Which of the following specimens should a phlebotomist protect from light immediately after collection?
Answer: D
Explanation:
Bilirubin specimens should be protected from light immediately after collection because bilirubin is photosensitive. Exposure to light can degrade bilirubin and produce falsely decreased results. The phlebotomist should follow facility procedure, which may include wrapping the tube in foil or using an amber transport container. Blood urea nitrogen is not classically light-sensitive; it is generally handled as a routine chemistry analyte unless special facility requirements apply. Sodium testing does not require light protection. Hemoglobin A1c reflects long-term glycemic exposure through glycated hemoglobin and is not light-sensitive in the same way bilirubin is. The broader technical principle is that specimen handling requirements are test-specific. Some specimens require chilling, some must remain warm, some require rapid transport, some must avoid light, and some require timed collection. Failure to follow these requirements creates preanalytical error even when the venipuncture itself was performed correctly. Reference topics: Special Collections; Processing Specimens; light-sensitive specimens; bilirubin handling; specimen integrity.
NEW QUESTION # 62
A phlebotomist is collecting blood from a patient with small fragile veins. Which of the following devices is most appropriate?
Answer: D
Explanation:
A winged infusion set is most appropriate for a patient with small fragile veins. Butterfly devices provide better control, flexible tubing, and a shallower insertion angle, making them useful for hand veins, pediatric patients, geriatric patients, or difficult venous access. A 16-gauge needle is too large for routine diagnostic venipuncture and would likely damage fragile veins. A blood culture bottle adapter is used for blood culture collection but does not solve the problem of fragile vein access by itself. A lancet is used for dermal puncture, not venous collection, and may not provide the volume or specimen type required for ordered venipuncture tests. When using a winged infusion set, the phlebotomist should anchor the vein carefully, insert bevel up at a low angle, stabilize the device, monitor for infiltration, and activate the safety mechanism immediately after withdrawal. Equipment selection is a clinical safety decision, not a convenience choice. Reference topics: Routine Blood Collections; winged infusion set; fragile veins; equipment selection; venipuncture technique.
NEW QUESTION # 63
Which of the following tests should a phlebotomist anticipate to complete for a patient who has a fever of unknown origin?
Answer: C
Explanation:
For a patient with fever of unknown origin, the phlebotomist should anticipate blood culture collection. Blood cultures are ordered to detect microorganisms in the bloodstream and are especially important when infection, bacteremia, or sepsis is suspected. Fever without a known source is a classic clinical reason for obtaining cultures before antimicrobial therapy when possible. ESR may support evaluation of inflammation, but it does not identify bloodstream infection. Immunology tests may be used for immune or infectious disease investigations, but they are not the primary phlebotomy collection expected for fever of unknown origin. Rapid plasma renin evaluates the renin-angiotensin system and is associated with blood pressure and endocrine evaluation, not unexplained fever. Blood culture collection requires strict aseptic technique, correct antiseptic contact time, proper bottle order, adequate volume, correct number of sets, documentation of collection site, and timely transport. Contamination can produce false-positive results and inappropriate treatment. NHA CPT competencies include blood culture collection, special collections, infection control, site preparation, bottle handling, and specimen integrity. Reference topics: Special Collections; blood cultures; fever workup; contamination prevention.
NEW QUESTION # 64
A laboratory is scheduled for a routine annual inspection with primary focus on equipment maintenance logs. Which of the following areas will be the focus of the inspection?
Answer: D
Explanation:
The focus is mechanical safety because equipment maintenance logs document whether laboratory equipment is being inspected, maintained, calibrated, and monitored properly. In a phlebotomy or clinical laboratory setting, mechanical safety includes safe use and maintenance of centrifuges, refrigerators, freezers, analyzers, timers, and other equipment used in specimen collection and processing. Maintenance logs demonstrate that the facility follows required quality-control procedures and that equipment problems are reported and corrected. Chemical safety would focus on chemical labeling, SDS access, storage compatibility, spill response, and exposure controls. Radiation safety would apply to radioactive materials or imaging-related hazards, not routine phlebotomy equipment logs. Electrical safety would involve cords, plugs, grounding, and electrical hazards, which may be inspected separately but are not the primary focus when the question specifically identifies equipment maintenance logs. NHA CPT safety content includes performing quality control for laboratory equipment, maintaining logs for equipment inspection, reporting and troubleshooting equipment issues, and following manufacturer recommendations for equipment maintenance and calibration. Reference topics: Safety and Compliance; equipment maintenance logs; quality control; mechanical safety.
NEW QUESTION # 65
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