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| Section | Objectives |
|---|---|
| Specimen Processing and Handling | - Specimen transport and storage - Labeling and documentation - Quality control and rejection criteria |
| Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
| Specimen Collection | - Capillary puncture procedures - Venipuncture techniques - Order of draw and tube handling |
| Patient Preparation | - Explaining procedures and obtaining consent - Patient identification and communication - Site selection and preparation |
| Safety and Compliance | - Infection control and PPE usage - Needlestick prevention and biohazard disposal - OSHA standards and safety protocols |
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NEW QUESTION # 111
Which of the following actions should a phlebotomist take when a specimen requires immediate processing?
Answer: A
Explanation:
A specimen requiring immediate processing should be delivered or processed according to stat or time-sensitive protocol. Some analytes degrade rapidly, some cells change after collection, and some tests depend on strict timing. Leaving the specimen until the next courier pickup may cause inaccurate results or rejection. Marking it routine ignores the priority and may delay care. Refrigerating it overnight is inappropriate unless specifically required, and even then it would not satisfy immediate processing. The phlebotomist must recognize priority indicators such as STAT, timed, fasting, peak/trough, chilled, protected-from-light, and immediate-spin requirements. The responsibility does not end when blood enters the tube. Specimen integrity depends on timely transport, correct temperature, proper centrifugation, and accurate documentation. If a delay occurs, the phlebotomist should communicate it according to facility policy rather than silently submitting a compromised specimen. Reference topics: Processing Specimens; stat specimens; time-sensitive processing; transport priority; specimen stability.
NEW QUESTION # 112
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 # 113
Which of the following types of medication is an indication for an INR draw?
Answer: D
Explanation:
An anticoagulant is the medication type most directly associated with an INR draw. INR, or international normalized ratio, is used to evaluate clotting time and is especially important for monitoring patients who take warfarin or other anticoagulant therapy. These medications reduce the blood's ability to clot, so laboratory monitoring helps determine whether the patient is within the therapeutic range or at risk for bleeding or clotting complications. Anti-inflammatory medications may affect bleeding risk in some situations, but they are not the primary indication for an INR draw. Antihistamines are used for allergic symptoms, and antiemetics are used for nausea or vomiting; neither is routinely monitored by INR. From a phlebotomy standpoint, anticoagulant therapy also alerts the technician to apply pressure longer after venipuncture and observe for prolonged bleeding. Reference topics: Special Collections; coagulation testing; point-of-care INR; medication-related collection considerations; hemostasis. The NHA CPT test plan includes special collections, waived testing, and coagulation/hemostasis-related competencies.
NEW QUESTION # 114
A blood specimen is rejected by the laboratory for testing. Which of the following actions should the phlebotomist take?
Answer: B
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 # 115
Which of the following patient positions is safest for a patient who reports a history of fainting during blood draws?
Answer: B
Explanation:
A patient with a history of fainting should be positioned reclining or lying down before collection. Syncope is a common phlebotomy complication and can lead to falls, head injury, needle injury, or specimen loss if the patient is not positioned safely. Standing is never appropriate for venipuncture because a fainting patient can collapse. Sitting on an unsupported exam table is also unsafe because the patient may fall from a height. Sitting with legs crossed can affect circulation and does not protect against syncope. The phlebotomist should ask about prior fainting, observe the patient's color and behavior, explain the procedure calmly, and stop the draw if the patient becomes pale, diaphoretic, dizzy, nauseated, or unresponsive. If syncope occurs, the phlebotomist should remove the needle when safe, activate the safety device, call for assistance, lower the patient's head or follow facility policy, and monitor the patient until help arrives. Reference topics: Patient Preparation; syncope prevention; patient positioning; adverse reactions; venipuncture safety.
NEW QUESTION # 116
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