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| Section | Weight | Objectives |
|---|---|---|
| Safety and Compliance | 26% | - Quality control & error prevention - PPE & sharps disposal - Infection control & OSHA standards - HIPAA & patient confidentiality - Bloodborne pathogens & exposure control |
| Patient Preparation | 20% | - Patient identification & verification - Site selection & preparation - Patient positioning & comfort - Informed consent & communication - Requisition review & test verification |
| Special Collections | 12% | - Blood cultures & sterile collection - Blood alcohol & legal collections - Therapeutic drug monitoring - Glucose tolerance & dynamic tests - Pediatric & geriatric collections |
| Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Capillary puncture procedures - Tourniquet use & vein assessment - Order of draw & tube selection - Post-collection care & labeling |
| Specimen Processing & Handling | 14% | - Processing & centrifugation - Specimen rejection criteria - Aliquoting & preservation - Documentation & tracking - Transport & storage requirements |
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NEW QUESTION # 34
Which of the following actions should a phlebotomist take to prevent reflux during venipuncture?
Answer: D
Explanation:
To prevent reflux, the patient's arm should be kept in a downward position so the collection tube remains below the puncture site. Reflux occurs when blood or tube additive flows backward from the tube into the patient's vein. Keeping the tube below the venipuncture site and allowing tubes to fill properly reduces this risk. Holding the tube above the puncture site increases the chance of backflow. Removing the tube before it fills can create incorrect blood-to-additive ratios and does not prevent reflux. Inserting the needle bevel down is incorrect technique; venipuncture needles are inserted bevel up to enter the vein smoothly and reduce trauma. Reflux prevention also includes using proper tube position, avoiding excessive movement, not pushing tube contents toward the patient, and releasing the tourniquet appropriately. This is especially important with additive tubes because additive contamination of the patient's circulation, while uncommon, is a preventable safety concern. Reference topics: Routine Blood Collections; reflux prevention; evacuated tube technique; arm positioning; tube handling.
NEW QUESTION # 35
Which of the following actions should the phlebotomist take after filling the last tube of a venipuncture procedure?
Answer: B
Explanation:
After the last tube has filled, the phlebotomist must complete the venipuncture termination sequence safely. The correct action from the choices is to withdraw the needle from the puncture site. In routine venipuncture, the tourniquet is released before needle removal, then the needle is withdrawn smoothly, the safety device is activated, and pressure is applied with clean gauze or cotton only after the needle is out. Applying cotton while the needle is still inserted can cause the needle to cut or traumatize the vein. Cleaning the site with antiseptic occurs before puncture, not after collection. A warm compress is not part of routine completion; it may be used only for selected complications or difficult venous access before collection. The NHA CPT outline specifically includes standard tourniquet removal, needle removal, safety-device use, post-procedural care, and bandaging as routine blood collection competencies. Reference topics: Routine Blood Collections; removing tourniquet, tubes, and needle; post-procedural patient care.
NEW QUESTION # 36
A phlebotomist receives a phone call from a provider's practice asking for a patient's CBC results. To which of the following departments should the phlebotomist transfer the call?
Answer: C
Explanation:
A complete blood count, or CBC, is handled by the hematology department because it evaluates cellular components of blood, including red blood cells, white blood cells, hemoglobin, hematocrit, platelets, and differential findings when ordered. Chemistry focuses on analytes such as glucose, electrolytes, enzymes, renal markers, liver markers, and metabolic panels. Coagulation handles clotting studies such as PT, INR, aPTT, fibrinogen, and related hemostasis testing. Serology focuses on antigen-antibody testing and immune-response assays. A phlebotomist should not disclose results unless authorized by facility policy and role scope. The correct action is to direct the caller to the department that performs or releases the requested test result. This protects patient confidentiality and avoids miscommunication of clinical information. NHA CPT processing content includes communication between non-laboratory personnel, retrieving specimen or result data through laboratory systems, distributing results to ordering providers, and understanding blood components and laboratory testing roles. Reference topics: Processing Specimens; laboratory departments; hematology testing; communication of laboratory results.
NEW QUESTION # 37
Which of the following PPE should a phlebotomist wear when there is a risk of blood splatter during collection?
Answer: C
Explanation:
When there is a risk of blood splatter, the phlebotomist should wear eye and face protection, such as a face shield or goggles with a mask. Standard gloves protect the hands but do not protect the mucous membranes of the eyes, nose, and mouth. Sterile gloves are not routinely required for standard venipuncture; clean gloves are typically used unless a sterile procedure is specified. Shoe covers are not the primary protection for facial splash exposure. An N95 respirator protects against airborne particles but does not replace splash protection unless combined with appropriate eye and face protection when needed. The correct PPE is based on anticipated exposure. A routine venipuncture may require gloves only, but procedures with splash risk require additional barriers. The phlebotomist must evaluate the procedure, patient behavior, specimen type, and environment before collection. PPE use also includes proper donning, removal, disposal, and hand hygiene after glove removal. Reference topics: Safety and Compliance; PPE selection; standard precautions; splash exposure; mucous membrane protection.
NEW QUESTION # 38
Which of the following actions should a phlebotomist take after removing the needle from a venipuncture site?
Answer: C
Explanation:
After removing the needle, the phlebotomist should apply pressure with clean gauze. Direct pressure supports hemostasis and reduces bruising, bleeding, and hematoma formation. Asking the patient to bend the elbow tightly is incorrect because it can increase pressure at the puncture site and promote hematoma formation or continued bleeding under the skin. Recapping the needle is unsafe and increases needlestick risk; the safety device should be activated and the needle discarded in an approved sharps container. Labeling the tube cap only is also incorrect because caps can be removed or switched. The specimen label must be placed on the tube or container itself according to facility policy. After pressure is applied, the phlebotomist should check that bleeding has stopped before applying a bandage, especially for patients on anticoagulants or with bleeding disorders. Post-procedure care is not an afterthought; it is part of patient safety and specimen workflow. Reference topics: Routine Blood Collections; needle removal; post-procedure care; hemostasis; labeling requirements.
NEW QUESTION # 39
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