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| Section | Objectives |
|---|---|
| Topic 1: Patient Preparation | - Site selection and preparation - Patient identification and communication - Explaining procedures and obtaining consent |
| Topic 2: Professional Practice | - Communication and professionalism - Ethics and patient confidentiality (HIPAA) |
| Topic 3: Specimen Collection | - Venipuncture techniques - Order of draw and tube handling - Capillary puncture procedures |
| Topic 4: Specimen Processing and Handling | - Labeling and documentation - Specimen transport and storage - Quality control and rejection criteria |
| Topic 5: Safety and Compliance | - OSHA standards and safety protocols - Needlestick prevention and biohazard disposal - Infection control and PPE usage |
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NEW QUESTION # 63
Which of the following collections requires the phlebotomist to discard the first voided specimen and save all subsequent urine for a full day?
Answer: D
Explanation:
A 24-hour urine collection requires the patient to discard the first voided specimen and then save all subsequent urine for the full collection period, including the final void at the ending time. Discarding the first void empties the bladder and establishes the start of the timed interval. A clean-catch urine culture requires cleansing and collecting a midstream specimen in a sterile container, not saving urine for 24 hours. A random urinalysis is collected at a single time and does not require timed accumulation. A sputum culture is a respiratory specimen, not a urine collection. Patient instruction is critical because one missed urine specimen can invalidate the entire 24-hour collection. The phlebotomist should explain start and stop times, storage requirements, preservative hazards if present, labeling, and return instructions. The patient should not change fluid intake unless instructed by the provider. Reference topics: Special Collections; 24-hour urine; patient instructions; non-blood specimens; timed collection.
NEW QUESTION # 64
Which of the following tests should a phlebotomist anticipate to complete for a patient who has a fever of unknown origin?
Answer: B
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 # 65
Which of the following practices violates standard precautions?
Answer: B
Explanation:
Reusing a tourniquet visibly contaminated with blood violates standard precautions. Any reusable equipment contaminated with blood must be cleaned and disinfected according to facility policy, and single-use items must be discarded. Blood is treated as potentially infectious regardless of the patient's diagnosis or appearance. Wearing gloves during venipuncture is correct practice. Treating all blood as potentially infectious is the core principle of standard precautions. Washing hands after glove removal is also required because gloves can have microscopic defects or hands can become contaminated during removal. A contaminated tourniquet can transfer bloodborne pathogens or other organisms to patients, staff, and surfaces. Phlebotomists should inspect equipment before use, avoid placing supplies on contaminated surfaces, use disposable tourniquets when required, and disinfect reusable items appropriately. Infection-control failures often occur through routine shortcuts, not dramatic emergencies. This question tests whether the technician understands standard precautions as everyday behavior, not just PPE vocabulary. Reference topics: Safety and Compliance; standard precautions; reusable equipment; blood contamination; infection prevention.
NEW QUESTION # 66
Which of the following is a possible complication of venipuncture collection for a patient who has been on warfarin therapy?
Answer: B
Explanation:
Prolonged bleeding is the expected complication for a patient on warfarin therapy. Warfarin is an anticoagulant, meaning it interferes with normal clot formation and can increase bleeding time after venipuncture. The phlebotomist should be alert for delayed hemostasis, apply firm pressure after needle removal, avoid having the patient bend the arm sharply, and confirm that bleeding has stopped before applying a bandage and leaving the patient. Blood clotting is the opposite of the expected medication effect. Hemostasis is the normal stopping of bleeding, not a complication. Petechiae can occur from tourniquet pressure, fragile capillaries, or platelet-related issues, but in this question the medication-specific risk is prolonged bleeding. Proper technique reduces complications: release the tourniquet, withdraw the needle smoothly, activate the safety device, apply pressure, and monitor the puncture site. Reference topics: Routine Blood Collections; post-procedure care; anticoagulant therapy; bleeding complications; hemostasis; patient observation. NHA includes routine venipuncture complications and post-collection care within the CPT test plan.
NEW QUESTION # 67
A phlebotomist uses a point-of-care instrument to perform a prothrombin time/INR test on a patient that results in a critical value. Which of the following type of medication should the phlebotomist expect to see on the patient's medication list?
Answer: B
Explanation:
A prothrombin time/INR test evaluates the extrinsic and common coagulation pathways and is commonly used to monitor anticoagulant therapy, especially warfarin. Therefore, when a PT/INR point-of-care result is critically abnormal, the medication category most expected on the patient's list is anticoagulants. Anticoagulants interfere with clot formation and can prolong PT/INR values, creating an increased bleeding risk if outside the therapeutic range. Opioids are analgesics and do not directly monitor through PT/INR. Antidiabetics are associated with glucose monitoring, not coagulation testing. Statins are lipid-lowering medications and are usually monitored through lipid panels and liver-related considerations, not PT/INR. A critical PT/INR value must be handled according to facility policy, documented accurately, and reported through the correct clinical pathway; the phlebotomist does not interpret or treat the result independently. The NHA CPT outline covers point-of-care testing, critical values for POC and CLIA-waived testing, hemostasis, coagulation, and reporting requirements. Reference topics: Special Collections; point-of-care testing; hemostasis and coagulation; critical value reporting.
NEW QUESTION # 68
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