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| Section | Weight | Objectives |
|---|---|---|
| Patient Preparation | 20% | - Site selection & preparation - Requisition review & test verification - Informed consent & communication - Patient positioning & comfort - Patient identification & verification |
| Specimen Processing & Handling | 14% | - Aliquoting & preservation - Specimen rejection criteria - Transport & storage requirements - Documentation & tracking - Processing & centrifugation |
| Safety and Compliance | 26% | - HIPAA & patient confidentiality - Quality control & error prevention - Infection control & OSHA standards - PPE & sharps disposal - Bloodborne pathogens & exposure control |
| Special Collections | 12% | - Blood alcohol & legal collections - Therapeutic drug monitoring - Blood cultures & sterile collection - Pediatric & geriatric collections - Glucose tolerance & dynamic tests |
| Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Capillary puncture procedures - Tourniquet use & vein assessment - Post-collection care & labeling - Order of draw & tube selection |
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NEW QUESTION # 108
Which of the following actions should a phlebotomist take to prevent reflux during venipuncture?
Answer: C
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 # 109
A phlebotomist is preparing to perform a phlebotomy procedure on a hospitalized patient. Which of the following steps should the phlebotomist take for the initial introduction?
Answer: A
Explanation:
The best initial introduction is to knock on the door, greet the patient, and introduce themselves. This sequence respects privacy, establishes professional presence, and begins communication before any technical identification or collection step. Entering quietly without first knocking may be inappropriate in a patient-care environment because the patient has a right to privacy and dignity. Turning on lights immediately can be abrupt, especially for hospitalized patients who may be resting, anxious, or ill. Checking the ID band is essential, but it follows professional entry and introduction. Checking the provider's prescription or order is important before collection, but it is not the interpersonal "initial introduction" step at bedside. The correct approach supports patient cooperation, consent, and safety. After introduction, the phlebotomist should verify the order, use two identifiers, explain the procedure, assess patient readiness, and obtain consent according to facility policy. Reference topics: Patient Preparation; therapeutic communication; patient rights; bedside approach; patient identification; consent. NHA's CPT test plan includes patient communication and preparation as a major domain.
NEW QUESTION # 110
Which of the following needle gauges can be used for blood donation collection?
Answer: D
Explanation:
Blood donation collection requires a large-bore needle because a full unit of blood must be collected efficiently while minimizing hemolysis and maintaining adequate flow into the collection bag. An 18-gauge needle is the correct option from the list. Blood donor collections commonly use larger needles than routine diagnostic venipuncture because donor collection volume is much greater than routine tube collection. A 25-gauge or 27-gauge needle is too small; it would slow flow excessively, increase mechanical stress on cells, and be inappropriate for donor collection. A 21-gauge needle is common for routine adult venipuncture but is not the best answer for blood donation collection because donor procedures require faster sustained flow. The phlebotomist must also confirm donor eligibility, follow blood bank protocol, use correct equipment, maintain aseptic technique, and monitor the donor for adverse reactions. The NHA CPT outline includes phlebotomy for blood donations and blood donation standards such as hemoglobin/hematocrit screening, weight, and complete screening. Reference topics: Special Collections; blood donation; needle gauge selection; donor collection standards.
NEW QUESTION # 111
Which of the following situations increases a phlebotomist's risk for a needlestick?
Answer: B
Explanation:
A nearly full sharps container increases the risk for a needlestick because contaminated needles or other sharps may protrude, rebound, or be difficult to place safely into the container. Sharps containers must be puncture-resistant, leak-resistant, properly labeled or color-coded, kept upright, and replaced before they become overfilled. OSHA specifically warns not to allow sharps containers to overfill and requires routine replacement to reduce sharps injury risk. A tight tourniquet can cause patient discomfort, hemoconcentration, or venous obstruction, but it is not the best answer for needlestick risk. A 22-gauge needle is commonly used for routine venipuncture, especially for smaller veins, and is not inherently unsafe. A transfer device used with the syringe method is actually a safety control because it prevents the phlebotomist from manually pushing blood through a needle into evacuated tubes. NHA CPT safety content includes bloodborne pathogens, sharps safety, OSHA standards, exposure control, and safe disposal of contaminated equipment. Reference topics: Safety and Compliance; OSHA Bloodborne Pathogens Standard; sharps disposal; needlestick prevention.
NEW QUESTION # 112
Which of the following actions should the phlebotomist take when labelling inpatient specimens?
Answer: A
Explanation:
For inpatient specimens, the phlebotomist should label the specimen collection container immediately after collection using the patient's wristband information as the identification source. The key control is bedside labeling in the presence of the patient, after positive identification and collection, so the specimen is tied to the correct patient before it leaves the room. Labeling the lid is unsafe because lids can be removed, switched, or separated from the specimen. Having the patient write demographic information is not an acceptable patient-identification process and does not satisfy laboratory labeling requirements. Provider pre-labeling is also unsafe because it creates a risk of wrong-patient collection if the container is later used for another patient or if identification is not verified at collection. Correct labeling usually includes patient name, second identifier, date and time of collection, collector identity, and any facility-required information. The NHA CPT outline specifically includes patient identifiers, labeling procedures and requirements, documentation, and the task of labeling all specimens. Reference topics: Routine Blood Collections; patient identification; specimen labeling; documentation requirements.
NEW QUESTION # 113
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