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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Specimen Processing & Handling | 14% | - Processing & centrifugation - Aliquoting & preservation - Documentation & tracking - Transport & storage requirements - Specimen rejection criteria |
| Topic 2: Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Order of draw & tube selection - Tourniquet use & vein assessment - Post-collection care & labeling - Capillary puncture procedures |
| Topic 3: Safety and Compliance | 26% | - PPE & sharps disposal - Infection control & OSHA standards - Quality control & error prevention - Bloodborne pathogens & exposure control - HIPAA & patient confidentiality |
| Topic 4: Patient Preparation | 20% | - Patient identification & verification - Patient positioning & comfort - Informed consent & communication - Requisition review & test verification - Site selection & preparation |
| Topic 5: Special Collections | 12% | - Glucose tolerance & dynamic tests - Pediatric & geriatric collections - Blood cultures & sterile collection - Therapeutic drug monitoring - Blood alcohol & legal collections |
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NEW QUESTION # 13
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 # 14
A phlebotomist is preparing to collect a CBC and a basic metabolic panel using evacuated tubes. Which of the following tubes should the phlebotomist collect first?
Answer: B
Explanation:
For a CBC and basic metabolic panel, the green-top tube should be collected before the lavender-top tube when following the standard order of draw after sterile/blood culture tubes and coagulation tubes. A basic metabolic panel is commonly collected in a green-top heparin tube or serum tube depending on facility protocol, while a CBC requires a lavender-top EDTA tube. Additive carryover is the key concept. EDTA from a lavender tube can contaminate later specimens and falsely elevate potassium while lowering calcium because EDTA binds calcium. This makes lavender-top collection before chemistry specimens technically unsafe when chemistry testing is also ordered. Gray-top tubes are generally used for glucose or lactate testing and are collected later. Yellow SPS tubes are used for blood cultures and would be collected first only if blood cultures were ordered. The phlebotomist must know order of draw, tube additives, and the clinical consequence of additive contamination. Reference topics: Routine Blood Collections; order of draw; tube additives; CBC; chemistry specimen collection.
NEW QUESTION # 15
Which of the following actions should a phlebotomist take if a patient develops a rapidly forming hematoma during venipuncture?
Answer: A
Explanation:
If a rapidly forming hematoma develops, the phlebotomist should remove the needle and apply pressure. A hematoma occurs when blood leaks into surrounding tissue, often because the needle has gone through the vein, partially exited the vein, or the vein wall has been injured. Continuing the collection can worsen bleeding, increase pain, and compromise the specimen. Asking the patient to pump their fist increases venous pressure and can worsen leakage or alter some test results. Inserting the needle deeper is unsafe because it may worsen vessel injury or strike nearby structures. The correct response is to release the tourniquet, remove the needle, activate the safety device, apply firm pressure, and monitor the site. A bandage should be applied only after bleeding has stopped. The phlebotomist should document or report the complication according to facility policy and avoid recollecting from the affected site. Reference topics: Routine Blood Collections; hematoma; venipuncture complications; needle removal; post-procedure care.
NEW QUESTION # 16
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 # 17
A phlebotomist should instruct a patient to take which of the following actions when providing a sputum specimen?
Answer: B
Explanation:
For a sputum specimen, the patient should take a deep breath and then expectorate material from the lower respiratory tract into the appropriate container. Sputum is not saliva; it must come from the lungs or bronchi after a deep cough. The phlebotomist's role is to provide clear collection instructions, confirm the correct container, reduce contamination, and ensure the specimen is labeled and transported according to facility procedure. Option A describes stool collection, not sputum collection. Option B describes the start of a 24-hour urine collection, where the first void is discarded and subsequent urine is saved. Option C describes a buccal swab or oral specimen procedure and is not appropriate for sputum. "Aggressively" swabbing the cheek could cause discomfort or trauma and still would not produce a respiratory specimen. A valid sputum specimen is clinically useful for respiratory infection testing because it contains secretions from the affected airway. NHA CPT competencies include non-blood specimen collection, patient instructions, specimen identification, and maintaining specimen integrity. Reference topics: Special Collections; non-blood specimens; patient instructions; specimen integrity.
NEW QUESTION # 18
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