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| Section | Weight | Objectives |
|---|---|---|
| Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Capillary puncture procedures - Post-collection care & labeling - Tourniquet use & vein assessment - Order of draw & tube selection |
| Special Collections | 12% | - Blood cultures & sterile collection - Blood alcohol & legal collections - Pediatric & geriatric collections - Therapeutic drug monitoring - Glucose tolerance & dynamic tests |
| Patient Preparation | 20% | - Informed consent & communication - Requisition review & test verification - Patient positioning & comfort - Site selection & preparation - Patient identification & verification |
| Safety and Compliance | 26% | - Quality control & error prevention - PPE & sharps disposal - Infection control & OSHA standards - Bloodborne pathogens & exposure control - HIPAA & patient confidentiality |
| Specimen Processing & Handling | 14% | - Documentation & tracking - Transport & storage requirements - Processing & centrifugation - Aliquoting & preservation - Specimen rejection criteria |
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NEW QUESTION # 32
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: C
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 # 33
Which of the following is the maximum allowed time for a tourniquet application before possibly affecting test results?
Answer: A
Explanation:
The maximum recommended tourniquet application time before results may be affected is 60 seconds. A tourniquet is applied to increase venous filling and make the vein easier to locate and access, but prolonged application causes venous stasis and hemoconcentration. When blood remains trapped below the tourniquet too long, fluid shifts from the vascular space into surrounding tissue, concentrating cells, proteins, and protein-bound analytes. This can falsely elevate results such as potassium, calcium, proteins, and other chemistry values. It can also increase patient discomfort and make the collection more difficult. Thirty and forty-five seconds are acceptable but are not the maximum allowed time. Ninety seconds is too long and increases the risk of altered test values. Correct practice is to apply the tourniquet only long enough to select the site and establish blood flow, then release it promptly, especially before removing the needle. Reference topics: Routine Blood Collections; tourniquet application; hemoconcentration; venipuncture preanalytical variables.
NEW QUESTION # 34
Which of the following actions should a phlebotomist take after removing gloves?
Answer: D
Explanation:
The phlebotomist should perform hand hygiene after removing gloves. Gloves reduce contamination but do not replace hand hygiene. Hands can become contaminated during glove removal, and gloves may have microscopic defects. Putting used gloves in a lab coat pocket is a contamination hazard. Sanitizing gloves for reuse is incorrect because medical gloves used during patient care are single-use items and should be discarded appropriately. Touching clean supplies immediately after glove removal without hand hygiene can contaminate the clean supply area and spread organisms to future patients. Proper glove workflow includes performing hand hygiene before gloving when indicated, wearing gloves for blood collection, avoiding unnecessary surface contact while gloved, removing gloves without contaminating the hands, discarding them properly, and performing hand hygiene afterward. This question tests routine infection-control behavior. Many healthcare-associated contamination events happen through simple missed hand hygiene after glove removal. Reference topics: Safety and Compliance; hand hygiene; glove removal; standard precautions; contamination prevention.
NEW QUESTION # 35
Which of the following needle gauges can be used for blood donation collection?
Answer: B
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 # 36
Which of the following actions should a phlebotomy technician take upon withdrawing a winged infusion needle?
Answer: C
Explanation:
Upon withdrawing a winged infusion needle, the phlebotomy technician should activate the safety device. Winged infusion sets have a built-in safety mechanism designed to shield or retract the needle after use, reducing the risk of needlestick injury and bloodborne pathogen exposure. The device should be activated immediately according to the manufacturer's instructions and then disposed of in an appropriate sharps container. Disposing of a 16-gauge needle is not the best answer because winged sets for routine phlebotomy are not typically described as 16-gauge, and disposal occurs after safety activation. Placing a capillary pipette in clay relates to microhematocrit tube sealing, not venipuncture completion. Depressing a syringe plunger is unrelated to winged needle removal and could create exposure or specimen-handling problems if done incorrectly. The critical safety action is engineering-control use: activate the safety feature without recapping or unnecessary handling. Reference topics: Routine Blood Collections; Safety and Compliance; winged infusion sets; needle withdrawal; sharps safety; needlestick prevention. NHA CPT domains include equipment selection, needle removal, safety-device use, and exposure-control procedures.
NEW QUESTION # 37
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