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| Section | Objectives |
|---|---|
| Topic 1: Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
| Topic 2: Safety and Compliance | - OSHA standards and safety protocols - Needlestick prevention and biohazard disposal - Infection control and PPE usage |
| Topic 3: Specimen Processing and Handling | - Specimen transport and storage - Labeling and documentation - Quality control and rejection criteria |
| Topic 4: Specimen Collection | - Capillary puncture procedures - Venipuncture techniques - Order of draw and tube handling |
| Topic 5: Patient Preparation | - Patient identification and communication - Site selection and preparation - Explaining procedures and obtaining consent |
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NEW QUESTION # 83
Which of the following practices violates standard precautions?
Answer: D
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 # 84
Which of the following additives is commonly found in a gray-top tube used for glucose testing?
Answer: A
Explanation:
Sodium fluoride is commonly found in gray-top tubes used for glucose testing. Sodium fluoride inhibits glycolysis, which helps preserve glucose concentration after collection by slowing cellular glucose consumption. Many gray-top tubes also contain potassium oxalate as an anticoagulant. Sodium citrate is found in light-blue tubes used for coagulation studies because it binds calcium reversibly. EDTA is found in lavender-top tubes and is commonly used for hematology testing such as CBC. SPS is sodium polyanethol sulfonate, an additive used in blood culture bottles or yellow SPS tubes because it supports organism recovery by reducing certain inhibitory effects. Tube additives are not trivia; they determine specimen type and test validity. A glucose specimen collected in the wrong tube or processed late may produce inaccurate results because cells continue metabolizing glucose after collection. The phlebotomist must match test, tube, additive, order of draw, fill volume, and handling requirements. Reference topics: Special Collections; glucose testing; gray-top tube; sodium fluoride; additive function.
NEW QUESTION # 85
Which of the following actions should a phlebotomy technician take upon withdrawing a winged infusion needle?
Answer: D
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 # 86
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 # 87
A phlebotomist is preparing to perform venipuncture on a patient who has had a right-sided mastectomy. Which of the following collection sites should the phlebotomist select?
Answer: A
Explanation:
The phlebotomist should select the left antecubital area because the patient has had a right-sided mastectomy. Venipuncture should generally be avoided on the side of a mastectomy due to the risk of impaired lymphatic drainage, lymphedema, infection, and delayed healing. The right cephalic and right basilic veins are on the affected side and should not be used unless a provider specifically authorizes collection from that side. The left femoral artery is not an appropriate routine phlebotomy site and arterial collection is outside standard venipuncture practice unless performed under specialized authorization and scope. The left antecubital area is the safest option listed because it uses the unaffected arm and provides standard venipuncture access. The technician should still assess vein suitability, avoid sites with IVs, edema, scarring, hematoma, or infection, and follow facility policy if no acceptable site is available. This question tests contraindicated sites and safe site selection, not simply vein-name recall. Reference topics: Routine Blood Collections; mastectomy precautions; venipuncture site selection; contraindicated sites; patient safety.
NEW QUESTION # 88
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