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| Section | Objectives |
|---|---|
| Routine Blood Collections | - Venipuncture procedures - Order of draw - Equipment selection and use |
| Specimen Processing and Handling | - Specimen transport and storage - Common errors and rejection criteria - Quality assurance procedures |
| Special Collections | - Pediatric and geriatric considerations - Capillary puncture (fingerstick/heel stick) - Non-routine specimen collection methods |
| Safety and Compliance | - Infection control and standard precautions - OSHA regulations and patient safety - HIPAA and patient confidentiality |
| Patient Preparation | - Specimen labeling procedures - Site selection and preparation - Patient identification and communication |
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質問 # 68
A phlebotomist receives a phone call from a provider's practice asking for a patient's CBC results. To which of the following departments should the phlebotomist transfer the call?
正解：A
解説：
A complete blood count, or CBC, is handled by the hematology department because it evaluates cellular components of blood, including red blood cells, white blood cells, hemoglobin, hematocrit, platelets, and differential findings when ordered. Chemistry focuses on analytes such as glucose, electrolytes, enzymes, renal markers, liver markers, and metabolic panels. Coagulation handles clotting studies such as PT, INR, aPTT, fibrinogen, and related hemostasis testing. Serology focuses on antigen-antibody testing and immune-response assays. A phlebotomist should not disclose results unless authorized by facility policy and role scope. The correct action is to direct the caller to the department that performs or releases the requested test result. This protects patient confidentiality and avoids miscommunication of clinical information. NHA CPT processing content includes communication between non-laboratory personnel, retrieving specimen or result data through laboratory systems, distributing results to ordering providers, and understanding blood components and laboratory testing roles. Reference topics: Processing Specimens; laboratory departments; hematology testing; communication of laboratory results.
質問 # 69
Which of the following should a phlebotomist do if a specimen must remain warm during transport?
正解：A
解説：
If a specimen must remain warm during transport, the phlebotomist should use an approved warming device according to facility policy. Some tests, such as cold agglutinin-related specimens or specific specialized assays, may require warm handling to prevent analyte or cellular changes. Placing the specimen on ice or refrigerating it would violate warm-transport requirements and could compromise results. Leaving it near a sunny window is uncontrolled, unsafe, and may expose the specimen to light or excessive heat. Temperature requirements must be controlled and documented when required. The phlebotomist should not improvise with unapproved heat sources because overheating can also damage specimens. Proper specimen handling means knowing whether the specimen should be transported at room temperature, chilled, frozen, protected from light, or kept warm. Failure to follow special handling instructions creates preanalytical error and may require recollection. Reference topics: Processing Specimens; warm specimens; transport requirements; temperature control; specimen integrity.
質問 # 70
Which of the following agencies enforces workplace standards related to bloodborne pathogens?
正解：C
解説：
OSHA enforces workplace standards related to bloodborne pathogens. In phlebotomy, OSHA's Bloodborne Pathogens Standard is central because technicians routinely handle blood, sharps, contaminated equipment, and potentially infectious materials. OSHA requirements support exposure-control plans, engineering controls, sharps safety, PPE, hepatitis B vaccination access, training, and post-exposure follow-up. The FDA regulates drugs, biologics, and medical devices, but it does not enforce employer bloodborne pathogen workplace standards in the same way OSHA does. CMS administers Medicare and Medicaid and oversees certain healthcare quality and laboratory-related regulatory structures, but it is not the primary workplace bloodborne pathogen enforcement agency. DEA regulates controlled substances, which is unrelated to routine phlebotomy safety. A phlebotomist does not need to be a legal scholar, but they must know which agencies govern common safety and compliance issues. This knowledge supports correct behavior during needlesticks, sharps disposal, PPE use, exposure reporting, and infection-control practice. Reference topics: Safety and Compliance; OSHA; bloodborne pathogens; exposure-control plan; workplace safety.
質問 # 71
Which of the following actions should a phlebotomist take when using a syringe for venipuncture?
正解：D
解説：
When using a syringe for venipuncture, the phlebotomist should transfer blood into tubes using a safety transfer device. A syringe may be used for fragile veins or situations where vacuum pressure could collapse the vein, but it introduces additional handling risk. Pulling the plunger forcefully can cause vein collapse, pain, and hemolysis. Removing tube stoppers and pouring blood into tubes is unsafe because it exposes the specimen and staff to blood, increases contamination risk, and disrupts additive ratios. Attaching a used needle to fill evacuated tubes is dangerous and creates needlestick risk. A safety transfer device allows blood to move from the syringe into evacuated tubes while maintaining a closed system and preserving order of draw. The phlebotomist should also avoid excessive force, fill tubes correctly, mix additive tubes gently, activate safety features, and discard sharps immediately. Reference topics: Routine Blood Collections; syringe method; blood transfer device; hemolysis prevention; sharps safety.
質問 # 72
Which of the following is an example of a patient giving a phlebotomist implied consent to complete a blood draw?
正解：C
解説：
The patient extending their arm is an example of implied consent because the patient's action indicates cooperation with the blood draw without a written or explicit verbal statement. In routine phlebotomy, implied consent often occurs when the patient allows identification, listens to the procedure explanation, and physically presents the arm for collection. Signing a consent form is written consent, not implied consent. Saying "Okay" is verbal or expressed consent because the patient directly communicates agreement. Asking questions about the procedure is not consent by itself; it shows the patient is seeking information before deciding whether to proceed. The phlebotomist must still explain the procedure, verify identity, answer process-related questions within scope, respect refusal, and avoid coercion. Consent is not a technical formality; it is tied to patient rights, communication, and ethical practice. If a patient refuses or withdraws cooperation, the technician should not force collection and should follow facility reporting procedures. Reference topics: Patient Preparation; consent types; patient rights; communication; routine venipuncture preparation.
質問 # 73
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