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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Specimen Processing & Handling | 14% | - Documentation & tracking - Processing & centrifugation - Transport & storage requirements - Aliquoting & preservation - Specimen rejection criteria |
| Topic 2: Special Collections | 12% | - Blood cultures & sterile collection - Pediatric & geriatric collections - Blood alcohol & legal collections - Therapeutic drug monitoring - Glucose tolerance & dynamic tests |
| Topic 3: Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Tourniquet use & vein assessment - Post-collection care & labeling - Order of draw & tube selection - Capillary puncture procedures |
| Topic 4: Safety and Compliance | 26% | - PPE & sharps disposal - Bloodborne pathogens & exposure control - HIPAA & patient confidentiality - Infection control & OSHA standards - Quality control & error prevention |
| Topic 5: Patient Preparation | 20% | - Site selection & preparation - Informed consent & communication - Patient identification & verification - Patient positioning & comfort - Requisition review & test verification |
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NEW QUESTION # 17
Which of the following collections requires the phlebotomist to discard the first voided specimen and save all subsequent urine for a full day?
Answer: D
Explanation:
A 24-hour urine collection requires the patient to discard the first voided specimen and then save all subsequent urine for the full collection period, including the final void at the ending time. Discarding the first void empties the bladder and establishes the start of the timed interval. A clean-catch urine culture requires cleansing and collecting a midstream specimen in a sterile container, not saving urine for 24 hours. A random urinalysis is collected at a single time and does not require timed accumulation. A sputum culture is a respiratory specimen, not a urine collection. Patient instruction is critical because one missed urine specimen can invalidate the entire 24-hour collection. The phlebotomist should explain start and stop times, storage requirements, preservative hazards if present, labeling, and return instructions. The patient should not change fluid intake unless instructed by the provider. Reference topics: Special Collections; 24-hour urine; patient instructions; non-blood specimens; timed collection.
NEW QUESTION # 18
A phlebotomist in an emergency department is obtaining a blood sample from a patient who asks the purpose of the test. Which of the following responses should the phlebotomist give?
Answer: B
Explanation:
The phlebotomist should respond, "It's best that you ask the provider." A phlebotomist may explain the collection procedure, identify themselves, verify the patient, and answer process-related questions, but the clinical purpose, diagnosis, treatment rationale, and interpretation of ordered tests belong to the ordering provider or authorized clinical personnel. Saying the test screens for communicable diseases is unsafe because it may be inaccurate and could mislead or alarm the patient. Saying "I'm not sure" is weak communication and does not guide the patient to the correct source. Saying the purpose can be explained after completion is also inappropriate because it delays the patient's right to ask clinical questions before the procedure. The correct professional response maintains scope of practice, avoids unauthorized interpretation, and directs the patient to the person responsible for the order. NHA CPT patient-preparation content includes communication with patients, explaining the phlebotomy procedure, receiving consent, complying with ethical standards, and respecting scope of practice. Reference topics: Patient Preparation; scope of practice; patient communication; consent and procedure explanation.
NEW QUESTION # 19
Which of the following types of medication is an indication for an INR draw?
Answer: B
Explanation:
An anticoagulant is the medication type most directly associated with an INR draw. INR, or international normalized ratio, is used to evaluate clotting time and is especially important for monitoring patients who take warfarin or other anticoagulant therapy. These medications reduce the blood's ability to clot, so laboratory monitoring helps determine whether the patient is within the therapeutic range or at risk for bleeding or clotting complications. Anti-inflammatory medications may affect bleeding risk in some situations, but they are not the primary indication for an INR draw. Antihistamines are used for allergic symptoms, and antiemetics are used for nausea or vomiting; neither is routinely monitored by INR. From a phlebotomy standpoint, anticoagulant therapy also alerts the technician to apply pressure longer after venipuncture and observe for prolonged bleeding. Reference topics: Special Collections; coagulation testing; point-of-care INR; medication-related collection considerations; hemostasis. The NHA CPT test plan includes special collections, waived testing, and coagulation/hemostasis-related competencies.
NEW QUESTION # 20
A phlebotomist is scheduled to perform a venipuncture on a patient who had a bilateral radical mastectomy. Which of the following actions should the phlebotomist take?
Answer: D
Explanation:
The phlebotomist should contact the provider for approval. After a mastectomy, especially radical mastectomy with lymph node involvement, venipuncture on the affected side is generally avoided because impaired lymphatic drainage can increase risk for lymphedema, infection, delayed healing, and patient complications. With a bilateral radical mastectomy, both arms may be restricted, so the phlebotomist should not independently choose an alternate arm vein. Drawing from an ulnar vein is not a standard solution and could still be in a restricted extremity. Requesting surgical outpatient records is not the immediate collection action and does not provide authorization to proceed. Obtaining a specimen from the subclavian vein is outside the phlebotomist's routine scope and would be a provider-level invasive procedure. The correct approach is to pause, follow facility policy, notify the nurse or provider, and obtain explicit direction for an approved site or alternate collection method. Reference topics: Routine Blood Collections; site contraindications; mastectomy precautions; provider communication; patient safety.
NEW QUESTION # 21
Which of the following is a possible complication of venipuncture collection for a patient who has been on warfarin therapy?
Answer: C
Explanation:
Prolonged bleeding is the expected complication for a patient on warfarin therapy. Warfarin is an anticoagulant, meaning it interferes with normal clot formation and can increase bleeding time after venipuncture. The phlebotomist should be alert for delayed hemostasis, apply firm pressure after needle removal, avoid having the patient bend the arm sharply, and confirm that bleeding has stopped before applying a bandage and leaving the patient. Blood clotting is the opposite of the expected medication effect. Hemostasis is the normal stopping of bleeding, not a complication. Petechiae can occur from tourniquet pressure, fragile capillaries, or platelet-related issues, but in this question the medication-specific risk is prolonged bleeding. Proper technique reduces complications: release the tourniquet, withdraw the needle smoothly, activate the safety device, apply pressure, and monitor the puncture site. Reference topics: Routine Blood Collections; post-procedure care; anticoagulant therapy; bleeding complications; hemostasis; patient observation. NHA includes routine venipuncture complications and post-collection care within the CPT test plan.
NEW QUESTION # 22
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