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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Safety and Compliance | 26% | - Infection control & OSHA standards - Quality control & error prevention - PPE & sharps disposal - Bloodborne pathogens & exposure control - HIPAA & patient confidentiality |
| Topic 2: Special Collections | 12% | - Blood alcohol & legal collections - Glucose tolerance & dynamic tests - Blood cultures & sterile collection - Therapeutic drug monitoring - Pediatric & geriatric collections |
| Topic 3: Routine Blood Collections | 28% | - Tourniquet use & vein assessment - Capillary puncture procedures - Post-collection care & labeling - Venipuncture techniques & equipment - Order of draw & tube selection |
| Topic 4: Patient Preparation | 20% | - Requisition review & test verification - Patient positioning & comfort - Informed consent & communication - Site selection & preparation - Patient identification & verification |
| Topic 5: Specimen Processing & Handling | 14% | - Processing & centrifugation - Transport & storage requirements - Specimen rejection criteria - Documentation & tracking - Aliquoting & preservation |
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問題 #113
A phlebotomist uses a point-of-care instrument to perform a prothrombin time/INR test on a patient that results in a critical value. Which of the following type of medication should the phlebotomist expect to see on the patient's medication list?
答案：A
解題說明：
A prothrombin time/INR test evaluates the extrinsic and common coagulation pathways and is commonly used to monitor anticoagulant therapy, especially warfarin. Therefore, when a PT/INR point-of-care result is critically abnormal, the medication category most expected on the patient's list is anticoagulants. Anticoagulants interfere with clot formation and can prolong PT/INR values, creating an increased bleeding risk if outside the therapeutic range. Opioids are analgesics and do not directly monitor through PT/INR. Antidiabetics are associated with glucose monitoring, not coagulation testing. Statins are lipid-lowering medications and are usually monitored through lipid panels and liver-related considerations, not PT/INR. A critical PT/INR value must be handled according to facility policy, documented accurately, and reported through the correct clinical pathway; the phlebotomist does not interpret or treat the result independently. The NHA CPT outline covers point-of-care testing, critical values for POC and CLIA-waived testing, hemostasis, coagulation, and reporting requirements. Reference topics: Special Collections; point-of-care testing; hemostasis and coagulation; critical value reporting.
問題 #114
A laboratory is scheduled for a routine annual inspection with primary focus on equipment maintenance logs. Which of the following areas will be the focus of the inspection?
答案：B
解題說明：
The focus is mechanical safety because equipment maintenance logs document whether laboratory equipment is being inspected, maintained, calibrated, and monitored properly. In a phlebotomy or clinical laboratory setting, mechanical safety includes safe use and maintenance of centrifuges, refrigerators, freezers, analyzers, timers, and other equipment used in specimen collection and processing. Maintenance logs demonstrate that the facility follows required quality-control procedures and that equipment problems are reported and corrected. Chemical safety would focus on chemical labeling, SDS access, storage compatibility, spill response, and exposure controls. Radiation safety would apply to radioactive materials or imaging-related hazards, not routine phlebotomy equipment logs. Electrical safety would involve cords, plugs, grounding, and electrical hazards, which may be inspected separately but are not the primary focus when the question specifically identifies equipment maintenance logs. NHA CPT safety content includes performing quality control for laboratory equipment, maintaining logs for equipment inspection, reporting and troubleshooting equipment issues, and following manufacturer recommendations for equipment maintenance and calibration. Reference topics: Safety and Compliance; equipment maintenance logs; quality control; mechanical safety.
問題 #115
Which of the following actions should a phlebotomist take when using a syringe for venipuncture?
答案：B
解題說明：
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.
問題 #116
A phlebotomist notices that an outpatient appears confused and cannot state their date of birth. Which of the following actions should the phlebotomist take?
答案：B
解題說明：
The phlebotomist should use an approved alternate identification process. If a patient cannot reliably state their date of birth because of confusion, cognitive impairment, language barrier, or illness, the technician must follow facility policy for identification. This may involve a caregiver, legal guardian, identification band, photo identification, nurse verification, or other approved method depending on the setting. Proceeding using the requisition only is unsafe because the requisition is not the patient. Asking the patient to guess is obviously unreliable and creates wrong-patient risk. Labeling the specimen later in the laboratory is also unsafe because labeling must occur immediately after collection in the patient's presence or according to strict facility procedure. Accurate patient identification is the first major defense against specimen mislabeling, wrong diagnosis, wrong treatment, and patient harm. The phlebotomist must not improvise identity verification just to keep workflow moving. Reference topics: Patient Preparation; patient identification; alternate identification; outpatient collection; specimen labeling.
問題 #117
Using outdated supplies can result in which of the following?
答案：D
解題說明：
Using outdated supplies can result in specimen rejection because expired collection materials may fail to preserve the specimen correctly or meet laboratory acceptance criteria. Expired evacuated tubes may have inadequate vacuum, degraded additives, compromised sterility, or incorrect blood-to-additive performance. These problems are preanalytical errors, meaning they occur before testing and can make results unreliable. The laboratory may reject the specimen rather than risk reporting inaccurate data. Stat processing refers to urgent priority handling and is unrelated to supply expiration. Postanalytical error occurs after testing, such as reporting or result-delivery mistakes, not from using expired collection supplies during acquisition. Claim rejection is a billing or insurance issue, not a specimen integrity issue. A competent phlebotomist prevents rejection by checking tube expiration dates, inspecting supplies, confirming required specimen type, filling tubes properly, mixing additives correctly, and following transport requirements. NHA CPT processing and routine collection content covers specimen integrity, preanalytical errors, equipment quality control, expiration checks, and recollection when required. Reference topics: Processing Specimens; preanalytical error; specimen rejection; equipment quality control.
問題 #118
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