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| Section | Objectives |
|---|---|
| Routine Blood Collections | - Order of draw - Venipuncture procedures - Equipment selection and use |
| Patient Preparation | - Specimen labeling procedures - Site selection and preparation - Patient identification and communication |
| Specimen Processing and Handling | - Specimen transport and storage - Quality assurance procedures - Common errors and rejection criteria |
| Safety and Compliance | - HIPAA and patient confidentiality - OSHA regulations and patient safety - Infection control and standard precautions |
| Special Collections | - Pediatric and geriatric considerations - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) |
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NEW QUESTION # 51
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?
Answer: A
Explanation:
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.
NEW QUESTION # 52
A phlebotomist observes that the lid of a sharps container will not close. Which of the following actions should the phlebotomist take?
Answer: A
Explanation:
The sharps container should be replaced. A sharps container must be closable, puncture-resistant, leak-resistant, and properly labeled or color-coded. If the lid will not close, the container no longer provides safe containment and creates a needlestick or exposure hazard. Continuing to use it is unsafe even if it has not reached the fill line. Emptying sharps into another container is strictly inappropriate because it requires handling contaminated needles and increases exposure risk. Taping the opening closed is not an approved correction and does not restore the container's designed safety function. The phlebotomist should obtain an approved replacement container and report the defective container according to facility protocol. This is not a minor housekeeping issue; sharps disposal is an engineering-control requirement designed to prevent occupational exposure to bloodborne pathogens. Phlebotomy technicians must dispose of needles immediately after use, never recap used needles, and never place sharps in regular trash or soft biohazard bags. Reference topics: Safety and Compliance; sharps disposal; engineering controls; needlestick prevention.
NEW QUESTION # 53
Which of the following is the purpose of centrifuging a blood specimen?
Answer: B
Explanation:
The purpose of centrifuging a blood specimen is to separate specimen components. Centrifugation uses force to separate cells from serum or plasma based on density. In serum separator tubes, centrifugation separates serum from the clot after the specimen has fully clotted. In plasma separator tubes, centrifugation separates plasma from blood cells in the presence of anticoagulant. It does not disinfect the specimen; blood specimens must still be treated as potentially infectious. It does not activate tube additives; additives function through mixing by gentle inversion after collection. It also does not increase specimen volume. Improper centrifugation can damage specimens. Centrifuging too soon, too long, too fast, or at the wrong temperature can cause hemolysis, fibrin formation, poor separation, or analyte instability. The phlebotomist must follow manufacturer and facility instructions for clotting time, centrifuge speed, duration, balancing, and specimen removal. Reference topics: Processing Specimens; centrifugation; serum and plasma separation; specimen integrity; equipment operation.
NEW QUESTION # 54
A phlebotomist receives a specimen without a patient identifier on the tube. Which of the following actions should the phlebotomist expect?
Answer: D
Explanation:
The laboratory should reject an unlabeled specimen. A specimen without patient identification cannot be reliably linked to the correct patient, even if a requisition is nearby or a provider verbally confirms the order. Labeling a tube later from the requisition is unsafe because it breaks the chain between patient, collection event, and specimen. Testing based only on an order number does not meet safe identification practice. Verbal confirmation after the fact cannot correct an unlabeled specimen because the tube's identity was not secured at the bedside or collection site. Proper labeling should occur immediately after collection in the presence of the patient, using required identifiers such as full name, date of birth, medical record number, date/time of collection, and collector identity according to facility policy. Mislabeling and unlabeled specimens are serious preanalytical errors that can cause wrong diagnosis, wrong treatment, transfusion risk, and patient harm. Reference topics: Processing Specimens; specimen labeling; patient identification; rejection criteria; preanalytical error.
NEW QUESTION # 55
Which of the following is the minimum amount of time required to perform vigorous handwashing according to standard precaution guidelines?
Answer: B
Explanation:
The minimum time for vigorous handwashing is 20 seconds. Proper handwashing requires wetting the hands, applying soap, rubbing all surfaces vigorously, cleaning between fingers and under nails, rinsing, and drying with a clean towel or approved drying method. Ten seconds is too short to reliably remove transient microorganisms. Two or three minutes is excessive for routine handwashing under standard precautions and is more consistent with extended surgical scrub concepts, not ordinary clinical hand hygiene before and after patient contact. In phlebotomy, hand hygiene is required before patient contact, after glove removal, after contact with blood or body fluids, after touching contaminated surfaces, and whenever hands are visibly soiled. Gloves do not replace hand hygiene; they are an additional barrier. Correct hand hygiene reduces healthcare-associated infection risk and protects both the patient and the phlebotomist. Reference topics: Safety and Compliance; standard precautions; hand hygiene; infection prevention; PPE. CDC guidance states that healthcare personnel should wash hands with soap and water for at least 20 seconds in indicated situations.
NEW QUESTION # 56
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