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| Section | Objectives |
|---|---|
| Safety and Compliance | - Infection control and standard precautions - OSHA regulations and patient safety - HIPAA and patient confidentiality |
| Special Collections | - Capillary puncture (fingerstick/heel stick) - Non-routine specimen collection methods - Pediatric and geriatric considerations |
| Patient Preparation | - Specimen labeling procedures - Site selection and preparation - Patient identification and communication |
| Routine Blood Collections | - Venipuncture procedures - Equipment selection and use - Order of draw |
| Specimen Processing and Handling | - Quality assurance procedures - Common errors and rejection criteria - Specimen transport and storage |
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NEW QUESTION # 120
When performing a capillary collection, which of the following tubes should a phlebotomist collect last?
Answer: C
Explanation:
In capillary collection, the red tube should be collected last from the options listed. Capillary order of draw differs from venipuncture order of draw because capillary blood begins clotting quickly after puncture. Tubes containing anticoagulants are collected before serum tubes to prevent platelet clumping and microclot formation that could invalidate hematology or other additive-based testing. Lavender EDTA specimens are typically prioritized early because hematology testing requires well-mixed anticoagulated whole blood. Lithium heparin is also an additive tube and should be collected before a non-additive or serum specimen. Red tubes are generally serum tubes and are collected later because clotting is expected for serum production. Microhematocrit collection depends on the procedure and whether anticoagulated capillary tubes are used, but it is not the best answer for "last" in this item. The phlebotomist must also wipe away the first drop, avoid excessive squeezing, fill microcollection containers properly, and mix additive specimens immediately by gentle inversion. NHA CPT competencies include dermal puncture, capillary order of draw, microcollection devices, and specimen integrity. Reference topics: Routine Blood Collections; capillary collection; dermal puncture; microcollection order of draw.
NEW QUESTION # 121
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: C
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 # 122
Which of the following specimens is commonly collected using filter paper?
Answer: A
Explanation:
Newborn screening specimens are commonly collected using filter paper. These specimens are obtained by heel puncture and applied to designated circles on approved filter paper cards. The blood must soak through completely from one side, filling each circle properly without layering multiple drops. Blood cultures are collected in aerobic and anaerobic culture bottles, not filter paper. Coagulation studies require light-blue citrate tubes filled to the correct blood-to-additive ratio. Crossmatch specimens are collected in tubes specified by the transfusion service, with strict patient identification and labeling requirements. Filter-paper collection has its own technical risks: insufficient saturation, layering, contamination, touching the collection area, failure to dry completely, and improper transport can all make the specimen unsatisfactory. The phlebotomist must warm the heel if needed, use an approved puncture site, avoid excessive squeezing, and allow the card to dry horizontally away from direct heat or sunlight. Reference topics: Special Collections; newborn screening; PKU/metabolic screening; filter-paper collection; infant heel puncture.
NEW QUESTION # 123
Which of the following terms means a decrease in white blood cells?
Answer: A
Explanation:
Leukopenia means a decreased number of white blood cells. "Leuko-" refers to white blood cells, and "-penia" means deficiency or decrease. Leukocytosis means an increased white blood cell count and is often associated with infection, inflammation, stress response, or hematologic disorders. Thrombocytopenia means a decreased platelet count, which can increase bleeding risk after venipuncture. Erythrocytosis means an increased red blood cell count. This terminology matters to phlebotomy because laboratory orders and patient conditions often use hematologic language. The phlebotomist does not diagnose these conditions, but understanding terms helps the technician anticipate safety concerns and specimen requirements. For example, thrombocytopenia may require longer pressure after collection, while leukopenia may be associated with immunocompromised status and strict infection-control awareness. A CBC is the common test used to evaluate red cells, white cells, hemoglobin, hematocrit, and platelets. Reference topics: Phlebotomy Fundamentals; medical terminology; hematology; CBC components; blood cell disorders.
NEW QUESTION # 124
Which of the following collection sites is appropriate for a dermal puncture on an infant?
Answer: A
Explanation:
The appropriate dermal puncture site on an infant is the medial or lateral plantar surface of the heel. These areas reduce the risk of puncturing bone and provide suitable capillary blood flow for neonatal testing. The posterior curvature of the heel should be avoided because the bone may be close to the surface, increasing risk of osteomyelitis or injury. The arch of the foot is not an approved puncture site and may damage nerves, tendons, or deeper structures. The tip of the index finger is inappropriate for infants because there is insufficient tissue depth and greater risk of bone injury. Correct infant dermal puncture also requires using an age-appropriate lancet depth, warming the site if needed, cleaning and drying the skin, wiping away the first drop when required, avoiding excessive squeezing, and collecting specimens in the correct order. Infant blood volume is limited, so collection volume must be minimized. Reference topics: Special Collections; infant heel puncture; dermal puncture sites; neonatal safety; osteomyelitis prevention.
NEW QUESTION # 125
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