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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Patient Preparation | 20% | - Patient positioning & comfort - Informed consent & communication - Site selection & preparation - Patient identification & verification - Requisition review & test verification |
| Topic 2: Special Collections | 12% | - Blood cultures & sterile collection - Blood alcohol & legal collections - Glucose tolerance & dynamic tests - Therapeutic drug monitoring - Pediatric & geriatric collections |
| Topic 3: Routine Blood Collections | 28% | - Capillary puncture procedures - Tourniquet use & vein assessment - Post-collection care & labeling - Order of draw & tube selection - Venipuncture techniques & equipment |
| Topic 4: Specimen Processing & Handling | 14% | - Transport & storage requirements - Aliquoting & preservation - Processing & centrifugation - Documentation & tracking - Specimen rejection criteria |
| Topic 5: Safety and Compliance | 26% | - Quality control & error prevention - Infection control & OSHA standards - Bloodborne pathogens & exposure control - PPE & sharps disposal - HIPAA & patient confidentiality |
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NEW QUESTION # 37
A patient refuses a blood draw after the phlebotomist explains the procedure. Which of the following actions should the phlebotomist take?
Answer: C
Explanation:
The phlebotomist should notify the nurse or provider according to facility policy. A competent adult patient has the right to refuse a blood draw, even when the test is ordered. Proceeding against the patient's refusal is unethical and can constitute battery. Asking a family member to pressure the patient is inappropriate because consent must come from the patient or legally authorized representative when applicable, not from coercion. Using a smaller needle does not address refusal unless the patient specifically refused because of needle size and then gives consent after discussion. The phlebotomist should remain professional, clarify the patient's concern within scope, avoid arguing, document or report the refusal as required, and allow authorized clinical personnel to follow up. This question tests patient rights, consent, communication, and scope of practice. Phlebotomy is invasive, so consent is not optional. The technician's authority ends where patient refusal begins unless a specific emergency or legal policy applies through authorized medical personnel. Reference topics: Patient Preparation; patient refusal; consent; patient rights; communication; documentation.
NEW QUESTION # 38
Which of the following types of testing requires chain of custody documentation for specimens?
Answer: C
Explanation:
Drug testing requires chain of custody documentation when the specimen is collected for legal, employment, forensic, or regulatory purposes. Chain of custody tracks the specimen from collection through transport, receipt, testing, storage, and final disposition. It documents who collected the specimen, who handled it, when transfers occurred, whether seals were intact, and whether the specimen remained secure. This protects the legal defensibility of the result by reducing the possibility of substitution, tampering, contamination, or misidentification. Blood typing requires strict patient identification and specimen labeling because of transfusion risk, but it is not the classic chain-of-custody specimen in this question. HIV testing requires confidentiality and consent requirements according to policy, but not forensic custody tracking in routine care. Tuberculosis testing requires correct collection or test procedure, infection-control precautions, and documentation, not legal custody control. For drug screening, the phlebotomist must follow collection kit instructions exactly, verify identity, seal the specimen properly, complete all required documentation, and maintain specimen security. Reference topics: Processing Specimens; chain of custody; toxicology testing; forensic specimens; legal documentation.
NEW QUESTION # 39
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 # 40
Which of the following should a sharps container have?
Answer: D
Explanation:
A sharps container should have a leakproof lid or leak-resistant closure to prevent contaminated blood or fluid from escaping during handling, storage, or transport. Sharps containers must also be puncture-resistant, closable, upright and stable during use, and properly labeled or color-coded as biohazardous. A "room temperature" label is used for certain specimen storage or transport conditions, not for sharps disposal. A 1-gallon capacity is not a universal requirement; sharps containers come in multiple approved sizes depending on the setting and volume of use. Dual openings are not required and could increase risk if poorly designed. The essential safety standard is containment: the device must prevent puncture injury and leakage while allowing safe disposal at the point of use. The phlebotomist must never overfill a sharps container, reach into it, shake it, force items into it, or dispose of sharps in regular trash or soft biohazard bags. Reference topics: Safety and Compliance; sharps container requirements; biohazard disposal; OSHA bloodborne pathogen safety; needlestick prevention.
NEW QUESTION # 41
Which of the following tube colors is commonly used for coagulation testing?
Answer: D
Explanation:
Light-blue tubes are commonly used for coagulation testing because they contain sodium citrate. Citrate binds calcium reversibly, preventing clotting while preserving the specimen for coagulation analysis such as PT, INR, and aPTT. The tube must be filled to the required level because coagulation testing depends on a precise blood-to-anticoagulant ratio. Underfilling a light-blue tube can falsely prolong clotting results and cause specimen rejection. Lavender tubes contain EDTA and are commonly used for hematology tests such as CBC. Gray tubes often contain sodium fluoride and potassium oxalate and are used for glucose or lactate testing depending on facility protocol. Red tubes are generally serum tubes without anticoagulant or with clot activator depending on manufacturer. The phlebotomist must collect light-blue tubes in the correct order of draw and inspect for proper fill. This is a high-yield NHA-style concept because it combines tube color, additive, test department, and specimen acceptability. Reference topics: Routine Blood Collections; coagulation tubes; sodium citrate; fill volume; order of draw.
NEW QUESTION # 42
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