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| Section | Weight | Objectives |
|---|---|---|
| Safety and Compliance | 26% | - HIPAA & patient confidentiality - Quality control & error prevention - PPE & sharps disposal - Bloodborne pathogens & exposure control - Infection control & OSHA standards |
| Patient Preparation | 20% | - Site selection & preparation - Patient positioning & comfort - Requisition review & test verification - Patient identification & verification - Informed consent & communication |
| Special Collections | 12% | - Blood cultures & sterile collection - Therapeutic drug monitoring - Glucose tolerance & dynamic tests - Pediatric & geriatric collections - Blood alcohol & legal collections |
| Specimen Processing & Handling | 14% | - Processing & centrifugation - Specimen rejection criteria - Transport & storage requirements - Aliquoting & preservation - Documentation & tracking |
| Routine Blood Collections | 28% | - Capillary puncture procedures - Post-collection care & labeling - Tourniquet use & vein assessment - Order of draw & tube selection - Venipuncture techniques & equipment |
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질문 # 108
A phlebotomist should identify which of the following as the best site for phenylketonuria collection on an infant?
정답：B
설명：
The best site for phenylketonuria, or PKU, collection on an infant is the medial or lateral plantar surface of the heel. PKU screening is a newborn metabolic screening test commonly collected by heel stick onto filter paper. The medial and lateral heel areas are selected because they provide adequate capillary blood flow while reducing the risk of puncturing bone. The central area of the heel is unsafe because the calcaneus may be closer to the puncture site, increasing the risk of bone injury or osteomyelitis. Fingertip puncture is inappropriate for infants because the tissue is small, bone is close to the surface, and the site does not provide the recommended specimen collection area for newborn screening. Proper PKU collection also requires warming the heel when indicated, allowing blood to flow freely, filling filter-paper circles completely from one side, avoiding layering, and allowing the specimen to dry properly before transport. NHA CPT special collection content includes collecting blood for metabolic syndromes such as PKU, filter-paper collection techniques, pediatric considerations, and minimum/maximum volume requirements. Reference topics: Special Collections; PKU collection; infant heel puncture; filter-paper specimen collection.
질문 # 109
Which of the following is the life span of an erythrocyte?
정답：C
설명：
The life span of an erythrocyte, or red blood cell, is approximately 120 days. Erythrocytes are specialized cells that transport oxygen through hemoglobin and support carbon dioxide transport from tissues back to the lungs. Because mature erythrocytes lack nuclei and many organelles, they cannot repair themselves indefinitely; they gradually lose membrane flexibility and are removed primarily by the spleen and reticuloendothelial system. A 14-day lifespan is far too short for normal red blood cells and is more consistent with certain abnormal disease states or other cellular turnover concepts. Eighty days and 160 days are not the standard lifespan used in basic hematology. This knowledge matters in phlebotomy because blood collection, CBC interpretation context, hemolysis awareness, and specimen quality all depend on understanding blood components. The phlebotomist is not diagnosing anemia or hemolytic disease, but must understand formed elements and their general characteristics. Reference topics: Phlebotomy Fundamentals; blood composition; erythrocytes; hematology basics; CBC-related concepts. MedlinePlus states that red blood cells live about 120 days.
질문 # 110
A phlebotomist is collecting a blood culture from a 6-month-old infant who has no known allergies. Which of the following disinfectants should the phlebotomist use?
정답：C
설명：
Chlorhexidine gluconate is the best answer for blood culture skin antisepsis in this 6-month-old infant with no known allergies. Blood cultures require stricter skin disinfection than routine venipuncture because contamination can produce false-positive culture results, unnecessary antibiotics, repeat testing, and delayed diagnosis. Sodium polyanethol sulfonate is not a skin disinfectant; it is an anticoagulant/additive used in blood culture media to support organism recovery. Sodium hypochlorite is a bleach-type disinfectant used for environmental decontamination, not patient skin preparation for venipuncture. Hydrogen peroxide is not the standard blood culture skin antiseptic. Chlorhexidine is widely used for effective skin antisepsis, and CDC guidance recognizes chlorhexidine-containing agents in healthcare infection-control contexts when age, skin maturity, and clinical risk are considered. For collection technique, the phlebotomist should cleanse the site properly, allow the antiseptic to dry, avoid repalpating unless sterile technique is used, collect adequate volume, and label/document accurately. Reference topics: Special Collections; blood culture collection; pediatric skin preparation; contamination prevention.
질문 # 111
Which of the following tests should a phlebotomist anticipate to complete for a patient who has a fever of unknown origin?
정답：C
설명：
For a patient with fever of unknown origin, the phlebotomist should anticipate blood culture collection. Blood cultures are ordered to detect microorganisms in the bloodstream and are especially important when infection, bacteremia, or sepsis is suspected. Fever without a known source is a classic clinical reason for obtaining cultures before antimicrobial therapy when possible. ESR may support evaluation of inflammation, but it does not identify bloodstream infection. Immunology tests may be used for immune or infectious disease investigations, but they are not the primary phlebotomy collection expected for fever of unknown origin. Rapid plasma renin evaluates the renin-angiotensin system and is associated with blood pressure and endocrine evaluation, not unexplained fever. Blood culture collection requires strict aseptic technique, correct antiseptic contact time, proper bottle order, adequate volume, correct number of sets, documentation of collection site, and timely transport. Contamination can produce false-positive results and inappropriate treatment. NHA CPT competencies include blood culture collection, special collections, infection control, site preparation, bottle handling, and specimen integrity. Reference topics: Special Collections; blood cultures; fever workup; contamination prevention.
질문 # 112
Which of the following angles should a phlebotomist use when inserting a butterfly needle into a patient's dorsal hand veins?
정답：D
설명：
A butterfly needle inserted into dorsal hand veins should be introduced at a shallow angle, and from the options provided, 10° is the best answer. Hand veins are usually superficial, smaller, and more mobile than antecubital veins, so a steep angle increases the risk of passing through the vein, causing infiltration, hematoma formation, pain, or failed collection. A winged infusion set gives better control for fragile or difficult veins, but the phlebotomist must still anchor the vein, insert bevel up, and keep the angle low. A 25° or 30° angle is more consistent with routine antecubital venipuncture rather than shallow hand-vein access. A 45° angle is excessive for venous collection and creates unnecessary tissue trauma. The NHA CPT test plan places this under routine blood collection skills, including equipment selection, winged collection sets, hand vascular anatomy, site selection, and angle of needle insertion and withdrawal. Reference topics: Routine Blood Collections; winged collection set; hand veins; angle of needle insertion.
질문 # 113
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