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| Section | Objectives |
|---|---|
| Topic 1: Safety and Compliance | - Needlestick prevention and biohazard disposal - OSHA standards and safety protocols - Infection control and PPE usage |
| Topic 2: Patient Preparation | - Site selection and preparation - Patient identification and communication - Explaining procedures and obtaining consent |
| Topic 3: Professional Practice | - Communication and professionalism - Ethics and patient confidentiality (HIPAA) |
| Topic 4: Specimen Processing and Handling | - Specimen transport and storage - Labeling and documentation - Quality control and rejection criteria |
| Topic 5: Specimen Collection | - Order of draw and tube handling - Capillary puncture procedures - Venipuncture techniques |
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NEW QUESTION # 51
When performing a capillary collection, which of the following tubes should a phlebotomist collect last?
Answer: D
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 # 52
Which of the following should a phlebotomist verify for quality control protocol prior to using vacuum tubes?
Answer: B
Explanation:
Before using evacuated vacuum tubes, the phlebotomist must verify the expiration date. Expired tubes can lose vacuum, produce inadequate draw volume, compromise the blood-to-additive ratio, or contain additives that no longer perform as intended. This can directly affect specimen integrity and may lead to inaccurate results or specimen rejection. Needle integrity is also important, but it applies to needle inspection rather than vacuum tube quality control. Visible additive may be observed in some tubes, but not all additives are easily visible, and visibility alone does not confirm the tube is acceptable for use. Name on label is not checked before using an unused tube because patient labeling occurs after collection according to facility policy and positive patient identification requirements. Tube quality control includes inspecting tubes for cracks, contamination, expired dates, defective stoppers, and compromised vacuum. NHA CPT routine collection content specifically includes selecting and assembling equipment, verifying equipment quality, checking expiration dates, and inspecting evacuated tubes required for laboratory testing. Reference topics: Routine Blood Collections; evacuated tube quality control; expiration dates; equipment inspection.
NEW QUESTION # 53
A phlebotomist has just performed quality control measurements on a glucose monitor. The values exceed the acceptable limits. Which of the following actions should the phlebotomist take?
Answer: A
Explanation:
When glucose monitor quality control values exceed acceptable limits, the phlebotomist should perform the manufacturer's recommended actions. Out-of-range QC means the instrument, strips, controls, operator technique, storage conditions, or environmental factors may be unreliable. Patient testing should not proceed until the problem is corrected and QC results return to acceptable range according to the device instructions and facility procedure. Cleaning the monitor may be part of troubleshooting, but it is not automatically the complete or correct response unless the manufacturer's protocol identifies contamination as the cause. Replacing batteries may be appropriate only if the device indicates low power or the manufacturer's instructions direct it. Documenting the values is necessary, but documentation alone does not correct the failed QC or validate patient results. The correct professional action is to follow the device-specific troubleshooting and QC procedure, repeat controls when indicated, remove defective materials from use, and notify the appropriate supervisor if unresolved. NHA CPT competencies include point-of-care testing, quality control, CLIA-waived testing, equipment maintenance, and accurate documentation. Reference topics: Special Collections; point-of-care glucose testing; quality control; manufacturer instructions.
NEW QUESTION # 54
Which of the following sites should a phlebotomist use for collecting a capillary blood specimen from an adult patient?
Answer: B
Explanation:
For an adult capillary blood specimen, the third digit with the cut perpendicular to the fingerprint grooves is the best answer. The third digit is the middle finger, one of the preferred fingers for dermal puncture because it usually has adequate tissue depth and blood flow. The incision should be made perpendicular to the fingerprint lines so blood forms a rounded drop instead of running along the fingerprint grooves, which improves collection efficiency and reduces specimen smearing. The second digit, or index finger, is generally avoided because it may be more calloused or sensitive and is used frequently for touch. The fifth digit should be avoided because it has less tissue depth and greater risk of bone injury. A cut parallel to fingerprint grooves is technically poor because blood can track along the grooves and make collection more difficult. Correct adult capillary collection requires site warming when needed, antisepsis, complete drying, appropriate lancet depth, wiping away the first drop when required, and avoiding excessive squeezing. Reference topics: Routine Blood Collections; dermal puncture; adult capillary site selection; lancet orientation; microcollection technique.
NEW QUESTION # 55
Which of the following angles should a phlebotomist use when inserting a butterfly needle into a patient's dorsal hand veins?
Answer: B
Explanation:
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.
NEW QUESTION # 56
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