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| Section | Objectives |
|---|---|
| Topic 1: Routine Blood Collections | - Order of draw - Venipuncture procedures - Equipment selection and use |
| Topic 2: Special Collections | - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) - Pediatric and geriatric considerations |
| Topic 3: Patient Preparation | - Site selection and preparation - Patient identification and communication - Specimen labeling procedures |
| Topic 4: Safety and Compliance | - OSHA regulations and patient safety - Infection control and standard precautions - HIPAA and patient confidentiality |
| Topic 5: Specimen Processing and Handling | - Common errors and rejection criteria - Specimen transport and storage - Quality assurance procedures |
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NEW QUESTION # 78
Which of the following collection sites is appropriate for a dermal puncture on an infant?
Answer: B
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 # 79
Which of the following veins is usually the last choice for antecubital venipuncture?
Answer: D
Explanation:
The basilic vein is usually the last choice for antecubital venipuncture. The median cubital vein is preferred because it is typically large, well anchored, superficial, and less likely to roll. The cephalic vein is commonly the second choice when the median cubital is unavailable. The basilic vein is used cautiously because it lies closer to the brachial artery and median nerve, creating greater risk if the needle is inserted too deeply or inaccurately. The dorsal metacarpal veins are hand veins, not antecubital veins, and may be used when antecubital access is unavailable, often with a butterfly needle and shallow angle. This question tests anatomical risk control. A phlebotomist must not simply pick the most visible vein; they must evaluate vein safety, depth, direction, resilience, patient history, and contraindications such as IV sites, edema, burns, scars, hematomas, fistulas, and mastectomy restrictions. Proper site selection reduces pain, nerve injury, arterial puncture, hematoma, and recollection risk. Reference topics: Routine Blood Collections; antecubital anatomy; vein selection; basilic vein risk.
NEW QUESTION # 80
Which of the following situations increases a phlebotomist's risk for a needlestick?
Answer: C
Explanation:
A nearly full sharps container increases the risk for a needlestick because contaminated needles or other sharps may protrude, rebound, or be difficult to place safely into the container. Sharps containers must be puncture-resistant, leak-resistant, properly labeled or color-coded, kept upright, and replaced before they become overfilled. OSHA specifically warns not to allow sharps containers to overfill and requires routine replacement to reduce sharps injury risk. A tight tourniquet can cause patient discomfort, hemoconcentration, or venous obstruction, but it is not the best answer for needlestick risk. A 22-gauge needle is commonly used for routine venipuncture, especially for smaller veins, and is not inherently unsafe. A transfer device used with the syringe method is actually a safety control because it prevents the phlebotomist from manually pushing blood through a needle into evacuated tubes. NHA CPT safety content includes bloodborne pathogens, sharps safety, OSHA standards, exposure control, and safe disposal of contaminated equipment. Reference topics: Safety and Compliance; OSHA Bloodborne Pathogens Standard; sharps disposal; needlestick prevention.
NEW QUESTION # 81
From which of the following sites should a phlebotomist take a capillary collection from a 3-year-old child?
Answer: B
NEW QUESTION # 82
Which of the following actions should a phlebotomist take after removing the needle from a venipuncture site?
Answer: D
Explanation:
After removing the needle, the phlebotomist should apply pressure with clean gauze. Direct pressure supports hemostasis and reduces bruising, bleeding, and hematoma formation. Asking the patient to bend the elbow tightly is incorrect because it can increase pressure at the puncture site and promote hematoma formation or continued bleeding under the skin. Recapping the needle is unsafe and increases needlestick risk; the safety device should be activated and the needle discarded in an approved sharps container. Labeling the tube cap only is also incorrect because caps can be removed or switched. The specimen label must be placed on the tube or container itself according to facility policy. After pressure is applied, the phlebotomist should check that bleeding has stopped before applying a bandage, especially for patients on anticoagulants or with bleeding disorders. Post-procedure care is not an afterthought; it is part of patient safety and specimen workflow. Reference topics: Routine Blood Collections; needle removal; post-procedure care; hemostasis; labeling requirements.
NEW QUESTION # 83
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