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| Section | Objectives |
|---|---|
| Topic 1: Professional Practice | - Communication and professionalism - Ethics and patient confidentiality (HIPAA) |
| Topic 2: Patient Preparation | - Patient identification and communication - Site selection and preparation - Explaining procedures and obtaining consent |
| Topic 3: Safety and Compliance | - OSHA standards and safety protocols - Needlestick prevention and biohazard disposal - Infection control and PPE usage |
| Topic 4: Specimen Collection | - Venipuncture techniques - Order of draw and tube handling - Capillary puncture procedures |
| Topic 5: Specimen Processing and Handling | - Quality control and rejection criteria - Specimen transport and storage - Labeling and documentation |
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112. Frage
Which of the following complications can a phlebotomist cause by underfilling a gray-topped tube?
Antwort: D
Begründung:
Underfilling a gray-topped tube can contribute to hemolysis and specimen rejection because the blood-to-additive ratio becomes incorrect. Gray-top tubes commonly contain sodium fluoride and potassium oxalate. When the tube is underfilled, the additive concentration becomes excessive relative to the blood volume, which can damage cells and interfere with specimen integrity. Hemolysis means red blood cells rupture, releasing intracellular contents into the serum or plasma and potentially altering test results. Iatrogenic anemia is caused by excessive or repeated blood removal from a patient, not by underfilling one additive tube. "Homeostasis" is the body's general maintenance of internal stability and is not a phlebotomy complication in this context; the clinically relevant term would be hemostasis. Thrombocytosis means an elevated platelet count and is not caused by underfilling a gray-top tube. The technical lesson is blunt: additive tubes must be filled to the required volume and mixed gently by inversion. Reference topics: Processing Specimens; preanalytical error; tube fill requirements; additive ratio; hemolysis.
113. Frage
A phlebotomist centrifuges a serum specimen before it has fully clotted. Which of the following is most likely to occur?
Antwort: A
Begründung:
If a serum specimen is centrifuged before it has fully clotted, fibrin strands can form in the serum. These strands can interfere with testing instruments, cause sample aspiration problems, and lead to inaccurate results or specimen rejection. Serum specimens must be allowed to clot for the required time before centrifugation. Centrifugation does not increase specimen volume, neutralize additives, or sterilize blood. Blood specimens remain potentially infectious regardless of processing. This question tests the difference between serum and plasma. Serum is the liquid portion after clotting; plasma is the liquid portion of anticoagulated blood. If the phlebotomist rushes serum processing, the specimen may look separated but still contain fibrin. The correct workflow includes observing required clot time, balancing centrifuge tubes, using the correct speed and duration, and removing specimens promptly after centrifugation when required. Speed is not quality; specimen integrity is quality. Reference topics: Processing Specimens; clotting time; serum processing; centrifugation; fibrin formation.
114. Frage
Which of the following actions should a phlebotomy technician take upon withdrawing a winged infusion needle?
Antwort: C
Begründung:
Upon withdrawing a winged infusion needle, the phlebotomy technician should activate the safety device. Winged infusion sets have a built-in safety mechanism designed to shield or retract the needle after use, reducing the risk of needlestick injury and bloodborne pathogen exposure. The device should be activated immediately according to the manufacturer's instructions and then disposed of in an appropriate sharps container. Disposing of a 16-gauge needle is not the best answer because winged sets for routine phlebotomy are not typically described as 16-gauge, and disposal occurs after safety activation. Placing a capillary pipette in clay relates to microhematocrit tube sealing, not venipuncture completion. Depressing a syringe plunger is unrelated to winged needle removal and could create exposure or specimen-handling problems if done incorrectly. The critical safety action is engineering-control use: activate the safety feature without recapping or unnecessary handling. Reference topics: Routine Blood Collections; Safety and Compliance; winged infusion sets; needle withdrawal; sharps safety; needlestick prevention. NHA CPT domains include equipment selection, needle removal, safety-device use, and exposure-control procedures.
115. Frage
Which of the following actions should the phlebotomist take when labelling inpatient specimens?
Antwort: C
Begründung:
For inpatient specimens, the phlebotomist should label the specimen collection container immediately after collection using the patient's wristband information as the identification source. The key control is bedside labeling in the presence of the patient, after positive identification and collection, so the specimen is tied to the correct patient before it leaves the room. Labeling the lid is unsafe because lids can be removed, switched, or separated from the specimen. Having the patient write demographic information is not an acceptable patient-identification process and does not satisfy laboratory labeling requirements. Provider pre-labeling is also unsafe because it creates a risk of wrong-patient collection if the container is later used for another patient or if identification is not verified at collection. Correct labeling usually includes patient name, second identifier, date and time of collection, collector identity, and any facility-required information. The NHA CPT outline specifically includes patient identifiers, labeling procedures and requirements, documentation, and the task of labeling all specimens. Reference topics: Routine Blood Collections; patient identification; specimen labeling; documentation requirements.
116. Frage
Which of the following is the purpose of centrifuging a blood specimen?
Antwort: A
Begründung:
The purpose of centrifuging a blood specimen is to separate specimen components. Centrifugation uses force to separate cells from serum or plasma based on density. In serum separator tubes, centrifugation separates serum from the clot after the specimen has fully clotted. In plasma separator tubes, centrifugation separates plasma from blood cells in the presence of anticoagulant. It does not disinfect the specimen; blood specimens must still be treated as potentially infectious. It does not activate tube additives; additives function through mixing by gentle inversion after collection. It also does not increase specimen volume. Improper centrifugation can damage specimens. Centrifuging too soon, too long, too fast, or at the wrong temperature can cause hemolysis, fibrin formation, poor separation, or analyte instability. The phlebotomist must follow manufacturer and facility instructions for clotting time, centrifuge speed, duration, balancing, and specimen removal. Reference topics: Processing Specimens; centrifugation; serum and plasma separation; specimen integrity; equipment operation.
117. Frage
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