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| Section | Weight | Objectives |
|---|---|---|
| Patient Preparation | 20% | - Patient positioning & comfort - Site selection & preparation - Patient identification & verification - Requisition review & test verification - Informed consent & communication |
| Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Order of draw & tube selection - Post-collection care & labeling - Tourniquet use & vein assessment - Capillary puncture procedures |
| Safety and Compliance | 26% | - Quality control & error prevention - Infection control & OSHA standards - HIPAA & patient confidentiality - PPE & sharps disposal - Bloodborne pathogens & exposure control |
| Specimen Processing & Handling | 14% | - Specimen rejection criteria - Processing & centrifugation - Aliquoting & preservation - Documentation & tracking - Transport & storage requirements |
| Special Collections | 12% | - Blood alcohol & legal collections - Pediatric & geriatric collections - Glucose tolerance & dynamic tests - Therapeutic drug monitoring - Blood cultures & sterile collection |
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NEW QUESTION # 27
Which of the following actions should a phlebotomy technician take upon withdrawing a winged infusion needle?
Answer: D
Explanation:
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.
NEW QUESTION # 28
Which of the following types of testing requires chain of custody documentation for specimens?
Answer: A
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 # 29
A phlebotomist is collecting a blood culture set. Which of the following actions helps reduce contamination?
Answer: A
Explanation:
Allowing the antiseptic to dry before puncture helps reduce blood culture contamination. Blood cultures require strict aseptic technique because skin organisms can enter the specimen and produce false-positive results. Repalpating the site after antisepsis with an ungloved finger contaminates the prepared area and should not be done. If repalpation is absolutely necessary, facility policy may require sterile technique or repeat antisepsis. A gray-top tube is not collected before culture bottles; blood cultures are collected first in the order of draw to maintain sterility. Cleaning only the bottle cap is incomplete because both the patient's skin and bottle access surfaces must be prepared according to procedure. Blood culture quality depends on correct skin antisepsis, adequate drying time, correct bottle order, sufficient volume, separate collection sites when ordered, and accurate documentation. Contaminated cultures can lead to unnecessary antibiotics, longer hospitalization, additional testing, and patient harm. Reference topics: Special Collections; blood cultures; contamination prevention; antiseptic drying; aseptic technique.
NEW QUESTION # 30
Which of the following findings should cause a phlebotomist to delay collection and seek assistance?
Answer: D
Explanation:
A patient who is diaphoretic and says they feel faint requires the phlebotomist to delay collection and seek assistance. Diaphoresis, dizziness, pallor, nausea, and weakness can signal an impending syncopal episode. Continuing with venipuncture in this condition increases the risk of falls, needle injury, hematoma, and patient harm. Confirming date of birth is normal patient identification. Asking which arm will be used is a reasonable patient question and does not require delay. A visible median cubital vein is generally favorable for routine venipuncture. The phlebotomist should position the patient safely, preferably reclining or lying down if fainting risk is present, notify appropriate personnel, and proceed only when safe according to facility policy. If symptoms occur during a draw, the technician should remove the tourniquet and needle when safe, activate the safety device, call for help, and monitor the patient. Reference topics: Patient Preparation; syncope warning signs; patient assessment; collection delay; emergency response.
NEW QUESTION # 31
Which of the following needle gauges can be used for blood donation collection?
Answer: C
Explanation:
Blood donation collection requires a large-bore needle because a full unit of blood must be collected efficiently while minimizing hemolysis and maintaining adequate flow into the collection bag. An 18-gauge needle is the correct option from the list. Blood donor collections commonly use larger needles than routine diagnostic venipuncture because donor collection volume is much greater than routine tube collection. A 25-gauge or 27-gauge needle is too small; it would slow flow excessively, increase mechanical stress on cells, and be inappropriate for donor collection. A 21-gauge needle is common for routine adult venipuncture but is not the best answer for blood donation collection because donor procedures require faster sustained flow. The phlebotomist must also confirm donor eligibility, follow blood bank protocol, use correct equipment, maintain aseptic technique, and monitor the donor for adverse reactions. The NHA CPT outline includes phlebotomy for blood donations and blood donation standards such as hemoglobin/hematocrit screening, weight, and complete screening. Reference topics: Special Collections; blood donation; needle gauge selection; donor collection standards.
NEW QUESTION # 32
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