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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Safety and Compliance | 26% | - Quality control & error prevention - PPE & sharps disposal - Bloodborne pathogens & exposure control - HIPAA & patient confidentiality - Infection control & OSHA standards |
| Topic 2: Patient Preparation | 20% | - Patient positioning & comfort - Requisition review & test verification - Site selection & preparation - Informed consent & communication - Patient identification & verification |
| Topic 3: Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Post-collection care & labeling - Order of draw & tube selection - Tourniquet use & vein assessment - Capillary puncture procedures |
| Topic 4: Specimen Processing & Handling | 14% | - Documentation & tracking - Transport & storage requirements - Processing & centrifugation - Aliquoting & preservation - Specimen rejection criteria |
| Topic 5: Special Collections | 12% | - Pediatric & geriatric collections - Therapeutic drug monitoring - Glucose tolerance & dynamic tests - Blood alcohol & legal collections - Blood cultures & sterile collection |
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質問 # 40
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?
正解：C
解説：
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.
質問 # 41
Which of the following tests should a phlebotomist anticipate to complete for a patient who has a fever of unknown origin?
正解：C
解説：
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.
質問 # 42
Which of the following terms means a decrease in white blood cells?
正解：B
解説：
Leukopenia means a decreased number of white blood cells. "Leuko-" refers to white blood cells, and "-penia" means deficiency or decrease. Leukocytosis means an increased white blood cell count and is often associated with infection, inflammation, stress response, or hematologic disorders. Thrombocytopenia means a decreased platelet count, which can increase bleeding risk after venipuncture. Erythrocytosis means an increased red blood cell count. This terminology matters to phlebotomy because laboratory orders and patient conditions often use hematologic language. The phlebotomist does not diagnose these conditions, but understanding terms helps the technician anticipate safety concerns and specimen requirements. For example, thrombocytopenia may require longer pressure after collection, while leukopenia may be associated with immunocompromised status and strict infection-control awareness. A CBC is the common test used to evaluate red cells, white cells, hemoglobin, hematocrit, and platelets. Reference topics: Phlebotomy Fundamentals; medical terminology; hematology; CBC components; blood cell disorders.
質問 # 43
A phlebotomist notices that a serum separator tube has not clotted before centrifugation. Which of the following actions should the phlebotomist take?
正解：C
解説：
The phlebotomist should allow the serum separator tube to clot completely before centrifugation. Serum specimens require clot formation before centrifugation so the liquid serum can separate properly from the clot. Centrifuging before clotting is complete can cause fibrin strands, incomplete separation, instrument issues, and possible specimen rejection. Shaking the tube vigorously is incorrect because it can hemolyze the specimen and disrupt cellular integrity. Transferring the specimen into a plasma tube is unsafe and invalid because the specimen was not collected with the correct anticoagulant at the correct blood-to-additive ratio. Proper processing means respecting the requirements of the tube collected: serum tubes must clot for the required time, additive tubes must be gently inverted, and specimens must be centrifuged according to time, speed, and temperature requirements. This item tests processing discipline, not speed. A phlebotomist must protect specimen integrity from collection through transport and processing. Reference topics: Processing Specimens; serum separation; clotting time; centrifugation; specimen rejection.
質問 # 44
Which of the following is an example of a patient giving a phlebotomist implied consent to complete a blood draw?
正解：D
解説：
The patient extending their arm is an example of implied consent because the patient's action indicates cooperation with the blood draw without a written or explicit verbal statement. In routine phlebotomy, implied consent often occurs when the patient allows identification, listens to the procedure explanation, and physically presents the arm for collection. Signing a consent form is written consent, not implied consent. Saying "Okay" is verbal or expressed consent because the patient directly communicates agreement. Asking questions about the procedure is not consent by itself; it shows the patient is seeking information before deciding whether to proceed. The phlebotomist must still explain the procedure, verify identity, answer process-related questions within scope, respect refusal, and avoid coercion. Consent is not a technical formality; it is tied to patient rights, communication, and ethical practice. If a patient refuses or withdraws cooperation, the technician should not force collection and should follow facility reporting procedures. Reference topics: Patient Preparation; consent types; patient rights; communication; routine venipuncture preparation.
質問 # 45
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