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| Section | Objectives |
|---|---|
| Topic 1: Patient Preparation | - Site selection and preparation - Specimen labeling procedures - Patient identification and communication |
| Topic 2: Routine Blood Collections | - Equipment selection and use - Venipuncture procedures - Order of draw |
| Topic 3: Safety and Compliance | - Infection control and standard precautions - HIPAA and patient confidentiality - OSHA regulations and patient safety |
| Topic 4: Specimen Processing and Handling | - Common errors and rejection criteria - Quality assurance procedures - Specimen transport and storage |
| Topic 5: Special Collections | - Capillary puncture (fingerstick/heel stick) - Non-routine specimen collection methods - Pediatric and geriatric considerations |
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NEW QUESTION # 19
A phlebotomist should instruct a patient to take which of the following actions when providing a sputum specimen?
Answer: D
Explanation:
For a sputum specimen, the patient should take a deep breath and then expectorate material from the lower respiratory tract into the appropriate container. Sputum is not saliva; it must come from the lungs or bronchi after a deep cough. The phlebotomist's role is to provide clear collection instructions, confirm the correct container, reduce contamination, and ensure the specimen is labeled and transported according to facility procedure. Option A describes stool collection, not sputum collection. Option B describes the start of a 24-hour urine collection, where the first void is discarded and subsequent urine is saved. Option C describes a buccal swab or oral specimen procedure and is not appropriate for sputum. "Aggressively" swabbing the cheek could cause discomfort or trauma and still would not produce a respiratory specimen. A valid sputum specimen is clinically useful for respiratory infection testing because it contains secretions from the affected airway. NHA CPT competencies include non-blood specimen collection, patient instructions, specimen identification, and maintaining specimen integrity. Reference topics: Special Collections; non-blood specimens; patient instructions; specimen integrity.
NEW QUESTION # 20
Which of the following specimens is commonly collected using filter paper?
Answer: A
Explanation:
Newborn screening specimens are commonly collected using filter paper. These specimens are obtained by heel puncture and applied to designated circles on approved filter paper cards. The blood must soak through completely from one side, filling each circle properly without layering multiple drops. Blood cultures are collected in aerobic and anaerobic culture bottles, not filter paper. Coagulation studies require light-blue citrate tubes filled to the correct blood-to-additive ratio. Crossmatch specimens are collected in tubes specified by the transfusion service, with strict patient identification and labeling requirements. Filter-paper collection has its own technical risks: insufficient saturation, layering, contamination, touching the collection area, failure to dry completely, and improper transport can all make the specimen unsatisfactory. The phlebotomist must warm the heel if needed, use an approved puncture site, avoid excessive squeezing, and allow the card to dry horizontally away from direct heat or sunlight. Reference topics: Special Collections; newborn screening; PKU/metabolic screening; filter-paper collection; infant heel puncture.
NEW QUESTION # 21
Which of the following actions should the phlebotomist take after filling the last tube of a venipuncture procedure?
Answer: D
Explanation:
After the last tube has filled, the phlebotomist must complete the venipuncture termination sequence safely. The correct action from the choices is to withdraw the needle from the puncture site. In routine venipuncture, the tourniquet is released before needle removal, then the needle is withdrawn smoothly, the safety device is activated, and pressure is applied with clean gauze or cotton only after the needle is out. Applying cotton while the needle is still inserted can cause the needle to cut or traumatize the vein. Cleaning the site with antiseptic occurs before puncture, not after collection. A warm compress is not part of routine completion; it may be used only for selected complications or difficult venous access before collection. The NHA CPT outline specifically includes standard tourniquet removal, needle removal, safety-device use, post-procedural care, and bandaging as routine blood collection competencies. Reference topics: Routine Blood Collections; removing tourniquet, tubes, and needle; post-procedural patient care.
NEW QUESTION # 22
Which of the following specimens should be collected before antibiotics are administered when ordered for suspected bloodstream infection?
Answer: C
Explanation:
Blood cultures should be collected before antibiotics are administered when ordered for suspected bloodstream infection. Antibiotics can reduce or inhibit microbial growth in the specimen, potentially producing false-negative results. Blood cultures are used to detect bacteria or fungi in the bloodstream and require careful timing, strict antisepsis, adequate volume, and correct bottle handling. A lipid panel, hemoglobin A1c, and electrolyte panel do not depend on organism recovery and are not the priority before antibiotic therapy in this context. The phlebotomist must follow facility policy for collection order, number of sets, collection sites, bottle order, skin preparation, and documentation. If antibiotics have already been started, the phlebotomist should not cancel the test independently; they should collect according to order and document or communicate relevant timing if required. Blood culture contamination is a serious quality problem, but delayed collection after antibiotic administration can also reduce diagnostic value. Reference topics: Special Collections; blood cultures; timing before antibiotics; bloodstream infection; aseptic technique.
NEW QUESTION # 23
Which of the following forms accompanies a toxicology drug screen for legal purposes?
Answer: A
Explanation:
A toxicology drug screen performed for legal, forensic, workplace, or evidentiary purposes must be accompanied by a chain-of-custody form. Chain of custody documents each person who handles the specimen, the date and time of transfer, specimen condition, identification verification, sealing, storage, and delivery. Its purpose is to prove that the specimen belongs to the correct individual and was not substituted, altered, contaminated, or mishandled. A requisition identifies the ordered test and patient/order details, but it does not provide the legal transfer record required for forensic validity. An encounter form supports visit documentation or administrative capture, not specimen evidence control. CMS 1500 is a health insurance claim form and has no role in legal specimen tracking. The phlebotomist must follow strict identification, sealing, labeling, and documentation procedures because any break in custody can invalidate the specimen for legal use. NHA CPT processing content explicitly includes chain-of-custody guidelines when required, including forensic studies and blood alcohol specimens, and special collection requirements for drug screening. Reference topics: Processing Specimens; chain of custody; drug screening; legal specimen documentation.
NEW QUESTION # 24
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