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| Section | Objectives |
|---|---|
| Patient Preparation | - Site selection and preparation - Patient identification and communication - Explaining procedures and obtaining consent |
| Specimen Collection | - Capillary puncture procedures - Order of draw and tube handling - Venipuncture techniques |
| Safety and Compliance | - Needlestick prevention and biohazard disposal - Infection control and PPE usage - OSHA standards and safety protocols |
| Specimen Processing and Handling | - Quality control and rejection criteria - Specimen transport and storage - Labeling and documentation |
| Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
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NEW QUESTION # 36
Which of the following conditions is a reason for specimen rejection?
Answer: A
Explanation:
A clotted lavender-top specimen is a reason for specimen rejection. Lavender-top tubes contain EDTA anticoagulant and are used for tests such as CBCs, which require anticoagulated whole blood. If the specimen clots, the cellular components are trapped in the clot, platelet counts can be falsely low, and automated hematology analysis becomes unreliable. Properly labeled specimens, correctly filled light-blue tubes, and specimens transported upright are acceptable practices, not rejection causes. A clotted lavender specimen usually results from failure to mix the tube properly immediately after collection, delayed inversion, underfilling or collection difficulty, or drawing blood slowly and allowing clotting to begin before the specimen contacts the additive. The correct prevention is to fill the tube to the required volume and gently invert it the recommended number of times immediately after collection. The phlebotomist should never shake the tube, because vigorous agitation can cause hemolysis. Reference topics: Processing Specimens; specimen rejection; EDTA tube mixing; clotted specimens; hematology testing.
NEW QUESTION # 37
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 # 38
A phlebotomist notices that an outpatient appears confused and cannot state their date of birth. Which of the following actions should the phlebotomist take?
Answer: A
Explanation:
The phlebotomist should use an approved alternate identification process. If a patient cannot reliably state their date of birth because of confusion, cognitive impairment, language barrier, or illness, the technician must follow facility policy for identification. This may involve a caregiver, legal guardian, identification band, photo identification, nurse verification, or other approved method depending on the setting. Proceeding using the requisition only is unsafe because the requisition is not the patient. Asking the patient to guess is obviously unreliable and creates wrong-patient risk. Labeling the specimen later in the laboratory is also unsafe because labeling must occur immediately after collection in the patient's presence or according to strict facility procedure. Accurate patient identification is the first major defense against specimen mislabeling, wrong diagnosis, wrong treatment, and patient harm. The phlebotomist must not improvise identity verification just to keep workflow moving. Reference topics: Patient Preparation; patient identification; alternate identification; outpatient collection; specimen labeling.
NEW QUESTION # 39
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?
Answer: B
Explanation:
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.
NEW QUESTION # 40
A phlebotomist is instructing a patient who has a prescription for a 24-hr urine collection. Which of the following instructions should the phlebotomist include?
Answer: C
Explanation:
For a 24-hour urine collection, the patient should discard the first urine on the day of collection, record the start time, and then collect all urine passed during the next 24 hours, including the final specimen at the end time. Discarding the first void empties the bladder and establishes a clean starting point for the timed collection. Keeping the specimen at room temperature is usually incorrect because many 24-hour urine specimens require refrigeration, ice, or preservatives depending on the ordered test. Urinating directly into the large collection container may be unsafe or impractical, especially if the container contains preservative; patients are commonly given a separate collection device and then transfer urine as instructed. Doubling fluid intake is incorrect because it can dilute analytes and alter test results unless specifically ordered by the provider. The phlebotomist must explain timing, storage, missed specimens, labeling, and return instructions clearly because incomplete collection is a major preanalytical error. NHA CPT competencies include non-blood specimen collection, patient instructions, timed urine collection, specimen storage, and specimen integrity. Reference topics: Special Collections; 24-hour urine; non-blood specimens; patient preparation.
NEW QUESTION # 41
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