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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Patient Preparation | 20% | - Patient identification & verification - Requisition review & test verification - Patient positioning & comfort - Site selection & preparation - Informed consent & communication |
| Topic 2: Safety and Compliance | 26% | - Bloodborne pathogens & exposure control - HIPAA & patient confidentiality - Infection control & OSHA standards - Quality control & error prevention - PPE & sharps disposal |
| Topic 3: Routine Blood Collections | 28% | - Tourniquet use & vein assessment - Capillary puncture procedures - Order of draw & tube selection - Venipuncture techniques & equipment - Post-collection care & labeling |
| Topic 4: Specimen Processing & Handling | 14% | - Specimen rejection criteria - Processing & centrifugation - Aliquoting & preservation - Documentation & tracking - Transport & storage requirements |
| Topic 5: Special Collections | 12% | - Therapeutic drug monitoring - Pediatric & geriatric collections - Glucose tolerance & dynamic tests - Blood alcohol & legal collections - Blood cultures & sterile collection |
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NEW QUESTION # 82
Which of the following actions can cause hemolysis during venipuncture?
Answer: A
Explanation:
Using a needle with a gauge that is too small can cause hemolysis. A small-bore needle can create excessive mechanical force as blood passes through the lumen, damaging red blood cells and releasing intracellular contents into serum or plasma. Hemolysis can alter test results, especially potassium, lactate dehydrogenase, and other analytes affected by red-cell rupture. Allowing alcohol to dry before puncture is correct practice because it reduces stinging and helps prevent contamination. Releasing the tourniquet before needle removal is also correct because it reduces pressure and supports safer needle withdrawal. Mixing additive tubes by gentle inversion is required; the danger occurs when tubes are shaken vigorously. Additional hemolysis causes include probing, drawing through a hematoma, forcing blood from a syringe into a tube, rough transport, incorrect centrifugation, and delayed processing. A phlebotomist must choose equipment appropriate to the patient's vein while maintaining specimen quality. Reference topics: Routine Blood Collections; hemolysis; needle gauge selection; specimen integrity; preanalytical error.
NEW QUESTION # 83
Which of the following collections requires the phlebotomist to discard the first voided specimen and save all subsequent urine for a full day?
Answer: B
Explanation:
A 24-hour urine collection requires the patient to discard the first voided specimen and then save all subsequent urine for the full collection period, including the final void at the ending time. Discarding the first void empties the bladder and establishes the start of the timed interval. A clean-catch urine culture requires cleansing and collecting a midstream specimen in a sterile container, not saving urine for 24 hours. A random urinalysis is collected at a single time and does not require timed accumulation. A sputum culture is a respiratory specimen, not a urine collection. Patient instruction is critical because one missed urine specimen can invalidate the entire 24-hour collection. The phlebotomist should explain start and stop times, storage requirements, preservative hazards if present, labeling, and return instructions. The patient should not change fluid intake unless instructed by the provider. Reference topics: Special Collections; 24-hour urine; patient instructions; non-blood specimens; timed collection.
NEW QUESTION # 84
Which of the following actions should a phlebotomist take after removing gloves?
Answer: A
Explanation:
The phlebotomist should perform hand hygiene after removing gloves. Gloves reduce contamination but do not replace hand hygiene. Hands can become contaminated during glove removal, and gloves may have microscopic defects. Putting used gloves in a lab coat pocket is a contamination hazard. Sanitizing gloves for reuse is incorrect because medical gloves used during patient care are single-use items and should be discarded appropriately. Touching clean supplies immediately after glove removal without hand hygiene can contaminate the clean supply area and spread organisms to future patients. Proper glove workflow includes performing hand hygiene before gloving when indicated, wearing gloves for blood collection, avoiding unnecessary surface contact while gloved, removing gloves without contaminating the hands, discarding them properly, and performing hand hygiene afterward. This question tests routine infection-control behavior. Many healthcare-associated contamination events happen through simple missed hand hygiene after glove removal. Reference topics: Safety and Compliance; hand hygiene; glove removal; standard precautions; contamination prevention.
NEW QUESTION # 85
When performing a capillary collection, which of the following tubes should a phlebotomist collect last?
Answer: B
Explanation:
In capillary collection, the red tube should be collected last from the options listed. Capillary order of draw differs from venipuncture order of draw because capillary blood begins clotting quickly after puncture. Tubes containing anticoagulants are collected before serum tubes to prevent platelet clumping and microclot formation that could invalidate hematology or other additive-based testing. Lavender EDTA specimens are typically prioritized early because hematology testing requires well-mixed anticoagulated whole blood. Lithium heparin is also an additive tube and should be collected before a non-additive or serum specimen. Red tubes are generally serum tubes and are collected later because clotting is expected for serum production. Microhematocrit collection depends on the procedure and whether anticoagulated capillary tubes are used, but it is not the best answer for "last" in this item. The phlebotomist must also wipe away the first drop, avoid excessive squeezing, fill microcollection containers properly, and mix additive specimens immediately by gentle inversion. NHA CPT competencies include dermal puncture, capillary order of draw, microcollection devices, and specimen integrity. Reference topics: Routine Blood Collections; capillary collection; dermal puncture; microcollection order of draw.
NEW QUESTION # 86
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 # 87
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