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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Special Collections | 12% | - Blood alcohol & legal collections - Therapeutic drug monitoring - Glucose tolerance & dynamic tests - Pediatric & geriatric collections - Blood cultures & sterile collection |
| Topic 2: Specimen Processing & Handling | 14% | - Specimen rejection criteria - Aliquoting & preservation - Documentation & tracking - Transport & storage requirements - Processing & centrifugation |
| Topic 3: Patient Preparation | 20% | - Patient identification & verification - Requisition review & test verification - Patient positioning & comfort - Site selection & preparation - Informed consent & communication |
| Topic 4: Routine Blood Collections | 28% | - Post-collection care & labeling - Capillary puncture procedures - Order of draw & tube selection - Tourniquet use & vein assessment - Venipuncture techniques & equipment |
| Topic 5: Safety and Compliance | 26% | - PPE & sharps disposal - Bloodborne pathogens & exposure control - Infection control & OSHA standards - HIPAA & patient confidentiality - Quality control & error prevention |
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NEW QUESTION # 124
Which of the following actions should a phlebotomist take if blood flow stops during an evacuated tube collection?
Answer: B
Explanation:
If blood flow stops during an evacuated tube collection, the phlebotomist may gently adjust the needle position. Blood flow can stop if the bevel rests against the vein wall, the needle partially exits the vein, the needle passes through the vein, or the tube vacuum is defective. Small, controlled adjustments are acceptable, but aggressive probing is not. Rotating the needle 360 degrees is dangerous and can injure the vein, surrounding tissue, or nerves. Removing the tube and shaking it does not correct needle placement and can hemolyze the specimen. Pulling the needle almost completely out is unsafe because it can leave the vein, cause hematoma, or create a needlestick risk. If gentle adjustment does not restore flow, the phlebotomist should discontinue the attempt according to facility policy and consider recollection. Patient safety and specimen quality are more important than forcing a failed draw. Reference topics: Routine Blood Collections; troubleshooting venipuncture; blood flow failure; needle adjustment; complications prevention.
NEW QUESTION # 125
Which of the following sites should a phlebotomist use for collecting a capillary blood specimen from an adult patient?
Answer: C
Explanation:
For an adult capillary blood specimen, the third digit with the cut perpendicular to the fingerprint grooves is the best answer. The third digit is the middle finger, one of the preferred fingers for dermal puncture because it usually has adequate tissue depth and blood flow. The incision should be made perpendicular to the fingerprint lines so blood forms a rounded drop instead of running along the fingerprint grooves, which improves collection efficiency and reduces specimen smearing. The second digit, or index finger, is generally avoided because it may be more calloused or sensitive and is used frequently for touch. The fifth digit should be avoided because it has less tissue depth and greater risk of bone injury. A cut parallel to fingerprint grooves is technically poor because blood can track along the grooves and make collection more difficult. Correct adult capillary collection requires site warming when needed, antisepsis, complete drying, appropriate lancet depth, wiping away the first drop when required, and avoiding excessive squeezing. Reference topics: Routine Blood Collections; dermal puncture; adult capillary site selection; lancet orientation; microcollection technique.
NEW QUESTION # 126
Which of the following is required for a midstream clean-catch urine specimen?
Answer: D
Explanation:
A midstream clean-catch urine specimen requires use of a sterile specimen container because the purpose is to reduce contamination from skin flora, genital secretions, and environmental organisms. The patient is instructed to clean the area using the facility-provided cleansing materials, begin voiding, then collect the midstream portion without touching the inside of the container or lid. Filling the container to the lid is not required and can create leakage, contamination, or transport problems. Labeling the lid is incorrect because the label must be placed on the specimen container itself; lids can be separated or switched. Cleansing with alcohol wipes is also not the standard answer because urine collection kits typically use antiseptic cleansing towelettes designed for clean-catch collection, not alcohol as the defining requirement. The phlebotomist must provide clear patient instructions and verify that the specimen is properly labeled and handled. The NHA CPT outline includes non-blood specimen collection, patient instructions for urine specimens, specimen handling, and processing requirements. Reference topics: Special Collections; non-blood specimen collection; urine specimen instructions; specimen integrity.
NEW QUESTION # 127
A phlebotomist centrifuges a serum specimen before it has fully clotted. Which of the following is most likely to occur?
Answer: C
Explanation:
If a serum specimen is centrifuged before it has fully clotted, fibrin strands can form in the serum. These strands can interfere with testing instruments, cause sample aspiration problems, and lead to inaccurate results or specimen rejection. Serum specimens must be allowed to clot for the required time before centrifugation. Centrifugation does not increase specimen volume, neutralize additives, or sterilize blood. Blood specimens remain potentially infectious regardless of processing. This question tests the difference between serum and plasma. Serum is the liquid portion after clotting; plasma is the liquid portion of anticoagulated blood. If the phlebotomist rushes serum processing, the specimen may look separated but still contain fibrin. The correct workflow includes observing required clot time, balancing centrifuge tubes, using the correct speed and duration, and removing specimens promptly after centrifugation when required. Speed is not quality; specimen integrity is quality. Reference topics: Processing Specimens; clotting time; serum processing; centrifugation; fibrin formation.
NEW QUESTION # 128
Which of the following practices violates standard precautions?
Answer: B
Explanation:
Reusing a tourniquet visibly contaminated with blood violates standard precautions. Any reusable equipment contaminated with blood must be cleaned and disinfected according to facility policy, and single-use items must be discarded. Blood is treated as potentially infectious regardless of the patient's diagnosis or appearance. Wearing gloves during venipuncture is correct practice. Treating all blood as potentially infectious is the core principle of standard precautions. Washing hands after glove removal is also required because gloves can have microscopic defects or hands can become contaminated during removal. A contaminated tourniquet can transfer bloodborne pathogens or other organisms to patients, staff, and surfaces. Phlebotomists should inspect equipment before use, avoid placing supplies on contaminated surfaces, use disposable tourniquets when required, and disinfect reusable items appropriately. Infection-control failures often occur through routine shortcuts, not dramatic emergencies. This question tests whether the technician understands standard precautions as everyday behavior, not just PPE vocabulary. Reference topics: Safety and Compliance; standard precautions; reusable equipment; blood contamination; infection prevention.
NEW QUESTION # 129
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