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| Section | Objectives |
|---|---|
| Routine Blood Collections | - Order of draw - Venipuncture procedures - Equipment selection and use |
| Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
| Specimen Processing and Handling | - Common errors and rejection criteria - Quality assurance procedures - Specimen transport and storage |
| Safety and Compliance | - OSHA regulations and patient safety - Infection control and standard precautions - HIPAA and patient confidentiality |
| Special Collections | - Non-routine specimen collection methods - Pediatric and geriatric considerations - Capillary puncture (fingerstick/heel stick) |
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NEW QUESTION # 69
Which of the following actions should a phlebotomist take when transporting specimens to an outside laboratory?
Answer: C
Explanation:
The phlebotomist should use appropriate leakproof transport packaging when specimens are transported to an outside laboratory. Specimen transport must protect the patient sample, courier, laboratory personnel, and documentation from leakage, breakage, contamination, and temperature-related instability. Requisitions should be kept separate from the specimen container, usually in an outer pouch, so paperwork is not contaminated if leakage occurs. Removing labels is never acceptable because identification must remain intact from collection through testing. Freezing all specimens is incorrect because temperature requirements are test-specific; freezing some specimens can destroy cells, alter analytes, or make the sample unsuitable. Proper transport includes correct labeling, biohazard identification, absorbent material when required, secure closure, upright positioning when appropriate, and compliance with time, light, and temperature requirements. The phlebotomist must know the difference between routine transport, chilled transport, frozen transport, and protected-from-light transport. Reference topics: Processing Specimens; specimen transport; leakproof packaging; biohazard handling; specimen integrity.
NEW QUESTION # 70
Which of the following should a phlebotomist review on a requisition prior to collection for an outpatient draw?
Answer: D
Explanation:
Before collecting an outpatient specimen, the phlebotomist must review the requisition to confirm what test is ordered and what specimen requirements apply. Specimen requirements include tube type, additive, minimum volume, handling conditions, fasting status, timing, temperature, light protection, and whether the specimen requires special processing or transport. This step prevents preanalytical errors such as collecting the wrong tube, insufficient volume, wrong timing, or improperly handled specimens. Medications and allergies can be clinically relevant during patient interview, but they are not the primary item reviewed on the requisition for collection accuracy unless the test requirement specifically involves medication timing or patient compliance. Insurance authorization is administrative and should not drive the technical collection step. The requisition is the controlling document for collection, because it links patient identification, ordering provider, diagnosis or test code, test priority, and ordered tests. The NHA CPT outline includes obtaining, reviewing, and verifying orders or requisitions, confirming testing requirements, and understanding requisition field requirements. Reference topics: Patient Preparation; requisition review; testing requirements; specimen requirements; outpatient collection workflow.
NEW QUESTION # 71
Which of the following situations increases a phlebotomist's risk for a needlestick?
Answer: A
Explanation:
A nearly full sharps container increases the risk for a needlestick because contaminated needles or other sharps may protrude, rebound, or be difficult to place safely into the container. Sharps containers must be puncture-resistant, leak-resistant, properly labeled or color-coded, kept upright, and replaced before they become overfilled. OSHA specifically warns not to allow sharps containers to overfill and requires routine replacement to reduce sharps injury risk. A tight tourniquet can cause patient discomfort, hemoconcentration, or venous obstruction, but it is not the best answer for needlestick risk. A 22-gauge needle is commonly used for routine venipuncture, especially for smaller veins, and is not inherently unsafe. A transfer device used with the syringe method is actually a safety control because it prevents the phlebotomist from manually pushing blood through a needle into evacuated tubes. NHA CPT safety content includes bloodborne pathogens, sharps safety, OSHA standards, exposure control, and safe disposal of contaminated equipment. Reference topics: Safety and Compliance; OSHA Bloodborne Pathogens Standard; sharps disposal; needlestick prevention.
NEW QUESTION # 72
Which of the following tests is most likely to require collection in a chilled specimen tube?
Answer: B
Explanation:
Ammonia is most likely to require collection in a chilled specimen tube and rapid transport, depending on facility protocol. Ammonia is unstable and can be affected by delayed processing, temperature, and cellular metabolism after collection. Chilling slows metabolic activity and helps preserve specimen integrity. Total cholesterol is generally a routine chemistry test and does not usually require immediate chilling. Hemoglobin A1c is collected to evaluate long-term glycemic control and is not typically a chilled specimen. Blood cultures require aseptic technique, correct culture bottles, adequate volume, and timely incubation or transport, not chilling. The broader lesson is that special handling requirements are analyte-specific. Some specimens must be chilled, some kept warm, some protected from light, and some delivered immediately. The phlebotomist must review the requisition, laboratory directory, or facility procedure before collection. Improper temperature handling can produce inaccurate results even if the specimen was collected in the correct tube. Reference topics: Special Collections; chilled specimens; ammonia handling; specimen stability; transport requirements.
NEW QUESTION # 73
Which of the following is the maximum allowed time for a tourniquet application before possibly affecting test results?
Answer: A
Explanation:
The maximum recommended tourniquet application time before results may be affected is 60 seconds. A tourniquet is applied to increase venous filling and make the vein easier to locate and access, but prolonged application causes venous stasis and hemoconcentration. When blood remains trapped below the tourniquet too long, fluid shifts from the vascular space into surrounding tissue, concentrating cells, proteins, and protein-bound analytes. This can falsely elevate results such as potassium, calcium, proteins, and other chemistry values. It can also increase patient discomfort and make the collection more difficult. Thirty and forty-five seconds are acceptable but are not the maximum allowed time. Ninety seconds is too long and increases the risk of altered test values. Correct practice is to apply the tourniquet only long enough to select the site and establish blood flow, then release it promptly, especially before removing the needle. Reference topics: Routine Blood Collections; tourniquet application; hemoconcentration; venipuncture preanalytical variables.
NEW QUESTION # 74
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