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| Section | Weight | Objectives |
|---|---|---|
| Patient Preparation | 20% | - Informed consent & communication - Patient positioning & comfort - Patient identification & verification - Requisition review & test verification - Site selection & preparation |
| Special Collections | 12% | - Glucose tolerance & dynamic tests - Pediatric & geriatric collections - Blood alcohol & legal collections - Therapeutic drug monitoring - Blood cultures & sterile collection |
| Routine Blood Collections | 28% | - Post-collection care & labeling - Order of draw & tube selection - Venipuncture techniques & equipment - Tourniquet use & vein assessment - Capillary puncture procedures |
| Safety and Compliance | 26% | - HIPAA & patient confidentiality - PPE & sharps disposal - Quality control & error prevention - Bloodborne pathogens & exposure control - Infection control & OSHA standards |
| Specimen Processing & Handling | 14% | - Aliquoting & preservation - Transport & storage requirements - Documentation & tracking - Processing & centrifugation - Specimen rejection criteria |
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NEW QUESTION # 28
A phlebotomist is collecting a blood culture set. Which of the following actions helps reduce contamination?
Answer: D
Explanation:
Allowing the antiseptic to dry before puncture helps reduce blood culture contamination. Blood cultures require strict aseptic technique because skin organisms can enter the specimen and produce false-positive results. Repalpating the site after antisepsis with an ungloved finger contaminates the prepared area and should not be done. If repalpation is absolutely necessary, facility policy may require sterile technique or repeat antisepsis. A gray-top tube is not collected before culture bottles; blood cultures are collected first in the order of draw to maintain sterility. Cleaning only the bottle cap is incomplete because both the patient's skin and bottle access surfaces must be prepared according to procedure. Blood culture quality depends on correct skin antisepsis, adequate drying time, correct bottle order, sufficient volume, separate collection sites when ordered, and accurate documentation. Contaminated cultures can lead to unnecessary antibiotics, longer hospitalization, additional testing, and patient harm. Reference topics: Special Collections; blood cultures; contamination prevention; antiseptic drying; aseptic technique.
NEW QUESTION # 29
Which of the following tests should a phlebotomist anticipate to complete for a patient who has a fever of unknown origin?
Answer: D
Explanation:
For a patient with fever of unknown origin, the phlebotomist should anticipate blood culture collection. Blood cultures are ordered to detect microorganisms in the bloodstream and are especially important when infection, bacteremia, or sepsis is suspected. Fever without a known source is a classic clinical reason for obtaining cultures before antimicrobial therapy when possible. ESR may support evaluation of inflammation, but it does not identify bloodstream infection. Immunology tests may be used for immune or infectious disease investigations, but they are not the primary phlebotomy collection expected for fever of unknown origin. Rapid plasma renin evaluates the renin-angiotensin system and is associated with blood pressure and endocrine evaluation, not unexplained fever. Blood culture collection requires strict aseptic technique, correct antiseptic contact time, proper bottle order, adequate volume, correct number of sets, documentation of collection site, and timely transport. Contamination can produce false-positive results and inappropriate treatment. NHA CPT competencies include blood culture collection, special collections, infection control, site preparation, bottle handling, and specimen integrity. Reference topics: Special Collections; blood cultures; fever workup; contamination prevention.
NEW QUESTION # 30
Which of the following specimens is commonly collected using filter paper?
Answer: D
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 # 31
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 # 32
Which of the following is an example of a patient giving a phlebotomist implied consent to complete a blood draw?
Answer: C
Explanation:
The patient extending their arm is an example of implied consent because the patient's action indicates cooperation with the blood draw without a written or explicit verbal statement. In routine phlebotomy, implied consent often occurs when the patient allows identification, listens to the procedure explanation, and physically presents the arm for collection. Signing a consent form is written consent, not implied consent. Saying "Okay" is verbal or expressed consent because the patient directly communicates agreement. Asking questions about the procedure is not consent by itself; it shows the patient is seeking information before deciding whether to proceed. The phlebotomist must still explain the procedure, verify identity, answer process-related questions within scope, respect refusal, and avoid coercion. Consent is not a technical formality; it is tied to patient rights, communication, and ethical practice. If a patient refuses or withdraws cooperation, the technician should not force collection and should follow facility reporting procedures. Reference topics: Patient Preparation; consent types; patient rights; communication; routine venipuncture preparation.
NEW QUESTION # 33
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