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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Routine Blood Collections | 28% | - Capillary puncture procedures - Tourniquet use & vein assessment - Order of draw & tube selection - Post-collection care & labeling - Venipuncture techniques & equipment |
| Topic 2: Patient Preparation | 20% | - Patient identification & verification - Site selection & preparation - Requisition review & test verification - Informed consent & communication - Patient positioning & comfort |
| Topic 3: Specimen Processing & Handling | 14% | - Transport & storage requirements - Specimen rejection criteria - Aliquoting & preservation - Documentation & tracking - Processing & centrifugation |
| Topic 4: Safety and Compliance | 26% | - HIPAA & patient confidentiality - PPE & sharps disposal - Infection control & OSHA standards - Quality control & error prevention - Bloodborne pathogens & exposure control |
| Topic 5: Special Collections | 12% | - Glucose tolerance & dynamic tests - Pediatric & geriatric collections - Therapeutic drug monitoring - Blood cultures & sterile collection - Blood alcohol & legal collections |
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NEW QUESTION # 46
Which of the following is the purpose of centrifuging a blood specimen?
Answer: C
Explanation:
The purpose of centrifuging a blood specimen is to separate specimen components. Centrifugation uses force to separate cells from serum or plasma based on density. In serum separator tubes, centrifugation separates serum from the clot after the specimen has fully clotted. In plasma separator tubes, centrifugation separates plasma from blood cells in the presence of anticoagulant. It does not disinfect the specimen; blood specimens must still be treated as potentially infectious. It does not activate tube additives; additives function through mixing by gentle inversion after collection. It also does not increase specimen volume. Improper centrifugation can damage specimens. Centrifuging too soon, too long, too fast, or at the wrong temperature can cause hemolysis, fibrin formation, poor separation, or analyte instability. The phlebotomist must follow manufacturer and facility instructions for clotting time, centrifuge speed, duration, balancing, and specimen removal. Reference topics: Processing Specimens; centrifugation; serum and plasma separation; specimen integrity; equipment operation.
NEW QUESTION # 47
A phlebotomist observes that the lid of a sharps container will not close. Which of the following actions should the phlebotomist take?
Answer: B
Explanation:
The sharps container should be replaced. A sharps container must be closable, puncture-resistant, leak-resistant, and properly labeled or color-coded. If the lid will not close, the container no longer provides safe containment and creates a needlestick or exposure hazard. Continuing to use it is unsafe even if it has not reached the fill line. Emptying sharps into another container is strictly inappropriate because it requires handling contaminated needles and increases exposure risk. Taping the opening closed is not an approved correction and does not restore the container's designed safety function. The phlebotomist should obtain an approved replacement container and report the defective container according to facility protocol. This is not a minor housekeeping issue; sharps disposal is an engineering-control requirement designed to prevent occupational exposure to bloodborne pathogens. Phlebotomy technicians must dispose of needles immediately after use, never recap used needles, and never place sharps in regular trash or soft biohazard bags. Reference topics: Safety and Compliance; sharps disposal; engineering controls; needlestick prevention.
NEW QUESTION # 48
A phlebotomist notices that a serum separator tube has not clotted before centrifugation. Which of the following actions should the phlebotomist take?
Answer: D
Explanation:
The phlebotomist should allow the serum separator tube to clot completely before centrifugation. Serum specimens require clot formation before centrifugation so the liquid serum can separate properly from the clot. Centrifuging before clotting is complete can cause fibrin strands, incomplete separation, instrument issues, and possible specimen rejection. Shaking the tube vigorously is incorrect because it can hemolyze the specimen and disrupt cellular integrity. Transferring the specimen into a plasma tube is unsafe and invalid because the specimen was not collected with the correct anticoagulant at the correct blood-to-additive ratio. Proper processing means respecting the requirements of the tube collected: serum tubes must clot for the required time, additive tubes must be gently inverted, and specimens must be centrifuged according to time, speed, and temperature requirements. This item tests processing discipline, not speed. A phlebotomist must protect specimen integrity from collection through transport and processing. Reference topics: Processing Specimens; serum separation; clotting time; centrifugation; specimen rejection.
NEW QUESTION # 49
Which of the following sites should a phlebotomist use as the second choice to perform venipuncture on an adult patient?
Answer: D
Explanation:
The cephalic vein is the second-choice vein for routine adult venipuncture. The median cubital vein is preferred first because it is usually large, well anchored, superficial, and located away from major nerves and arteries. If the median cubital vein is unavailable or unsuitable, the cephalic vein is typically selected next because it is generally accessible and safer than the basilic vein. The basilic vein is usually the last choice in the antecubital area because it lies closer to the brachial artery and median nerve, increasing the risk of serious complications if the needle placement is poor. The median antebrachial vein may be visible in the forearm but is not the standard second-choice site for routine venipuncture. Proper site selection is not cosmetic; it is risk control. The phlebotomist must evaluate vein size, depth, resilience, direction, and surrounding anatomy while avoiding sites with edema, hematoma, burns, scarring, IV lines, infection, or mastectomy restrictions. Reference topics: Routine Blood Collections; antecubital vein selection; median cubital, cephalic, and basilic veins; site safety.
NEW QUESTION # 50
Which of the following types of testing requires chain of custody documentation for specimens?
Answer: A
Explanation:
Drug testing requires chain of custody documentation when the specimen is collected for legal, employment, forensic, or regulatory purposes. Chain of custody tracks the specimen from collection through transport, receipt, testing, storage, and final disposition. It documents who collected the specimen, who handled it, when transfers occurred, whether seals were intact, and whether the specimen remained secure. This protects the legal defensibility of the result by reducing the possibility of substitution, tampering, contamination, or misidentification. Blood typing requires strict patient identification and specimen labeling because of transfusion risk, but it is not the classic chain-of-custody specimen in this question. HIV testing requires confidentiality and consent requirements according to policy, but not forensic custody tracking in routine care. Tuberculosis testing requires correct collection or test procedure, infection-control precautions, and documentation, not legal custody control. For drug screening, the phlebotomist must follow collection kit instructions exactly, verify identity, seal the specimen properly, complete all required documentation, and maintain specimen security. Reference topics: Processing Specimens; chain of custody; toxicology testing; forensic specimens; legal documentation.
NEW QUESTION # 51
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