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| Section | Objectives |
|---|---|
| Specimen Collection | - Capillary puncture procedures - Venipuncture techniques - Order of draw and tube handling |
| Specimen Processing and Handling | - Labeling and documentation - Quality control and rejection criteria - Specimen transport and storage |
| Safety and Compliance | - OSHA standards and safety protocols - Infection control and PPE usage - Needlestick prevention and biohazard disposal |
| Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
| Patient Preparation | - Site selection and preparation - Explaining procedures and obtaining consent - Patient identification and communication |
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93. Frage
Which of the following situations increases a phlebotomist's risk for a needlestick?
Antwort: C
Begründung:
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.
94. Frage
A phlebotomist should identify which of the following as the best site for phenylketonuria collection on an infant?
Antwort: D
Begründung:
The best site for phenylketonuria, or PKU, collection on an infant is the medial or lateral plantar surface of the heel. PKU screening is a newborn metabolic screening test commonly collected by heel stick onto filter paper. The medial and lateral heel areas are selected because they provide adequate capillary blood flow while reducing the risk of puncturing bone. The central area of the heel is unsafe because the calcaneus may be closer to the puncture site, increasing the risk of bone injury or osteomyelitis. Fingertip puncture is inappropriate for infants because the tissue is small, bone is close to the surface, and the site does not provide the recommended specimen collection area for newborn screening. Proper PKU collection also requires warming the heel when indicated, allowing blood to flow freely, filling filter-paper circles completely from one side, avoiding layering, and allowing the specimen to dry properly before transport. NHA CPT special collection content includes collecting blood for metabolic syndromes such as PKU, filter-paper collection techniques, pediatric considerations, and minimum/maximum volume requirements. Reference topics: Special Collections; PKU collection; infant heel puncture; filter-paper specimen collection.
95. Frage
Which of the following information should a phlebotomist document for a blood culture collection?
Antwort: D
Begründung:
For blood culture collection, the phlebotomist should document the site of collection. Blood cultures are often drawn from separate sites to help distinguish true bloodstream infection from contamination. Accurate site documentation supports interpretation if one bottle set grows organisms and another does not. It also provides traceability for collection quality, timing, and possible contamination review. Type of culture media is generally determined by the blood culture bottle system and laboratory protocol; it is not the key patient-specific documentation item in this question. Blood collection technique is expected to follow facility policy, but it is not typically the primary required field compared with date, time, collector identity, and site. Informed consent is not usually a separate required document for routine blood culture collection unless facility policy or special circumstances require it. Blood culture technique requires strict antisepsis, appropriate bottle preparation, correct order, sufficient volume, and avoidance of contamination. NHA CPT special collection content includes performing blood culture collections, blood culture locations, skin preparation, equipment, volume requirements, bottle preparation, and order of draw. Reference topics: Special Collections; blood culture collection; site documentation; contamination control.
96. Frage
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?
Antwort: A
Begründung:
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.
97. Frage
Which of the following conditions requires a blood transfusion due to cumulative blood loss for neonatal patients?
Antwort: D
Begründung:
Anemia is the condition that can require blood transfusion due to cumulative blood loss in neonatal patients. Neonates have a small total blood volume, so repeated laboratory collections can remove a clinically significant amount of blood over time. This is called iatrogenic blood loss and is a major concern in premature or critically ill infants who require frequent testing. If blood loss becomes excessive relative to the infant's circulating volume, hemoglobin and hematocrit can decline, producing or worsening anemia and potentially requiring transfusion. Osteochondritis involves inflammation of bone and cartilage and is unrelated to cumulative phlebotomy blood loss. Osteomyelitis is bone infection, a possible complication of improper heel puncture, but it is not the transfusion-related condition tested here. Galactosemia is a metabolic disorder screened in newborn testing, not a condition caused by repeated blood collection. The phlebotomist must use pediatric tubes, collect only the required volume, avoid unnecessary redraws, and follow minimum-volume requirements. Reference topics: Special Collections; neonatal blood collection; pediatric microcollection; iatrogenic anemia; blood volume limits.
98. Frage
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