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| Section | Weight | Objectives |
|---|---|---|
| Patient Preparation | 20% | - Patient positioning & comfort - Patient identification & verification - Site selection & preparation - Informed consent & communication - Requisition review & test verification |
| Safety and Compliance | 26% | - PPE & sharps disposal - Quality control & error prevention - HIPAA & patient confidentiality - Bloodborne pathogens & exposure control - Infection control & OSHA standards |
| Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Order of draw & tube selection - Tourniquet use & vein assessment - Post-collection care & labeling - Capillary puncture procedures |
| Special Collections | 12% | - Pediatric & geriatric collections - Therapeutic drug monitoring - Blood alcohol & legal collections - Glucose tolerance & dynamic tests - Blood cultures & sterile collection |
| Specimen Processing & Handling | 14% | - Processing & centrifugation - Specimen rejection criteria - Aliquoting & preservation - Transport & storage requirements - Documentation & tracking |
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NEW QUESTION # 84
A blood specimen is rejected by the laboratory for testing. Which of the following actions should the phlebotomist take?
Answer: C
Explanation:
The phlebotomist should contact the patient to repeat the venipuncture collection, following facility policy and provider notification procedures. A rejected specimen cannot be tested reliably, so the practical correction is recollection using the proper tube, volume, labeling, handling, and transport requirements. Waiting until the next yearly visit is unacceptable because the ordered test was needed for current clinical care. Shredding documentation is improper unless performed under approved records-management procedures, and it does not solve the missing valid specimen. Sending laboratory results by mail is impossible or inappropriate when the specimen was rejected and no valid result exists. Specimen rejection usually results from preanalytical problems such as wrong tube, insufficient volume, hemolysis, clotting in an anticoagulant tube, unlabeled or mislabeled specimen, expired supplies, improper temperature, or delayed transport. The phlebotomist's job is to correct the collection failure promptly and prevent recurrence. Reference topics: Processing Specimens; specimen rejection; recollection; preanalytical error; specimen integrity.
NEW QUESTION # 85
Which of the following additives is commonly found in a gray-top tube used for glucose testing?
Answer: D
Explanation:
Sodium fluoride is commonly found in gray-top tubes used for glucose testing. Sodium fluoride inhibits glycolysis, which helps preserve glucose concentration after collection by slowing cellular glucose consumption. Many gray-top tubes also contain potassium oxalate as an anticoagulant. Sodium citrate is found in light-blue tubes used for coagulation studies because it binds calcium reversibly. EDTA is found in lavender-top tubes and is commonly used for hematology testing such as CBC. SPS is sodium polyanethol sulfonate, an additive used in blood culture bottles or yellow SPS tubes because it supports organism recovery by reducing certain inhibitory effects. Tube additives are not trivia; they determine specimen type and test validity. A glucose specimen collected in the wrong tube or processed late may produce inaccurate results because cells continue metabolizing glucose after collection. The phlebotomist must match test, tube, additive, order of draw, fill volume, and handling requirements. Reference topics: Special Collections; glucose testing; gray-top tube; sodium fluoride; additive function.
NEW QUESTION # 86
Which of the following terms means a decrease in white blood cells?
Answer: D
Explanation:
Leukopenia means a decreased number of white blood cells. "Leuko-" refers to white blood cells, and "-penia" means deficiency or decrease. Leukocytosis means an increased white blood cell count and is often associated with infection, inflammation, stress response, or hematologic disorders. Thrombocytopenia means a decreased platelet count, which can increase bleeding risk after venipuncture. Erythrocytosis means an increased red blood cell count. This terminology matters to phlebotomy because laboratory orders and patient conditions often use hematologic language. The phlebotomist does not diagnose these conditions, but understanding terms helps the technician anticipate safety concerns and specimen requirements. For example, thrombocytopenia may require longer pressure after collection, while leukopenia may be associated with immunocompromised status and strict infection-control awareness. A CBC is the common test used to evaluate red cells, white cells, hemoglobin, hematocrit, and platelets. Reference topics: Phlebotomy Fundamentals; medical terminology; hematology; CBC components; blood cell disorders.
NEW QUESTION # 87
Which of the following actions should a phlebotomist take after receiving a critical value?
Answer: D
Explanation:
A critical value must be reported to the provider directly and promptly according to facility policy. Critical values represent results that may indicate an immediate threat to the patient's health, so delayed communication can create patient-safety risk. The phlebotomist should follow the organization's read-back, documentation, escalation, and notification procedure, especially when the result comes from point-of-care or waived testing performed by the phlebotomist. Waiting until all collections are completed is unsafe because critical values require timely clinical action. Asking a colleague to repeat the testing is not the correct first response unless the facility's procedure specifically requires confirmatory testing and the phlebotomist is authorized to perform it. Recording the value in the chart for later nurse review is also insufficient because it does not ensure immediate provider notification. Critical value handling is part of specimen processing, communication, patient safety, and point-of-care testing responsibility. NHA CPT competencies include reporting abnormal or critical results, communicating with clinical personnel, documenting results, and following testing protocols. Reference topics: Processing Specimens; Special Collections; point-of-care testing; critical value reporting.
NEW QUESTION # 88
Which of the following actions can cause hemolysis during venipuncture?
Answer: A
Explanation:
Using a needle with a gauge that is too small can cause hemolysis. A small-bore needle can create excessive mechanical force as blood passes through the lumen, damaging red blood cells and releasing intracellular contents into serum or plasma. Hemolysis can alter test results, especially potassium, lactate dehydrogenase, and other analytes affected by red-cell rupture. Allowing alcohol to dry before puncture is correct practice because it reduces stinging and helps prevent contamination. Releasing the tourniquet before needle removal is also correct because it reduces pressure and supports safer needle withdrawal. Mixing additive tubes by gentle inversion is required; the danger occurs when tubes are shaken vigorously. Additional hemolysis causes include probing, drawing through a hematoma, forcing blood from a syringe into a tube, rough transport, incorrect centrifugation, and delayed processing. A phlebotomist must choose equipment appropriate to the patient's vein while maintaining specimen quality. Reference topics: Routine Blood Collections; hemolysis; needle gauge selection; specimen integrity; preanalytical error.
NEW QUESTION # 89
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