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| Section | Objectives |
|---|---|
| Patient Preparation | - Patient identification and communication - Site selection and preparation - Explaining procedures and obtaining consent |
| Safety and Compliance | - Needlestick prevention and biohazard disposal - Infection control and PPE usage - OSHA standards and safety protocols |
| Specimen Processing and Handling | - Quality control and rejection criteria - Specimen transport and storage - Labeling and documentation |
| Professional Practice | - Communication and professionalism - Ethics and patient confidentiality (HIPAA) |
| Specimen Collection | - Venipuncture techniques - Order of draw and tube handling - Capillary puncture procedures |
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NEW QUESTION # 10
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 # 11
A phlebotomist should immediately report which of the following to a supervisor?
Answer: A
Explanation:
A needlestick injury must be reported immediately to a supervisor because it is an occupational exposure incident involving potential transmission of bloodborne pathogens. Immediate reporting triggers the facility's exposure-control plan, which may include wound cleansing, documentation, source-patient evaluation when permitted, employee health assessment, post-exposure prophylaxis consideration, and required follow-up testing. Delayed reporting can compromise medical management and regulatory documentation. Outdated blood collection supplies should be removed from use and handled according to inventory or quality-control policy, but they do not carry the same immediate occupational exposure urgency. An allergic reaction must be managed clinically and reported according to severity and facility procedure, but the most direct supervisor-reporting requirement in this item is the needlestick injury. Patient noncompliance with dietary requirements should be documented or communicated as required because it may affect test validity, but it is not an occupational exposure emergency. NHA CPT safety content specifically includes following exposure control plans for needle sticks, notification requirements, needle stick protocols, bloodborne pathogen standards, and reporting requirements. Reference topics: Safety and Compliance; needlestick injury; exposure control protocols; reporting requirements.
NEW QUESTION # 12
Which of the following tube colors is commonly used for coagulation testing?
Answer: B
Explanation:
Light-blue tubes are commonly used for coagulation testing because they contain sodium citrate. Citrate binds calcium reversibly, preventing clotting while preserving the specimen for coagulation analysis such as PT, INR, and aPTT. The tube must be filled to the required level because coagulation testing depends on a precise blood-to-anticoagulant ratio. Underfilling a light-blue tube can falsely prolong clotting results and cause specimen rejection. Lavender tubes contain EDTA and are commonly used for hematology tests such as CBC. Gray tubes often contain sodium fluoride and potassium oxalate and are used for glucose or lactate testing depending on facility protocol. Red tubes are generally serum tubes without anticoagulant or with clot activator depending on manufacturer. The phlebotomist must collect light-blue tubes in the correct order of draw and inspect for proper fill. This is a high-yield NHA-style concept because it combines tube color, additive, test department, and specimen acceptability. Reference topics: Routine Blood Collections; coagulation tubes; sodium citrate; fill volume; order of draw.
NEW QUESTION # 13
A phlebotomist uses a point-of-care instrument to perform a prothrombin time/INR test on a patient that results in a critical value. Which of the following type of medication should the phlebotomist expect to see on the patient's medication list?
Answer: C
Explanation:
A prothrombin time/INR test evaluates the extrinsic and common coagulation pathways and is commonly used to monitor anticoagulant therapy, especially warfarin. Therefore, when a PT/INR point-of-care result is critically abnormal, the medication category most expected on the patient's list is anticoagulants. Anticoagulants interfere with clot formation and can prolong PT/INR values, creating an increased bleeding risk if outside the therapeutic range. Opioids are analgesics and do not directly monitor through PT/INR. Antidiabetics are associated with glucose monitoring, not coagulation testing. Statins are lipid-lowering medications and are usually monitored through lipid panels and liver-related considerations, not PT/INR. A critical PT/INR value must be handled according to facility policy, documented accurately, and reported through the correct clinical pathway; the phlebotomist does not interpret or treat the result independently. The NHA CPT outline covers point-of-care testing, critical values for POC and CLIA-waived testing, hemostasis, coagulation, and reporting requirements. Reference topics: Special Collections; point-of-care testing; hemostasis and coagulation; critical value reporting.
NEW QUESTION # 14
Which of the following patient positions is safest for a patient who reports a history of fainting during blood draws?
Answer: A
Explanation:
A patient with a history of fainting should be positioned reclining or lying down before collection. Syncope is a common phlebotomy complication and can lead to falls, head injury, needle injury, or specimen loss if the patient is not positioned safely. Standing is never appropriate for venipuncture because a fainting patient can collapse. Sitting on an unsupported exam table is also unsafe because the patient may fall from a height. Sitting with legs crossed can affect circulation and does not protect against syncope. The phlebotomist should ask about prior fainting, observe the patient's color and behavior, explain the procedure calmly, and stop the draw if the patient becomes pale, diaphoretic, dizzy, nauseated, or unresponsive. If syncope occurs, the phlebotomist should remove the needle when safe, activate the safety device, call for assistance, lower the patient's head or follow facility policy, and monitor the patient until help arrives. Reference topics: Patient Preparation; syncope prevention; patient positioning; adverse reactions; venipuncture safety.
NEW QUESTION # 15
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