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| Section | Objectives |
|---|---|
| Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
| Specimen Processing and Handling | - Specimen transport and storage - Common errors and rejection criteria - Quality assurance procedures |
| Routine Blood Collections | - Venipuncture procedures - Order of draw - Equipment selection and use |
| Special Collections | - Pediatric and geriatric considerations - Capillary puncture (fingerstick/heel stick) - Non-routine specimen collection methods |
| Safety and Compliance | - OSHA regulations and patient safety - HIPAA and patient confidentiality - Infection control and standard precautions |
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NEW QUESTION # 46
Which of the following pathologies requires a phlebotomist to use an N95 respirator?
Answer: D
Explanation:
Tuberculosis requires airborne precautions, including use of a properly fitted N95 respirator or equivalent respiratory protection when indicated by facility protocol. Tuberculosis can spread through airborne droplet nuclei, so a simple surgical mask is not the same level of respiratory protection for healthcare personnel entering a TB-risk environment. Lyme disease is transmitted through tick exposure, not routine airborne patient contact. Heart disease is cardiovascular pathology and does not require an N95 respirator as a transmission-based precaution. Thrombocytopenia is a low platelet count and affects bleeding risk, not respiratory isolation. The phlebotomist must follow posted isolation signage, perform hand hygiene, use required PPE, and avoid entering isolation rooms without proper protection and training. This question tests transmission-based precautions and recognition of airborne disease hazards. Reference topics: Safety and Compliance; PPE; airborne precautions; infection control; respiratory protection; isolation signage. CDC guidance specifically identifies respiratory protection programs for healthcare personnel using respirators to protect against Mycobacterium tuberculosis exposure.
NEW QUESTION # 47
Which of the following is an example of a postanalytical error?
Answer: C
Explanation:
Failing to report a critical value promptly is a postanalytical error because it occurs after testing has produced a result. Postanalytical processes include result reporting, documentation, communication, verification, and delivery to the appropriate provider or clinical team. Collecting the wrong tube, underfilling a citrate tube, and hemolyzing a specimen during collection are preanalytical errors because they occur before laboratory analysis. These preanalytical errors may lead to specimen rejection or inaccurate results. Critical values require urgent communication because they may indicate an immediate threat to patient safety. The phlebotomist's role depends on facility policy; if performing point-of-care testing, the technician may be responsible for documenting and reporting results through a defined workflow. A delayed critical result can be just as dangerous as an incorrect specimen because the patient may not receive timely intervention. This question tests the three phases of laboratory testing: preanalytical, analytical, and postanalytical. Reference topics: Processing Specimens; postanalytical error; critical value reporting; documentation; laboratory workflow.
NEW QUESTION # 48
Which of the following actions should a phlebotomist take to prevent reflux during venipuncture?
Answer: C
Explanation:
To prevent reflux, the patient's arm should be kept in a downward position so the collection tube remains below the puncture site. Reflux occurs when blood or tube additive flows backward from the tube into the patient's vein. Keeping the tube below the venipuncture site and allowing tubes to fill properly reduces this risk. Holding the tube above the puncture site increases the chance of backflow. Removing the tube before it fills can create incorrect blood-to-additive ratios and does not prevent reflux. Inserting the needle bevel down is incorrect technique; venipuncture needles are inserted bevel up to enter the vein smoothly and reduce trauma. Reflux prevention also includes using proper tube position, avoiding excessive movement, not pushing tube contents toward the patient, and releasing the tourniquet appropriately. This is especially important with additive tubes because additive contamination of the patient's circulation, while uncommon, is a preventable safety concern. Reference topics: Routine Blood Collections; reflux prevention; evacuated tube technique; arm positioning; tube handling.
NEW QUESTION # 49
A phlebotomist is collecting a blood culture from a 6-month-old infant who has no known allergies. Which of the following disinfectants should the phlebotomist use?
Answer: B
Explanation:
Chlorhexidine gluconate is the best answer for blood culture skin antisepsis in this 6-month-old infant with no known allergies. Blood cultures require stricter skin disinfection than routine venipuncture because contamination can produce false-positive culture results, unnecessary antibiotics, repeat testing, and delayed diagnosis. Sodium polyanethol sulfonate is not a skin disinfectant; it is an anticoagulant/additive used in blood culture media to support organism recovery. Sodium hypochlorite is a bleach-type disinfectant used for environmental decontamination, not patient skin preparation for venipuncture. Hydrogen peroxide is not the standard blood culture skin antiseptic. Chlorhexidine is widely used for effective skin antisepsis, and CDC guidance recognizes chlorhexidine-containing agents in healthcare infection-control contexts when age, skin maturity, and clinical risk are considered. For collection technique, the phlebotomist should cleanse the site properly, allow the antiseptic to dry, avoid repalpating unless sterile technique is used, collect adequate volume, and label/document accurately. Reference topics: Special Collections; blood culture collection; pediatric skin preparation; contamination prevention.
NEW QUESTION # 50
Which of the following actions should a phlebotomist take after removing the needle from a venipuncture site?
Answer: B
Explanation:
After removing the needle, the phlebotomist should apply pressure with clean gauze. Direct pressure supports hemostasis and reduces bruising, bleeding, and hematoma formation. Asking the patient to bend the elbow tightly is incorrect because it can increase pressure at the puncture site and promote hematoma formation or continued bleeding under the skin. Recapping the needle is unsafe and increases needlestick risk; the safety device should be activated and the needle discarded in an approved sharps container. Labeling the tube cap only is also incorrect because caps can be removed or switched. The specimen label must be placed on the tube or container itself according to facility policy. After pressure is applied, the phlebotomist should check that bleeding has stopped before applying a bandage, especially for patients on anticoagulants or with bleeding disorders. Post-procedure care is not an afterthought; it is part of patient safety and specimen workflow. Reference topics: Routine Blood Collections; needle removal; post-procedure care; hemostasis; labeling requirements.
NEW QUESTION # 51
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