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| Section | Objectives |
|---|---|
| Topic 1: Safety and Compliance | - HIPAA and patient confidentiality - Infection control and standard precautions - OSHA regulations and patient safety |
| Topic 2: Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
| Topic 3: Specimen Processing and Handling | - Specimen transport and storage - Common errors and rejection criteria - Quality assurance procedures |
| Topic 4: Routine Blood Collections | - Equipment selection and use - Order of draw - Venipuncture procedures |
| Topic 5: Special Collections | - Capillary puncture (fingerstick/heel stick) - Non-routine specimen collection methods - Pediatric and geriatric considerations |
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NEW QUESTION # 103
Which of the following collection sites is appropriate for a dermal puncture on an infant?
Answer: C
Explanation:
The appropriate dermal puncture site on an infant is the medial or lateral plantar surface of the heel. These areas reduce the risk of puncturing bone and provide suitable capillary blood flow for neonatal testing. The posterior curvature of the heel should be avoided because the bone may be close to the surface, increasing risk of osteomyelitis or injury. The arch of the foot is not an approved puncture site and may damage nerves, tendons, or deeper structures. The tip of the index finger is inappropriate for infants because there is insufficient tissue depth and greater risk of bone injury. Correct infant dermal puncture also requires using an age-appropriate lancet depth, warming the site if needed, cleaning and drying the skin, wiping away the first drop when required, avoiding excessive squeezing, and collecting specimens in the correct order. Infant blood volume is limited, so collection volume must be minimized. Reference topics: Special Collections; infant heel puncture; dermal puncture sites; neonatal safety; osteomyelitis prevention.
NEW QUESTION # 104
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 # 105
A phlebotomist is collecting blood from a patient with small fragile veins. Which of the following devices is most appropriate?
Answer: A
Explanation:
A winged infusion set is most appropriate for a patient with small fragile veins. Butterfly devices provide better control, flexible tubing, and a shallower insertion angle, making them useful for hand veins, pediatric patients, geriatric patients, or difficult venous access. A 16-gauge needle is too large for routine diagnostic venipuncture and would likely damage fragile veins. A blood culture bottle adapter is used for blood culture collection but does not solve the problem of fragile vein access by itself. A lancet is used for dermal puncture, not venous collection, and may not provide the volume or specimen type required for ordered venipuncture tests. When using a winged infusion set, the phlebotomist should anchor the vein carefully, insert bevel up at a low angle, stabilize the device, monitor for infiltration, and activate the safety mechanism immediately after withdrawal. Equipment selection is a clinical safety decision, not a convenience choice. Reference topics: Routine Blood Collections; winged infusion set; fragile veins; equipment selection; venipuncture technique.
NEW QUESTION # 106
Which of the following specimens should a phlebotomist protect from light immediately after collection?
Answer: B
Explanation:
Bilirubin specimens should be protected from light immediately after collection because bilirubin is photosensitive. Exposure to light can degrade bilirubin and produce falsely decreased results. The phlebotomist should follow facility procedure, which may include wrapping the tube in foil or using an amber transport container. Blood urea nitrogen is not classically light-sensitive; it is generally handled as a routine chemistry analyte unless special facility requirements apply. Sodium testing does not require light protection. Hemoglobin A1c reflects long-term glycemic exposure through glycated hemoglobin and is not light-sensitive in the same way bilirubin is. The broader technical principle is that specimen handling requirements are test-specific. Some specimens require chilling, some must remain warm, some require rapid transport, some must avoid light, and some require timed collection. Failure to follow these requirements creates preanalytical error even when the venipuncture itself was performed correctly. Reference topics: Special Collections; Processing Specimens; light-sensitive specimens; bilirubin handling; specimen integrity.
NEW QUESTION # 107
A patient has had a left-sided mastectomy. Which of the following actions should the phlebotomist take when collecting for a CBC and comprehensive metabolic panel?
Answer: B
Explanation:
The phlebotomist should draw from the right arm because the patient has had a left-sided mastectomy. The affected side should generally be avoided for venipuncture unless a provider specifically authorizes it, due to risk of lymphedema, impaired lymph drainage, infection, and delayed tissue recovery. Drawing from the left hand still uses the affected extremity and does not solve the problem. Cleaning with soap and water only is not an appropriate substitute for standard antisepsis and does not address the mastectomy restriction. A capillary stick is not automatically acceptable for a CBC and comprehensive metabolic panel, and it may not provide the correct specimen volume or type for both tests. The better and safer approach is to use the unaffected right arm when it is available and appropriate. If the unaffected arm is inaccessible, the phlebotomist should escalate according to policy instead of improvising. Reference topics: Routine Blood Collections; venipuncture site selection; mastectomy restrictions; CBC/CMP collection; patient safety.
NEW QUESTION # 108
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