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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Special Collections | 12% | - Therapeutic drug monitoring - Glucose tolerance & dynamic tests - Blood alcohol & legal collections - Blood cultures & sterile collection - Pediatric & geriatric collections |
| Topic 2: Safety and Compliance | 26% | - Infection control & OSHA standards - Quality control & error prevention - Bloodborne pathogens & exposure control - PPE & sharps disposal - HIPAA & patient confidentiality |
| Topic 3: Routine Blood Collections | 28% | - Order of draw & tube selection - Post-collection care & labeling - Venipuncture techniques & equipment - Tourniquet use & vein assessment - Capillary puncture procedures |
| Topic 4: Specimen Processing & Handling | 14% | - Transport & storage requirements - Processing & centrifugation - Documentation & tracking - Specimen rejection criteria - Aliquoting & preservation |
| Topic 5: Patient Preparation | 20% | - Patient positioning & comfort - Site selection & preparation - Patient identification & verification - Informed consent & communication - Requisition review & test verification |
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NEW QUESTION # 90
Which of the following actions should a phlebotomist take when a specimen requires immediate processing?
Answer: C
Explanation:
A specimen requiring immediate processing should be delivered or processed according to stat or time-sensitive protocol. Some analytes degrade rapidly, some cells change after collection, and some tests depend on strict timing. Leaving the specimen until the next courier pickup may cause inaccurate results or rejection. Marking it routine ignores the priority and may delay care. Refrigerating it overnight is inappropriate unless specifically required, and even then it would not satisfy immediate processing. The phlebotomist must recognize priority indicators such as STAT, timed, fasting, peak/trough, chilled, protected-from-light, and immediate-spin requirements. The responsibility does not end when blood enters the tube. Specimen integrity depends on timely transport, correct temperature, proper centrifugation, and accurate documentation. If a delay occurs, the phlebotomist should communicate it according to facility policy rather than silently submitting a compromised specimen. Reference topics: Processing Specimens; stat specimens; time-sensitive processing; transport priority; specimen stability.
NEW QUESTION # 91
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: D
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 # 92
Which of the following conditions requires a blood transfusion due to cumulative blood loss for neonatal patients?
Answer: A
Explanation:
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.
NEW QUESTION # 93
A phlebotomist completes a venipuncture procedure and activates the safety mechanism on the winged infusion set up to discard it into the sharps container. Which of the following actions should the phlebotomist take if the sharps container is locked?
Answer: B
Explanation:
If the sharps container is locked and cannot accept the used winged infusion set, the phlebotomist should obtain a new sharps container. A contaminated needle or winged infusion set must be discarded immediately into an approved sharps container that is puncture-resistant, leak-resistant, properly labeled or color-coded, closable, and accessible at the point of use. Unlocking or forcing a container is unsafe and may expose the technician to contaminated sharps. A trash container is never acceptable for needle disposal because it creates risk for housekeeping staff, patients, and other personnel. A biohazard bag is also incorrect because bags are for regulated soft biohazard waste, not sharps; needles can puncture the bag and cause injury. The correct action is to maintain control of the activated device safely and use an appropriate replacement sharps container. This is a direct OSHA and standard-precaution issue. Reference topics: Safety and Compliance; sharps disposal; safety-engineered devices; needlestick prevention; OSHA bloodborne pathogen precautions.
NEW QUESTION # 94
Which of the following types of medication is an indication for an INR draw?
Answer: D
Explanation:
An anticoagulant is the medication type most directly associated with an INR draw. INR, or international normalized ratio, is used to evaluate clotting time and is especially important for monitoring patients who take warfarin or other anticoagulant therapy. These medications reduce the blood's ability to clot, so laboratory monitoring helps determine whether the patient is within the therapeutic range or at risk for bleeding or clotting complications. Anti-inflammatory medications may affect bleeding risk in some situations, but they are not the primary indication for an INR draw. Antihistamines are used for allergic symptoms, and antiemetics are used for nausea or vomiting; neither is routinely monitored by INR. From a phlebotomy standpoint, anticoagulant therapy also alerts the technician to apply pressure longer after venipuncture and observe for prolonged bleeding. Reference topics: Special Collections; coagulation testing; point-of-care INR; medication-related collection considerations; hemostasis. The NHA CPT test plan includes special collections, waived testing, and coagulation/hemostasis-related competencies.
NEW QUESTION # 95
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