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| Section | Objectives |
|---|---|
| Topic 1: Special Collections | - Pediatric and geriatric considerations - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) |
| Topic 2: Specimen Processing and Handling | - Quality assurance procedures - Specimen transport and storage - Common errors and rejection criteria |
| Topic 3: Safety and Compliance | - Infection control and standard precautions - OSHA regulations and patient safety - HIPAA and patient confidentiality |
| Topic 4: Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
| Topic 5: Routine Blood Collections | - Equipment selection and use - Venipuncture procedures - Order of draw |
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NEW QUESTION # 79
Which of the following conditions requires a blood transfusion due to cumulative blood loss for neonatal patients?
Answer: D
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 # 80
Which of the following actions should a phlebotomist take before palpating a vein?
Answer: D
Explanation:
The phlebotomist should put on gloves before palpating a vein. Gloves are required because the phlebotomist is preparing for an invasive procedure with potential blood exposure. Palpation helps assess vein size, depth, direction, resilience, and suitability, but it must occur after hand hygiene and glove application. Removing the needle cap before site selection is unsafe because it exposes the needle unnecessarily and increases needlestick risk. Labeling collection tubes before collection is improper because tubes must be labeled after collection in the presence of the patient to prevent misidentification. Asking the patient to bend the arm is not appropriate for vein palpation and is especially unsafe after needle removal because bending the arm can cause hematoma formation. The correct sequence is patient identification, hand hygiene, gloves, position patient, apply tourniquet, select/palpate vein, release/reapply tourniquet as needed, clean site, allow antiseptic to dry, anchor, and perform venipuncture. Reference topics: Routine Blood Collections; glove use; vein palpation; venipuncture sequence; patient safety.
NEW QUESTION # 81
A phlebotomist is preparing a container for a 24-hr urine collection when a chemical splash occurs. The phlebotomist should find information about this chemical from which of the following sources?
Answer: C
Explanation:
The correct source is the Safety Data Sheet. An SDS provides chemical-specific information about hazards, exposure controls, personal protective equipment, first aid, spill response, handling, storage, and disposal. During a chemical splash, the phlebotomist must follow facility policy immediately, use the eyewash or shower if indicated, notify appropriate personnel, and consult the SDS for the exact chemical involved. Current Procedural Terminology is a medical coding system and has no role in chemical exposure response. The CDC provides infection-control guidance, but it is not the primary document for a specific chemical's hazard and first-aid requirements. OSHA establishes workplace safety regulations, including hazard communication expectations, but the SDS is the actual document used at the point of exposure for chemical-specific instructions. NHA CPT safety content includes workplace safety regulations, exposure control protocols, reporting requirements, PPE, and biohazard or chemical safety practices. OSHA also describes SDSs as documents containing chemical properties, hazards, protective measures, and safety precautions. Reference topics: Safety and Compliance; chemical exposure; SDS; OSHA hazard communication.
NEW QUESTION # 82
Which of the following actions can cause hemolysis during venipuncture?
Answer: B
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 # 83
Which of the following actions should a phlebotomist take after removing the needle from a venipuncture site?
Answer: A
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 # 84
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