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| Section | Objectives |
|---|---|
| Topic 1: Safety and Compliance | - HIPAA and patient confidentiality - OSHA regulations and patient safety - Infection control and standard precautions |
| Topic 2: Specimen Processing and Handling | - Specimen transport and storage - Quality assurance procedures - Common errors and rejection criteria |
| Topic 3: Patient Preparation | - Site selection and preparation - Specimen labeling procedures - Patient identification and communication |
| Topic 4: Routine Blood Collections | - Venipuncture procedures - Order of draw - Equipment selection and use |
| Topic 5: Special Collections | - Pediatric and geriatric considerations - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) |
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67. Frage
Which of the following actions is required before using a new lot number of point-of-care testing strips?
Antwort: B
Begründung:
Quality control testing should be performed before using a new lot number of point-of-care testing strips. Lot-to-lot variation can affect test performance, and QC confirms that the strips, controls, meter, and operator process are producing acceptable results before patient testing begins. Freezing strips is incorrect unless a manufacturer specifically requires a storage condition, and most reagent strips have controlled storage requirements that must not be improvised. Mixing old and new lots is unsafe because it creates traceability problems and can invalidate quality control. Using strips only for "control patients" is meaningless; patient specimens should not be used to validate unverified supplies. For waived testing and point-of-care testing, the phlebotomist must follow manufacturer instructions, document QC results, check expiration dates, store materials properly, and stop patient testing when controls fail. If QC is outside range, patient results should not be reported until corrective action is completed. Reference topics: Safety and Compliance; Special Collections; point-of-care testing; quality control; reagent lot verification.
68. Frage
A phlebotomist must recollect a blood sample after the initial sample was rejected by the laboratory. Which of the following factors might have caused the sample to be rejected?
Antwort: B
Begründung:
An underfilled collection tube is a common reason for laboratory rejection because many tests require a specific blood-to-additive ratio. This is especially critical for coagulation specimens, where insufficient blood relative to anticoagulant can falsely prolong clotting results. Underfilling can also produce inadequate specimen volume for testing, repeat analysis, or instrument requirements. A hematoma at the puncture site is a patient complication and may indicate procedural difficulty, but it does not automatically require specimen rejection unless it affected specimen quality. Use of a multiple-sample needle is a standard venipuncture method and is not a rejection criterion by itself. The cephalic vein is an acceptable antecubital vein when selected appropriately, so using it does not invalidate the specimen. Processing accuracy begins at collection: correct tube, correct volume, correct mixing, correct labeling, and correct transport. The NHA CPT outline identifies preanalytical errors, minimum and maximum volume requirements, fill levels and ratios, maintaining specimen integrity, and recollection as core processing and collection competencies. Reference topics: Processing Specimens; preanalytical errors; tube fill level; specimen rejection and recollection.
69. Frage
Which of the following situations increases a phlebotomist's risk for a needlestick?
Antwort: C
Begründung:
A nearly full sharps container increases the risk for a needlestick because contaminated needles or other sharps may protrude, rebound, or be difficult to place safely into the container. Sharps containers must be puncture-resistant, leak-resistant, properly labeled or color-coded, kept upright, and replaced before they become overfilled. OSHA specifically warns not to allow sharps containers to overfill and requires routine replacement to reduce sharps injury risk. A tight tourniquet can cause patient discomfort, hemoconcentration, or venous obstruction, but it is not the best answer for needlestick risk. A 22-gauge needle is commonly used for routine venipuncture, especially for smaller veins, and is not inherently unsafe. A transfer device used with the syringe method is actually a safety control because it prevents the phlebotomist from manually pushing blood through a needle into evacuated tubes. NHA CPT safety content includes bloodborne pathogens, sharps safety, OSHA standards, exposure control, and safe disposal of contaminated equipment. Reference topics: Safety and Compliance; OSHA Bloodborne Pathogens Standard; sharps disposal; needlestick prevention.
70. Frage
Which of the following methods should a phlebotomist use to anchor a vein?
Antwort: A
Begründung:
The vein is anchored by placing the thumb of the free hand below the intended puncture site and gently pulling the skin taut. This stabilizes the vein, reduces rolling, creates a firmer puncture surface, and supports accurate needle entry. Anchoring above the site is unsafe because it places the phlebotomist's hand in the direction of needle travel and increases needlestick risk. Using two fingers instead of the thumb provides less controlled traction and may interfere with the venipuncture angle or contaminate the prepared site. The phlebotomist should avoid touching the cleansed puncture site after antisepsis unless the site is re-cleansed. Proper anchoring is especially important for superficial or mobile veins because failure to stabilize the vein can cause missed access, hematoma formation, probing, patient discomfort, or specimen collection failure. The NHA CPT outline identifies anchoring the vein below the venipuncture site and knowledge of anchoring techniques as routine venipuncture competencies. Reference topics: Routine Blood Collections; site selection; anchoring below venipuncture site; venous anatomy and safe insertion technique.
71. Frage
A phlebotomist discovers that they obtained a specimen in an expired additive tube. Which of the following actions should the technician take?
Antwort: C
Begründung:
The specimen must be redrawn in an unexpired tube. Expired additive tubes cannot be trusted because the vacuum, sterility, additive concentration, stopper integrity, and chemical performance may be compromised. Once blood has been collected into an expired additive tube, the specimen is already affected by that collection environment; transferring it into another tube does not correct the original exposure and can introduce additional hemolysis, contamination, clotting, or additive-ratio errors. Placing the specimen on ice does not reverse an expired additive problem. Submitting the specimen because the tube is "within 30 days" of expiration is unsafe; expired means expired, and laboratory acceptance criteria are based on valid collection supplies. This is a preventable preanalytical error, and the phlebotomist should also remove expired supplies from use to prevent recurrence. Tube expiration checks must occur before collection, not after the draw. Reference topics: Processing Specimens; preanalytical error; expired supplies; specimen rejection; tube quality control; recollection procedures.
72. Frage
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