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| Section | Objectives |
|---|---|
| Patient Preparation | - Patient identification and communication - Explaining procedures and obtaining consent - Site selection and preparation |
| Specimen Processing and Handling | - Specimen transport and storage - Labeling and documentation - Quality control and rejection criteria |
| Professional Practice | - Ethics and patient confidentiality (HIPAA) - Communication and professionalism |
| Safety and Compliance | - Needlestick prevention and biohazard disposal - Infection control and PPE usage - OSHA standards and safety protocols |
| Specimen Collection | - Venipuncture techniques - Capillary puncture procedures - Order of draw and tube handling |
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NEW QUESTION # 33
Which of the following specimens is commonly collected using filter paper?
Answer: C
Explanation:
Newborn screening specimens are commonly collected using filter paper. These specimens are obtained by heel puncture and applied to designated circles on approved filter paper cards. The blood must soak through completely from one side, filling each circle properly without layering multiple drops. Blood cultures are collected in aerobic and anaerobic culture bottles, not filter paper. Coagulation studies require light-blue citrate tubes filled to the correct blood-to-additive ratio. Crossmatch specimens are collected in tubes specified by the transfusion service, with strict patient identification and labeling requirements. Filter-paper collection has its own technical risks: insufficient saturation, layering, contamination, touching the collection area, failure to dry completely, and improper transport can all make the specimen unsatisfactory. The phlebotomist must warm the heel if needed, use an approved puncture site, avoid excessive squeezing, and allow the card to dry horizontally away from direct heat or sunlight. Reference topics: Special Collections; newborn screening; PKU/metabolic screening; filter-paper collection; infant heel puncture.
NEW QUESTION # 34
Which of the following is a possible complication of venipuncture collection for a patient who has been on warfarin therapy?
Answer: C
Explanation:
Prolonged bleeding is the expected complication for a patient on warfarin therapy. Warfarin is an anticoagulant, meaning it interferes with normal clot formation and can increase bleeding time after venipuncture. The phlebotomist should be alert for delayed hemostasis, apply firm pressure after needle removal, avoid having the patient bend the arm sharply, and confirm that bleeding has stopped before applying a bandage and leaving the patient. Blood clotting is the opposite of the expected medication effect. Hemostasis is the normal stopping of bleeding, not a complication. Petechiae can occur from tourniquet pressure, fragile capillaries, or platelet-related issues, but in this question the medication-specific risk is prolonged bleeding. Proper technique reduces complications: release the tourniquet, withdraw the needle smoothly, activate the safety device, apply pressure, and monitor the puncture site. Reference topics: Routine Blood Collections; post-procedure care; anticoagulant therapy; bleeding complications; hemostasis; patient observation. NHA includes routine venipuncture complications and post-collection care within the CPT test plan.
NEW QUESTION # 35
Which of the following situations increases a phlebotomist's risk for a needlestick?
Answer: A
Explanation:
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.
NEW QUESTION # 36
Which of the following terms means a decrease in white blood cells?
Answer: D
Explanation:
Leukopenia means a decreased number of white blood cells. "Leuko-" refers to white blood cells, and "-penia" means deficiency or decrease. Leukocytosis means an increased white blood cell count and is often associated with infection, inflammation, stress response, or hematologic disorders. Thrombocytopenia means a decreased platelet count, which can increase bleeding risk after venipuncture. Erythrocytosis means an increased red blood cell count. This terminology matters to phlebotomy because laboratory orders and patient conditions often use hematologic language. The phlebotomist does not diagnose these conditions, but understanding terms helps the technician anticipate safety concerns and specimen requirements. For example, thrombocytopenia may require longer pressure after collection, while leukopenia may be associated with immunocompromised status and strict infection-control awareness. A CBC is the common test used to evaluate red cells, white cells, hemoglobin, hematocrit, and platelets. Reference topics: Phlebotomy Fundamentals; medical terminology; hematology; CBC components; blood cell disorders.
NEW QUESTION # 37
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 # 38
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