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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Special Collections | 12% | - Blood alcohol & legal collections - Pediatric & geriatric collections - Blood cultures & sterile collection - Therapeutic drug monitoring - Glucose tolerance & dynamic tests |
| Topic 2: Routine Blood Collections | 28% | - Post-collection care & labeling - Capillary puncture procedures - Order of draw & tube selection - Tourniquet use & vein assessment - Venipuncture techniques & equipment |
| Topic 3: Specimen Processing & Handling | 14% | - Processing & centrifugation - Aliquoting & preservation - Documentation & tracking - Specimen rejection criteria - Transport & storage requirements |
| Topic 4: Safety and Compliance | 26% | - Infection control & OSHA standards - PPE & sharps disposal - Quality control & error prevention - HIPAA & patient confidentiality - Bloodborne pathogens & exposure control |
| Topic 5: Patient Preparation | 20% | - Patient positioning & comfort - Informed consent & communication - Patient identification & verification - Requisition review & test verification - Site selection & preparation |
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NEW QUESTION # 103
A phlebotomist receives a specimen without a patient identifier on the tube. Which of the following actions should the phlebotomist expect?
Answer: C
Explanation:
The laboratory should reject an unlabeled specimen. A specimen without patient identification cannot be reliably linked to the correct patient, even if a requisition is nearby or a provider verbally confirms the order. Labeling a tube later from the requisition is unsafe because it breaks the chain between patient, collection event, and specimen. Testing based only on an order number does not meet safe identification practice. Verbal confirmation after the fact cannot correct an unlabeled specimen because the tube's identity was not secured at the bedside or collection site. Proper labeling should occur immediately after collection in the presence of the patient, using required identifiers such as full name, date of birth, medical record number, date/time of collection, and collector identity according to facility policy. Mislabeling and unlabeled specimens are serious preanalytical errors that can cause wrong diagnosis, wrong treatment, transfusion risk, and patient harm. Reference topics: Processing Specimens; specimen labeling; patient identification; rejection criteria; preanalytical error.
NEW QUESTION # 104
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 # 105
Which of the following additives is commonly found in a gray-top tube used for glucose testing?
Answer: B
Explanation:
Sodium fluoride is commonly found in gray-top tubes used for glucose testing. Sodium fluoride inhibits glycolysis, which helps preserve glucose concentration after collection by slowing cellular glucose consumption. Many gray-top tubes also contain potassium oxalate as an anticoagulant. Sodium citrate is found in light-blue tubes used for coagulation studies because it binds calcium reversibly. EDTA is found in lavender-top tubes and is commonly used for hematology testing such as CBC. SPS is sodium polyanethol sulfonate, an additive used in blood culture bottles or yellow SPS tubes because it supports organism recovery by reducing certain inhibitory effects. Tube additives are not trivia; they determine specimen type and test validity. A glucose specimen collected in the wrong tube or processed late may produce inaccurate results because cells continue metabolizing glucose after collection. The phlebotomist must match test, tube, additive, order of draw, fill volume, and handling requirements. Reference topics: Special Collections; glucose testing; gray-top tube; sodium fluoride; additive function.
NEW QUESTION # 106
Which of the following is a possible complication of venipuncture collection for a patient who has been on warfarin therapy?
Answer: A
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 # 107
Which of the following collection sites is appropriate for a dermal puncture on an infant?
Answer: B
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 # 108
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