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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Special Collections | 12% | - Blood alcohol & legal collections - Therapeutic drug monitoring - Blood cultures & sterile collection - Pediatric & geriatric collections - Glucose tolerance & dynamic tests |
| Topic 2: Patient Preparation | 20% | - Requisition review & test verification - Patient identification & verification - Informed consent & communication - Site selection & preparation - Patient positioning & comfort |
| 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% | - Specimen rejection criteria - Aliquoting & preservation - Transport & storage requirements - Processing & centrifugation - Documentation & tracking |
| Topic 5: Safety and Compliance | 26% | - Infection control & OSHA standards - Quality control & error prevention - HIPAA & patient confidentiality - Bloodborne pathogens & exposure control - PPE & sharps disposal |
>> Phlebotomy-Technician模擬問題 <<
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質問 # 58
Which of the following veins is usually the last choice for antecubital venipuncture?
正解：D
解説：
The basilic vein is usually the last choice for antecubital venipuncture. The median cubital vein is preferred because it is typically large, well anchored, superficial, and less likely to roll. The cephalic vein is commonly the second choice when the median cubital is unavailable. The basilic vein is used cautiously because it lies closer to the brachial artery and median nerve, creating greater risk if the needle is inserted too deeply or inaccurately. The dorsal metacarpal veins are hand veins, not antecubital veins, and may be used when antecubital access is unavailable, often with a butterfly needle and shallow angle. This question tests anatomical risk control. A phlebotomist must not simply pick the most visible vein; they must evaluate vein safety, depth, direction, resilience, patient history, and contraindications such as IV sites, edema, burns, scars, hematomas, fistulas, and mastectomy restrictions. Proper site selection reduces pain, nerve injury, arterial puncture, hematoma, and recollection risk. Reference topics: Routine Blood Collections; antecubital anatomy; vein selection; basilic vein risk.
質問 # 59
Which of the following methods should a phlebotomist use to anchor a vein?
正解：B
解説：
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.
質問 # 60
Which of the following actions should a phlebotomist take after removing the needle from a venipuncture site?
正解：A
解説：
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.
質問 # 61
A phlebotomist observes that the lid of a sharps container will not close. Which of the following actions should the phlebotomist take?
正解：C
解説：
The sharps container should be replaced. A sharps container must be closable, puncture-resistant, leak-resistant, and properly labeled or color-coded. If the lid will not close, the container no longer provides safe containment and creates a needlestick or exposure hazard. Continuing to use it is unsafe even if it has not reached the fill line. Emptying sharps into another container is strictly inappropriate because it requires handling contaminated needles and increases exposure risk. Taping the opening closed is not an approved correction and does not restore the container's designed safety function. The phlebotomist should obtain an approved replacement container and report the defective container according to facility protocol. This is not a minor housekeeping issue; sharps disposal is an engineering-control requirement designed to prevent occupational exposure to bloodborne pathogens. Phlebotomy technicians must dispose of needles immediately after use, never recap used needles, and never place sharps in regular trash or soft biohazard bags. Reference topics: Safety and Compliance; sharps disposal; engineering controls; needlestick prevention.
質問 # 62
Which of the following actions should a phlebotomist take when a specimen requires immediate processing?
正解：C
解説：
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.
質問 # 63
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