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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Special Collections | 12% | - Blood alcohol & legal collections - Therapeutic drug monitoring - Glucose tolerance & dynamic tests - Pediatric & geriatric collections - Blood cultures & sterile collection |
| Topic 2: Patient Preparation | 20% | - Informed consent & communication - Site selection & preparation - Requisition review & test verification - Patient identification & verification - Patient positioning & comfort |
| Topic 3: Specimen Processing & Handling | 14% | - Transport & storage requirements - Processing & centrifugation - Specimen rejection criteria - Documentation & tracking - Aliquoting & preservation |
| Topic 4: Safety and Compliance | 26% | - PPE & sharps disposal - HIPAA & patient confidentiality - Quality control & error prevention - Bloodborne pathogens & exposure control - Infection control & OSHA standards |
| Topic 5: Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Post-collection care & labeling - Capillary puncture procedures - Order of draw & tube selection - Tourniquet use & vein assessment |
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NEW QUESTION # 88
Which of the following additives is commonly found in a gray-top tube used for glucose testing?
Answer: C
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 # 89
Which of the following collection sites is appropriate for a dermal puncture on an infant?
Answer: C
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 # 90
Which of the following angles should a phlebotomist use when inserting a butterfly needle into a patient's dorsal hand veins?
Answer: A
Explanation:
A butterfly needle inserted into dorsal hand veins should be introduced at a shallow angle, and from the options provided, 10° is the best answer. Hand veins are usually superficial, smaller, and more mobile than antecubital veins, so a steep angle increases the risk of passing through the vein, causing infiltration, hematoma formation, pain, or failed collection. A winged infusion set gives better control for fragile or difficult veins, but the phlebotomist must still anchor the vein, insert bevel up, and keep the angle low. A 25° or 30° angle is more consistent with routine antecubital venipuncture rather than shallow hand-vein access. A 45° angle is excessive for venous collection and creates unnecessary tissue trauma. The NHA CPT test plan places this under routine blood collection skills, including equipment selection, winged collection sets, hand vascular anatomy, site selection, and angle of needle insertion and withdrawal. Reference topics: Routine Blood Collections; winged collection set; hand veins; angle of needle insertion.
NEW QUESTION # 91
Which of the following specimens should a phlebotomist protect from light immediately after collection?
Answer: A
Explanation:
Bilirubin specimens should be protected from light immediately after collection because bilirubin is photosensitive. Exposure to light can degrade bilirubin and produce falsely decreased results. The phlebotomist should follow facility procedure, which may include wrapping the tube in foil or using an amber transport container. Blood urea nitrogen is not classically light-sensitive; it is generally handled as a routine chemistry analyte unless special facility requirements apply. Sodium testing does not require light protection. Hemoglobin A1c reflects long-term glycemic exposure through glycated hemoglobin and is not light-sensitive in the same way bilirubin is. The broader technical principle is that specimen handling requirements are test-specific. Some specimens require chilling, some must remain warm, some require rapid transport, some must avoid light, and some require timed collection. Failure to follow these requirements creates preanalytical error even when the venipuncture itself was performed correctly. Reference topics: Special Collections; Processing Specimens; light-sensitive specimens; bilirubin handling; specimen integrity.
NEW QUESTION # 92
Which of the following is the purpose of applying a tourniquet for venipuncture?
Answer: B
Explanation:
The purpose of applying a tourniquet is to enlarge veins. A properly applied tourniquet partially restricts venous return while arterial flow continues briefly, causing the selected vein to become more prominent, easier to palpate, and easier to access. This improves site selection and helps establish blood flow into the collection device. The tourniquet must not be applied too tightly or left on too long because prolonged stasis can cause hemoconcentration, discomfort, petechiae, or altered laboratory values. "To solidify veins" is incorrect because veins do not become solid; they become distended. "To shrink veins" is the opposite of the intended effect. "To roll veins" is also incorrect; rolling veins are a collection problem controlled by proper anchoring, not an intended effect of tourniquet use. The phlebotomist should apply the tourniquet above the intended site, palpate appropriately, remove it within accepted time limits, and release it before needle withdrawal. NHA CPT routine collection content includes standard tourniquet application and removal procedures, palpation, site selection, anchoring, and procedural steps for removing the tourniquet, tubes, and needle. Reference topics: Routine Blood Collections; tourniquet application; vein palpation; venipuncture preparation.
NEW QUESTION # 93
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