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| Section | Weight | Objectives |
|---|---|---|
| Specimen Processing & Handling | 14% | - Aliquoting & preservation - Specimen rejection criteria - Documentation & tracking - Processing & centrifugation - Transport & storage requirements |
| Routine Blood Collections | 28% | - Venipuncture techniques & equipment - Order of draw & tube selection - Tourniquet use & vein assessment - Post-collection care & labeling - Capillary puncture procedures |
| Patient Preparation | 20% | - Patient identification & verification - Requisition review & test verification - Informed consent & communication - Patient positioning & comfort - Site selection & preparation |
| Special Collections | 12% | - Therapeutic drug monitoring - Blood cultures & sterile collection - Blood alcohol & legal collections - Pediatric & geriatric collections - Glucose tolerance & dynamic tests |
| Safety and Compliance | 26% | - PPE & sharps disposal - HIPAA & patient confidentiality - Bloodborne pathogens & exposure control - Infection control & OSHA standards - Quality control & error prevention |
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NEW QUESTION # 78
Which of the following veins is usually the last choice for antecubital venipuncture?
Answer: C
Explanation:
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.
NEW QUESTION # 79
A phlebotomist is collecting from a patient under droplet precautions. Which of the following PPE is most directly indicated?
Answer: B
Explanation:
A surgical mask is most directly indicated for droplet precautions. Droplet precautions are used for organisms transmitted through respiratory droplets generated by coughing, sneezing, or talking. The mask helps protect the phlebotomist's nose and mouth from exposure at close range. A lead apron is used for radiation protection and has no role in droplet isolation. A sterile gown alone does not protect the respiratory mucosa and is not the primary droplet precaution. Shoe covers alone do not address droplet transmission. Depending on facility signage and procedure risk, additional PPE such as eye protection, gown, or gloves may be required, but from the options given, a surgical mask is the key droplet precaution. The phlebotomist should check isolation signs before entering, bring only necessary supplies, perform hand hygiene, wear PPE correctly, and remove PPE safely before leaving. This item tests transmission-based precaution matching: contact, droplet, airborne, and protective isolation are not interchangeable. Reference topics: Safety and Compliance; droplet precautions; PPE; isolation signage; infection control.
NEW QUESTION # 80
A phlebotomist is collecting a blood culture from a 6-month-old infant who has no known allergies. Which of the following disinfectants should the phlebotomist use?
Answer: B
Explanation:
Chlorhexidine gluconate is the best answer for blood culture skin antisepsis in this 6-month-old infant with no known allergies. Blood cultures require stricter skin disinfection than routine venipuncture because contamination can produce false-positive culture results, unnecessary antibiotics, repeat testing, and delayed diagnosis. Sodium polyanethol sulfonate is not a skin disinfectant; it is an anticoagulant/additive used in blood culture media to support organism recovery. Sodium hypochlorite is a bleach-type disinfectant used for environmental decontamination, not patient skin preparation for venipuncture. Hydrogen peroxide is not the standard blood culture skin antiseptic. Chlorhexidine is widely used for effective skin antisepsis, and CDC guidance recognizes chlorhexidine-containing agents in healthcare infection-control contexts when age, skin maturity, and clinical risk are considered. For collection technique, the phlebotomist should cleanse the site properly, allow the antiseptic to dry, avoid repalpating unless sterile technique is used, collect adequate volume, and label/document accurately. Reference topics: Special Collections; blood culture collection; pediatric skin preparation; contamination prevention.
NEW QUESTION # 81
Which of the following methods should a phlebotomist use to anchor a vein?
Answer: A
Explanation:
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.
NEW QUESTION # 82
Which of the following conditions is a reason for specimen rejection?
Answer: B
Explanation:
A clotted lavender-top specimen is a reason for specimen rejection. Lavender-top tubes contain EDTA anticoagulant and are used for tests such as CBCs, which require anticoagulated whole blood. If the specimen clots, the cellular components are trapped in the clot, platelet counts can be falsely low, and automated hematology analysis becomes unreliable. Properly labeled specimens, correctly filled light-blue tubes, and specimens transported upright are acceptable practices, not rejection causes. A clotted lavender specimen usually results from failure to mix the tube properly immediately after collection, delayed inversion, underfilling or collection difficulty, or drawing blood slowly and allowing clotting to begin before the specimen contacts the additive. The correct prevention is to fill the tube to the required volume and gently invert it the recommended number of times immediately after collection. The phlebotomist should never shake the tube, because vigorous agitation can cause hemolysis. Reference topics: Processing Specimens; specimen rejection; EDTA tube mixing; clotted specimens; hematology testing.
NEW QUESTION # 83
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