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| Section | Objectives |
|---|---|
| Routine Blood Collections | - Venipuncture procedures - Equipment selection and use - Order of draw |
| Special Collections | - Pediatric and geriatric considerations - Capillary puncture (fingerstick/heel stick) - Non-routine specimen collection methods |
| Specimen Processing and Handling | - Common errors and rejection criteria - Specimen transport and storage - Quality assurance procedures |
| Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
| Safety and Compliance | - HIPAA and patient confidentiality - Infection control and standard precautions - OSHA regulations and patient safety |
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問題 #83
A phlebotomist receives a specimen without a patient identifier on the tube. Which of the following actions should the phlebotomist expect?
答案：A
解題說明：
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.
問題 #84
A phlebotomist receives a phone call from a provider's practice asking for a patient's CBC results. To which of the following departments should the phlebotomist transfer the call?
答案：B
解題說明：
A complete blood count, or CBC, is handled by the hematology department because it evaluates cellular components of blood, including red blood cells, white blood cells, hemoglobin, hematocrit, platelets, and differential findings when ordered. Chemistry focuses on analytes such as glucose, electrolytes, enzymes, renal markers, liver markers, and metabolic panels. Coagulation handles clotting studies such as PT, INR, aPTT, fibrinogen, and related hemostasis testing. Serology focuses on antigen-antibody testing and immune-response assays. A phlebotomist should not disclose results unless authorized by facility policy and role scope. The correct action is to direct the caller to the department that performs or releases the requested test result. This protects patient confidentiality and avoids miscommunication of clinical information. NHA CPT processing content includes communication between non-laboratory personnel, retrieving specimen or result data through laboratory systems, distributing results to ordering providers, and understanding blood components and laboratory testing roles. Reference topics: Processing Specimens; laboratory departments; hematology testing; communication of laboratory results.
問題 #85
A phlebotomist enters a patient's room and finds the patient motionless and cyanotic. Which of the following actions should the phlebotomist take?
答案：A
解題說明：
The first action is to assess responsiveness by speaking loudly and directly to the patient, such as asking whether they are okay. A motionless, cyanotic patient may be in respiratory or cardiac arrest, but the phlebotomist must follow the emergency response sequence rather than jumping to airway maneuvers, rescue breaths, or AED use before confirming responsiveness and activating help according to facility protocol. The head-tilt/chin-lift maneuver is an airway-opening step, but it follows initial responsiveness assessment and emergency activation. Rescue breaths are not the first step and are performed only within the appropriate CPR sequence and training level. Applying an AED is appropriate when cardiac arrest is suspected and the emergency response process has been initiated, but the first immediate action from the options is responsiveness assessment. NHA CPT safety content includes recognizing emergencies, initiating first aid, responding to codes, and CPR-related guidelines. Reference topics: Safety and Compliance; emergency recognition; CPR sequence; first aid response.
問題 #86
Which of the following should a phlebotomist verify for quality control protocol prior to using vacuum tubes?
答案：B
解題說明：
Before using evacuated vacuum tubes, the phlebotomist must verify the expiration date. Expired tubes can lose vacuum, produce inadequate draw volume, compromise the blood-to-additive ratio, or contain additives that no longer perform as intended. This can directly affect specimen integrity and may lead to inaccurate results or specimen rejection. Needle integrity is also important, but it applies to needle inspection rather than vacuum tube quality control. Visible additive may be observed in some tubes, but not all additives are easily visible, and visibility alone does not confirm the tube is acceptable for use. Name on label is not checked before using an unused tube because patient labeling occurs after collection according to facility policy and positive patient identification requirements. Tube quality control includes inspecting tubes for cracks, contamination, expired dates, defective stoppers, and compromised vacuum. NHA CPT routine collection content specifically includes selecting and assembling equipment, verifying equipment quality, checking expiration dates, and inspecting evacuated tubes required for laboratory testing. Reference topics: Routine Blood Collections; evacuated tube quality control; expiration dates; equipment inspection.
問題 #87
A phlebotomist is scheduled to perform a venipuncture on a patient who had a bilateral radical mastectomy. Which of the following actions should the phlebotomist take?
答案：B
解題說明：
The phlebotomist should contact the provider for approval. After a mastectomy, especially radical mastectomy with lymph node involvement, venipuncture on the affected side is generally avoided because impaired lymphatic drainage can increase risk for lymphedema, infection, delayed healing, and patient complications. With a bilateral radical mastectomy, both arms may be restricted, so the phlebotomist should not independently choose an alternate arm vein. Drawing from an ulnar vein is not a standard solution and could still be in a restricted extremity. Requesting surgical outpatient records is not the immediate collection action and does not provide authorization to proceed. Obtaining a specimen from the subclavian vein is outside the phlebotomist's routine scope and would be a provider-level invasive procedure. The correct approach is to pause, follow facility policy, notify the nurse or provider, and obtain explicit direction for an approved site or alternate collection method. Reference topics: Routine Blood Collections; site contraindications; mastectomy precautions; provider communication; patient safety.
問題 #88
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