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| Section | Objectives |
|---|---|
| Topic 1: Routine Blood Collections | - Venipuncture procedures - Equipment selection and use - Order of draw |
| Topic 2: Specimen Processing and Handling | - Quality assurance procedures - Common errors and rejection criteria - Specimen transport and storage |
| Topic 3: Safety and Compliance | - OSHA regulations and patient safety - Infection control and standard precautions - HIPAA and patient confidentiality |
| Topic 4: Special Collections | - Pediatric and geriatric considerations - Non-routine specimen collection methods - Capillary puncture (fingerstick/heel stick) |
| Topic 5: Patient Preparation | - Patient identification and communication - Specimen labeling procedures - Site selection and preparation |
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NEW QUESTION # 115
A phlebotomist should identify which of the following as the best site for phenylketonuria collection on an infant?
Answer: A
Explanation:
The best site for phenylketonuria, or PKU, collection on an infant is the medial or lateral plantar surface of the heel. PKU screening is a newborn metabolic screening test commonly collected by heel stick onto filter paper. The medial and lateral heel areas are selected because they provide adequate capillary blood flow while reducing the risk of puncturing bone. The central area of the heel is unsafe because the calcaneus may be closer to the puncture site, increasing the risk of bone injury or osteomyelitis. Fingertip puncture is inappropriate for infants because the tissue is small, bone is close to the surface, and the site does not provide the recommended specimen collection area for newborn screening. Proper PKU collection also requires warming the heel when indicated, allowing blood to flow freely, filling filter-paper circles completely from one side, avoiding layering, and allowing the specimen to dry properly before transport. NHA CPT special collection content includes collecting blood for metabolic syndromes such as PKU, filter-paper collection techniques, pediatric considerations, and minimum/maximum volume requirements. Reference topics: Special Collections; PKU collection; infant heel puncture; filter-paper specimen collection.
NEW QUESTION # 116
At the completion of a routine venipuncture, a phlebotomist incurs a needlestick to their finger. Which of the following information should the phlebotomist include on the incident report for this situation?
Answer: A
Explanation:
The incident report should include the type of blood collection device used. For a needlestick or contaminated sharps injury, the device involved is central to exposure documentation because the facility must evaluate whether safer devices, training, handling, or disposal procedures failed. OSHA states that a sharps injury log must include, at minimum, the type and brand of device involved when known, the department or work area, and an explanation of how the incident occurred. The number and color of tubes collected may matter for specimen documentation but does not explain the exposure mechanism. The employee's primary care provider information is not the key occupational exposure detail. Proof of biohazard container fill-line adherence may be relevant only if the injury involved sharps disposal, but the broader required incident-report item is the collection device involved. The phlebotomist should immediately wash the area, report the injury, follow exposure-control policy, document the event, and obtain occupational health evaluation. Reference topics: Safety and Compliance; needlestick injury; exposure control; OSHA sharps injury log; incident reporting.
NEW QUESTION # 117
A phlebotomist should immediately report which of the following to a supervisor?
Answer: A
Explanation:
A needlestick injury must be reported immediately to a supervisor because it is an occupational exposure incident involving potential transmission of bloodborne pathogens. Immediate reporting triggers the facility's exposure-control plan, which may include wound cleansing, documentation, source-patient evaluation when permitted, employee health assessment, post-exposure prophylaxis consideration, and required follow-up testing. Delayed reporting can compromise medical management and regulatory documentation. Outdated blood collection supplies should be removed from use and handled according to inventory or quality-control policy, but they do not carry the same immediate occupational exposure urgency. An allergic reaction must be managed clinically and reported according to severity and facility procedure, but the most direct supervisor-reporting requirement in this item is the needlestick injury. Patient noncompliance with dietary requirements should be documented or communicated as required because it may affect test validity, but it is not an occupational exposure emergency. NHA CPT safety content specifically includes following exposure control plans for needle sticks, notification requirements, needle stick protocols, bloodborne pathogen standards, and reporting requirements. Reference topics: Safety and Compliance; needlestick injury; exposure control protocols; reporting requirements.
NEW QUESTION # 118
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 # 119
A phlebotomist must recollect a blood sample after the initial sample was rejected by the laboratory. Which of the following factors might have caused the sample to be rejected?
Answer: A
Explanation:
An underfilled collection tube is a common reason for laboratory rejection because many tests require a specific blood-to-additive ratio. This is especially critical for coagulation specimens, where insufficient blood relative to anticoagulant can falsely prolong clotting results. Underfilling can also produce inadequate specimen volume for testing, repeat analysis, or instrument requirements. A hematoma at the puncture site is a patient complication and may indicate procedural difficulty, but it does not automatically require specimen rejection unless it affected specimen quality. Use of a multiple-sample needle is a standard venipuncture method and is not a rejection criterion by itself. The cephalic vein is an acceptable antecubital vein when selected appropriately, so using it does not invalidate the specimen. Processing accuracy begins at collection: correct tube, correct volume, correct mixing, correct labeling, and correct transport. The NHA CPT outline identifies preanalytical errors, minimum and maximum volume requirements, fill levels and ratios, maintaining specimen integrity, and recollection as core processing and collection competencies. Reference topics: Processing Specimens; preanalytical errors; tube fill level; specimen rejection and recollection.
NEW QUESTION # 120
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