Which of the following agencies is responsible for setting guidelines for bloodborne exposure incidents?
Correct Answer: D
The Occupational Safety and Health Administration is responsible for workplace safety regulation, including requirements related to bloodborne pathogen exposure. In phlebotomy, bloodborne exposure incidents include needlesticks, blood splashes, mucous membrane exposure, and contact with non-intact skin. OSHA's Bloodborne Pathogens Standard requires employers to maintain exposure control plans, provide training, use engineering controls such as safety needles and sharps containers, support appropriate PPE, and establish procedures for exposure reporting and follow-up. CMS is primarily linked to Medicare, Medicaid, and healthcare payment/quality oversight, not direct bloodborne exposure incident standards. The FDA regulates medical devices, drugs, biologics, and related safety approvals. CLIA governs laboratory testing quality standards, not occupational blood exposure response. The option wording on the screen says "Occupational Safety of Health Administration," but the correct agency is OSHA: Occupational Safety and Health Administration. NHA CPT safety content includes OSHA, bloodborne pathogens, sharps disposal, biohazards, exposure control protocols, needlestick reporting, and workplace safety regulations. Reference topics: Safety and Compliance; OSHA; Bloodborne Pathogens Standard; exposure control protocols.
Question 2
When performing a capillary collection, which of the following tubes should a phlebotomist collect last?
Correct Answer: C
In capillary collection, the red tube should be collected last from the options listed. Capillary order of draw differs from venipuncture order of draw because capillary blood begins clotting quickly after puncture. Tubes containing anticoagulants are collected before serum tubes to prevent platelet clumping and microclot formation that could invalidate hematology or other additive-based testing. Lavender EDTA specimens are typically prioritized early because hematology testing requires well-mixed anticoagulated whole blood. Lithium heparin is also an additive tube and should be collected before a non-additive or serum specimen. Red tubes are generally serum tubes and are collected later because clotting is expected for serum production. Microhematocrit collection depends on the procedure and whether anticoagulated capillary tubes are used, but it is not the best answer for "last" in this item. The phlebotomist must also wipe away the first drop, avoid excessive squeezing, fill microcollection containers properly, and mix additive specimens immediately by gentle inversion. NHA CPT competencies include dermal puncture, capillary order of draw, microcollection devices, and specimen integrity. Reference topics: Routine Blood Collections; capillary collection; dermal puncture; microcollection order of draw.
Question 3
Which of the following needle gauges can be used for blood donation collection?
Correct Answer: C
Blood donation collection requires a large-bore needle because a full unit of blood must be collected efficiently while minimizing hemolysis and maintaining adequate flow into the collection bag. An 18-gauge needle is the correct option from the list. Blood donor collections commonly use larger needles than routine diagnostic venipuncture because donor collection volume is much greater than routine tube collection. A 25-gauge or 27-gauge needle is too small; it would slow flow excessively, increase mechanical stress on cells, and be inappropriate for donor collection. A 21-gauge needle is common for routine adult venipuncture but is not the best answer for blood donation collection because donor procedures require faster sustained flow. The phlebotomist must also confirm donor eligibility, follow blood bank protocol, use correct equipment, maintain aseptic technique, and monitor the donor for adverse reactions. The NHA CPT outline includes phlebotomy for blood donations and blood donation standards such as hemoglobin/hematocrit screening, weight, and complete screening. Reference topics: Special Collections; blood donation; needle gauge selection; donor collection standards.
Question 4
Which of the following actions should a phlebotomist take when a specimen requires immediate processing?
Correct Answer: C
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.
Question 5
Which of the following tests is most likely to require collection in a chilled specimen tube?
Correct Answer: A
Ammonia is most likely to require collection in a chilled specimen tube and rapid transport, depending on facility protocol. Ammonia is unstable and can be affected by delayed processing, temperature, and cellular metabolism after collection. Chilling slows metabolic activity and helps preserve specimen integrity. Total cholesterol is generally a routine chemistry test and does not usually require immediate chilling. Hemoglobin A1c is collected to evaluate long-term glycemic control and is not typically a chilled specimen. Blood cultures require aseptic technique, correct culture bottles, adequate volume, and timely incubation or transport, not chilling. The broader lesson is that special handling requirements are analyte-specific. Some specimens must be chilled, some kept warm, some protected from light, and some delivered immediately. The phlebotomist must review the requisition, laboratory directory, or facility procedure before collection. Improper temperature handling can produce inaccurate results even if the specimen was collected in the correct tube. Reference topics: Special Collections; chilled specimens; ammonia handling; specimen stability; transport requirements.
