NHA CPT EXAM STUDY QUESTIONS

A phlebotomist has a requisition to draw blood on a patient who has severe Downs' Syndrome. Which of the following steps should the phlebotomist take?

Speak with the patient's guardian before performing the venipuncture to ensure the explanation is understood

Which of the following procedural steps for a finger stick should the phlebotomist do first?

Confirm the correct identity of the patient

A phlebotomist is drawing blood from a patient and observes red spots. Which of the following is an appropriate action for the phlebotomist to take?

Apply pressure after collecting the specimen. The development of petechiae is a sign of reduced platelet function and carries an increased risk of bleeding.

Which of the following is appropriate to use when collecting for a chemistry test that requires serum?

SST

A phlebotomist working in a fertility clinic draws blood from a patient who also must submit a semen sample for analysis. Which of the following should the phlebotomist tell the patient?

"As soon as you collect the specimen, keep it next to your body. We will need to submit it right away for testing." Semen samples for fertility must be delivered to the laboratory within 2 hr of collection and kept at body temperature.

Which of the following test results are affected when povidone iodine is used to cleanse the site for a dermal puncture?

Potassium

Blood cultures have been ordered on a patient in the intensive care unit. The nurse calls the phlebotomist to bring the appropriate materials. Which of the following should the phlebotomist bring?

An aerobic and an anaerobic bottle

When a phlebotomist is distributing laboratory results to ordering physicians, which results have priority?

Pre-surgical test results are a priority to report, because the results may alter how or if a surgery is performed.

Which of the following can cause a hemolyzed specimen?

Shaking the collection tube vigorously. This will cause the red blood cells to rupture, causing hemolysis.

Which of the following is an example of the acceptable reporting of routine lab results?

Send the results to the physician in a marked envelope.

Before the phlebotomist performs a venipuncture, the patient warns the he is HIV positive. According to OSHA regulations, after donning gloves, the phlebotomist should...

perform the venipuncture as normal per OSHA regulations.

Which of the following is an appropriate cleanser for cleansing around the urinary meatus in a clean-catch urine collection

Benzalkonium chloride

The phlebotomist should use a tube with which of the following anticoagulants to collect a PT/PTT test?

Sodium citrate

When should the code on glucose cuvettes or strips be compared to the code on the glucose meter?

When a patient is tested

A phlebotomist receives orders to draw an infant screening card, O2 levels, bilirubin, and DNA. Which of the following should be drawn first?

O2 levels. The infant may cry due to the draw, so every attempt must be made to collect the O2 levels as close to resting as possible.

After performing a heel puncture for neonatal screening, which of the following is the correct procedure for collecting the blood?

Saturate each circle.

Which of the following indicates the correct order of draw?

Green, lavender, gray

The order of draw for capillary collections is different than venipuncture because of...

an increased rate of coagulation

A phlebotomist is preparing to perform a hand draw. Which of the following should the phlebotomist assemble?

Winged infusion set and adapter

A patient comes in to find out his test results. The phlebotomist notices the results are ready and verifies the patient's identity. Which of the following actions is most appropriate?

Inform the patient to contact the ordering physician to get the results

During a venipuncture, the patient reports a sharp pain radiating down the arm. Which of the following actions should the phlebotomist take?

Release the tourniquet and remove the needle

A blood specimen was rejected by the laboratory with the abbreviation QNS. Why was the specimen rejected.

The specimen was insufficient

Which of the following is the best method to prevent internal or external bleeding from the venipuncture site after the needle is removed?

Apply pressure to prevent leakage of blood into the tissues.

When collecting a routine blood sample, which of the following vessels should the phlebotomist attempt to draw from first

Median cubital

A diabetic patient states she prefers to be drawn on the inside of her wrist. Which of the following actions should the phlebotomist take?

Attempt to draw from the antecubital region. With any patient the antecubital region is the first choice for a draw.

Which of the following provides the phlebotomist the best protection when drawing blood from a patient with active tuberculosis?

N-95 respirator

According to the CLSI order of draw guidelines, which of the following samples should the phlebotomist collect first?

Blood Cultures are collected first to prevent contamination

A phlebotomist must invert anticoagulant tubes to prevent which of the following?

clotting

For which of the following does emergency first-aid treatment include maintaining an open airway, controlling bleeding, and keeping the victim warm until help arrives?

SHOCK

Performing a venipuncture for blood cultures differs from other venipuncture procedures in that...

The site is cleaned more stringently

Which of the following is the term for a donation of a patient's own blood for an upcoming surgery?

Autologeous donation

The tourniquet should be left of a patient's arm...

for no longer than 60 seconds

A phlebotomist is preparing to draw blood from a patient in a hospital. The patient extends his arm and turns his head away. Which of the following forms of consent does this indicate?

Implied consent

A phlebotomist is drawing five blood collection tubes. When should the tourniquet be released?

1-2 minutes

A phlebotomist must choose the correct tube color and additive for the corresponding...

laboratory test

Which of the following is the proper cleansing procedure for routine venipuncture?

Cleanse the site in an outward spiral

Which of the following actions is appropriate when labeling specimens?

Labeling specimens at the time of collection in front of the patients.

At what temperature should a semen sample be transported y the phlebotomist?

36-38 degrees C.

While performing a venipuncture, the first tube fills, but the second tube slows and does not fill completely. The phlebotomist needs to draw two additional tubes. Which of the following steps should the phlebotomist take?

Insert a new tube to see if it will fill.

Which of the following is the next step after removing the needle from the patient's arm?

Engage the needle safety device

Which of the following is the first step in the blood collection procedure?

Test requisition

Capillary specimen collection is preferred over venipunture when...

veins are inaccessible

A 69-year old unconscious patient is brought to the emergency department. Several blood tests are ordered. The phlebotomist collects blood under...

implied consent

A physician orders a specimen STAT, but the phlebotomist forgets to fill out the patient ID number. What is the appropriate procedure for a improperly labeled specimen once the outside laboratory receives it?

The laboratory rejects the mislabeled specimen

Which of the following is the best method to collect a blood specimen from an older adult patient who has fragile, easy-to-collapse veins?

Choose a syringe and butterfly assembly and transfer to an ETS tube.

A phlebotomist collects multiple specimens on a premature infant. Which of the following is a possible result of the procedure?

Iatrogenic anemia. This disease is caused by too much blood loss from testing, and clearing of lines.

Why is it important to place a specimen in a biohazard specimen bag when transporting to an outside laboratory?

The biohazard bag prevents a possible exposure incident

The phlebotomist should examine the antecubital veins of both arms for which of the following reasons?

The median cubital vein could be more accessible on one side than the other.

When should a phlebotomist perform external liquid controls for quality control on a CLIA-waived point of care test?

When a new lot number or kit is opened.

Which of the following is a potential consequence of mislabeling a blood bank specimen?

A transfusion reaction. Could cause a fatal transfusion.

Which of the following actions would result in a grossly hemolyzed specimen?

An incorrect needle gauge. A large-guage needle indicates a smaller lumen, which causes hemolysis.

Upon entering a patient's room for a routine blood draw, a phlebotomist notices a clergy member is with the patient. The phlebotomist should...

return after drawing other patients if it isn't a STAT test.

A patient states that this is his first blood draw. Which of the following actions is appropriate?

Describe the procedure

When alcohol is used to cleanse the veipuncture site, it must be allowed to air dry prior to the venipuncture because alcohol...

requires time for antiseptic action

A phlebotomist must centrifuge a serum specimen before shipment to an outside reference laboratory because...

cells must be separated from the serum. If not the cells continue to metabolize into the serum.

The phlebotomist needs to draw a glucose tolerance test (GTT) on a patient and notices an empty breakfast plate on the bedside table. Which of the following actions should the phlebotomist take?

Ask the patient when she last ate or drank

Some older-adult or obese patients may not have accessible antecubital veins. In this situation, the phlebotomist may use which of the following?

Dorsal veins (veins on the back of the hand)

While a phlebotomist is performing a venipuncture, the patient begins to seize. Which of the following is an appropriate action for the phlebotomist to take?

Discontinue the draw.

A phlebotomist is educating a patient about the proper at-home collection procedure for a semen specimen. Which of the following statements indicates the patient understands the teaching?

"I will collect the specimen in a sterile container and return with 1 hr."

During venipuncture, the phlebotomist is stuck with a used needle. Which of the following is the first action the phlebotomist should take?

Flush the injured area with running water

During a draw, the patient becomes unresponsive. What is the next action the phlebotomist should take?

Check for breathing

Which of the following statements by a phlebotomist regarding skin preparation for blood cultures is appropriate?

"I will cleanse the area with povidone iodine"

A phlebotomist sees a coworker receive a major electrical shock from an instrument. Which of the following is the first thing the phlebotomist must do.

Shut off power to the instrument

Which of the following identifies a specimen as long as it remains in the laboratory?

Accession number. This is the number which identifies the specimen as long as it remains in the laboratory.

The phlebotomist draws a CBC at the physician's office at 1800. The laboratory closed at 1730 and will not process specimens again until 0500. Which of the following is the proper temperature for preserving the specimen?

2-10 degrees C

Phlebotomists must comply with which of the following OSHA requirements specific to the venipuncture procedure?

Wear gloves when contact with blood is anticipated.

A phlebotomist is required to obtain which of the following from a potential blood donor?

Complete medical history

A phlebotomist should comply with HIPAA to protect which of the following

Patient's information

When performing a venipuncture on a patient of average weight, which of the following is a correct technique for needle insertion?

Insert until a change in resistance

What action should the phlebotomist take to verify the quality of veipuncture supplies before beginning a blood draw on an adult patient?

Inspect the integrity of the needle's seal

Which of the following actions is appropriate for preparing a peripheral blood smear?

Place a 1mm drop of blood a half-inch from the edge of the slide

Which of the following tubes should be collected first for dermal samples?

Lavender top, this minimizes the platelet clumping and microclot formation.

Which of the following is the proper procedure after collecting an ammonia specimen?

Place the specimen tube in a icewater slurry

The phlebotomist has a request to collect a routine CBC from a healthy 10-month-old infant. Which of the following is the most appropriate collection site?

Either heel. For children under 12 months

When performing an evacuated tube system (ETS) venipuncture, a phlebotomist should...

position the needle in the same direction as the vein and at a 30 degree agnle with the bevel up.

Why should a phlebotomist avoid drawing blood from the leg or foot of a diabetic patient?

These areas are more susceptible to infection

During a routine veipuncture, the patient becomes pale and diaphoretic. What condition is most likely to occur in this patient?

Syncope

Why should the phlebotomist document the total volume of blood drawn from a patient?

To determine if the patient is at risk for developing iatrogenic anemia

The phlebotomist must perform a blood draw on a patient with an IV on the right side, and there has been a mastectomy on the left side. Where should the phlebotomist perform the venipuncture?

Below the IV

Before collecting blood on an inpatient, the phlebotomist notices that the patient does not have a wristband on his wrist, but there is one attached to the patients IV stand. Which of the following is the proper action?

Don't draw until the nurse has attached a wristband to the patient

A patient states she is a difficult draw and requests a skin puncture. The test ordered is a PTT. Which of the following should the phlebotomist perform?

A syringe draw transferred into a light blue Vacutainer

A phlebotomist observes a hematoma developing at the site of a venous blood draw. The phlebotomist should...

release the tourniquet and stop the draw.

Which of the following venipuncture steps are in the appropriate order?

Access the site, cleanse the site, insert the needle

A phlebotomist working in an outpatient facility finds an unconscious patient in the waiting room bleeding profusely from the leg. Which of the following actions should the phlebotomist take first?

Apply direct pressure to the wound.

For which of the following must the phlebotomist follow chain of custody guidelines?

Paternity testing

According to standard precautions, what is the procedure for shipping specimens to a reference laboratory in hot weather?

Place in a box with cold packs and a biohazard label.

Before leaving the patient's room, which of the following actions is required for the phlebotomist to take?

Initial and date/time mark each tube drawn

When preparing for transport, which of the following specimens must be placed into an ice bath within 30 minutes after collection?

Arterial blood gases

Which of the following is the total blood volume of a 3.3kg infant?

240 to 330 ml

WBC, RBC, glucose, and electrolyte tests are ordered for a patient. The phlebotomist is unable to find accessible veins and has determined that it is acceptable to perform a skin puncture. What color tube should be drawn.

Lavender and red

Industry standards states that needle insertion in the antecubital area should be at a

15-30 degree angle

Which of the following questions is most important to ask the patient prior to collecting a metabolic panel?

"When was the last time you ate?"

Which of the following outcomes is the most damaging if data is entered incorrectly into the automated Laboratory Information System?

The incorrect data may be reported to the health care provider

A physician ordered a Tobramycin level to be drawn on hour after dose. The Tobramycin has been ordered for 1100. Which of the following actions should the phlebotomist take?

Check with the nurse to verify the exact time the medication was given.

Tubes with which of the following additives should be used when collecting a sample for a CBC

EDTA

Which of the following statements is an appropriate introduction for a student phlebotomist?

"Hi my name is Sally Smith. I am a student phlebotomist and I'm here to collect a blood specimen."

A patient asks the phlebotomist to please use her finger for the blood work. The phlebotomist can do this if...

the ordered tests can be performed on a capillary specimen.

After placing the tourniquet on a patient's arm, the phlebotomist notices small red spots below the tourniquet. Which of the following is the correct term fro these spots?

Petechiae

A phlebotomist performs a point-of-care glucose test on an outpatient. The result is in the critical value range. Which of the following actions is appropriate?

Report the result to the patient's physician.

Which of the following are appropriate forms of identification in the inpatient setting?

Verbal, wrist band