NHA test review

1.A phlebotomy technician is washing her hands at the beginning of her shift. WHich of the following actions should the technician take?

Answer: Use enough soap to foam lather

Explanation: The technician should form a lather by rubbing her hands together for at least 15 seconds covering all surfaces of her hands and fingers with soap

2. Which of the following test results are affected when a phlebotomy technician uses povidone iodine to cleanse a site for a dermal puncture?

Answer: Potassium

Explanation: Povidone iodine is contraindicated for potassium tests because it can cause false elevation of potassium levels in specimen

3 A phlebotomy technician is removing his gloves after a venipuncture procedure. WHich of the following actions should the technician take?

Answer: Remove the first gloves

Explanation: When removing gloves, the technician should turn the first glove inside out during removal to decrease chances of blood

4.A phlebotomy technician is preparing to dispose of contaminated sharps. According to OSHA standards, which of the following actions should the technician take?

Answer: Replace the sharps container when two thirds full

Explanation: According to OSHA standards the technician should replace the sharps container when its two thirds full.

5 A phlebotomy technician is preparing to perform a fingerstick for a patient. WHich of the following actions should the technician take first?

Answer: Confirm the identity of the patient

Explanation:The technician should identify the patient prior to performing any other steps of the procedure.

6. For which of the following procedures should the phlebotomy technician follow chain of custody guidelines.

Answer: paternity testing

Explanation: Chain of custody guidelines apply to drug screenings, forensic studies, blood alcohol tests and paternity testing

7 After exiting a patient's room which of the following is the last piece of personal protective equipment(PPE) a phlebotomy technician should remove?

Answer: Mask

Explanation; When removing PPE, the technician should first remove the gloves, then the goggles, and the gown. The mask is the last piece of PPE the technician should remove before or after exiting the patient’s room, depending on the isolation reason.

8 After verifying a patient’s identity, a phlebotomy technician sees that the patient’s labarotory results are ready. WHich of the following actions should the technician take?

Answer: Inform the patient to conatct the ordering provider

Explanation: Only the ordering provider can discuss laboratory resulta with patient. The technician should instruct the patient to contact the provider to obtain the laboratory results.

9 A phlebotomy technician should comply with HIPAA to protect which of the following

Answer: Patients’ information

Explanation: HIPAA or the health insurance portability and accountability act, protects patients’ personal health information

10 A phlebotomy technician should select a tube that has which of the following anticoagulant to collect a sample of PT/PTT

Answer: sodium citrate

Explanation: The technician should use a collection that has the anticoagulant sodium citrate to collect a sample for the PT/PTT

11 A phlebotomy technician is using an evacuated needle holder and blood collection tubes to collect blood from a patient. Which of the following actions should the technician take?

Answer: Push the first collection tube gently into the holder

Explanation: The technician should gently push the first collection tube into the holder to secure the placement tube.

12  A phlebotomy technician is disposing of used supplies when he accidentally receives a needlestick injury. According to OSHA guidelines which of the following actions should the technician take first?

Answer:Wash the puncture site with water

Explanation: The first step the technician should take after a receiving a needlestick injury to decontaminate the puncture site by washing it with soap and water for 30 seconds 

13 A phlebotomy technician is preparing to draw blood for a patient in an inpatient setting. The patient extends his armand turns his head away this action by the patient is an example of which of the following types of consent?

Answer: Implied consent

Explanation: By extending his arm to the technician, the patient is giving implied consent.

14 When should a phlebotomy technician perform external liquids controls quality control CLIA- waived glucose point of care? 

Answer: When a new lot number or kit is opened 

Explanation: The technician should perform external liquids controls when a new lot or kit is opened]

15 A phlebotomy technician is performing a venipunture for a patient who begins to seize. WHich of the following actions should the technician take?

Answer: Discontinue draw

Explanation: During a seizure, it is important for the technician to discontinue the draw and protect the patient from self-injury.

16. Which of the following tubes should a phlebotomy technician collect first when obtaining samples?

Answer; lavender

Explanation: The technician should collect the dermal samples using lavender topped tube first because this tube minimizes platelet clumping and microclot formation

17 A phlebotomy technician is preparing to draw a peak level for a medication that was administered orally to a patient. After verifying when the patient received the medication. Howl ong should the technician wait prior to attempting the draw 

Answer: 2 hr after administration.

Explanation: The technician should collect a peak level 1-2hr following an oral administration to ensure that the medication is not at a toxic level. 

18 Which of the following actions is a phlebotomy technician required to take before leaving the patient’s room

Answer: Initial and mark the date and time on each tube drawn

Explanation: The technician should mark each specimen with the date, time, and her initials before leaving the patient’s room

19 How frequently should a phlebotomy technician perform a quality control test on a glucometer in the laboratory?

Answer: Everyday the meter is used

Explanation: The technician should perform quality control testing on a glucometer everyday the glucometer everyday the glucometer is used to guarantee that readings are accurate and consistent

20 A phlebotomy technician is assembling the equipment he will need for collecting donor units of blood. Which of the following needle sizes should the technician select?

Answer: 18- gauge

Explanation: The technician should select an 18-gauge needle for the collection of donor units of blood. And 21-23 for laboratory assays(regular needles)

21 A phlebotomy technician is preparing a patient for a routine venipuncture. Which of the following antiseptic solutions should the technician use?

Answer: Isopropyl alcohol

Explanation: The technician should use isopropyl alcohol to decontaminate the puncture site during a routine venipuncture.

22 A phlebotomy technician is reviewing a laboratory requisition before obtaining blood specimens for a patient. The technician should verify that the requisition includes which of the following informations?

A specimen identification code. Requisitions should include a unique identification code , as well as the patient's identification information, such as the patient' full name and date of birth.

23.  A phlebotomy technician is selecting a site to collect a blood specimen from a patient . After applying a tourniquet, the technician sees no apparent vein to use for the venipuncture. Which of the following actions should the technician take?

Have the patient dangle her arm for 1 to 2 min. The tech should ask the patient to dangle her arm for 1 to 2 min for the veins to be filled to capacity with blood.

24. After placing a tourniquet on a patient's arm , a phlebotomy tech notices small red spots below the tourniquet . Which of the following describes these spots.

Petechiae.

25. A phlebotomy technician is collecting a urine specimen from a patient for a pre-employment drug test. Which of the following actions should the tech take?

Verify that the specimen contains at least 45 mL of urine. This amount allows for 30mL to be put in one specimen bottle and 15mL to be put in another bottle.

26.  A phlebotomy technician is preparing to collect a blood specimen who had a right-sded mastectomy. Which of the following sites should the technician select?

Medial cubital vein in the left arm. The tech should use the opposite arm of a mastectomy as a collection site for a blood draw to lessen the risk for lymphedema and infection.

1. A phlebotomy technician is using a point of care test system to determine a patient's WBC count. For which of the following results should the technician immediately notify the provider?

Answer: 1.8

Explanation: The tech should immediately report of 1.8mm^3 to the provider because this finding is outside the expected range of 4.4  to 11/mm^3 for white blood cells

2. A phlebotomy technician is preparing a peripheral blood smear from a patient’s capillary blood. Which of the following actions should the technician take?

Answer: Use the second drop of blood that emerges from the puncture 

Explanation: The technician should use the second drop of blood but emerges from the puncture to ensure accurate results.

The technician should use 1n 18 gauge needle for donor units( the smaller the number the bigger the tube)

The specimen identification code can be found in the requisition form

When looking for vein use blood pressure cuff at 40 and have the patient dangle their arm for 1 to 2 minutes

The tech should tie the tourniquet on the patients sleeve to cause less damage to the skin.

When collection fills halfway use a new collection bag to draw a new unit of blood.

The technician should encase the warm towel in a plastic bag for 3-5 mins to warm the area to make the veins more visible.

White blood count should be in the range 4.4-11m

PT/PTT(prothrombin time) tests are for sodium citrate 

The accession number identifies a specimen as long as it remains in the laboratory.

Taking off: gloves, goggles, gown, mask

Putting on:

For series of test regarding patient serum the tech should use the additive thrombin which help accelerate clotting for serum specimens

Thyroid is speckled tube

Ice slurry ( ammonia, lactic acid, arterial blood gas)

Povidone iodine can false elevate potassium levels 

Heparin is the additive you should use to perform a chromosome analysis for a patient.

Entering critical laboratory data is part of the post-examination phase of the CLSI clinical laboratory workflow pathway 

The phlebotomist should take the trough level of the medication within 15 minutes before the next dose of medicine is administered.

Newborn weighing 3kg(6.6) the maximum blood volume the technician can take would 

3 x 100= 300   300 x .01= 3ml

The semen should be transported at 37 C ( 98.6 F) AkA body temperature

Capillary collection has an increased rate of coagulation 

To avoid hemolysis ensure the alcohol at the insertion site has dried 

A phlebotomy wedge is used to stabilize the patient’s arm.

The troponin levels should in the range of 0 to 0.2ng/ml

When a patient's vein is inaccessible use the capillary( For erythrocyte tests you cannot do a capillary collection)

During a routine chemistry test that requires serum use a SST- serum separator tube

A health hazard sign is signified by the color blue in the NFPA 704 marking system

• Yellow- instability 

• Red - A fire hazard 

• Green - Indicates the presence of specific health hazards, such as corrosiveness or other toxic effectsthat may affect individuals in the vicinity.

  1. A phlebotomy technician is preparing to collect a blood specimen from a small vein of an older adult. They should use a small needle 

  2. I am preparing to collect a blood specimen from a patient who is allergic to alcohol. Which of the following antiseptic solutions should the technician use to prepare the insertion  ( chlorhexidine. ) 

  3. Which of the following actions should a phlebotomy technician take to maintain compliance with Hipaa?
     Clear phone numbers from the fax machine 

  4. I am using a glucose monitor for point of care testing use 130 mg/dL. 

  5. I am applying a tourniquet prior to collecting a blood specimen from a patient. WHich of the following actions should the technician take? Tuck a partial loop of tourniquet underneath the tourniquet.

  6. I have a requisition form for a series of tests on a patient’s serum. I should select a collection tube that contains Thrombin because it helps accelerate clotting for serum specimens. 

  7.  I am using the syringe method to obtain a blood culture specimen from an adult patient. WHich of the following actions should I take? Withdraw the blood into a sterile safety syringe. ( the technician should withdraw the blood into a sterile safety syringe after obtaining a blood culture specimen from an adult patient. 

  8. I am interviewing a patient before performing a venipuncture. During the interview the patient states that he lives nearby and ran to the facility to “ get in some running time today. WHich of the following precautionary actions should the technician take?  Have the patient rest comfortably for at least 15 min before the venipuncture. Because strenuous exercise affects coagulation, the technician should have the patient rest 15 to 30 min before performing the venipuncture.

  9. A phlebotomy technician is performing a venipuncture using a winged infusion set. The red topped tube fill but the light blue topped tube slows and does not fill completely. Which of the following action should the phlebotomist take? Correct Answer: Insert a new light blue topped tube to see if it will

  10.  For a patient who has fragile easy to collapse veins- choose syringe and butterfly assembly to transfer it to the ETS tube

  11. when using an evacuated needle holder and blood collection tubes to collect blood from a patient. Push the first collection tube gently into the holder

  12. For Point of care test system for patient WBC the range is expected to be 4.4 to 11mm^3

  13. For the total cholesterol point of care test the reference range is 140 to 200 mg/dL.

  14. When a patient extends his arm and turns his head away that is called implied consent.

  15. You should examine the antecubital on both arms to look for more accessible veins

  16. When shipping specimens in hot weather, transport them in a box with cold packs in a biohazard label.

  17. When collecting capillary blood on a filter paper card for a newborn apply blood to the printed side of the filter paper and do not touch the puncture site to the paper

  18. When collection urine culture test and sensitivity test the type of urine collection is mid stream(first morning- pregnancy test, Random- routine urine analysis testing, Timed urine collection- -laboratory studies such as hormones.

  19. For erythrocyte sedimentation rate test use a lavender tube tests- ( for red tube topped- drug level test)

  20. Ammonia- ice slurry, bilirubin- photosynthesive , semen body temp

  21. Outpatient or inpatient  wear gloves at all time 

  22. When collecting thyroid studies choose speckled because its a hormone. Green tube- potassium test, lactic acid is grey.

  23. For routine venipuncture use isopropyl alcohol as an antiseptic.

  24. The first step in the blood collection procedure is to have the requisition form

  25. When accidentally receives a needlestick wash area for 30 seconds with soap and water.

  26. Arterial blood gas needs to take a bath in an ice bath 30 minutes after the collection.