NHA Phlebotomy Exam..docx

OSHA - correct answer Establishes regulations and guidelines to direct phlebotomists to work at the highest level of safety possible when handling bio hazards and chemicals. The blood borne pathogens standard (OSHA) - correct answer - addresses use of PPE - availability to the Hep B immunization - Each workplace must have a exposure control plan - has guidelines to ensure safety - provides standard plans for after an exposure. - engineering controls and record keeping protocols PPE for venipuncture and capillary (OSHA) - correct answer well fitting gloves Airborne infection PPE (OSHA) - correct answer N99 or N95 mask What do you do when you have an accidental needle stick? (OSHA) - correct answer First you wash the area with soap and water (basic first aid), then undergo medical examination that includes you and the patient get tested for HIV, HBV and HCV. Then document the exposure in sharps injury log. What do you include in a sharps injury log? (OSHA) - correct answer date and time of incident, type of sharps used, who was involved (patient or staff w/o names), location and a detailed description of how it occurred. What is the joint commission? - correct answer - accredits and certifies healthcare organizations - independent, nongovernmental, and nonprofit - focuses on continual improvement of patient safety and quality of care through regulations and standards The national patient safety goals program (JC) - correct answer sets requirements for issues including training of health care professionals, communication of test results, and accurate IDs (2-factor method) Clinical and Laboratory Standards Institute (CLSI) - correct answer -develops standards and guidelines in order for a laboratory to be accredited - provides guidelines for phlebotomists for better accuracy and patient care (like for the use of tubes and needles). standards include level of additives and their use for which tests, order of draw, processing and handling, depth of needle and location needed for capillary collection - provides guidelines for quality control, patient care, risk reductions, and time saving and cost cutting measures. Centers for Disease Control and Prevention (CDC) - correct answer - helps ID and and educate about infections, illnesses and disease preventions. - IDs new disease and works to prevent spreads - Provides guidelines for PPE sharps handling and hand hygiene - recommends standard precautions when handling body fluids HIPPA - correct answer - Protects every patients PHI (protected health info) which is any and all info that relates to the patients medical record or electronic health record. - details what info is confidential and any authorized release of that info Info protected under HIPPA - correct answer demographic info, treatment, meds, diagnostic testing. Any info w/o a way to ID the patient is not protected When is the phlebotomist responsible for the patient? - correct answer Before, during and immediately after venipuncture What happens if you go through with the venipuncture without consent? - correct answer It would be considered assult Techniques to find a vein - correct answer warming the area, wiping it with an alcohol wipe, and lowering the limb below the level of the patients heart Why do phlebotomists avoid the wrist? - correct answer potential ulnar nerve damage or inadvertent arterial access Why is the basilic vein the least desirable for venipuncture? - correct answer it is close to the brachial artery and it is most painful Why would a phlebotomist avoid the legs and feet of a patient who has diabetes mellitus? - correct answer To prevent possible infection What do you do if a hematoma develops? - correct answer Stop the procedure What do you do if the patient shows early signs of a seizure or syncope? - correct answer You immediately stop the procedure and lie them on the floor or in their bed. Give them a cold compress and stay with them until they recover Quality control - correct answer a measure of precision or of how well an instrument is functioning over time Quality assurance - correct answer ensuring a test is as accurate as possible What do you write in the equipment log - correct answer The time and date you ran a quality control test and the results of the test How often should you clean lab equipment? - correct answer several times per day Why would a centrifuge be shaking excessively? - correct answer The tubes need to be about the same size and volume. The tubes also have to be placed directly across from each other What could happen if the centrifuge shakes too much - correct answer tube breakage or improper centrifuging What do you do if a piece of equipment is not working correctly or at all? - correct answer Make a repair report (state the date, description of issue, and the steps you took to try to fix the problem) How can you ensure quality control when using glucometers? - correct answer Use of external controls, matching test strip codes and reviewing expiration dates When do you use external controls when using a glucometer? - correct answer - when opening a new package of strips and each day you preform a test - drastically out of range readings - use at room temp and not past expiration date What step should the phlebotomist take after seeing 2 widely divergent test results in a glucometer? - correct answer Preform liquid controls (running controls will help to troubleshoot the problem) What should the phlebotomist do about the defective glucometer strips? - correct answer Contact the manufacturer and follow instructions for sending back the strips While collecting a blood specimen, a phlebotomist notices the glass collection tube is cracked. What would be the correct action? - correct answer dispose of the tube in a sharps container A phlebotomist is taking blood from a patient with a MRSA infected wound, what should they do once once the procedure is done? - correct answer Dispose of their gown before leaving the room A phlebotomist is performing a blood alcohol test. What antiseptic should they use? - correct answer Chlorhexidine gluconate (ethanol, iodine tincture and isopropyl alcohol all has alcohol in it and would skew the results) If a centrifuge where to catch on fire, which class of fire would it be? - correct answer Class C (it involves electrical equipment) What is the current procedure for CPR on an infant? - correct answer 30 compressions, 1.5 in deep (using 2 fingers) What piece of PPE should a phlebotomist remove first after a draw in an isolation room? - correct answer gloves (the most contaminated piece of PPE first) A phlebotomist gets a very large glucometer reading the first try and then is back in the normal range the second reading. What could have caused the first inaccurate reading? - correct answer too much blood was used A phlebotomist comes in the get another set of blood for a GTT (glucose tolerance test) and the patient starts to cry and doesn't comply. What statement should you say? - correct answer May I please perform the draw? A GTT requires multiple timed draws at set intervals. What department is responsible for processing cholesterol, troponin, and HDL tests? - correct answer Chemistry (body chemistry) What substance is used to clean a cerebral spinal specimen spill? - correct answer Chlorine bleach (1:10 bleach to water) What pieces of PPE are minimum requirements to wear for aliquoting a blood specimen? - correct answer face shield and gloves