NHA Exam 4 Questions and Answers

NHA Exam 4 Questions and Answers A phlebotomy technician is planning to collect a sputum specimen from a patient. which of the following instructions should the technician give the patient? a. "Rinse your mouth with mouthwash before we collect the specimen." b. "Gargle some water before we collect the specimen." c. "Leave your dentures in during specimen collection.'' d. "Breathe deeply and then cough up a specimen into te container. d. "Breathe deeply and then cough up a specimen into te container." The technician should instruct the patient to breathe deeply and then cough up a specimen into the container. This increases the chances for obtaining a quality sputum specimen rather than saliva. To prevent hospital-acquired infections, a phlebotomy technician shoud clean items that have been contaminated by blood with a 1:10 dilution of which of the following substances and water? a. Hydrogen peroxide b. Isopropyl alcohol c. Sodium hypochlorite d. Benzalkonium chloride c. Sodium hypochlorite The technician should use benzalkonium chloride as an antiseptic for skin, not as a disinfectant for items that are contaminated by blood. A phlebotomy technician is preparing to collect a blood specimen from a patient who signed a general informed consent form upon admission to the facility. Which of the following actions by the patient indicates implied consent for the venipuncture? a. Rolling up his shirtsleeve b. Asking about the technician's experience c. Expressing apprehension about the procedure d. Saying he needs to make sure his provider wants these tests. a. Rolling up his shirtsleeve The technician should identify that the patient is giving implied consent to the procedure when the patient rolls up his shirtsleeve or holds out his arm. A phlebotomy technician should select a tube that has which of the following additives when collecting a blood specimen for a CBC? a. SST b. EDTA c. Lithium heparin d. Sodium citrate b. EDTA The technician should use a collection tube that contains EDTA when collecting a specimen for a CBC. Which of the following test results are affected when a phlebotomy technician uses povidone-lodine to cleanse a site for a dermal puncture? a. Glucose b. Blood urea nitrogen c. Potassium d. Coagulation studies c. Potassium Povidone-iodine is contraindicated for potassium tests because it can cause a false elevation of potassium in a specimen. A phlebotomy technician should transport a semen sample at which of the following temperatures? a. -20° to -10° C b. 21° to 23° C c. 25° to 30° C d. 36° to 38° C d. 36° to 38° C The technician should identify that semen samples should be stored and transported at 37° C (98.6° F). A phlebotomy technician is preparing to draw blood from a patient in an inpatient setting. The patient extends his arm and turns his head away. This action by the patient is an example of which of the following types of consent? a. Informed consent b. Implied consent c. Refusal of consent d. Expressed consent b. Implied consent By extending his arm to the technician, the patient is giving implied consent. A phlebotomy technician is transporting blood specimens to a laboratory. Which of the following actions should the technician take? a. Place the specimens in a specimen collection tray. b. Place the specimens in the trunk of a car. c. Place the specimens in a lockable container. d. Place the specimens near an air-conditioning vent in a car. c. Place the specimens in a lockable container. The technician should place the specimens in a lockable container to avoid spills during transportation. A phlebotomy technician is preparing to draw a peak Level tor a medication that was administered orally to a patient. After verifying when the patient received the medication, how long should the technician wait prior to attempting the draw? a. 30 min after administration b. 2 hr after administration c. 15 min after administration d. 4 hr after administration b. 2 hr after administration The technician should collect a peak level 1 to 2 hr following an oral administration to ensure that the medication is not at a toxic level. A phlebotomy technician is preparing to obtain a blood specimen from a patient for thyroid studies. The technician should select a collection tube that has a top with which of the following colors? a. Speckled b. Gray c. Green d. Light blue a. Speckled The technician should select a collection tube that has a speckled top when collecting a specimen for thyroid studies (T3, T4, and thyroid-stimulating hormone). A phlebotomy technician is collecting capillary blood drops on a filter paper card to screen a newborn for phenylketonuria. Which of the following actions should the technician take? a. Apply blood to the printed side of the filter paper. B. Add a second drop of blood if a circle is not full. c. Touch the puncture site to the filter paper. d. Allow the blood spots to dry for a minimum of 2hr a. Apply blood to the printed side of the filter paper. The technician should only apply blood drops to the printed side of the filter paper. 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? a. 1.8/mm3 b. 4.6/mm3 c. 7.4/mm3 d. 10.8/mm3 a. 1.8/mm3 The technician should immediately report a finding of 1.8/mm3 to the provider, because this finding is outside the expected reference range of 4.4 to 11/mm3 for white hood cels A phlebotomy technician is preparing a peripheral blood smear from a patient's capillary blood. which of the following actions should the technician take? a. Select the patient's index finger for the capillary blood draw. b. Use the second drop of blood that emerges from ine puncture. c. Position the puncture device so it cuts along the lines of the fingerprint. d. Touch the slide to the blood at least 3.8 cm (1.5 in) from the end of the slide. b. Use the second drop of blood that emerges from ine puncture. The technician should use the second drop of blood that emerges from the puncture to ensure accurate results. Which of the following is the best method for a phlebotomy technician to collect a blood specimen from an older adult patient who has fragile, easy-to-collapse veins? a. Choose a butterfly assembly using a regular ETS tube. b. Choose a butterfly assembly and use a pediatric tube. c. Choose a syringe and butterfly assembly and transfer to an ETS tube. d. Choose a pediatric tube assembly and a regular ETS tube. c. Choose a syringe and butterfly assembly and transfer to an ETS tube. The technician should identify that a syringe minimizes pressure on fragile veins and helps prevent collapsing. How frequently should a phlebotomy technician perform a quality control test on a glucometer in the laboratory? a. Every month the meter is used b. Every week the meter is used c. Every day the meter is used d. Every 6 months the meter is used c. Every day the meter is used The technician should perform quality control testing on a glucometer every day the glucometer is used to guarantee tat reaaines are accurate ana consistent. A phlebotomy technician is following the Clinical and Laboratory Standards Institute's (CLSI) clinical laboratory workflow pathway. As part of the postexamination phase of this process, which of the following actions should the technician take? a. Process the specimen. b. RevIew and verity results c. Provide post-puncture care. d. Enter critical laboratory data. d. Enter critical laboratory data. Entering critical laboratory data is part of the post-examination phase of the CLSI clinical laboratory workflow pathway. A phlebotomy technician should comply with HIPAA to protect which of the following? a. Patients' consent b. Patients' standards c. Patients' information d. Patients' compliance c. Patients' information HIPAA, or the Health Insurance Portability and Accountability Act, protects patients' personal health information. Which of the following tubes should a phlebotomy technician collect first when obtaining dermal samples? a. Lavender top b. Green top c. Red top d. Light blue top a. Lavender top The technician should collect the dermal samples using a lavender-topped tube first because this tube minimizes platelet clumping and microclot formation. A phlebotomy technician is reviewing a laboratory requisition before obtaining blood specimens from a patient. The technician should verify that the requisition includes which of the following information? a. The patient's next of kin b. Emergency contact information c. The patient's previous medications d. A specimen identification code d. A specimen identification code Requisitions should include a unique specimen identification code, as well as the patient's identification information, such as the patient's full name and date of birth. A phlebotomy technician is preparing to collect a blood specimen from a patient who had a right-sided mastectomy. Which of the following sites should the technician select? a. Medial cubital vein in the right arm b. Medial cubital vein in the left arm c. Underside of the right wrist d. Underside of the left wrist b. Medial cubital vein in the left arm The technician should use the opposite arm of a mastectomy as a collection site for a blood draw to lessen the risk for lymphedema and infection. For which of the following reasons should a phlebotomy technician centrifuge a serum specimen before transport to an outside reference laboratory? a. Cells must be separated from the serum. b. Cells will hemolyze. c. Platelets must be separated from the serum. d. White blood cell levels will be elevated. a. Cells must be separated from the serum. If the specimen is not centrifuged, the cells continue to metabolize into the serum. Therefore, the technician should centrifuge a serum specimen before transporting it to a laboratory. Which of the following actions is a phlebotomy technician required to take before leaving a patient's room? a. Ask the patient for feedback. b. Alert the nurse that she is leaving. c. Initial and mark the date and time on each tube drawn. d. Initial and mark the date and time on the requisition form. c. Initial and mark the date and time on each tube drawn. The technician should mark each specimen with the date, time, and her initials before leaving the patient's room. A phlebotomy technician should identify that which of the following colors signifies a health hazard in the National Fire Protection Association (NFPA) 704 Marking system? a. Red b. White c. Yellow d. Blue d. Blue A health hazard is signified by the color blue in the NFPA 704 Marking System. A phlebotomy technician has a request to collect a routine CBC from a healthy 10-month-old infant. Which of the following collection sites should the technician select? a. Third finger of either hand b. Median antecubital vein c. Cephalic vein d. Either heel d. Either heel The technician should use a heel stick to collect specimen from infants who are under 1 year of age. Even if there is a well developed vein available. The heel stick is sufficient for collection and causes less trauma. A phlebotomy technician is performing a total cholesterol point-of-care test for a patient. Which of the following findings should the technician immediately report to the provider? a. 300 mg/dl b. 200 mg/dl c. 180 mg/dl d. 140 mg/dl a. 300 mg/dl The technician should identify that a finding of 300 mg/dL is above the reference range of 140 to 200 mg/dL for total cholesterol. The technician should immediately report this finding to the provider. A phlebotomy technician is collecting a blood specimen from a patient to measure the trough level of a medication. The technician should collect the specimen at which of the following times? a. Within 15 min before the patient receives the next dose of medication b. Less than 15 min after the patient receives a dose of the medication c. At least 2 hr after the patient receives a dose of the medication d. Approximately halfway between two doses of the medication a. Within 15 min before the patient receives the next dose of medication The technician should collect the specimen no more than 15 min prior to administration of the next dose of medication. The trough level is the lowest concentration of medication in the patient's blood. According to OSHA standards, which of the following vaccines must employers offer to their phlebotomists at no cost? a. Hepatitis B b. Hepatitis C c. Hepatitis D d. Hepatitis E a. Hepatitis B OSHA requires employers to offer the hepatitis B vaccine to at risk employees within 10 days of hire at no cost to une employee. Which of the following personal protective equipment provides a phlebotomy technician with the best protection when drawing blood from a patient who has active tuberculosis? a. Double gloves b. N95 respirator c. Surgical mask d. Shoe covers b. N95 respirator The technician is required by the CDC to wear an N95 respirator when working with patients who have active tuberculosis. An N95 respirator eliminates all particles in the air that are larger than 0.3 microns. When collecting a routine blood sample, which of the following veins should a phlebotomy technician attempt to draw from first? a. Radial b. Ulnar c. Distal cephalic d. Median cubital d. Median cubital The technician should attempt to draw from the patient's median cubital vein first. The median cubital vein is the preferred vein for routine blood samples because of its location, distance from large nerves, and large size. A phlebotomy technician is preparing to perform a venipuncture on a patient who states, "I faint at the sight of blood." Which of the following positions is optimal for the patient's safety during the procedure? a. Lying in a reclined position b. Standing against the wall c. Sitting upright in a chair d. Leaning on a stool a. Lying in a reclined position The technician should place the patient in an adjustable phlebotomy chair with armrests and a safety bar to prevent patients from falling if they faint. A phlebotomy technician is collecting a blood specimen from a patient who has pneumonia. Besides gloves, which of the following pieces of personal protective equipment should the technician wear? a. Googles b. Gown c. Mask d. N95 respirator c. Mask The technician should wear a mask when collecting a blood specimen from a patient who has pneumonia, which requires droplet precautions. The technician should wear the mask when working within 3 feet of the patent. After placing a tourniquet on a patient's arm, a phlebotomy technician notices small red spots below the tourniquet. Which of the following terms describes these Spots? a. Hemoconcentration b. Edema c. Urticaria d. Petechiae d. Petechiae The technician should identify that the small red spots are called petechiae, which are microcapillary bleeds that are associated with coagulation abnormalities A phlebotomy technician is obtaining a blood specimen from a patient. The patient reports experiencing a sharp, painful, and tingling sensation going down her arm and into her hand. The technician should recognize that which of a. Nerve injury b. Petechiae c. Hematoma d. Hemoconcentration a. Nerve injury The technician should recognize that the patient is experiencing nerve injury, which causes a sharp, painful, and tingling sensation that radiates down the patient's arm. A phlebotomy technician should identify that which of the following is an identifier for a specimen as long as it remains in the laboratory? a. ICD-10 codes b. Accession number c. CPT code d. Medical record number b. Accession number The accession number identifies a specimen as long as it remains in the laboratory. A phlebotomy technician is educating a patient about the at-nome collection of a semen specimen. which of the following statements by the patient indicates an understanding of the procedure? a. " I will collect the specimen in a sterile container and refrigerate it." b. "I will collect the specimen in a sterile container and return it to the lab with in 1 hour." c. "I will collect the specimen in a clean condom and return in 3 hours" d. "I will abstain from ejaculation for 12 hours prior to the test." b. "I will collect the specimen in a sterile container and return it to the lab with in 1 hour." An at-home semen specimen should be collected in a sterile container, kept warm, and delivered to the laboratory within 1 hr. A phlebotomy technician is preparing to obtain a blood specimen from a patient for an erythrocyte sedimentation rate test. The technician should select a collection tube that has a top with which of the following colors? a. Red b. Light green c. Lavender d. Royal blue c. Lavender The technician should select a collection tube that has lavender-colored top when collecting for an erythrocyte sedimentation rate test. A phlebotomy technician receives a chemical splash to his forearm. After removing his contaminated clothing, which of the following is the minimum amount of time the technician should rinse the attected area? a. 3 min b. 5 min c. 10 min d. 15 min d. 15 min The technician should rinse the affected area for a minimum of 15 min after the contaminated clothing has been removal. A phlebotomy technician should identify that the order or draw for capillary collections is ditterent from venipuncture for which of the following reasons? a. The risk of hemoconcentration b. An increased rate of coagulation c. Smaller size of specimens d. Additive cross-contamination b. An increased rate of coagulation Thromboplastin is released when the skin is punctured, causing blood to clot more quickly. Therefore, there is an increased rate of coagulation during capillary collections. According to standard precautions, a phlebotomy technician should take which of the following actions when shipping specimens to a reference laboratory in hot weather? a. Place the specimens in a box with bubble wrap and a biohazard label. b. Place the specimens in a box with cold packs and a biohazard label. c. Place the specimens in a padded envelope with cold packs and a biohazard label. d. Place the specimens in a padded envelope with bubble wrap and a biohazard label. b. Place the specimens in a box with cold packs and a biohazard label. Standard precautions require the technician to transport specimens in an encrosea contamer wit ice packs ana a biohazard label in hot weather. A phlebotomy technician is collecting blood from a patient for donation. The collection bag only fills halfway, and the vein collapses. Which of the following actions should the technician take? a. Mark the collection bag as half full. b. Use a new collection bag to draw a new unit of blood. c. Continue filling the collection bag from an alternate site. d. Combine two separate collection bags to make a whole. b. Use a new collection bag to draw a new unit of blood. The technician should use a new collection bag to draw a new unit of blood. The technician should take this action because collection bags have a specific amount of the additive citrate phosphate dextrose to prevent coagulation. A phlebotomy technician is collecting a blood specimen from a patient. To avoid hemolysis, which of the following precautions should the technician take? a. Leave the tourniquet in place for 90 seconds. b. Ensure the alcohol at the insertion site has dried. c. Shake the tube after filling it with the patient's blood. d. Readjust the needle after insertion. b. Ensure the alcohol at the insertion site has dried. The tecnnician should allow the alcoho at the insertion site to dry completely before performing the blood collection. Which of the following sources for patient identification should a phlebotomy technician use in an inpatient setting? a. Verbal and wristband b. Medical chart and nurse c. Family member and driver's license d. Spiritual advisor and provider a. Verbal and wristband The technician should use a verbal confirmation of the patient's identity and the patient's wristband to identify a patient in an inpatient setting. 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? a. Position the needle at a 45° angle to the skin. b. Insert the needle with the bevel side facing downward. c. Palpate below the puncture site if blood flow is not established d. Push the first collection tube gently into the holder. d. Push the first collection tube gently into the holder. The technician should gently push the first collection tube into the holder to secure the placement of the tube. Which of the following actions should a phlebotomy technician take after collecting an ammonia specimen? a. Protect the specimen tube from light. b. Keep the specimen tube warm. c. Keep the specimen at body temperature. d. Place the specimen tube in an ice-water slurry. d. Place the specimen tube in an ice-water slurry. The technician should place the specimen tube in an ice-water slurry. Chilling the specimen slows down metabolic processes and protects the analytes. When should a phlebotomy technician perform external liquid controls for quality control on a CLIA-waived glucose point-of-care test? a. With every patient b. Every week the test is performed c. When a new lot number or kit is opened d. When a different technician performs the test c. When a new lot number or kit is opened The technician should perform external liquid controls when a new lot number or kit is opened A phlebotomy technician should select a tube that has which of the following anticoagulants to collect a sample for a PT/PTT test? a. EDTA b. Sodium citrate c. Potassium oxalate d. Heparin b. Sodium citrate The technician should use a collection tube that has the anticoagulant sodium citrate to collect a sample for a PT/PTT test. A phlebotomy technician has a requisition form for a series of tests on a patient's serum. The technician should select a collection tube that contains which of the following additives? a. Sodium fluoride b. Thrombin c. Sodium citrate d. Heparin b. Thrombin The technician should use a collection tube that has the additive thrombin, which helps accelerate clotting for serum specimens A phlebotomy technician is preparing to draw blood from a patient's arm and observes a sore at the site where the tourniquet is to be placed. Which of the following actions should the technician take? a. Keep the tourniquet on the patient's arm for 2min b.Use a slip tourniquet. c.Tie the tourniquet over the patient's sleeve. d. Position the tourniquet distal to the antecubital Area c.Tie the tourniquet over the patient's sleeve. The technician should tie the tourniquet over the patient's sleeve to prevent any further damage to the skin A phlebotomy technician is preparing to collect a patient's troponin T level. Which of the following troponin T levels should the technician immediately report to the provider? a. 0.3 mg/ml b. 0.2 mg/ml c. 0.03 mg/ml d. 0.02 mg/ml a. 0.3 mg/ml The technician should identify that a troponin T level of 0.3 ng/mL is above the expected reference range of O to 0.2 ng/mL and is therefore a critical value. The technician should immediately report this finding to the provider. A phlebotomy technician is preparing to perform a venipuncture for a 2-year-old child. The child asks if the blood draw will hurt. Which of the following statements should the technician make? a. "This will not hurt at all." b. "This will go quickly." c. "You will feel a small prick." d. "You have no reason to worry." c. "You will feel a small prick." The technician should be honest with the child and explain that a small pricking sensation is expected. Which of the following actions should a phlebotomy technician take to locate a vein using the warming technique? a. Heat a clean towel to 45° C (113° F). b. Wrap the warm towel around the site for 1 to 2 min c. Encase the warm towel in a plastic bag. d. Ask the patient to rinse her hands in warm water for 2 min. c. Encase the warm towel in a plastic bag. The technician should encase the warm towel in a plastic bag to maintain the towel's temperature and to keep the patient's skin dry. A phlebotomy technician is preparing to collect a vancomycin peak level for a patient in an inpatient setting. Which of the following actions should the technician take prior to collecting the blood specimen? a. Ask the patient when he received his last dose of vancomycin b. Ask the attending nurse if the patient's vancomycin dose schedule is accurate. c. Ask the pharmacist when the next dose of vancomycin is scheduled for the patient. d. Ask the provider if the patient has received his dose of vancomvcin. b. Ask the attending nurse if the patient's vancomycin dose schedule is accurate. The technician should ask the attending nurse if the patient's vancomycin dose schedule is accurate prior to collection. This action ensures an accurate peak level for therapeutic medication monitoring. A phlebotomy technician is collecting a blood specimen from a patient who has cutaneous diphtheria. Besides gloves, which of the following pieces of personal protective equipment should the technician wear? a. Mask b. Gown c. Googles d. N95 respirator b. Gown The technician should wear a gown to protect the skin from infections that can be transmitted by contact. Because cutaneous diphtheria Is spread through contact, the technician should wear a gown. Prior to transport, which of the following specimens should a phlebotomy technician place in an ice bath within 30 min after collection? a. Arterial blood gas b. Cold agglutinin c. Cryoglobulin d. Blood culture a. Arterial blood gas The technician should immediately place an ABG specimen in an ice bath to stop the metabolic activity of the red blood cells for delivery to the laboratory. A phlebotomy technician is removing his gloves after a venipuncture procedure. Which of the following actions should the technician take? a. Grasp the tips of the fingers of one glove with the other gloved hand. b. Remove the first glove so that it turns inside out during removal. c. Discard the first glove before removing the second glove. d. Turn the gloves right side out before discarding them. b. Remove the first glove so that it turns inside out during removal. When removing gloves, the technician should turn the first glove inside out during removal to decrease chances o contact wit blood. A phlebotomy technician has a requisition form to pertorm a chromosome analysis for a patient. The technician should select a collection tube that contains which of the following additives? a. Sodium polyanethol sulfonate b. Thrombin c. Sodium citrate d. Heparin d. Heparin The technician should use a collection tube that contains the additive heparin, which is an anticoagulant that produces a plasma specimen for chromosome analysis.