NHA Phlebotomy Exam 2023 A+
OSHA - ANS-Establishes regulations and guidelines to direct phlebotomists to work at
the highest level of safety possible
... [Show More] when handling bio hazards and chemicals.
The blood borne pathogens standard (OSHA) - ANS-- 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) - ANS-well fitting gloves
Airborne infection PPE (OSHA) - ANS-N99 or N95 mask
What do you do when you have an accidental needle stick? (OSHA) - ANS-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) - ANS-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? - ANS-- 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) - ANS-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) - ANS--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) - ANS-- 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 - ANS-- 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 - ANS-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? - ANS-Before, during and
immediately after venipuncture
What happens if you go through with the venipuncture without consent? - ANS-It would
be considered assult
Techniques to find a vein - ANS-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? - ANS-potential ulnar nerve damage or
inadvertent arterial access
Why is the basilic vein the least desirable for venipuncture? - ANS-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? - ANS-To prevent possible infection
What do you do if a hematoma develops? - ANS-Stop the procedure
What do you do if the patient shows early signs of a seizure or syncope? - ANS-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 - ANS-a measure of precision or of how well an instrument is functioning
over time
Quality assurance - ANS-ensuring a test is as accurate as possible
What do you write in the equipment log - ANS-The time and date you ran a quality
control test and the results of the test
How often should you clean lab equipment? - ANS-several times per day
Why would a centrifuge be shaking excessively? - ANS-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 - ANS-tube breakage or improper
centrifuging
What do you do if a piece of equipment is not working correctly or at all? - ANS-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? - ANS-Use of external
controls, matching test strip codes and reviewing expiration dates
When do you use external controls when using a glucometer? - ANS-- 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? - ANS-Preform liquid controls (running controls will help to troubleshoot the
problem)
What should the phlebotomist do about the defective glucometer strips? - ANS-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? - ANS-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? - ANS-Dispose of their gown before leaving
the room
A phlebotomist is performing a blood alcohol test. What antiseptic should they use? -
ANS-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? - ANS-Class C (it
involves electrical equipment)
What is the current procedure for CPR on an infant? - ANS-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?
- ANS-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?
- ANS-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? -
ANS-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? -
ANS-Chemistry (body chemistry)
What substance is used to clean a cerebral spinal specimen spill? - ANS-Chlorine
bleach (1:10 bleach to water)
What pieces of PPE are minimum requirements to wear for aliquoting a blood
specimen? - ANS-face shield and gloves
What pathogen is the phlebotomist at most risk for in the case of an accidental needle
stick? - ANS-Hepatitis B virus (HBV)
Who can order lab tests? - ANS-Physicians, physician assistants, and nurse
practitioners
What info is on the requisition form? - ANS-- Patients name, DOB, sex, and ID number
- It can also have allergies, tendency to faint, excessive bleeding, and sites to avoid
- it has space for date and time of collection, billing info and diagnostic coding
What would you review the req form for? - ANS-duplicate test orders or missing info
What info needs to be on the tube label if there is no bar code? - ANS-date and time of
collection, your initials, the patients full name, DOB and other identifiers.
What are two identifiers that you can use when IDing the patient? - ANS-patients name,
DOB, home address, phone number, or social (if available)
- compare what they say with the req form
How can you cross check patient identifiers - ANS-you can cross check the patients
drivers license with the req form, or their hospital band. Never use a patients room or
bed number
Exceptions for teenage consent - ANS-married, in the military, emancipated, or
otherwise self supporting
Most common pretesting preparations - ANS-- fasting (8-12 hours not eating or drinking
other than water)
- Medications
- basal state (first thing in the morning or after sleeping)
before the blood collection make sure they completed the requirements
Things to ask the patent before continuing - ANS-allergies, fainting tendencies, blood
thinners, what arm they wish for you the use, current medications, drug and alcohol use
How long after a fainting spell should you stay with them? - ANS-at least 15 minutes
Complications that can occur with venipuncture - ANS-Excessive bleeding or bruising,
severe pain or lack of sensation, and infections
What to do in the case of excessive bleeding - ANS-apply pressure and ice to the site
and call for
What to do in the case of excessive bruising - ANS-apply pressure and ice to the site
and call for
What to do in the case of severe pain or lack of sensation? - ANS-It can indicate nerve
damage. stop the procedure and use ice if available
What to do in the case of infection? - ANS-If the site becomes red, swollen and painful,
they may have infection. Alert the patient to sign of infection and to contact a physician
if they appear
What are acceptable ways to position your patient while taking blood - ANS-- On a bed
(increases comfort and safety if they fall)
- chair with arm rests and adjustable heights
What are some examples of unacceptable ways to potion your patient while taking
blood? - ANS-- standing
- sitting on a high stool
- edge of an examination table
When would you not use a finger for dermal puncture? - ANS-If the finger is:
- cold
- cyanotic (blue)
- scarred
- swollen
- covered in a rash
Where do you collect capillary blood from an infant? - [Show Less]