120 questions/tasks. Use the approved directions below.
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An inpatient cannot communicate. The attached wristband has two identifiers that match the order. The facility requires a nurse to participate in this identification situation. Which plan meets the stated procedure?
☐ A. Use the room assignment because the patient cannot answer
☐ B. Use a relative's verbal assurance instead of checking the band
☐ C. Verify the attached band and order with the nurse before collection
☐ D. Collect first and ask the nurse to confirm the tube labels afterward
Show answer and explanation
Response:C
Final answer:Verify the attached band and order with the nurse before collection
The wristband and order agree on two identifiers, and the facility requires the nurse to participate because this patient cannot answer identification questions. Complete that verification before collection. A room assignment or a relative's assurance alone cannot provide the required patient-to-order check.
Question 2
A technician collects EDTA before a serum tube. The laboratory later suspects additive carryover in the serum sample. Which collection factor should be investigated?
☐ A. Whether the EDTA tube was mixed after it filled
☐ B. Whether the serum was centrifuged at the prescribed force
☐ C. Whether the venous order of draw was followed
☐ D. Whether the serum tube was allowed its full clotting time
Show answer and explanation
Response:C
Final answer:Whether the venous order of draw was followed
EDTA was collected before the serum tube, making the collection sequence the relevant place to investigate suspected additive carryover. Check the order of draw. Clotting time and centrifugation affect serum preparation, but neither explains how EDTA entered that specimen.
Question 3
A safety committee reviews deidentified records of injuries involving a particular collection device. What is the main safety purpose of that review?
☐ A. Identify patterns that can guide safer devices and work practices
☐ B. Estimate infection status from the number of device injuries
☐ C. Replace device evaluation with a count of completed training sessions
☐ D. Determine which injuries can wait for end-of-month clinical review
Show answer and explanation
Response:A
Final answer:Identify patterns that can guide safer devices and work practices
Device-specific injury records help the committee find recurring hazards and assess whether equipment or collection practices need improvement. They guide prevention. Infection status requires clinical evaluation, and reviewing the log never replaces prompt care after an individual injury.
Question 4
A newborn screening specimen will be collected by heel puncture. Which site is appropriate?
☐ A. The center of the plantar arch
☐ B. The posterior curve of the heel
☐ C. A previous puncture that remains bruised
☐ D. The medial or lateral plantar surface of the heel
Show answer and explanation
Response:D
Final answer:The medial or lateral plantar surface of the heel
Use the designated plantar heel surfaces. The medial and lateral areas are the appropriate sites for this newborn collection, with an approved neonatal device and avoidance of the arch, posterior curve, and already bruised punctures.
Question 5
A patient asks whether an abnormal blood result proves a serious illness. Which response stays within the phlebotomy role?
☐ A. Compare the value with a previous result and give a diagnostic opinion
☐ B. Explain that a high flag establishes how severe the illness is
☐ C. Refer interpretation to the treating clinician and help arrange contact
☐ D. Use the reference interval to confirm the suspected diagnosis
Show answer and explanation
Response:C
Final answer:Refer interpretation to the treating clinician and help arrange contact
Interpretation belongs to the treating clinician. Help the patient arrange that contact so the abnormal value can be assessed in its clinical context, including information that a flag or comparison with an earlier result alone cannot supply.
Question 6
The receiving laboratory's bilirubin directory requires an amber submission vial and protection from light. What handling meets that requirement?
☐ A. Keep the serum in a clear vial under ordinary bench lighting
☐ B. Use the amber vial but leave it uncapped during transport
☐ C. Use the required amber vial and maintain light protection
☐ D. Use a clear vial and protect it only on arrival at the laboratory
Show answer and explanation
Response:C
Final answer:Use the required amber vial and maintain light protection
The directory requires both an amber submission vial and continuous light protection, so maintain those conditions during preparation, handling, and transport. Secure the closure as well. Protecting a clear vial only after arrival leaves the earlier light exposure uncontrolled.
Question 7
A paper requisition contains patient identifiers and a clinician signature but no test name. What should the technician do?
☐ A. Select containers from the symptoms listed on the requisition
☐ B. Select tubes from the patient's previous laboratory order
☐ C. Clarify the ordered tests before selecting tubes and collecting
☐ D. Collect the clinic's usual screening panel without clarification
Show answer and explanation
Response:C
Final answer:Clarify the ordered tests before selecting tubes and collecting
The missing test name prevents reliable tube selection even though the requisition contains identifiers and a signature. Clarify the order before drawing. Yesterday's assays, a symptom-based guess, or the clinic's usual panel may require different specimens from those intended today.
Question 8
Blood is visible on the outside of a closed specimen tube. What transport measure is required in addition to following the spill and specimen-acceptance procedures?
☐ A. Remove the patient label so the outside can be wiped quickly
☐ B. Place the primary container in appropriate labeled leakproof secondary containment
☐ C. Wrap it in a paper requisition and hand it to the courier
☐ D. Use an ordinary open tray because the tube's cap is closed
Show answer and explanation
Response:B
Final answer:Place the primary container in appropriate labeled leakproof secondary containment
Use labeled leakproof secondary containment. Blood on the tube's exterior creates a contamination risk during transport, and neither the closed primary cap nor wrapping the tube in its requisition controls that exterior contamination while preserving specimen identity.
Question 9
An alert outpatient states a name that matches the order, but the stated date of birth differs from the order by one day. What should the technician do?
☐ A. Change the date on the order to the patient's statement without verification
☐ B. Pause and resolve the discrepancy through the approved identification process
☐ C. Collect now and ask registration to correct the record later
☐ D. Use the name alone because the difference is small
Show answer and explanation
Response:B
Final answer:Pause and resolve the discrepancy through the approved identification process
The birth-date discrepancy must be resolved through the approved process before the technician can link this patient reliably to the order. Pause collection. Drawing first would leave the specimen's identity uncertain even if registration later corrected the record.
Question 10
A patient taking anticoagulant medication continues to bleed after needle removal. Which action is appropriate?
☐ A. Apply a bandage immediately and ask the patient to leave
☐ B. Ask the patient to bend the elbow tightly instead of applying pressure
☐ C. Maintain direct pressure, reassess the site, and obtain clinical assistance if bleeding persists
☐ D. Massage the puncture to disperse the blood
Show answer and explanation
Response:C
Final answer:Maintain direct pressure, reassess the site, and obtain clinical assistance if bleeding persists
Maintain direct pressure and reassess bleeding. Anticoagulant medication can delay hemostasis, so obtain clinical assistance if the bleeding continues and avoid sending the patient away with an unchecked bandage or trying massage or elbow flexion in place of pressure.
Question 11
Registration finds an existing record with the same name but a different date of birth. The patient is new to this clinic. What should the technician do before creating or selecting the testing account?
☐ A. Create a new record without first resolving the possible duplicate
☐ B. Verify the identifiers and follow the record-matching procedure
☐ C. Select the existing record using the name match alone
☐ D. Replace the existing birth date using the patient's statement alone
Show answer and explanation
Response:B
Final answer:Verify the identifiers and follow the record-matching procedure
A matching name could identify a different person, and changing that record without verification could overwrite another patient's information. Check the identifiers first. The approved record-matching process determines whether the account belongs to this patient or a new account is needed.
Question 12
A valid point-of-care glucose result falls below the facility's critical threshold. The patient is awake, and the result has passed the required checks. What should the technician do?
☐ A. Notify the responsible clinician promptly under the critical-result protocol
☐ B. Wait for a central-laboratory result before initiating the required notification
☐ C. Hold the notification for the next routine result batch
☐ D. Repeat testing until a value falls within the reference interval
Show answer and explanation
Response:A
Final answer:Notify the responsible clinician promptly under the critical-result protocol
Notify the responsible clinician promptly. The result has already passed the required checks and falls below the facility's critical threshold, which activates its reporting pathway even though the patient is awake and a central-laboratory result is not yet available.
Question 13
A technician recognizes a neighbor's name in the laboratory system but has no assigned task involving that record. Which action respects patient privacy?
☐ A. Ask a coworker to check the record on the technician's behalf
☐ B. Open the record but avoid printing any results
☐ C. Open only the diagnosis section because no specimen is being collected
☐ D. Leave the record unopened unless a legitimate work assignment requires access
Show answer and explanation
Response:D
Final answer:Leave the record unopened unless a legitimate work assignment requires access
Leave the neighbor's record unopened. No assigned task authorizes this access, whether the technician views diagnoses only, avoids printing, or asks a coworker to look instead. Workforce access must serve a legitimate work purpose.
Question 14
The facility limits uninterrupted tourniquet application to 1 minute. A vein search reaches that limit before puncture. What should the technician do next?
☐ A. Tighten it slightly and continue looking for a vein
☐ B. Release the tourniquet and follow the procedure before reapplication
☐ C. Keep it applied because puncture has not yet occurred
☐ D. Keep it applied until the first tube is filled
Show answer and explanation
Response:B
Final answer:Release the tourniquet and follow the procedure before reapplication
Release the tourniquet now. The facility's uninterrupted-application limit has been reached during the vein search, so use its reassessment and reapplication procedure before continuing. Keeping it in place until puncture or tube filling would extend that interval.
Question 15
A forensic blood-alcohol kit requires an approved non-alcohol-containing skin preparation. Which supplied agent meets that instruction?
☐ A. A mixed product whose label lists both iodine and alcohol
☐ B. An isopropyl-alcohol pad used for routine venipuncture
☐ C. The clinic's ethanol-based hand antiseptic
☐ D. The kit's labeled aqueous povidone-iodine preparation
Show answer and explanation
Response:D
Final answer:The kit's labeled aqueous povidone-iodine preparation
The kit's aqueous povidone-iodine preparation meets the stated non-alcohol requirement because its labeled formulation is approved for this forensic collection. Check the formulation. A product containing iodine can also contain alcohol, making the mixed product unsuitable under this kit's instructions.
Question 16
A waived-test kit's instructions specify two drops of sample. A coworker routinely uses four to make the window fill faster. What is the technician's best response?
☐ A. Average a two-drop result and a four-drop result
☐ B. Follow the specified volume and report the departure for correction
☐ C. Treat any sample volume as acceptable because the test is waived
☐ D. Use four drops if the result appears clinically reasonable
Show answer and explanation
Response:B
Final answer:Follow the specified volume and report the departure for correction
Use the specified two drops. Waived testing still requires the manufacturer's procedure, and doubling the sample volume to fill the window faster can change test performance. Report the departure so it can be corrected.
Question 17
A patient says, ``I am afraid the needle will hurt.'' Which response best supports the collection explanation?
☐ A. Guarantee no discomfort so the patient can relax
☐ B. List complications before asking which part concerns the patient
☐ C. Acknowledge the concern, explain likely sensations, and ask what would help
☐ D. Continue the equipment setup without discussing the concern
Show answer and explanation
Response:C
Final answer:Acknowledge the concern, explain likely sensations, and ask what would help
An honest description of likely sensations lets the patient prepare for the draw without promising an experience the technician cannot guarantee, and asking what would help gives the patient a useful way to participate. Acknowledge the concern.
Question 18
A new, unprimed winged collection set will be used, and a citrate tube is the first specimen tube. The collection guide requires clearing the tubing's air before the citrate specimen is filled. What is the purpose of the discard tube?
☐ A. Prevent the discard tube additive from entering the citrate tube
☐ B. Increase the blood-to-citrate ratio above the required fill
☐ C. Prevent tubing air from causing an underfilled citrate specimen
☐ D. Replace the need to verify the citrate tube fill line
Show answer and explanation
Response:C
Final answer:Prevent tubing air from causing an underfilled citrate specimen
The discard tube clears tubing air. With an unprimed winged set, that dead space can reduce the blood reaching the first citrate tube and leave it underfilled even after flow stops. The citrate specimen's fill still needs checking.
Question 19
A reagent refrigerator is required to remain at 2--8 degrees C. Its log shows 5 degrees C at opening and 11 degrees C at noon. Which response preserves the quality-control record and reagent safety?
☐ A. Document the excursion and obtain the procedure-directed reagent disposition
☐ B. Assess only the current temperature when releasing the reagents
☐ C. Lower the setting and clear the issue once the next reading is normal
☐ D. Approve the reagents from the acceptable opening temperature alone
Show answer and explanation
Response:A
Final answer:Document the excursion and obtain the procedure-directed reagent disposition
The noon reading exceeds the supplied 2--8-degree range, so document the excursion and follow the procedure for assessing the affected reagents. Earlier compliance does not establish continued suitability. Lowering the refrigerator setting addresses temperature control without deciding reagent disposition.
Question 20
Before routine capillary collection, a technician wipes the first drop away with clean gauze. Which problem does this step primarily reduce?
☐ A. Platelet clumping caused by collecting chemistry before hematology
☐ B. Hemolysis caused by repeated forceful squeezing
☐ C. Tissue fluid and skin debris in the initial drop
☐ D. An incorrect blood-to-additive ratio from underfilling a microtube
Show answer and explanation
Response:C
Final answer:Tissue fluid and skin debris in the initial drop
The first drop may contain tissue fluid and skin debris, which is why routine capillary collection begins by wiping it away with clean gauze. Collect the next suitable drop. Gentle handling, correct tube order, and adequate filling address the other listed specimen-quality problems.
Question 21
A responsive patient falls while leaving the collection chair and reports hip pain. The patient is breathing normally, the area is safe, and the needle has already been discarded. Which response is appropriate?
☐ A. Resume collection once the patient says the dizziness has passed
☐ B. Help the patient stand before requesting an assessment
☐ C. Record the fall only when an external injury is visible
☐ D. Call for assistance and avoid unnecessary movement pending assessment
Show answer and explanation
Response:D
Final answer:Call for assistance and avoid unnecessary movement pending assessment
Keep the patient still pending assessment. The patient is responsive and breathing normally in a safe area, but hip pain after the fall raises concern for an injury. Call for assistance and monitor rather than helping the patient stand or resuming collection.
Question 22
A study specimen must remain between 2 and 8 degrees C during transport. Its logger records a rise above 8 degrees C at 10:05 a.m. and a return to the permitted range at 10:25 a.m. The courier arrives at 10:35 a.m. with the specimen at 6 degrees C. Which entry accurately describes the excursion?
☐ A. A 30-minute excursion, ending when the courier arrived
☐ B. No excursion, because the arrival temperature was 6 degrees C
☐ C. A 20-minute excursion, from 10:05 to 10:25 a.m.
☐ D. A 10-minute excursion, from 10:25 to 10:35 a.m.
Show answer and explanation
Response:C
Final answer:A 20-minute excursion, from 10:05 to 10:25 a.m.
The out-of-range interval began at 10:05 a.m. and ended at 10:25 a.m., giving a 20-minute excursion to enter in the record and assess under the study protocol. Arrival occurred later. The 6-degree arrival reading confirms cooling, not absence of the earlier exposure.
Question 23
An older patient's skin tears easily. A suitable vein has been selected. Which approach best adapts routine collection to this condition?
☐ A. Support the arm and stabilize the skin gently with suitable materials
☐ B. Increase anchoring tension until the skin no longer moves
☐ C. Use the usual approach without adapting for fragile skin
☐ D. Use a stronger adhesive dressing without assessing skin tolerance
Show answer and explanation
Response:A
Final answer:Support the arm and stabilize the skin gently with suitable materials
Fragile skin needs gentle stabilization. Support the arm and adapt anchoring and dressing materials to the assessed condition, because increased tension or a stronger adhesive can damage this patient's skin. An unchanged routine approach fails to make that adaptation.
Question 24
A used glucose meter and unopened lancets are on the same portable tray. What change best protects the clean supplies?
☐ A. Keep unused supplies in a designated clean area separate from used equipment
☐ B. Carry the unused lancets loose in a uniform pocket
☐ C. Put the unopened lancets beneath the used meter to save space
☐ D. Disinfect the outer lancet boxes after every patient instead of separating supplies
Show answer and explanation
Response:A
Final answer:Keep unused supplies in a designated clean area separate from used equipment
Separate clean supplies from used equipment. Move the lancets to their designated clean area because unopened packaging can still be exposed to contamination beneath the used meter, which also retains its own cleaning requirement.
Question 25
A patient has a dialysis fistula in the left arm and a suitable peripheral vein in the right arm. The facility prohibits routine draws from the fistula arm. Which site should be considered first?
☐ A. The left arm if the patient says it was used once previously
☐ B. The fistula itself because it carries more blood
☐ C. A vein next to the fistula to keep both procedures in one arm
☐ D. The suitable right-arm vein
Show answer and explanation
Response:D
Final answer:The suitable right-arm vein
Consider the right-arm vein first. It is suitable and unrestricted, while the stated facility rule excludes the fistula arm for this routine draw. A previous left-arm collection does not override that rule or make a vein beside the fistula an acceptable substitute.
Question 26
A serum tube's instructions require complete clot formation before centrifugation. The specimen is still visibly forming a clot. What should the technician do?
☐ A. Centrifuge immediately and inspect for fibrin only after analysis
☐ B. Transfer the partly clotted sample into an EDTA tube before spinning
☐ C. Allow clot formation to complete before the prescribed centrifugation
☐ D. Invert rapidly until the visible clot breaks apart
Show answer and explanation
Response:C
Final answer:Allow clot formation to complete before the prescribed centrifugation
Wait for complete clot formation. Under these tube instructions, centrifugation follows clotting so serum can be separated properly without the interfering fibrin that premature spinning may leave, while adding EDTA or breaking up a clot changes the requested specimen.
Question 27
A patient is under Contact Precautions. The posted facility instructions require gloves and a gown on entry for specimen collection. Which plan is appropriate?
☐ A. Wear gloves only because blood collection does not involve bathing
☐ B. Enter first and obtain the gown only if clothing touches the bed
☐ C. Add a surgical mask instead of the required gown
☐ D. Perform hand hygiene and don the required gown and gloves before entering
Show answer and explanation
Response:D
Final answer:Perform hand hygiene and don the required gown and gloves before entering
Put on the required gown and gloves before entry, after hand hygiene, because the posted Contact Precautions instructions apply to this collection and its possible contact with the patient's surroundings. Gloves alone are insufficient. Adding a surgical mask still leaves the clothing unprotected and cannot substitute for the required gown.
Question 28
Two unlabeled routine tubes are found after collections from two different patients. Neither specimen can be linked reliably to its source. What is the appropriate response?
☐ A. Follow the rejection and recollection procedure rather than assigning identities by guesswork
☐ B. Ask the courier to attach the most likely labels
☐ C. Use the fill levels to decide which patient provided each tube
☐ D. Assign the tubes based on the order in which patients were seen
Show answer and explanation
Response:A
Final answer:Follow the rejection and recollection procedure rather than assigning identities by guesswork
Neither tube has a reliable identity. Further clarification cannot help unless a trustworthy link to its patient can be established, and guessing from fill level or visit order could attach a result to the wrong person. Apply the rejection and recollection procedure.
Question 29
Which measurement is part of the Red Cross's pre-donation health screening, alongside blood pressure and pulse?
☐ A. Total bilirubin
☐ B. Blood urea nitrogen
☐ C. Serum potassium
☐ D. Hemoglobin
Show answer and explanation
Response:D
Final answer:Hemoglobin
Hemoglobin is the listed screening measurement. The Red Cross checks it alongside blood pressure and pulse to help determine donation eligibility, while the other options name general chemistry measurements and the hemoglobin screen does not directly measure iron stores.
Question 30
A patient has no known bloodborne infection. Which approach should govern the routine venipuncture?
☐ A. Omit gloves if the patient's skin has no visible lesions
☐ B. Use Standard Precautions because blood exposure is possible
☐ C. Use sterile isolation PPE solely because blood is being drawn
☐ D. Use blood-exposure precautions only after a positive infection test
Show answer and explanation
Response:B
Final answer:Use Standard Precautions because blood exposure is possible
Standard Precautions apply to this draw because blood exposure is possible, regardless of whether a bloodborne infection has been diagnosed. Wear task-appropriate protection. Neither visible skin lesions nor a positive infection test is required before using that protection.
Question 31
An outpatient's laboratory order is valid, but the listed insurer no longer matches the patient's current card. The facility requires registration verification before nonurgent testing. What should the technician do?
☐ A. Select the insurer from the previous laboratory appointment
☐ B. Refer for registration verification and document the confirmed update
☐ C. Use the new card number without the required registration verification
☐ D. Retain the old coverage record because the clinical order is valid
Show answer and explanation
Response:B
Final answer:Refer for registration verification and document the confirmed update
Refer the discrepancy to registration. The clinical order establishes the requested testing but does not verify the current insurer, so complete the facility's required coverage check and document the confirmed update before nonurgent testing proceeds.
Question 32
The protective cap is removed from a blood-culture bottle. What should be done with its rubber septum before inoculation?
☐ A. Disinfect the cap and then touch the exposed septum
☐ B. Disinfect the septum and inoculate before it has dried
☐ C. Use the septum directly after removing its protective cap
☐ D. Disinfect the septum and allow the required drying
Show answer and explanation
Response:D
Final answer:Disinfect the septum and allow the required drying
Disinfect the exposed septum with the required agent and let it dry according to the bottle and facility instructions before inoculation. Removing the cap is insufficient. CDC's adult collection guidance specifies 70% isopropyl alcohol for the septum.
Question 33
The collection needle has just been removed. What is the correct next handling of its built-in safety feature?
☐ A. Save activation until the tray is carried to the laboratory
☐ B. Recap with both hands before deciding whether to activate the shield
☐ C. Remove the shield so the needle fits in a smaller waste bag
☐ D. Activate it according to the device instructions and dispose of the device promptly
Show answer and explanation
Response:D
Final answer:Activate it according to the device instructions and dispose of the device promptly
Activate the device's safety feature as instructed immediately after removal, then discard the device promptly into suitable sharps containment. Avoid two-handed recapping. Carrying the exposed needle to another area prolongs the injury risk that the built-in protection is intended to reduce.
Question 34
Which measure is an engineering control used to reduce phlebotomy exposure?
☐ A. A rule prohibiting two-handed recapping
☐ B. A reminder to remove gloves before touching a phone
☐ C. A training session about exposure reporting
☐ D. A needle with an integrated safety shield
Show answer and explanation
Response:D
Final answer:A needle with an integrated safety shield
The integrated shield is an engineering control because it physically isolates the needle's sharp point rather than relying only on a change in worker behavior. Training supports safe use. Recapping rules and glove reminders describe work practices, not the listed physical barrier.
Question 35
A laboratory permits a particular specimen to remain at room temperature for no more than 60 minutes after collection. It was collected at 1:35 p.m. At 2:10 p.m., how much of that interval remains?
☐ A. 25 minutes
☐ B. 35 minutes
☐ C. 95 minutes
☐ D. 60 minutes
Show answer and explanation
Response:A
Final answer:25 minutes
From 1:35 p.m. to 2:10 p.m., 35 minutes have elapsed, leaving 25 of the allowed 60 minutes for handling under this laboratory's limit. Arrange timely transport. The 35-minute alternative gives elapsed time instead of the time remaining.
Question 36
A state screening program requires cards to air-dry flat for at least 3 hours before packaging. A freshly collected card is ready for handling. Which plan meets that requirement?
☐ A. Stack it between two freshly collected cards to conserve space
☐ B. Use a heater to dry it quickly without checking the program's instructions
☐ C. Seal it immediately in a moisture-tight bag to prevent dust
☐ D. Keep it flat in the designated protected drying area for the required interval
Show answer and explanation
Response:D
Final answer:Keep it flat in the designated protected drying area for the required interval
Dry the card flat as instructed. This program requires at least 3 hours in a protected location that allows air circulation before packaging, so stacking cards, trapping moisture in a sealed bag, or applying unapproved heat fails the supplied procedure.
Question 37
A glass specimen tube breaks on the floor. The area has been secured and appropriate PPE is in place. How should the fragments be collected?
☐ A. Use forceps and place the fragments in a suitable sharps container
☐ B. Use forceps and place the fragments in a soft biohazard bag
☐ C. Use doubled gloves to pick up the fragments individually
☐ D. Use a paper towel to collect the fragments by hand
Show answer and explanation
Response:A
Final answer:Use forceps and place the fragments in a suitable sharps container
Collect the fragments with forceps. Mechanical handling keeps hands away from contaminated edges, and the fragments must then enter suitable sharps containment so they cannot puncture a soft waste bag. Extra gloves or a paper towel do not make hand pickup safe.
Question 38
A fingerstick produces little blood. Which action is most likely to introduce tissue fluid into the sample?
☐ A. Repeatedly squeezing the puncture forcefully
☐ B. Holding the finger in the recommended position without strong pressure
☐ C. Using the approved site-warming procedure before puncture
☐ D. Allowing a free-flowing drop to form
Show answer and explanation
Response:A
Final answer:Repeatedly squeezing the puncture forcefully
Forceful squeezing can introduce tissue fluid into a capillary specimen and can also contribute to cell damage. Allow a free-flowing drop. Approved preparation, warming, and positioning support collection without repeatedly compressing the puncture to force blood out.
Question 39
After removing gloves, a technician notices visible blood on a hand. Which hand-hygiene method is indicated?
☐ A. Put on fresh gloves without cleaning the hand
☐ B. Use alcohol rub as the only cleaning step
☐ C. Wipe the blood away with a dry tissue only
☐ D. Wash with soap and water
Show answer and explanation
Response:D
Final answer:Wash with soap and water
Wash with soap and water. The visible blood makes this a visibly soiled-hand situation, for which CDC specifies washing. A new glove covers the contamination, and wiping with a dry tissue or relying on alcohol rub alone does not provide the indicated cleaning.
Question 40
Swelling appears around the puncture while blood collection is in progress. What is the appropriate immediate response?
☐ A. Massage the swelling while maintaining needle position
☐ B. Continue filling the remaining tubes before inspecting the swelling
☐ C. Stop the draw, release the tourniquet, remove the needle safely, and apply pressure
☐ D. Move the needle deeper into the swelling
Show answer and explanation
Response:C
Final answer:Stop the draw, release the tourniquet, remove the needle safely, and apply pressure
Swelling can signal blood escaping into the surrounding tissue, so stop the draw, release the tourniquet, remove the needle safely, and apply pressure. Do not continue filling tubes. Advancing into or massaging the swelling can prolong the problem instead of controlling it.
Question 41
A method specifies 1,500 times gravity, but the centrifuge display is set to revolutions per minute. What should the technician do before running the specimen?
☐ A. Use the validated rotor-specific setting or conversion
☐ B. Enter 1,500 rpm because the two units are equivalent
☐ C. Use the previous sample's rpm without checking the required force
☐ D. Use the same rpm listed for another rotor of a different radius
Show answer and explanation
Response:A
Final answer:Use the validated rotor-specific setting or conversion
Check the rotor-specific setting. The method specifies 1,500 times gravity, a relative centrifugal force whose conversion to rpm depends on rotor radius, so use the validated setting for the fitted rotor. Entering 1,500 rpm or copying a speed used with another rotor leaves the force requirement unverified.
Question 42
At 9:00 a.m., an urgent STAT specimen and a routine specimen are pending. A separate timed order specifies 9:10 a.m. collection. Which workflow best respects all three instructions?
☐ A. Collect all three at 9:00 without checking the timed-test requirement
☐ B. Begin the STAT draw and arrange timely coverage for the 9:10 draw
☐ C. Finish the earlier routine order before addressing the STAT request
☐ D. Complete the STAT draw and postpone the timed draw to the next round
Show answer and explanation
Response:B
Final answer:Begin the STAT draw and arrange timely coverage for the 9:10 draw
Begin the STAT collection and arrange coverage so the separate timed specimen can still be collected at 9:10 a.m. Routine work comes afterward. An urgent request does not cancel the timed order or permit moving all three collections to 9:00.
Question 43
At needle insertion, a patient reports an electric, shooting pain extending into the hand. What should the technician do?
☐ A. Ask for fist pumping while maintaining the needle position
☐ B. Advance until blood flows and then ask about the sensation
☐ C. Discontinue the draw, remove the needle safely, and obtain assessment
☐ D. Withdraw slightly and continue if the sensation lessens
Show answer and explanation
Response:C
Final answer:Discontinue the draw, remove the needle safely, and obtain assessment
Stop the draw for shooting electric pain, remove the needle safely, and arrange clinical assessment and documentation because the sensation may indicate nerve involvement. Continuing can prolong contact, and a slight withdrawal that lessens the sensation does not justify resuming collection without the indicated response.
Question 44
A technician must clean a blood spill that may splash toward the face. Gloves and a protective gown are already available. Which additional protection best addresses the remaining exposure route?
☐ A. A protective gown with shoe covers
☐ B. A mask with goggles or an appropriate face shield
☐ C. A second pair of gloves with a protective apron
☐ D. A surgical mask with a hair cover
Show answer and explanation
Response:B
Final answer:A mask with goggles or an appropriate face shield
Protect the facial mucous membranes. A mask with suitable goggles or an appropriate face shield addresses potential exposure of the eyes, nose, and mouth, which the available gloves and gown do not cover. A mask with a hair cover leaves the eyes unprotected.
Question 45
The tube's patient identifiers are correct, but the required collection time and collector identification are missing. The collecting technician is still present and the time is recorded in the verified collection log. Facility policy permits that technician to add verified missing data through a documented correction process. What should happen?
☐ A. Complete the data through the traceable process using the verified log
☐ B. Estimate collection time from the accession time
☐ C. Have the receiving technician enter their name as collector
☐ D. Leave the required collection data blank because patient identifiers match
Show answer and explanation
Response:A
Final answer:Complete the data through the traceable process using the verified log
The collector and collection time are verifiable, and the facility expressly allows that technician to add those missing data through a documented correction. Use the verified log. Accession time, a receiving technician's name, or a blank field cannot supply the actual collection history.
Question 46
The patient identifiers match, but the received tube is linked to a different test order than the requisition. What is the appropriate action?
☐ A. Select the patient's latest completed order as the intended test
☐ B. Process the test usually collected in that tube type
☐ C. Accession the test verbally mentioned by the courier without clarification
☐ D. Reconcile the specimen and order through the discrepancy process
Show answer and explanation
Response:D
Final answer:Reconcile the specimen and order through the discrepancy process
Reconcile the specimen and order before processing, since patient identifiers can match while the linked assay still differs from the requisition. Verify the intended test. Tube type, a previous completed order, or an unclarified courier statement cannot establish which current order the specimen fulfills.
Question 47
The laboratory requires unclotted EDTA whole blood for a cell count. A visible clot is found in the collected tube. What is the appropriate action?
☐ A. Remix the tube and proceed if no further clot is visible
☐ B. Report the cell count with a comment instead of applying the rejection policy
☐ C. Notify the laboratory and follow its recollection policy
☐ D. Remove the visible clot and submit the remaining cells
Show answer and explanation
Response:C
Final answer:Notify the laboratory and follow its recollection policy
A clot can trap cells. Removing it or remixing the remaining blood cannot restore the representative unclotted specimen that the cell count requires, so notify the laboratory and follow its rejection and recollection policy.
Question 48
A clinic's policy requires verified guardian permission for a nonemergency pediatric draw. The adult accompanying the child cannot establish that authority. What is the appropriate next step?
☐ A. Treat the child's silence as sufficient permission
☐ B. Collect because guardian verification can be completed during processing
☐ C. Accept the adult's request because they arrived with the child
☐ D. Delay the draw and obtain the required authorized permission
Show answer and explanation
Response:D
Final answer:Delay the draw and obtain the required authorized permission
Obtain the required permission first. This nonemergency draw is subject to the clinic's verified-guardian rule, and accompanying the child does not establish the adult's authority. The child's silence or later verification during processing cannot fulfill a requirement that applies before collection.
Question 49
Two structures are felt near a possible antecubital site. One has a distinct pulse. What should guide the technician's next action?
☐ A. Avoid the pulsating structure and confirm a venous site
☐ B. Continue preparation if the pulse disappears under pressure
☐ C. Use a smaller needle to make the pulsating site acceptable
☐ D. Select it because a palpable pulse confirms a suitable vein
Show answer and explanation
Response:A
Final answer:Avoid the pulsating structure and confirm a venous site
A distinct pulse suggests an artery. Avoid that structure and confirm a suitable venous site before puncture, since reducing needle size or compressing the pulse does not establish that the selected structure is a vein.
Question 50
A test protocol requires the patient to rest seated for 20 minutes before collection. The patient arrives immediately after climbing several flights of stairs. What should the technician do?
☐ A. Provide 5 minutes of seated rest instead of the required interval
☐ B. Provide the prescribed seated rest and document the conditions
☐ C. Collect after 20 minutes of walking around the waiting room
☐ D. Collect immediately after the patient has caught their breath
Show answer and explanation
Response:B
Final answer:Provide the prescribed seated rest and document the conditions
Provide 20 minutes of seated rest. The protocol specifies both duration and position, which recent stair climbing, catching the breath, a 5-minute pause, or walking for 20 minutes fails to reproduce. Document the collection conditions.
Question 51
During a draw, a patient becomes pale, sweaty, and says, ``I feel as if I may faint.'' Which response is appropriate?
☐ A. Complete the current tube before beginning the response
☐ B. Ask the patient to stand and move to a bed without stopping the draw
☐ C. Ask the patient to sit upright while the draw continues
☐ D. Stop the draw, remove the needle safely, and support the patient
Show answer and explanation
Response:D
Final answer:Stop the draw, remove the needle safely, and support the patient
Stop the collection promptly. Pallor, sweating, and reported faintness warn of impending syncope, so remove the needle safely and support the patient with assistance before a fall occurs. Completing a tube or moving the patient with the needle inserted adds avoidable risk.
Question 52
A glucose-tolerance protocol times the 2-hour specimen from completion of the drink. The patient finishes at 8:17 a.m. When is that specimen due?
☐ A. 10:00 a.m.
☐ B. 10:17 a.m.
☐ C. 9:17 a.m.
☐ D. 10:47 a.m.
Show answer and explanation
Response:B
Final answer:10:17 a.m.
Using the protocol's completion-time anchor, adding 2 hours to 8:17 a.m. puts this specimen's due time at 10:17 a.m. Record the actual collection time. The other clock times do not satisfy that interval, and another program's timing anchor should not replace the one supplied here.
Question 53
A courier cancels a pickup. A specimen's validated stability will expire before the next scheduled route. What should the technician do?
☐ A. Keep it at the current temperature beyond the verified limit
☐ B. Use an alternate delivery arrangement without approval or handling instructions
☐ C. Wait for the next route without checking another handling option
☐ D. Arrange an approved timely alternative with the laboratory and transport service
Show answer and explanation
Response:D
Final answer:Arrange an approved timely alternative with the laboratory and transport service
Contact the laboratory and transport service while stability remains so they can arrange an approved delivery alternative that preserves the specimen's handling requirements. Waiting would exceed the validated interval. A convenient but unapproved transport arrangement provides no assurance that the required conditions will be maintained.
Question 54
A citrate tube contains 0.30 mL of anticoagulant and requires a blood-to-anticoagulant ratio of 9:1. How much blood provides that ratio?
☐ A. 3.30 mL
☐ B. 2.70 mL
☐ C. 3.00 mL
☐ D. 0.90 mL
Show answer and explanation
Response:B
Final answer:2.70 mL
The question asks for blood volume. Multiply the 0.30 mL of citrate by nine to obtain 2.70 mL of blood, then recognize that the combined contents total 3.00 mL. Choosing 3.00 mL as blood would count the additive as blood.
Question 55
An adult blood-culture protocol specifies 10 mL in each of two bottles per set. Which factor most directly supports the set's intended diagnostic yield?
☐ A. Collecting the prescribed blood volume with aseptic technique
☐ B. Using one bottle instead of the ordered pair when the draw is difficult
☐ C. Collecting less blood so both bottle fill heights look identical
☐ D. Extending incubation to compensate for an inadequate collection volume
Show answer and explanation
Response:A
Final answer:Collecting the prescribed blood volume with aseptic technique
Collect the prescribed volume aseptically. The two adult bottles require 10 mL each to supply the amount available for organism recovery, which fewer bottles or longer incubation cannot replace when blood has been omitted at collection.
Question 56
A forensic specimen is passed from the collecting technician to an authorized courier. Which record best supports chain of custody?
☐ A. Courier identity and destination without linkage to the specimen identifier
☐ B. Specimen identity and dispatch time without identification of the receiving person
☐ C. Final assay result and receipt time without recording the handoff
☐ D. Specimen identity, releasing and receiving persons, transfer time, and required seal data
Show answer and explanation
Response:D
Final answer:Specimen identity, releasing and receiving persons, transfer time, and required seal data
Record the specimen identifier, both accountable people, transfer time, and required seal details together so the same forensic specimen can be traced through this handoff. Keep the transfer traceable. A dispatch or final-result entry that omits a participant leaves that record incomplete.
Question 57
An order states, ``Collect the trough immediately before the 2:00 p.m. dose.'' At 1:55 p.m., the nurse says the dose was already given at 1:40 p.m. What should the technician do?
☐ A. Notify the responsible staff and clarify timing before collecting and labeling a trough
☐ B. Wait until 2:00 p.m. and collect without reporting the early dose
☐ C. Change the order to a peak sample because the dose was early
☐ D. Collect at 1:55 p.m. and label it pre-dose because it precedes 2:00 p.m.
Show answer and explanation
Response:A
Final answer:Notify the responsible staff and clarify timing before collecting and labeling a trough
The dose was given at 1:40 p.m., so a subsequent draw cannot meet the order's requirement for a specimen immediately before that dose. Clarify the collection timing. Neither the scheduled 2:00 time nor an independent change to a peak order resolves the discrepancy.
Question 58
A routine venous draw requires blood cultures, citrate, serum, heparin, and EDTA specimens. The facility uses the standard order shown in its collection guide. Which sequence is correct?
☐ A. Serum, citrate, cultures, heparin, EDTA
☐ B. Citrate, cultures, heparin, serum, EDTA
☐ C. Cultures, citrate, serum, heparin, EDTA
☐ D. Cultures, serum, citrate, EDTA, heparin
Show answer and explanation
Response:C
Final answer:Cultures, citrate, serum, heparin, EDTA
Collect cultures, citrate, serum, heparin, then EDTA in the listed venous sequence, which limits additive carryover from an earlier tube into a later specimen. Use the facility guide. Specialized systems can require additional instructions beyond these five specimen types.
Question 59
The sharps container at a draw station has reached its marked fill limit. An unused replacement is nearby. What should happen before the next collection?
☐ A. Place the next used needle on the tray until pickup arrives
☐ B. Push the contents downward to make room for the next needle
☐ C. Transfer several sharps to the replacement by hand
☐ D. Close and replace the full container according to the facility procedure
Show answer and explanation
Response:D
Final answer:Close and replace the full container according to the facility procedure
Close and replace the full container. The marked capacity has been reached, so prepare the replacement before the next draw to permit immediate disposal. Compressing or transferring its contents, or leaving the next needle on a tray, creates a sharps exposure hazard.
Question 60
A patient reports a documented allergy to the antiseptic normally used for venipuncture. The facility has an approved alternative. What should the technician do?
☐ A. Use the usual agent after reducing its contact time
☐ B. Verify and use the approved alternative according to its instructions
☐ C. Use a smaller amount of the usual agent on a larger area
☐ D. Replace antisepsis with a dry-gauze wipe
Show answer and explanation
Response:B
Final answer:Verify and use the approved alternative according to its instructions
Verify the approved alternative's instructions and use that compatible preparation for this patient rather than applying the usual allergen with a smaller amount or shorter contact time. Dry gauze supplies no antisepsis. The reported allergy needs addressing before the agent touches the skin.
Question 61
The order requires an 8-hour fast. The patient reports eating breakfast 3 hours ago. What should the technician do?
☐ A. Ask the patient to exercise before collection to compensate for the meal
☐ B. Document the intake and clarify the fasting collection instructions
☐ C. Collect without recording the intake because the meal was small
☐ D. Collect and record fasting status from the time of the appointment
Show answer and explanation
Response:B
Final answer:Document the intake and clarify the fasting collection instructions
Document the breakfast and clarify the collection plan because eating 3 hours ago does not meet the ordered 8-hour fast. Record the actual preparation status. Meal size, exercise, or the appointment time cannot establish an 8-hour interval without food.
Question 62
A DOT-regulated urine collection has enough specimen for the required split. What minimum volumes go into the primary and split bottles, respectively?
☐ A. 30 mL and 15 mL
☐ B. 20 mL and 20 mL
☐ C. 15 mL and 30 mL
☐ D. 45 mL and 5 mL
Show answer and explanation
Response:A
Final answer:30 mL and 15 mL
Place at least 30 mL in the primary bottle and 15 mL in the split bottle for this DOT-regulated urine collection. Preserve the specified split. Pouring and sealing occur in the employee's presence under the rule, whose volumes do not govern all clinical urine specimens.
Question 63
Blood splashes into a technician's eye while a tube is being handled. The eyewash station is accessible. What is the immediate first-aid action?
☐ A. Request a source-patient test before using the eyewash
☐ B. Flush the eye with water before prompt exposure evaluation
☐ C. Blot the eyelid with gauze instead of irrigating the eye
☐ D. Complete the incident form before flushing the eye
Show answer and explanation
Response:B
Final answer:Flush the eye with water before prompt exposure evaluation
Flush the eye immediately with water. Irrigation addresses the exposed mucous membrane before prompt occupational-exposure reporting and evaluation. Waiting for a source-patient test or finishing a form postpones that first-aid action, and blotting the eyelid cannot substitute for eye irrigation.
Question 64
After site antisepsis and drying, a technician touches the puncture point with a nonsterile glove to locate the vein again. What is the appropriate response?
☐ A. Wipe the glove with a dry towel and insert the needle
☐ B. Proceed because any glove contact is sterile
☐ C. Change the collection tube but keep the same prepared site
☐ D. Reprepare the site according to the antiseptic procedure before puncture
Show answer and explanation
Response:D
Final answer:Reprepare the site according to the antiseptic procedure before puncture
Nonsterile glove contact has compromised the prepared puncture point, so repeat the required antiseptic application and drying before inserting the needle. Reprepare the skin. Cleaning the glove or changing the tube would leave the contaminated entry site unchanged.
Question 65
A forensic specimen arrives with a tamper-evident seal that is broken. The collection record says it was intact at dispatch. What should the receiving technician do?
☐ A. Document the discrepancy and apply the custody protocol before acceptance
☐ B. Accept it once the courier verbally confirms that delivery was on time
☐ C. Replace the seal and proceed using the dispatch record alone
☐ D. Proceed because the original tube label is still readable
Show answer and explanation
Response:A
Final answer:Document the discrepancy and apply the custody protocol before acceptance
Document the broken seal before acceptance. The intact-at-dispatch record conflicts with the specimen's present condition, requiring the custody protocol's investigation and disposition rather than an undocumented replacement that could conceal evidence needed to assess specimen integrity.
Question 66
Which feature distinguishes serum from anticoagulated plasma?
☐ A. Both are anticoagulated liquids distinguished only by tube size
☐ B. Serum follows clotting, and anticoagulated plasma retains fibrinogen
☐ C. Both follow clotting, but plasma is centrifuged for less time
☐ D. Plasma follows clotting, and anticoagulated serum retains fibrinogen
Show answer and explanation
Response:B
Final answer:Serum follows clotting, and anticoagulated plasma retains fibrinogen
Serum follows clotting. Plasma retains fibrinogen when an anticoagulant prevents clot formation, which distinguishes the two fractions before centrifugation duration or tube size is considered. Shortening a spin cannot turn serum into anticoagulated plasma.
Question 67
Which pair best supports positive identification of an alert patient before a draw?
☐ A. The test name and the ordering clinician's name
☐ B. Bed location and the time of the scheduled draw
☐ C. Patient-stated full name and date of birth matched with the order
☐ D. Room number and the name on the room's door
Show answer and explanation
Response:C
Final answer:Patient-stated full name and date of birth matched with the order
Match the patient's stated full name and date of birth to the order before drawing, using those patient-specific identifiers to establish the link. Location is not an identifier. A room can change, and a test or clinician name may be shared by many patients.
Question 68
A patient with suspected pulmonary tuberculosis is in an airborne-infection isolation room. The facility requires a fit-tested N95 or higher-level respirator for entry. Which technician is prepared to enter?
☐ A. One using a respirator without the required fit testing or training
☐ B. One who plans to remain at the doorway while drawing blood
☐ C. One wearing a surgical mask that fits closely at the nose
☐ D. One trained and cleared to use the required respirator who completes the seal check
Show answer and explanation
Response:D
Final answer:One trained and cleared to use the required respirator who completes the seal check
The ready technician has the required clearance, training, fit testing, and a completed seal check for the N95 or higher-level respirator specified for entry. Use the required respiratory protection. A closely fitting surgical mask or a short doorway visit does not meet the stated airborne precaution.
Question 69
A validated analyzer requires at least 0.6 mL of specimen in the specified pediatric tube. The tube holds only 0.4 mL. What should the technician do?
☐ A. Combine it with a different specimen without laboratory authorization
☐ B. Submit the tube because two-thirds of the minimum volume is present
☐ C. Ask the laboratory about a suitable recollection or validated alternative
☐ D. Use a smaller container to make the level appear adequate
Show answer and explanation
Response:C
Final answer:Ask the laboratory about a suitable recollection or validated alternative
The 0.4 mL collected is below the validated analyzer's 0.6 mL minimum, so ask the laboratory about suitable recollection or a validated alternative. A smaller tube adds no volume. Combining specimens without authorization may also change the specimen's required composition or identity.
Question 70
A patient asks whether to stop an anticoagulant before tomorrow's blood draw. No medication instruction is included in the order. What should the technician advise?
☐ A. Contact the prescribing clinician for medication instructions
☐ B. Recommend withholding the dose until after collection
☐ C. Recommend adjusting the dose according to the ease of the draw
☐ D. Recommend taking half the dose on the day of collection
Show answer and explanation
Response:A
Final answer:Contact the prescribing clinician for medication instructions
Ask the prescribing clinician for instructions. Deciding whether to stop or reduce anticoagulant treatment exceeds the technician's role, and the blood-draw order supplies no medication direction. Ease of venous access is not a basis for changing the prescribed dose.
Question 71
An approved six-position centrifuge rotor has positions numbered 1 through 6 clockwise at equal intervals. Two identical specimen tubes have total loaded masses of 14 g and 16 g in positions 1 and 2, respectively. Matching balance tubes of those masses are available. Where should the balance tubes be placed?
☐ A. 14 g in position 4 and 16 g in position 3
☐ B. 14 g in position 4 and 16 g in position 5
☐ C. 14 g in position 5 and 16 g in position 4
☐ D. 14 g in position 3 and 16 g in position 6
Show answer and explanation
Response:B
Final answer:14 g in position 4 and 16 g in position 5
In the stated six-position rotor, position 4 opposes position 1 and position 5 opposes position 2, so place the matching 14 g and 16 g balance tubes there. Match the opposing masses. Swapping those masses or using an adjacent position leaves at least one pair unbalanced.
Question 72
A venous specimen is ordered for a CBC with differential using Labcorp test 005009. Which available in-date collection tube is appropriate?
☐ A. An in-date tube labeled as containing EDTA
☐ B. A tube with no additive intended to produce serum
☐ C. A tube containing sodium citrate for a coagulation assay
☐ D. A tube containing a clot activator only
Show answer and explanation
Response:A
Final answer:An in-date tube labeled as containing EDTA
Select the EDTA tube. Labcorp test 005009 requires anticoagulated whole blood and rejects an anticoagulant other than EDTA, while plain and clot-activator tubes allow clotting. Those serum preparations cannot supply the cellular specimen required for this CBC.
Question 73
A trained technician is authorized to obtain an oropharyngeal specimen. The laboratory requires its approved swab and transport tube. During collection, which approach helps preserve the intended specimen?
☐ A. Swab the tongue first and then use the same tip on the posterior oropharynx
☐ B. Touch the swab tip to the teeth before collecting from the tonsillar areas
☐ C. Swab the tonsillar areas and posterior oropharynx while avoiding the tongue and gums
☐ D. Swab only the inside of the cheek to avoid the posterior oropharynx
Show answer and explanation
Response:C
Final answer:Swab the tonsillar areas and posterior oropharynx while avoiding the tongue and gums
Sample the specified throat surfaces. For this authorized oropharyngeal collection, CDC identifies the tonsillar areas and posterior oropharynx and directs avoidance of the tongue, teeth, and gums. Use the approved swab and transport system to keep the collection compatible with the ordered assay.
Question 74
A request to fax a laboratory report includes a number that differs from the verified provider number in the system. What should the technician do before sending?
☐ A. Remove the patient's name and fax the remaining identified report
☐ B. Use the unfamiliar number because it is on the newest message
☐ C. Send to both numbers so one reaches the provider
☐ D. Verify the intended recipient and correct destination through the approved process
Show answer and explanation
Response:D
Final answer:Verify the intended recipient and correct destination through the approved process
Verify the recipient and destination before sending because the new fax number differs from the provider number already verified in the system. Sending twice increases disclosure risk. Removing the patient's name alone does not necessarily deidentify the report or authorize the unfamiliar recipient.
Question 75
The instructions for the EDTA tube in use require 8--10 gentle inversions after filling. Which handling meets that instruction?
☐ A. Turn the tube completely over and back 9 times without shaking
☐ B. Shake the tube vigorously 9 times
☐ C. Wait until arrival in the laboratory before beginning mixing
☐ D. Turn the tube completely over and back twice, then place it upright
Show answer and explanation
Response:A
Final answer:Turn the tube completely over and back 9 times without shaking
Nine inversions meet the stated range. Turn the tube completely over and back gently each time to mix the additive promptly, avoiding the cell damage of vigorous shaking and the clotting that delayed or insufficient mixing can permit.
Question 76
A nasal-swab assay requires a designated synthetic swab and its supplied transport medium. Which collection plan is appropriate?
☐ A. Use the blood-collection transport container because both travel to the same lab
☐ B. Use the specified swab, medium, and assay instructions
☐ C. Use the supplied medium with a different swab material
☐ D. Use the specified swab with a different available transport medium
Show answer and explanation
Response:B
Final answer:Use the specified swab, medium, and assay instructions
Use the specified swab and medium. They form the assay's validated collection system, so substituting either component still changes the system and requires laboratory authorization rather than an assumption that the available alternatives are compatible.
Question 77
Which bloodborne-pathogen vaccine must an employer offer to eligible workers with occupational exposure under OSHA's standard?
☐ A. Hepatitis B vaccine
☐ B. Seasonal influenza vaccine
☐ C. Tetanus-diphtheria booster
☐ D. Hepatitis A vaccine
Show answer and explanation
Response:A
Final answer:Hepatitis B vaccine
OSHA's bloodborne-pathogen standard requires the employer to offer hepatitis B vaccination to eligible workers with occupational exposure, subject to its stated exceptions. The required vaccine is hepatitis B. Influenza, tetanus, and hepatitis A protection address other risks and cannot fulfill this requirement.
Question 78
A collection tube's expiration date has passed. Its closure looks intact. Which reason best supports replacing it before use?
☐ A. An intact cap verifies additive performance beyond expiration
☐ B. The specified vacuum and additive performance are no longer assured
☐ C. A normal fill volume establishes that an expired tube remains acceptable
☐ D. The expiration date affects the label but not specimen collection
Show answer and explanation
Response:B
Final answer:The specified vacuum and additive performance are no longer assured
Replace the expired tube. An intact closure and a seemingly normal fill cannot establish that the specified vacuum and additive performance remain assured beyond expiration. The date is part of the collection-device quality check, not merely a labeling detail.
Question 79
A routine glass blood tube is closed and its exterior is clean. The local courier requires a sealed leakproof secondary specimen bag. A padded holder and separate paperwork pouch are ready, but the secondary bag has a torn zipper that will not close. What should the technician do before release?
☐ A. Wrap tape around the tube and use the damaged bag as it is
☐ B. Use the paperwork pouch to hold the tube with its requisition
☐ C. Send the closed tube in its padded holder without the required bag
☐ D. Replace the damaged secondary bag with an intact compatible bag that seals
Show answer and explanation
Response:D
Final answer:Replace the damaged secondary bag with an intact compatible bag that seals
Replace the bag before transport. Its torn zipper prevents the required leakproof secondary closure even though the primary tube is clean and capped, while the padded holder protects glass from impact and the paperwork pouch retains a separate purpose.
Question 80
The ordered tubes have been filled. Which sequence best completes the puncture portion of a routine draw?
☐ A. Apply the bandage while the needle is still in the vein
☐ B. Leave the tourniquet in place until the patient leaves the chair
☐ C. Remove the needle, tighten the tourniquet, and apply pressure
☐ D. Release any remaining tourniquet, remove the needle, and apply pressure
Show answer and explanation
Response:D
Final answer:Release any remaining tourniquet, remove the needle, and apply pressure
Release any remaining tourniquet first. Then withdraw the needle safely and apply direct pressure to the site, completing the puncture without continued constriction or attempting to put a bandage around a needle still in the vein.
Question 81
An outpatient reports fainting during two previous blood draws. The clinic has a reclining collection chair. Which preparation best reduces injury risk?
☐ A. Position the patient safely reclined and arrange monitoring before beginning
☐ B. Have the patient stand to improve circulation
☐ C. Use a seated position without support and ask the patient to report symptoms after the draw
☐ D. Seat the patient on a high stool so the arm is easier to reach
Show answer and explanation
Response:A
Final answer:Position the patient safely reclined and arrange monitoring before beginning
Recline and support the patient before beginning, with monitoring arranged because the previous fainting episodes make fall protection a specific preparation need. Use the available reclining chair. An unsupported seat or a plan to hear about symptoms only after collection leaves the injury risk unaddressed.
Question 82
A capillary draw requires EDTA, heparin, and serum microcollection specimens. No blood-gas specimen is ordered. Which sequence matches the capillary order of draw?
☐ A. EDTA, serum, heparin
☐ B. Heparin, serum, EDTA
☐ C. EDTA, heparin, serum
☐ D. Serum, EDTA, heparin
Show answer and explanation
Response:C
Final answer:EDTA, heparin, serum
Collect EDTA, heparin, then serum. The capillary sequence puts EDTA first and other additive tubes next, with serum last for this set of specimens. Prompt collection and mixing help preserve small samples that may begin clotting during collection.
Question 83
After the needle is safely removed, an adult becomes unresponsive and is not breathing normally. The trained technician finds no definite pulse within 10 seconds. What takes priority?
☐ A. Continue checking for a pulse for several minutes before calling for help
☐ B. Provide rescue breaths alone while waiting for a pulse to return
☐ C. Activate emergency help and begin the trained CPR and AED response
☐ D. Place the patient in a recovery position and wait for normal breathing
Show answer and explanation
Response:C
Final answer:Activate emergency help and begin the trained CPR and AED response
Activate help and begin the trained CPR and AED response because abnormal breathing and no definite pulse within 10 seconds place this unresponsive adult on the cardiac-arrest pathway. Do not prolong the pulse check. Rescue breaths alone belong to the pathway where a pulse is present.
Question 84
A competent adult initially extends an arm, then says, ``I do not want this blood test.'' The collection has not started. What should the technician do?
☐ A. Stop, respect the refusal, and notify the responsible clinician according to procedure
☐ B. Proceed because extending the arm established permanent consent
☐ C. Collect the minimum volume because the order is still active
☐ D. Ask another technician to complete the draw without discussing the refusal
Show answer and explanation
Response:A
Final answer:Stop, respect the refusal, and notify the responsible clinician according to procedure
Respect the patient's refusal. The competent adult has withdrawn consent before puncture, so stop and notify the responsible clinician through the required procedure. An active order, earlier extended arm, smaller collection volume, or a different technician cannot override that expressed decision.
Question 85
A routine draw has been completed and the patient remains at the chair. When should the technician label the collected tubes?
☐ A. After leaving the room to find an empty labeling station
☐ B. At the end of the round, grouping tubes by room number
☐ C. Before identifying the patient, to reduce time at the chair
☐ D. Immediately at the patient, after verifying the identifiers against the order
Show answer and explanation
Response:D
Final answer:Immediately at the patient, after verifying the identifiers against the order
Label immediately in the patient's presence. Verify the tube identifiers against the patient and order while that link can be confirmed directly at the chair. Delaying until after departure or grouping tubes by room during a later round increases the opportunity for identity exchange.
Question 86
A meter is designed for professional multi-patient use. Its instructions specify a compatible disinfectant and contact time. What is required between patients?
☐ A. Use any stronger cleaning chemical without checking compatibility
☐ B. Change the lancet but leave the meter unchanged
☐ C. Clean and disinfect the meter after each use according to those instructions
☐ D. Disinfect it only when blood is visible
Show answer and explanation
Response:C
Final answer:Clean and disinfect the meter after each use according to those instructions
Follow the meter's cleaning instructions. This professional shared device needs cleaning and disinfection after every use with the compatible product and contact time, since changing a lancet or seeing no visible blood does not clean potentially contaminated meter surfaces.
Question 87
Two correctly labeled specimens are being aliquoted into secondary containers. Which workflow best prevents identity exchange?
☐ A. Pour both specimens first and label the aliquots from memory afterward
☐ B. Process one specimen at a time and label each aliquot from its verified primary identity
☐ C. Identify the aliquots by the rack's room-number order alone
☐ D. Use the same specimen identifier for both because they share a test order
Show answer and explanation
Response:B
Final answer:Process one specimen at a time and label each aliquot from its verified primary identity
Work on one specimen at a time so each secondary container receives the identity verified from its own primary container during the transfer. Maintain the individual specimen link. Memory, room-number order, or a shared test order cannot distinguish the two patients' aliquots reliably.
Question 88
An authorized nurse is collecting a specimen from a vascular line. The technician's assigned role is to prepare the required tubes and labels. What should the technician do?
☐ A. Substitute a peripheral specimen without clarifying the ordered source
☐ B. Access the line independently instead of waiting for the nurse
☐ C. Record a peripheral site because the technician did not access the line
☐ D. Provide verified materials and coordinate handling with the nurse
Show answer and explanation
Response:D
Final answer:Provide verified materials and coordinate handling with the nurse
Prepare the verified tubes and labels and coordinate handling with the nurse, who is the clinician authorized to collect from the line in this scenario. Stay within that assigned role. Record the actual source rather than substituting a peripheral specimen or documenting a site that was not used.
Question 89
A facility's approved spill disinfectant requires the cleaned surface to remain wet for 4 minutes. The surface becomes dry after 1 minute. Which action meets the stated instruction?
☐ A. Count the cleaning time toward the remaining contact time
☐ B. Complete several brief wipes totaling 4 minutes of work
☐ C. Allow 3 additional dry minutes before using the surface
☐ D. Reapply as directed to achieve the required wet contact time
Show answer and explanation
Response:D
Final answer:Reapply as directed to achieve the required wet contact time
Reapply the product as directed to achieve the full 4 minutes during which the cleaned surface must remain wet. Dry waiting time cannot count. Cleaning time and repeated brief wipes likewise do not establish the specified continuous wet contact.
Question 90
A bilirubin assay's directory lists gross hemolysis as a rejection condition. The received serum is grossly hemolyzed. What should the technician do?
☐ A. Test it and omit the hemolysis finding if the result seems plausible
☐ B. Proceed using rejection limits from an unrelated serum assay
☐ C. Remove visible red material and assume the remaining serum is suitable
☐ D. Apply the assay's rejection process and arrange a replacement
Show answer and explanation
Response:D
Final answer:Apply the assay's rejection process and arrange a replacement
Apply this assay's rejection process. The directory expressly rejects grossly hemolyzed serum, requiring replacement rather than another assay's limits, a judgment based on a plausible result, or removal of visible material that does not restore suitability for this method.
Question 91
Which device is appropriate for assisted fingerstick glucose testing across a clinic's patients?
☐ A. A separate single-use, auto-disabling lancet for each puncture
☐ B. One lancet cleaned with alcohol between patients
☐ C. A reusable pen shared only among patients with negative infection histories
☐ D. One reusable fingerstick pen with a new needle for each patient
Show answer and explanation
Response:A
Final answer:A separate single-use, auto-disabling lancet for each puncture
Use a fresh auto-disabling lancet. Assisted glucose testing requires the single-use device for each puncture, and a reusable fingerstick pen must never be shared between patients even when its needle is replaced. Infection histories or alcohol cleaning cannot authorize that sharing.
Question 92
A study requires centrifugation and transfer into a labeled plasma aliquot within 30 minutes after collection. A specimen was collected at 9:12 a.m. An available centrifuge can finish at 9:34 a.m., and aliquoting and labeling take 6 minutes. The protocol permits the completed aliquot to remain at its specified storage temperature until the 10:00 a.m. central-laboratory courier. Which plan meets the requirements?
☐ A. Finish centrifugation at 9:34, complete the aliquot by 9:40, and store it as specified for the 10:00 courier
☐ B. Wait for the 9:45 batch so all study tubes can be processed together
☐ C. Start the 30-minute interval when the specimen reaches the centrifuge instead of at collection
☐ D. Finish centrifugation at 9:34 but leave the plasma in the primary tube until the courier arrives
Show answer and explanation
Response:A
Final answer:Finish centrifugation at 9:34, complete the aliquot by 9:40, and store it as specified for the 10:00 courier
The 30-minute processing window ends at 9:42 a.m., and the available spin plus 6 minutes for transfer and labeling finishes the aliquot at 9:40 a.m. Store it as the protocol permits. Waiting for a later batch, resetting the clock, or leaving plasma in the primary tube fails the processing requirement.
Question 93
Before collection, a patient reports a latex allergy. Which preparation is appropriate?
☐ A. Use the usual tourniquet if it will touch the skin for less than a minute
☐ B. Cover any latex item with a paper towel and assume it is safe
☐ C. Check and select appropriate latex-free collection supplies according to facility policy
☐ D. Proceed and ask about the allergy only if a rash develops
Show answer and explanation
Response:C
Final answer:Check and select appropriate latex-free collection supplies according to facility policy
Check for suitable latex-free supplies. Obtain them before collection under the facility policy, because briefly exposing the patient to latex or wrapping a latex item in paper does not establish safe avoidance. Waiting for a rash would abandon the purpose of checking the allergy history.
Question 94
The laboratory requests a redraw because a specimen was unsuitable. Which message is most appropriate when contacting the verified patient through the approved process?
☐ A. Explain the replacement need and provide the confirmed collection instructions
☐ B. Recommend a medication change before arranging the replacement draw
☐ C. Predict the replacement result from the rejected specimen's appearance
☐ D. Explain that specimen rejection establishes an abnormal patient result
Show answer and explanation
Response:A
Final answer:Explain the replacement need and provide the confirmed collection instructions
Explain why replacement collection is needed and provide the laboratory's confirmed preparation and scheduling directions so the patient knows how to complete the redraw. Specimen rejection is not a diagnosis. Medication changes and predictions about a future result require information and authority beyond this collection message.
Question 95
One antecubital site is visibly edematous. A suitable vein is available on the opposite arm without a restriction. What is the better collection choice?
☐ A. The edematous site after extending tourniquet time
☐ B. The unaffected opposite-arm site
☐ C. The edematous site with the most prominent vein
☐ D. The edematous site with the least visible swelling
Show answer and explanation
Response:B
Final answer:The unaffected opposite-arm site
Choose the unaffected opposite-arm site. Its suitable unrestricted vein avoids the edema that can complicate collection and introduce tissue-fluid effects, whereas prolonging tourniquet use or choosing a prominent vein in the swollen area leaves that site problem unchanged.
Question 96
A final laboratory report is ready. Which distribution plan meets the order's documented routing while protecting the patient?
☐ A. Use the most recent unverified callback number on a message
☐ B. Use the authorized system and verified ordering-provider destination
☐ C. Send to the general appointment inbox instead of the documented route
☐ D. Use a provider with a similar name in the clinic directory
Show answer and explanation
Response:B
Final answer:Use the authorized system and verified ordering-provider destination
Use the authorized system and verified ordering-provider destination to distribute this final report according to its documented routing and record-update requirements. Check the actual destination. A similar name, scheduling inbox, or unverified callback number cannot identify the intended authorized recipient reliably.
Question 97
During a collection, a technician notices a small tear in one glove before touching the puncture site again. What should the technician do?
☐ A. Clean the damaged glove with alcohol before continuing
☐ B. Cover the tear with another glove and finish the collection
☐ C. Remove the damaged gloves, perform hand hygiene, and put on a fresh pair
☐ D. Finish the procedure because the skin beneath the tear looks intact
Show answer and explanation
Response:C
Final answer:Remove the damaged gloves, perform hand hygiene, and put on a fresh pair
Replace the gloves before continuing. Remove them safely, perform hand hygiene, and put on a fresh pair to restore the barrier compromised by the tear, which neither alcohol on the glove nor intact underlying skin can repair.
Question 98
An adult order calls for two peripheral blood-culture sets from separate venipuncture sites. Each set has two bottles. Which plan fulfills the order?
☐ A. Split the first collection into four bottles and assign two site labels
☐ B. Collect one two-bottle set from each of two peripheral sites
☐ C. Collect both two-bottle sets consecutively from one peripheral site
☐ D. Use two punctures but inoculate only one bottle from each
Show answer and explanation
Response:B
Final answer:Collect one two-bottle set from each of two peripheral sites
Collect one pair of bottles from each of the two peripheral sites specified by the order, keeping both the bottle count and the independent site requirement. Document both collection sites. Splitting one draw into four bottles supplies the count without the second venipuncture.
Question 99
The laboratory requests a midstream clean-catch urine specimen. Which instruction best describes the collection portion of the procedure after the required cleansing?
☐ A. Collect the initial portion before the urine stream is established
☐ B. Begin voiding, collect the middle portion, and finish in the toilet
☐ C. Collect the final portion after most urine has passed
☐ D. Collect equal portions from the beginning, middle, and end
Show answer and explanation
Response:B
Final answer:Begin voiding, collect the middle portion, and finish in the toilet
Begin voiding into the toilet. After the required cleansing, collect the middle portion and then finish voiding into the toilet, which gives the requested midstream specimen. Initial, final, or pooled portions change the specified sampling method.
Question 100
A discarded transfer device has an exposed internal needle. Which feature determines its disposal category?
☐ A. It is mostly plastic and therefore belongs in general waste
☐ B. It lacks a conventional syringe and is not a sharp
☐ C. It can puncture skin and belongs in an appropriate sharps container
☐ D. It is small enough to fit safely in a standard waste bag
Show answer and explanation
Response:C
Final answer:It can puncture skin and belongs in an appropriate sharps container
Use appropriate sharps containment. The exposed internal needle can puncture skin, making it a sharps hazard even though much of the transfer device is plastic. A small size or absence of a conventional syringe does not make an ordinary waste bag protective.
Question 101
After a routine draw, which finding should be confirmed before the patient leaves the collection area?
☐ A. A bandage covers the site without an additional bleeding check
☐ B. The patient reports feeling well without a puncture-site check
☐ C. Bleeding has stopped and the site has been appropriately dressed
☐ D. The patient has maintained elbow flexion for 1 minute
Show answer and explanation
Response:C
Final answer:Bleeding has stopped and the site has been appropriately dressed
Confirm that bleeding has stopped. Inspect the puncture and provide an appropriate dressing before release because a covered site or a patient's general sense of well-being does not establish hemostasis, and elapsed elbow-flexion time is not that check.
Question 102
A patient has received written instructions for a timed urine collection. Which follow-up best checks understanding?
☐ A. Ask the patient to confirm that the sheet has been read
☐ B. Ask the patient whether the instruction sheet is clear
☐ C. Ask the patient to state the name of the ordered test
☐ D. Ask the patient to explain the start time and response to a missed specimen
Show answer and explanation
Response:D
Final answer:Ask the patient to explain the start time and response to a missed specimen
Ask the patient to describe the collection steps in their own words, including when to start and what to do after a missed specimen. Listen for misunderstandings. Reading the sheet, naming the test, or answering a clarity question may leave a procedural error undiscovered.
Question 103
Blood was collected in a compatible syringe. A needleless transfer device is available. How should the blood enter evacuated tubes?
☐ A. Push the syringe plunger firmly to accelerate filling
☐ B. Use the transfer device and let each tube's vacuum draw the blood
☐ C. Remove the tube cap and pour from the syringe at the bedside
☐ D. Pierce a handheld tube stopper with the exposed collection needle
Show answer and explanation
Response:B
Final answer:Use the transfer device and let each tube's vacuum draw the blood
Use the compatible needleless transfer device. Let each evacuated tube draw blood by its own vacuum without forcing the syringe plunger, preserving a closed transfer and reducing the injury and hemolysis risks of the listed alternatives.
Question 104
An anticoagulated specimen has been centrifuged for a plasma assay. Which aliquoting technique best preserves the requested liquid fraction?
☐ A. Draw liquid from the bottom of the tube through the cellular layer
☐ B. Resuspend the cellular layer before removing the plasma
☐ C. Transfer the upper plasma without drawing in underlying cells
☐ D. Transfer equal volumes of plasma and cells to the aliquot
Show answer and explanation
Response:C
Final answer:Transfer the upper plasma without drawing in underlying cells
Transfer the upper plasma without disturbing the cellular layer because the ordered assay requires the separated liquid fraction of the anticoagulated blood. Keep cells out of the aliquot. Resuspending the tube or drawing through its bottom changes that requested specimen.
Question 105
A pediatric protocol permits no more than 2.5 mL per kg for the specified collection interval. A child weighs 6 kg and has already had 9 mL collected during that interval. What additional volume remains within this limit?
☐ A. 24 mL
☐ B. 15 mL
☐ C. 9 mL
☐ D. 6 mL
Show answer and explanation
Response:D
Final answer:6 mL
The supplied weight-based allowance gives mL for the interval, from which the 9 mL already collected must be deducted. Six mL remains. This applies only the stated protocol, with any stricter clinical limit and required specimen approval still to be considered.
Question 106
Two collection needles are labeled 21 gauge and 23 gauge. Which statement about their nominal outside diameters is correct?
☐ A. The 23-gauge needle has the smaller outside diameter
☐ B. The 21-gauge needle has the smaller outside diameter
☐ C. Both needles have the same outside diameter if their lengths match
☐ D. The gauge number describes length instead of outside diameter
Show answer and explanation
Response:A
Final answer:The 23-gauge needle has the smaller outside diameter
The higher gauge is narrower here. The nominal outside diameter of the 23-gauge needle is smaller than that of the 21-gauge needle, independently of needle length. Wall design can change the inner diameter, so this outside-diameter comparison should not be extended to every bore design.
Question 107
A newborn screening card needs another acceptable blood spot. One circle has already been partly filled and is beginning to dry. Which approach avoids layering?
☐ A. Press the paper against the heel to spread the existing spot
☐ B. Collect a fresh free-flowing drop onto an unused circle according to the card instructions
☐ C. Add several small drops onto the drying circle until its surface looks full
☐ D. Apply a drop to each side of the same partly dried circle
Show answer and explanation
Response:B
Final answer:Collect a fresh free-flowing drop onto an unused circle according to the card instructions
Collect onto an unused circle. Apply a fresh free-flowing drop as the card instructs so it saturates evenly without adding layers to the partly dried spot. Touching the paper to the heel or placing drops on both sides can compromise the intended specimen.
Question 108
A patient who reads lips asks the technician to repeat the collection explanation. Which response is most appropriate?
☐ A. Face the patient, use the preferred accommodation, and confirm understanding
☐ B. Face the supply cart and repeat the instructions at greater volume
☐ C. Speak rapidly to shorten the time spent reading facial cues
☐ D. Treat a signed consent form as confirmation that aftercare was understood
Show answer and explanation
Response:A
Final answer:Face the patient, use the preferred accommodation, and confirm understanding
Face the patient while explaining, use the requested accommodation, and check understanding so the patient can read the technician's lips and follow the collection information. Speak at a suitable pace. Turning away, rushing, or relying on a signature does not demonstrate that aftercare was understood.
Question 109
Where should the technician generally place the anchoring hand's thumb for a routine venipuncture?
☐ A. Beside the entry point, touching the cleaned skin surface
☐ B. Across the prepared entry point, pressing the vein in place
☐ C. Below the puncture site, clear of the needle path
☐ D. Immediately above the puncture site, along the needle path
Show answer and explanation
Response:C
Final answer:Below the puncture site, clear of the needle path
Place the thumb below the puncture. Anchoring there clear of the needle path stabilizes the vein without touching the cleaned entry point, avoiding the contamination of across-site placement and the thumb-injury risk of above-site placement along the advancing needle's path.
Question 110
Both controls for a glucose meter are outside their assigned ranges. Repeat controls with unexpired materials remain out of range. The posted policy prohibits patient testing until controls pass. What should the technician do?
☐ A. Adjust the control range to include the repeated results
☐ B. Test patients but flag every result as potentially inaccurate
☐ C. Report patient values only when they match the patient's previous values
☐ D. Remove the meter from patient use and escalate troubleshooting according to policy
Show answer and explanation
Response:D
Final answer:Remove the meter from patient use and escalate troubleshooting according to policy
Remove the meter from patient use. Escalate troubleshooting through policy because the repeated failed controls have not established acceptable performance, which a result flag, adjusted control limits, or agreement with an old patient value cannot supply.
Question 111
The selected antiseptic has been applied, but the site is still wet. Its instructions require air-drying. What should happen before puncture?
☐ A. Blot the site dry with clean gauze immediately after application
☐ B. Allow the site to air-dry as directed
☐ C. Insert the needle while the antiseptic remains wet
☐ D. Wipe the site with a dry fingertip inside a fresh glove
Show answer and explanation
Response:B
Final answer:Allow the site to air-dry as directed
Allow the site to air-dry. The selected agent requires that step before puncture, and blotting with gauze or wiping with a gloved fingertip changes the preparation and can reintroduce contamination at the entry point.
Question 112
After disposing of a used needle, a technician discovers a puncture wound on a finger. Which response best follows an occupational exposure plan?
☐ A. Wash the site and report only if redness develops
☐ B. Wash the site and promptly report for exposure evaluation
☐ C. Wait for the source test result before initiating the exposure process
☐ D. Finish the collection round and then request an evaluation
Show answer and explanation
Response:B
Final answer:Wash the site and promptly report for exposure evaluation
Wash and report promptly. The exposure plan provides evaluation and follow-up after this puncture even when redness is absent or a source test is pending, so finishing the collection round first would delay access to the required response.
Question 113
A clinic requires a receipt number to be entered when a laboratory copayment is collected. The technician receives payment, but the system does not save the receipt entry. What should happen?
☐ A. Collect a second payment because the receipt entry failed
☐ B. Mark payment complete without the required receipt reference
☐ C. Verify the transaction and complete the required payment documentation
☐ D. Defer the discrepancy without recording that payment was received
Show answer and explanation
Response:C
Final answer:Verify the transaction and complete the required payment documentation
Verify whether the transaction succeeded before repairing its documentation, because a failed receipt entry alone does not establish a failed payment. Avoid a duplicate charge. Complete the required receipt reference so the actual payment is traceable in the system.
Question 114
The needle appears properly positioned, but blood does not enter the first evacuated tube. The facility's troubleshooting guide lists loss of tube vacuum as a possible cause. Which action tests that cause?
☐ A. Extend tourniquet application before checking the tube
☐ B. Withdraw the needle slightly before checking the tube
☐ C. Try a new suitable tube with the needle safely maintained
☐ D. Increase needle depth before checking the tube
Show answer and explanation
Response:C
Final answer:Try a new suitable tube with the needle safely maintained
Try a new suitable tube. Keeping the needle safely positioned while exchanging tubes tests the guide's suspected vacuum failure before changing depth or extending tourniquet use. Those other actions investigate different possibilities without checking whether the original tube can draw blood.
Question 115
During setup, a needle's protective package is intact, but its safety shield is visibly damaged. The device has not touched the patient. What is the appropriate action?
☐ A. Set it aside according to the defect-reporting procedure and obtain an intact device
☐ B. Detach the damaged shield and use the exposed needle
☐ C. Use it and manually recap afterward
☐ D. Use it because package sterility is the only relevant check
Show answer and explanation
Response:A
Final answer:Set it aside according to the defect-reporting procedure and obtain an intact device
Obtain an intact replacement device. The package may preserve sterility but cannot repair the damaged shield, so follow defect reporting instead of detaching the shield or relying on manual recapping that sacrifices the intended sharps protection.
Question 116
Before a draw, a patient's record lists a legal name and a different name used in conversation. Which introduction is appropriate?
☐ A. Introduce the technician's name and role, ask how the patient prefers to be addressed, and verify required identifiers separately
☐ B. Use only the legal name in every conversation regardless of the patient's preference
☐ C. Use the preferred name as the sole identifier for tube labeling
☐ D. Ask a visitor which pronouns the technician should use without consulting the patient
Show answer and explanation
Response:A
Final answer:Introduce the technician's name and role, ask how the patient prefers to be addressed, and verify required identifiers separately
Ask the patient their preferred form of address while introducing your name and role, then verify the required formal identifiers separately for the order and specimen. Respect the stated preference. A conversational name alone does not provide the complete specimen-identification process.
Question 117
A new employee asks where to find the procedure for blood splashes and needlesticks. Which document is the most direct resource?
☐ A. The employer's exposure-control plan
☐ B. The waived-test kit's quality-control instructions
☐ C. The laboratory's specimen-rejection policy
☐ D. The collection device's patient-use instructions
Show answer and explanation
Response:A
Final answer:The employer's exposure-control plan
Consult the employer's exposure-control plan. It is the direct workplace resource for preventing and responding to blood contact, including splashes and needlesticks, while kit controls, specimen rejection, and patient-use instructions concern other parts of testing or collection.
Question 118
A patient cannot adequately understand the collection explanation in the technician's language. A qualified interpreter is available through the facility. Which approach best supports informed cooperation?
☐ A. Begin the draw and explain the procedure after the interpreter arrives
☐ B. Use the interpreter and speak directly to the patient in short, clear segments
☐ C. Explain the procedure more loudly in the same language
☐ D. Ask an untrained visitor to interpret because it is faster
Show answer and explanation
Response:B
Final answer:Use the interpreter and speak directly to the patient in short, clear segments
Use the available qualified interpreter to explain before collection, speaking directly to the patient in short, clear segments that allow accurate interpretation and questions. Confirm understanding. Louder speech in the same language or an untrained visitor cannot provide the stated language-access service.
Question 119
For routine venipuncture with a BD Eclipse Signal blood-collection needle, which orientation is appropriate at entry?
☐ A. Bevel up, perpendicular to the selected vein
☐ B. Bevel up, aligned with the selected vein
☐ C. Bevel sideways, crossing the selected vein
☐ D. Bevel down, aligned with the selected vein
Show answer and explanation
Response:B
Final answer:Bevel up, aligned with the selected vein
Enter bevel up along the vein. The named BD Eclipse Signal instructions specify the bevel orientation, while a shallow approach aligned with the vessel supports entry. Crossing the vein or reversing the bevel fails the technique described for this device.
Question 120
A patient reports dizziness during a draw. The technician stops collection, removes the needle safely, and requests assessment. No blood pressure has been measured. Which entry records the observed event accurately?
☐ A. Patient had an anxiety attack. Collection stopped and assistance requested
☐ B. Patient developed hypotension. Collection stopped and assistance requested
☐ C. Patient reported dizziness. Collection stopped and assistance requested
☐ D. Patient had hypoglycemia. Collection stopped and assistance requested
Show answer and explanation
Response:C
Final answer:Patient reported dizziness. Collection stopped and assistance requested
Document the reported dizziness and the collection stop, safe needle removal, and request for assessment, which are the events actually supplied in the question. No blood pressure was measured. Add later findings through the documentation process without labeling an unestablished diagnosis as an observed fact.