Which of the following is the correct method for cleaning a small blood spill?
Answer : C
A small blood spill should be cleaned using an approved disinfectant according to facility policy. Blood is treated as potentially infectious, so spill response requires gloves, appropriate PPE, containment, removal of visible material, disinfection with correct contact time, and proper disposal of contaminated materials. Dry gauze alone does not disinfect the surface and can spread contamination. Air freshener has no disinfection role. Covering the spill and leaving it to dry is unsafe because dried blood may still represent a contamination hazard and creates exposure risk for staff and patients. The specific disinfectant may vary by facility, but it must be appropriate for bloodborne pathogens and used as directed. The phlebotomist must also avoid direct hand contact, dispose of materials in designated biohazard waste when required, and perform hand hygiene after glove removal. This question tests standard precautions, environmental safety, and infection-control discipline. Reference topics: Safety and Compliance; blood spill cleanup; disinfectants; standard precautions; biohazard waste.
Question 2
Which of the following patient positions is safest for a patient who reports a history of fainting during blood draws?
Answer : C
A patient with a history of fainting should be positioned reclining or lying down before collection. Syncope is a common phlebotomy complication and can lead to falls, head injury, needle injury, or specimen loss if the patient is not positioned safely. Standing is never appropriate for venipuncture because a fainting patient can collapse. Sitting on an unsupported exam table is also unsafe because the patient may fall from a height. Sitting with legs crossed can affect circulation and does not protect against syncope. The phlebotomist should ask about prior fainting, observe the patient's color and behavior, explain the procedure calmly, and stop the draw if the patient becomes pale, diaphoretic, dizzy, nauseated, or unresponsive. If syncope occurs, the phlebotomist should remove the needle when safe, activate the safety device, call for assistance, lower the patient's head or follow facility policy, and monitor the patient until help arrives. Reference topics: Patient Preparation; syncope prevention; patient positioning; adverse reactions; venipuncture safety.
Question 3
Which of the following situations increases a phlebotomist's risk for a needlestick?
Answer : C
A nearly full sharps container increases the risk for a needlestick because contaminated needles or other sharps may protrude, rebound, or be difficult to place safely into the container. Sharps containers must be puncture-resistant, leak-resistant, properly labeled or color-coded, kept upright, and replaced before they become overfilled. OSHA specifically warns not to allow sharps containers to overfill and requires routine replacement to reduce sharps injury risk. A tight tourniquet can cause patient discomfort, hemoconcentration, or venous obstruction, but it is not the best answer for needlestick risk. A 22-gauge needle is commonly used for routine venipuncture, especially for smaller veins, and is not inherently unsafe. A transfer device used with the syringe method is actually a safety control because it prevents the phlebotomist from manually pushing blood through a needle into evacuated tubes. NHA CPT safety content includes bloodborne pathogens, sharps safety, OSHA standards, exposure control, and safe disposal of contaminated equipment. Reference topics: Safety and Compliance; OSHA Bloodborne Pathogens Standard; sharps disposal; needlestick prevention.
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Question 4
Which of the following collection sites is appropriate for a dermal puncture on an infant?
Answer : B
The appropriate dermal puncture site on an infant is the medial or lateral plantar surface of the heel. These areas reduce the risk of puncturing bone and provide suitable capillary blood flow for neonatal testing. The posterior curvature of the heel should be avoided because the bone may be close to the surface, increasing risk of osteomyelitis or injury. The arch of the foot is not an approved puncture site and may damage nerves, tendons, or deeper structures. The tip of the index finger is inappropriate for infants because there is insufficient tissue depth and greater risk of bone injury. Correct infant dermal puncture also requires using an age-appropriate lancet depth, warming the site if needed, cleaning and drying the skin, wiping away the first drop when required, avoiding excessive squeezing, and collecting specimens in the correct order. Infant blood volume is limited, so collection volume must be minimized. Reference topics: Special Collections; infant heel puncture; dermal puncture sites; neonatal safety; osteomyelitis prevention.
Question 5
Which of the following findings should cause a phlebotomist to delay collection and seek assistance?
Answer : B
A patient who is diaphoretic and says they feel faint requires the phlebotomist to delay collection and seek assistance. Diaphoresis, dizziness, pallor, nausea, and weakness can signal an impending syncopal episode. Continuing with venipuncture in this condition increases the risk of falls, needle injury, hematoma, and patient harm. Confirming date of birth is normal patient identification. Asking which arm will be used is a reasonable patient question and does not require delay. A visible median cubital vein is generally favorable for routine venipuncture. The phlebotomist should position the patient safely, preferably reclining or lying down if fainting risk is present, notify appropriate personnel, and proceed only when safe according to facility policy. If symptoms occur during a draw, the technician should remove the tourniquet and needle when safe, activate the safety device, call for help, and monitor the patient. Reference topics: Patient Preparation; syncope warning signs; patient assessment; collection delay; emergency response.
Question 6
Which of the following is the life span of an erythrocyte?
Answer : D
The life span of an erythrocyte, or red blood cell, is approximately 120 days. Erythrocytes are specialized cells that transport oxygen through hemoglobin and support carbon dioxide transport from tissues back to the lungs. Because mature erythrocytes lack nuclei and many organelles, they cannot repair themselves indefinitely; they gradually lose membrane flexibility and are removed primarily by the spleen and reticuloendothelial system. A 14-day lifespan is far too short for normal red blood cells and is more consistent with certain abnormal disease states or other cellular turnover concepts. Eighty days and 160 days are not the standard lifespan used in basic hematology. This knowledge matters in phlebotomy because blood collection, CBC interpretation context, hemolysis awareness, and specimen quality all depend on understanding blood components. The phlebotomist is not diagnosing anemia or hemolytic disease, but must understand formed elements and their general characteristics. Reference topics: Phlebotomy Fundamentals; blood composition; erythrocytes; hematology basics; CBC-related concepts. MedlinePlus states that red blood cells live about 120 days.
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Question 7
Which of the following actions should a phlebotomist take when preparing a specimen for transport?
Answer : B
When preparing a specimen for transport, the phlebotomist should keep the tube with the stopper upright whenever practical. Upright positioning helps reduce leakage risk, prevents specimen contact with the stopper area more than necessary, and supports safe handling during movement to the laboratory or processing area. Refrigerating infectious substances is not a universal transport rule; temperature requirements depend on the ordered test and specimen handling instructions. Agitating a tube vigorously is incorrect because it can cause hemolysis, clot disruption, foaming, or cellular damage. Additive tubes are mixed by gentle inversion according to manufacturer guidance, not shaking. Wrapping multiple tubes together is also poor practice because tubes should be protected from breakage, leakage, and cross-contamination using proper specimen transport bags, absorbent material when required, and separated compartments when applicable. Proper transport preserves analyte stability, patient safety, and biohazard control. NHA CPT processing content includes preparing specimens for testing or transport, maintaining specimen integrity based on temperature, light, or time requirements, and following handling, storage, transportation, and disposal requirements. Reference topics: Processing Specimens; specimen transport; tube handling; specimen integrity.
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