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Quiz Session - Attempts With Random Questions

NHA CPT Exam Questions

Page 3 of 50

41.

What is Continuous Quality Improvement (CQI)?

  • A system to improve lab quality by monitoring and identifying areas for improvement

  • The body that sets standards for healthcare organizations

  • An association that phlebotomists can join

  • A law that regulates all laboratory facilities in the US

Correct answer: A system to improve lab quality by monitoring and identifying areas for improvement

Two parts of quality assurance in health care are to ensure that minimum expectations are met, which is the responsibility of a total quality management plan, and to strive to exceed expectations, which is the goal of continuous quality improvement (CQI).

42.

What time frame is required for a Purified Protein Derivative (PPD) test to be read?

  • 48–72 hours

  • 12–24 hours

  • 24–36 hours

  • After 72 hours

Correct answer: 48–72 hours

The PPD test takes 48–72 hours to develop into a finalized induration; this is a standard time frame. Any test read before 48 hours or after 72 hours could yield inaccurate results.

43.

If the phlebotomist is able to easily visualize and palpate a patient's vein, which angle would be optimal for needle insertion?

  • 15

  • 30

  • 45

  • 10

Correct answer: 15

The angle at which the needle is inserted into the skin of the patient depends on the depth of the vein the phlebotomist has selected. Shallow veins require a more shallow angle, whereas deeper veins require a steeper angle. The phlebotomist should remember that too shallow of an angle will create more pain for the patient, while too steep of an angle will not provide adequate blood flow and may damage underlying structures.

44.

Phlebotomist Maria is escorting a patient in a wheelchair through a medical office to the laboratory. The patient has the flu, and he is on droplet precautions.

Which of the following is true regarding transporting a patient using droplet precautions?

  • The patient should wear a mask, but the phlebotomist does not need to wear a mask.

  • The patient should wear a mask, and the phlebotomist needs to wear a mask.

  • Neither the patient nor the phlebotomist needs to wear a mask.

  • The patient does not need to wear a mask, but the phlebotomist does need to wear a mask.

Correct answer: The patient should wear a mask, but the phlebotomist does not need to wear a mask.

Other guidelines for transporting patients when following droplet precautions include:

  • Limit transport and movement of patients to only those that are medically necessary.
  • When transport or movement is necessary in a healthcare setting, patients should wear a mask and follow respiratory hygiene/cough etiquette.
  • No mask is required for workers who are transporting patients with droplet precautions because they are not infectious.

45.

Why are patients never to be seated on a stool or standing when undergoing venipuncture?

  • There is always a possibility the patient could faint and be injured

  • It is less comfortable for the patient

  • Veins will not adequately engorge with blood when the patient is standing

  • The phlebotomist cannot adequately puncture the skin if the patient is standing or on a stool

Correct answer: There is always a possibility the patient could faint and be injured

One of the most common risks associated with venipuncture is a patient becoming light-headed or fainting. This happens because of a vagal response triggered by fear of the procedure. To help eliminate this danger, it is most appropriate to have a patient lying down or reclining.

46.

A phlebotomist working in a pediatrician's office frequently performs throat culture swabs for detection of streptococcal (strep) throat infections. Which of the following is false regarding the throat culture specimen collection procedure?

  • The back of the tongue should be swabbed along with the tonsils.

  • The phlebotomist must wash their hands prior to the procedure, and wear gloves and a mask.

  • A tongue depressor should be used to depress the tongue while the patient says "ah" to raise the uvula out of the way.

  • Any areas of ulceration, exudation, or inflammation should be swabbed.

Correct answer: The back of the tongue should be swabbed along with the tonsils.

The tongue should not touch the specimen swab because it will contaminate the swab. 

The throat specimen swab is meant to collect microbes that are present in the throat and tonsils, but should not come in contact with the lips, tongue, or uvula.

47.

If you are to draw plasma for glucose testing, along with a CBC and PT, what is the correct order of draw for the multi-tube collection?

  • PT, CBC, glucose

  • PT, glucose, CBC

  • CBC, PT, glucose

  • CBC, glucose, PT

Correct answer: PT, CBC, glucose

Plasma for glucose testing commonly requires an oxalate (gray) tube since this additive preserves the whole blood and prevents the breakdown of glucose in the sample.

CBC or complete blood count is drawn using a lavender EDTA tube. 

PT or "pro-time" test is a measure of blood clotting and requires an anticoagulant (blue) tube.  

According to the order of draw, you will collect blue, lavender, and gray. So the correct order of draw for this collection is PT, CBC, and glucose.

48.

Which of the following is true of Clinical Laboratory Improvement Amendment (CLIA) waived tests?

  • Internal quality checks on Point of Care Testing machines meet CLIA standards for waived tests.

  • All Point of Care Tests are waived.

  • Waived tests require the same quality checks as non-waived tests.

  • Waived tests require a certified pathologist to perform quality checks.

Correct answer: Internal quality checks on Point of Care Testing machines meet CLIA standards for waived tests.

For waived tests, quality checks must be performed according to the manufacturer's instructions, which includes internal quality checks.

Not all Point of Care Tests are waived, although the regulations frequently change and more tests are being added.

49.

A patient asks you how to get a do-not-resuscitate (DNR) order. 

What is the best response?

  • A doctor must write the order for you.

  • An attorney can draw up the paperwork for you.

  • You can write the DNR yourself and have 2 witnesses sign it.

  • You can apply for a DNR at the health department.

Correct answer: A doctor must write the order for you.

A DNR order is a medical order. Therefore, it must be written by a doctor. 

A DNR instructs healthcare workers to not attempt cardiopulmonary resuscitation (CPR) when a patient does not want to be resuscitated if they stop breathing or go into cardiac arrest. 

50.

When mixing specimen tubes, which of the following counts as a single inversion?

  • Turn the wrist 180 degrees and back again.

  • Rotate the specimen 90 degrees and back again.

  • Shake the tube firmly once.

  • Turn the tube upside down and shake once.

Correct answer: Turn the wrist 180 degrees and back again.

Tubes must be mixed by gently inverting them 3-8 times (depending on the type of additive and manufacturer's recommendations). Lack of, delayed, or inadequate mixing of tubes can lead to clot formation and may require specimen recollection. 

51.

In preparation for a 5-HIAA test, what types of foods must the patient avoid?

  • Foods with a high serotonin content

  • Foods with a high acid content

  • Foods with a high sodium content

  • Dairy, nuts, and meat products

Correct answer: Foods with a high serotonin content

A 24-hour urine specimen for 5-hydroxyindoleacetic acid (5-HIAA) requires patients to avoid foods with a high serotonin content for 72 hours before and during the collection period. This includes the following foods:

  • Avocados
  • Bananas
  • Kiwi fruit
  • Specific kinds of nuts
  • Tomato products 

5-HIAA is a product of the breakdown of serotonin that is measured in the diagnosis of and monitoring of a certain type of tumor that produces serotonin. 

52.

Which of the following is an example of ethical standards applicable to the practice of phlebotomy?

  • The phlebotomist must be considerate of patient privacy

  • The patient does not have the right to refuse treatment

  • The phlebotomist can share details about patients only with immediate family members

  • Explaining the venipuncture procedure is not a part of informed consent

Correct answer: The phlebotomist must be considerate of patient privacy

It is important to remember to be discreet in approaching the patient. Often the phlebotomist may be in the room at the time another procedure is being performed, the patient is completing personal hygiene, or the physician is examining the patient. Under all these different circumstances, it is necessary to approach the patient and the situation in a mature fashion.

53.

Which glucose analyzer should be used when obtaining a fingerstick capillary glucose level from critically ill patients in an ICU setting?

  • Fingerstick capillary blood glucose checks are not approved for critically ill patients.

  • StatStrip

  • HemoCue

  • Accu-Check Inform

Correct answer: Fingerstick capillary blood glucose checks are not approved for critically ill patients. 

Capillary specimens of critically ill patients are unreliable because dehydration, shock, and certain medications can cause insufficient blood flow to collect a fingerstick sample. Capillary specimens should be used in noncritical care settings.

StatStrip machines are FDA-approved for use in critically ill patients but require a whole blood sample or arterial blood sample.

54.

Which of the following factors is key for regulatory authorities in determining whether a diagnostic test qualifies for a CLIA waiver?

  • Complexity

  • Cost

  • Accuracy

  • Availability

Correct answer: Complexity

The complexity of a test procedure is a key factor in determining whether it is classified as CLIA-waived.

Complexity is based on the difficulty involved in performing the test and the degree of risk of harm to a patient if the test is performed incorrectly. CLIA-waved tests must be easy to perform and have little chance of incorrect results.

55.

Healthcare workers are at risk for back injury because of activities they are required to do, such as lifting or moving patients. When lifting a heavy object, what should you do to protect your spine?

  • Bend your knees and squat low.

  • Lock your knees and bend at the waist.

  • Bend at the waist and lift with the upper body muscles.

  • Lock your core and bend at the hips.

Correct answer: Bend your knees and squat.

 Strategies to prevent back injury include proper mechanics, lumbar support, and exercises to strengthen muscles. When lifting a heavy object, follow these steps to proper body mechanics:

  1. Bend your knees and squat.
  2. Use muscles in the legs and arms, not the back.
  3. Keep items close to your body and lift.

56.

The most effective thing that healthcare workers can do to prevent disease transmission is:

  • Observe good hand hygiene

  • Take daily vitamins

  • Get adequate sleep

  • Wear an N95 respirator

Correct answer: Observe good hand hygiene

Hand hygiene is the most important way to prevent the spread of microbes among workers, patients, and in the community.

57.

If a phlebotomist is transporting samples in a car, what is used to protect samples from extreme temperatures?

  • A plastic cooler

  • Air conditioning vents

  • A blanket

  • A paper bag

Correct answer: A plastic cooler

A phlebotomist can use a standard work vehicle to transport samples to the lab. When this is the case, a standard plastic or metal cooler is acceptable to protect samples from extreme temperatures. The cooler only functions as a secondary container if only one patient's specimens are in it; otherwise, all the samples need to be in separate secondary bags.

Specimens transported by mobile phlebotomist or courier should also be placed on the floor of the vehicle behind the driver's seat where it has no direct exposure to sun or air vents.

58.

What is needed in order for laboratories to release patient results to the patients themselves?

  • A signed release form

  • Nothing; results are always sent to the patient

  • A court order

  • Mediation between the laboratory and the patient's lawyer

Correct answer: A signed release form

Results may not be released automatically for several reasons, the most important being the possibility that those results are mistakenly displayed to unintended viewers. A release form, therefore, is required to release the laboratory of patient confidentiality responsibilities.

59.

Phlebotomist Steven is preparing to collect an oropharyngeal swab on a child with a respiratory infection.

Which of the following precautions must Steven follow when working with this child?

  • Contact plus droplet precautions

  • Contact precautions only

  • Droplet precautions only

  • No precautions

Correct answer: Contact plus droplet precautions

Respiratory infections can have many causes, including viruses and bacteria that can be transmitted through coughing, respiratory droplets, and contact with skin or surfaces. 

Respiratory infections in children may be caused by:

  • Respiratory syncytial virus (RSV)
  • Parainfluenza virus
  • Adenovirus (common cold)
  • Influenza virus ("flu")

Until a doctor diagnoses the source of the infection, healthcare workers must be careful to prevent the spread through multiple routes. 

In this scenario, the phlebotomist should follow contact plus droplet precautions. After adenovirus and influenza are ruled out as a possible cause of the infection, droplet precautions can be discontinued.

60.

All the following are common tests for blood smears, except:

  • Liver panels

  • Malaria

  • Special hematology procedures

  • Complete blood count

Correct answer: Liver panels

Blood smears are not very common tests; however, a phlebotomist should be familiar with what they are. They are small drops of blood approximately the size of a dime placed on a glass slide to be evaluated in a lab. Blood smear tests for malaria are used in hematology, and for complete blood counts.

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