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Quiz Session - Attempts With Random Questions

NHA CPT Exam Questions

Page 8 of 50

141.

The tourniquet should be on the patient's arm for a maximum of: 

  • One minute

  • Two minutes

  • 30 seconds

  • Three minutes

Correct answer: One minute

A tourniquet should be on the patient for no longer than one minute to prevent stagnation of blood which deprives tissues of oxygen. The phlebotomist can place the tourniquet, look for a vein, release the tourniquet for one minute, then re-tie the tourniquet if necessary.

142.

Which of the following tubes is most likely to provide erroneous results if not inverted properly?

  • Light blue and lavender

  • Orange and red

  • Green

  • Gray and yellow

Correct answer: Light blue and lavender

The only appropriate way to mix a sample is by inversion, which is accomplished by putting the blood tube in hand and turning it upside down five to eight times, ensuring proper mixing with additives. Any other method, especially shaking, can lead to a damaged sample or even the tube. Light blue and lavender tubes are anticoagulant tubes and are, therefore, the most sensitive to mixing.

143.

What must the phlebotomist remember about handling patients in altered mental states?

  • They require the assistance of a nurse or another healthcare worker for safety.

  • They are often the easiest to handle since they are pleasantly confused.

  • They can verify their identity and consent to procedures without a relative or guardian.

  • They do not require any special treatment or consideration. 

Correct answer: They require the assistance of a nurse or another healthcare worker for safety.

An altered mental state is a condition that is significantly different from the normal waking state of a conscious person. It is characterized by changes in brain function including:

  • Confusion
  • Disorientation (not knowing who or where they are)
  • Memory loss
  • Disturbed perceptions
  • Abnormal behaviors
  • Emotional outbursts

Patients in this state can be a liability. Consult your facility's protocol for guidance. Usually, assistance with patients who are in altered states of consciousness is required for the safety of everyone involved, including others nearby. 

144.

What is true about selecting a hair specimen for DNA analysis?

  • Pluck from the root

  • Cut from the head

  • Pluck from the face, chest, or arm

  • Cut from the face, chest, or arm

Correct answer: Pluck from the root

For DNA analysis, the hair must include the root, so samples must be plucked, not cut. Head hair is the preferred specimen, but other hair (from the chest, pubic area, or face) may be used in rare cases. Specimens are submitted at room temperature. 

145.

Phlebotomy technician Tom is working with an old piece of equipment. Years of wear and tear have caused deterioration and breakdown in the electrical wires. You are working with Tom in the lab when he suffers a severe electric shock injury. He collapses on the floor next to the equipment, and he has no pulse.

In this scenario, which of the following is not an appropriate response to help Tom?

  • Turn him on his side

  • Cover him with a blanket

  • Start CPR

  • Call for help

Correct answer: Turn him on his side

If an electric shock occurs, the following actions should be taken:

  1. Shut off the source of electricity
  2. Call for medical assistance
  3. Start CPR if indicated (not breathing, no pulse)
  4. Keep the victim warm

Turning a victim on their side is appropriate first aid for a seizure but not for electric shock.

146.

What are the two components of a syringe?

  • Barrel and plunger

  • Safety shield and needle

  • Needle and barrel

  • Cannula and needle

Correct answer: Barrel and plunger

A syringe is compromised of a barrel and plunger. The barrel is a hollow tube which is used for storing and measuring various liquids. The plunger creates the physical means to either draw or push a liquid into the barrel. A phlebotomist must be very careful to control the amount of force they exert on the plunger so as to not damage to blood cells.

147.

Phlebotomists should visually inspect the needle after removing the cover or cap to ensure there are no defects. What is a normal finding when examining a phlebotomy needle?

  • Beveled tip

  • Rough surface

  • Lumen obstruction

  • Metal barb

Correct answer: Beveled tip

A smooth, sharp-pointed bevel is not a manufacturer's defect. Rather, a needle should appear to have a smooth surface and a sharp beveled tip. 

Manufacturer defects that are rare and problematic include rough surfaces, lumen obstructions, or metal barbs. If these defects are discovered, the needle should be discarded in a biohazard container, and a different needle should be used.

148.

How many antiseptic wipes are preferred when collecting a clean-catch midstream urine sample from a female patient?

  • Three

  • One

  • Two

  • Four

Correct answer: Three

Three antiseptic wipes are preferred for cleaning the labia and vagina to ensure a clean sample catch. One is used for each fold of the labia and the third for the urethra opening.

149.

What is the most common type of diurnal test?

  • Cortisol

  • Recreational drugs

  • Platelet function

  • Digoxin

Correct answer: Cortisol

Cortisol is a natural hormone of the body and exhibits diurnal effects. It is also the most common target for diurnal testing.

Digoxin also exhibits diurnal effects; however, it is tested for far less commonly than cortisol.

150.

Which of the following instructions should you give when telling a patient how to perform an "8-hour urine" test?

  • Collect the sample first thing in the morning after waking.

  • Void first thing in the morning after waking, wait 30 minutes, and then collect the specimen.

  • Collect all the urine voided during the 8 hours from the time when you wake up.

  • Choose a time to start the collection and collect all urine that is voided during the next 8 hours.

Correct answer: Collect the sample first thing in the morning after waking.

A first-morning or "8-hour urine" specimen, (also called a first-voided, overnight, or early-morning specimen) is usually collected immediately upon awakening in the morning after approximately 8 hours of sleep. This type of specimen has a high specific gravity, so it is more concentrated than a random specimen. A concentrated urine specimen may contain substances and formed elements such as cells and casts that would not appear in other more dilute specimens. 

To instruct a patient on collection of an 8-hour urine specimen, you would tell them to collect the specimen first thing in the morning after waking.

151.

Which solution and strength is the preferred antiseptic for cleaning a routine venipuncture site?

  • Isopropyl alcohol 70%

  • Isopropyl alcohol 100%

  • Isopropyl alcohol 10%

  • Isopropyl alcohol 30%

Correct answer: Isopropyl alcohol 70%

Isopropyl alcohol 70% is widely available as commercially packaged, individual alcohol prep pads. If you do not have prep pads, 70% isopropyl alcohol and a gauze pad may be used. 

When cleaning the skin for venipuncture, use a back-and-forth motion with gentle friction to remove surface dirt and debris. However, be careful not to irritate the skin by rubbing too hard. 

152.

Which of the following is not considered part of properly greeting the patient?

  • Reading the patient's chart

  • Introducing yourself

  • Making eye contact

  • Describing your role in the patient's care

Correct answer: Reading the patient's chart

When greeting a patient, introduce yourself with your name and role, make eye contact to ensure the patient is attentive, and describe the venipuncture procedure.

While the patient's chart is important, it does not contain the information a phlebotomist needs to greet the patient and develop trust. Reading the patient's chart should not be done at this time.

153.

Current American Heart Association (AHA) guidelines for Infant or Child Cardiopulmonary Resuscitation (CPR) include:

  • Compression depth of four centimeters for infants

  • CPR begins with rescue breaths for infants and children

  • The compression rate is faster for adult CPR than for infants

  • One rescuer CPR only for children

Correct answer: Compression depth of four centimeters for infants

For Infant or Child CPR: CPR begins with 30 compressions (single-rescuer) or 15 compressions (two-person CPR). Recommended compression depth is 4 cm for infants and 5 cm for children up to the onset of puberty. 

An infant or child compression rate of 100 to 120 per minute is the same as current guidelines for adult CPR. One or two healthcare professionals can perform CPR on a victim.

154.

What is the primary purpose of quality control in a laboratory setting?

  • Ensuring the accuracy of test results

  • Following standard operating procedures

  • Conducting regular equipment maintenance

  • Balancing centrifuge tubes

Correct answer: Ensuring the accuracy of test results

Quality control (QC) measures are meant to maintain precision and consistency in test results over time, ultimately ensuring lab accuracy. QC activities and techniques identify and correct errors by being reactive. 

Quality assurance (QA) in the lab improves processes to prevent errors by being proactive. Quality assurance measures include balancing centrifuges, conducting maintenance, and following standard procedures. 

155.

Phlebotomy technician Samantha needs to collect blood from a 3-year-old with very small veins. Her patient is known to be fidgety and nervous when he comes to the lab. Samantha wants to minimize the chances of vein collapse and ensure proper specimen collection. 

Which equipment should Samantha use to reduce the chance of vein collapse and ensure an adequate specimen?

  • 23-gauge butterfly needle with a small evacuated tube

  • 21-gauge needle with a syringe

  • 25-gauge butterfly needle with a large evacuated tube

  • 22-gauge needle with a large evacuated tube holder

Correct answer: 23-gauge butterfly needle with a small evacuated tube

The 23-gauge butterfly needle with a small evacuated tube reduces the vacuum draw on the vein and allows for flexibility if the patient moves, minimizing the risk of vein collapse and ensuring adequate specimen collection. 

156.

The patient has left, and the phlebotomist has noted the blood tubes are not filled to the appropriate level. After notifying the patient’s nurse, what should the phlebotomist do?

  • Send the results to the lab

  • Call the patient to return immediately

  • Call the physician

  • Use sterile water to attain the correct volume

Correct answer: Send the results to the lab

Sometimes, blood tubes cannot be filled completely. In some cases, underfilled tubes may be accepted for testing. Laboratories have procedures for tubes not being filled appropriately, and sometimes they can circumvent filling requirements with applied chemistry. Always make sure to notify the nurse and make a note in the chart.

157.

Which of the following patients is most at risk for an error in white blood cell (WBC) count?

  • A crying baby

  • A patient who is lying down

  • An unconscious patient

  • A patient with a heart condition

Correct answer: A crying baby

The WBC count of a blood test can be significantly altered if a baby has been crying forcefully without being consoled. It is common for infants to cry when a blood sample is taken; therefore, it is important to use proper technique when dealing with pediatric patients.

158.

While preparing to collect a fasting lipid panel, you ask the patient if they've been fasting to verify that the patient has followed their dietary restriction. The patient says, "Yes, I did exactly like Dr. Schmidt told me. I ate nothing after midnight and only had coffee for breakfast."

Which of the following would be the most appropriate action in this scenario?

  • Notify the patient's nurse.

  • Draw the specimen.

  • Reschedule the appointment.

  • Give the patient 8-10 oz of water to drink before collection.

Correct answer: Notify the patient's nurse.

Compliance with diet restrictions is essential for accurate test results. If the only restriction is "fasting," then the patient is allowed to have water only for 8–12 hours before specimen collection. If the patient is NPO for surgery, then the patient should not have water either. Drinking water can help ensure the patient does not become dehydrated, which could make venipuncture harder and affect test results. 

In this scenario, the patient admits to having coffee. So, the phlebotomist must contact the nurse or healthcare provider so that a decision can be made regarding whether to proceed with specimen collection. If the provider does want to go ahead with collecting a sample, the requisition and specimen label should be marked "non-fasting" and any other details as required by the facility's policy. You should not collect the specimen without notifying the provider because they may want to reschedule the patient and give them another opportunity to comply with the dietary restriction, so the doctor can get an accurate result.

159.

The most crucial step in collection of blood cultures is cleansing the venipuncture site. Failure to rid the skin surface of microorganisms could produce a false positive result. 

Which of the following is true about preparing the venipuncture site for blood culture collection?

  • Tincture of iodine should be used after alcohol or chlorhexidine/alcohol

  • Site preparation for neonates is more aggressive than adults because their skin is different

  • After the tourniquet is applied, it is important to start preparation immediately

  • To speed up the process, the phlebotomist should fan or blow on the antiseptic solution

Correct answer: Tincture of iodine should be used after alcohol or chlorhexidine/alcohol

To prepare for blood culture collection, the phlebotomist should remove the tourniquet because it will take more than one minute to clean the site.

Tincture of iodine takes approximately 30 seconds to dry, and povidone-iodine (Betadine) takes 60–90 seconds. Each solution must dry before moving to the next step. Do not fan or blow on the site. Air-drying allows time for the antiseptic to eliminate skin microbes.

Aggressive scrubbing on adult skin helps remove oils and bacteria from the skin. But in neonates, it is important to take a more gentle approach because their skin is fragile and scrubbing could cause skin tears.

160.

What are the first tubes to be collected in a series?

  • Blood culture tubes

  • Coagulant tubes

  • Heparin tubes

  • EDTA tubes

Correct answer: Blood culture tubes

When using a transfer device or a standard needle to deliver blood to a collection tube, the additives within that tube contaminate the needle. If those additives are added to the blood for another tube, the results from that tube could be wrong. An order of draw has been established to prevent this and is set up in such a way that the additives from the first tube do not interfere with the additives of the following tube.

The order is: blood cultures → coagulants (light blue) → serum tubes → heparin tubes → EDTA tubes.

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