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Quiz Session - Attempts With Random Questions

NHA CPT Exam Questions

Page 9 of 50

161.

Overfilling microtubes that contain anticoagulants can result in which of the following?

  • Microclots

  • Inaccurate results

  • Hemolysis

  • Excessive anticoagulation

Correct answer: Microclots

Pay strict attention to the fill levels of microtubes that contain anticoagulants. Overfilling can result in the presence of microclots in the specimen, or even complete clotting of the specimen because there may not be enough anticoagulant for the excess amount of blood. Also, excess anticoagulant in underfilled microtubes can negatively affect test results. 

162.

What is the purpose of preparing platelet-poor plasma (PPP) in the laboratory?

  • To facilitate coagulation tests that require platelet-poor plasma

  • To ensure accurate blood smear results

  • To isolate platelets for further analysis

  • To remove excess cells from a specimen

Correct answer: To facilitate coagulation tests that require platelet-poor plasma

Platelet-poor plasma is used for coagulation tests and other assays that require plasma that is devoid of platelets. The process of preparing PPP involves carefully transferring plasma from centrifuged specimens to remove remaining platelets and ensure accurate test results. 

PPP is not used for blood smear analysis or platelet analysis.

163.

Which color tube protects a blood sample from light?

  • Amber

  • Gray

  • Clear

  • Black

Correct answer: Amber

Protecting a tube from light is important in several types of tests including, and most especially, bilirubin. An amber-tinted tube is designed for this purpose. If an amber tube is not available, tin foil may be wrapped around the tube.

164.

Daron is a phlebotomist at a nursing home. When he goes to draw blood on Mr. Jones, he finds that Mr. Jones has been transferred to the hospital because he was having chest pains that morning. 

What should Daron do if he is unable to obtain specimens from Mr. Jones?

  • Notify Mr. Jones' nurse

  • Call the hospital lab and ask them to collect the specimen

  • Throw the requisition form away 

  • Cancel the order

Correct answer: Notify Mr. Jones' nurse

Sometimes, a phlebotomist is unable to collect an inpatient specimen because the patient has moved to surgery or another department. If the specimen cannot be obtained, the phlebotomist should notify the nurse or physician. They may be required to fill out a form stating that the specimen was not obtained and give the reason why. In some facilities, this form is placed on the patient's chart, and the lab retains a copy. The phlebotomist should always follow facility protocols. 

165.

All the following are types of diabetes, except:

  • Post-diabetes

  • Pre-diabetes

  • Diabetes mellitus type 1

  • Diabetes mellitus type 2

Correct answer: Post-diabetes

The three types of diabetes the phlebotomist needs to be aware of are pre-diabetes, diabetes mellitus type 1, and diabetes mellitus type 2.

166.

Shelly has drawn blood and labeled her tubes for transport. She checks the patient's venipuncture site and sees that the bleeding has stopped. Next, she covers it with a gauze pad secured by a Coban bandage. The patient asks when they can take off the bandage.

Which response is best?

  • 15–30 minutes

  • 1 hour

  • Overnight

  • 5–10 minutes

Correct answer: 15–30 minutes

Patients should be instructed to leave bandages on for a minimum of 15 minutes, but no longer than 30 minutes, to avoid skin irritation. 

Patients in the outpatient setting, such as a doctor's office or lab center, should also be cautioned to avoid lifting anything heavy like a purse or grocery bag with that arm for several hours to avoid reopening the wound. It is a good idea to ask patients to repeat the instructions so you can ensure that they understand. 

167.

What does the "peak level" (post dose) refer to?

  • A time at which drug levels in the blood are highest

  • A time at which drug levels in the blood are lowest

  • Urine drug samples collected at the end of the day

  • Drug levels tested when the patient wakes up

Correct answer: A time at which drug levels in the blood are highest

When determining a therapeutic range, peak levels (also known as post dose) are taken to understand how long the patient needs to metabolize the medications given. This helps determine the timing and size of doses.

168.

What is the goal of standard precautions?

  • To reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection

  • To isolate the patient

  • To kill the worst kinds of bacteria

  • To prevent droplets from traveling one meter or more

Correct answer: To reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection

Standard precautions create the first tier of precautions for all patients, regardless of their diagnosis or infectious status. Standard precautions are derived from universal precautions and body substance isolation precautions. Standard precautions are to be used in all patient interactions.

169.

What size of induration of a purified protein derivative (PPD) test signifies a positive tuberculosis test?

  • Greater than or equal to 10 mm

  • 5-10 mm

  • 1-5 mm

  • 4-8 mm

Correct answer: Greater than or equal to 10 mm

A purified protein derivative test for tuberculosis creates a wheal underneath the skin that then turns into an induration. The induration will most likely be red; however, the size of the induration is what is observed. If the induration is less than 5 mm, the test is negative; if it is between 5-10 mm, the test is doubtful. If the induration is greater than 10 mm, the test is positive and more testing must be conducted.

170.

Which of the following is the correct instruction to give a patient when performing a throat culture specimen collection?

  • "Please tilt your head back and open your mouth wide."

  • "Please tilt your chin down and open your mouth wide."

  • "Please cough twice. Then open your mouth wide."

  • "Please tilt your head back and open your mouth to cough."

Correct answer: "Please tilt your head back and open your mouth wide."

Instructing the patient to tilt their head back and open their mouth wide allows adequate evaluation of the collection site and ease in specimen collection. Using a penlight, the phlebotomist can visualize the back of the throat to see where to direct the swab and can avoid contaminating the swab by touching the tongue or lips.

The phlebotomist should not instruct the patient to cough because that could expel pathogens into the air. Tilting the head down would make it harder to collect the specimen.

171.

Per OSHA regulations, if a phlebotomist is using a needle without a safety feature, what else should they use for venipuncture?

  • Tube holder with a safety feature

  • Tube holder or syringe from the same manufacturer

  • Tube holder from a different manufacturer

  • Syringe from a different manufacturer

Current answer: Tube holder with a safety feature

To satisfy OSHA regulations, if a needle does not have a safety feature, the equipment with which it is used (e.g., a tube holder or syringe) must have a safety feature to minimize the chance of accidental needlestick. 

It is recommended to use components from the same manufacturer. When parts are mixed and matched, the risk of problems increases. For instance, the needle could come unscrewed from the syringe or pop off during venipuncture. However, this best practice is not considered an OSHA safety regulation. 

172.

A laboratory technician observes that a centrifuge is vibrating excessively during operation. 

What should be the technician's corrective action?

  • Balance the centrifuge tubes

  • Perform a calibration check

  • Conduct quality-control testing

  • Ignore the issue and continue operation

Correct answer: Balance the centrifuge tubes

When a centrifuge shakes, vibrates excessively, or is noisier than usual when it is turned on, it may not be properly balanced. You should turn off the machine immediately. Then, you must rebalance the centrifuge tubes. An unbalanced centrifuge might break the tubes, causing the tube contents to form aerosols. 

173.

How long does the Centers for Disease Control and Prevention (CDC) recommend washing your hands in the healthcare setting for routine handwashing?

  • At least 20 seconds

  • At least 1 minute

  • At least 15 seconds

  • At least 2 minutes

Correct answer: At least 20 seconds

According to the Centers for Disease Control and Prevention (CDC), routine handwashing should take at least 20 seconds, which is the time it takes to hum the "Happy Birthday" song or ABCs twice.

174.

While performing venipuncture, your patient asks you if you can send the results to her therapist who she recently started seeing. Which of the following is the best response to the patient in this scenario?

  • To protect your privacy, we are unable to share results without written consent. Please check with the nurse for a release form.

  • The lab is not responsible for medical records. Please check with your doctor about sending the therapist a copy.

  • Your therapist should not need a copy of lab results since they are not a part of your medical team.

  • When you get the lab results you can show them to your therapist.

Correct answer: To protect your privacy, we are unable to share results without written consent. Please check with the nurse for a release form.

Phlebotomists are often asked to send lab results to outside providers. It is important to always consider patient confidentiality. Both the Clinical Laboratory Improvement Act (CLIA) and The Health Insurance Portability and Accountability Act (HIPAA) ensure that only authorized providers can view patient results. Most facilities require patients to complete a waiver before their information is shared. However, providers can request medical records for continuity of care whenever needed. In most situations, without a signed waiver or a physician's request, only the patient and the ordering doctor can receive the test results.

In this scenario, you want to acknowledge the patient's request and honor their right to have their records shared with their providers. The best response is to explain how to release the records by telling the patient they must sign a release form and where to obtain the form. 

175.

What is the goal of Continuous Quality Management (CQI)?

  • To seek to improve any chosen practice or procedure beyond minimum expectations

  • To achieve minimum expectations in phlebotomy

  • To delineate scope of care

  • To assess the effectiveness of actions

Correct answer: To seek to improve any chosen practice or procedure beyond minimum expectations

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).

176.

A patient arrives at an outpatient laboratory with orders for multiple lab tests. Which of them should the phlebotomist collect first?

  • UA

  • CBC

  • CMP

  • PT/INR

Correct answer: UA

If a urine test is ordered along with blood tests on an outpatient, ask the person to collect the urine specimen first. Otherwise, the patient could become faint after the venipuncture and pass out in the restroom with the door locked. 

In this scenario, the UA should be collected first.

  • UA = urinalysis (urine test)
  • CBC = complete blood count (blood test)
  • CMP = complete metabolic profile (blood test)
  • PT/INR = prothrombin time, international normalized ratio (blood test)

177.

Regarding lab requisition forms, which of the following is not required?

  • Specimen handling requirements

  • Physician's signature

  • Date and time of scheduled collection

  • Special patient precautions

Correct answer: Specimen handling requirements

Specimen handling requirements—such as volume, storage temperature, and any special handling notes—are not required on test requisitions. Instead, these details are found in the laboratory's test directory or test menu. The directory or menu is often available in a digital format online. 

178.

Osteoarthritis in the elderly can cause trouble with walking or transferring in and out of the phlebotomy chair. 

Which of the following best describes osteoarthritis?

  • Joint inflammation caused by age or injury, which can restrict movement

  • Connective tissue disease that is associated with inflammation and may affect the heart and lungs

  • Neurological disease that results in slow movement, stiffness, and loss of balance

  • Brain disorder that affects memory and thinking 

Correct answer: Joint inflammation caused by age or injury, which can restrict movement

Osteoarthritis occurs with aging and also as a result of injury. The hips and knees are the most commonly affected. 

Rheumatoid arthritis is the other basic type of arthritis, but it affects connective tissue throughout the body and can occur at any age. Patients with rheumatoid arthritis may have problems with the heart, lungs, eyes, kidneys, and skin. 

Parkinson's disease is a neurological condition that results in slow, stiff movements and loss of balance. 

Dementia is a brain disorder that affects memory and thinking skills.

179.

Which of the following best describes hemoglobin?

  • A protein containing iron

  • A molecule that carries carbon dioxide

  • A carbohydrate containing glucose

  • A lipid containing glycerol

Correct answer: A protein containing iron

Hemoglobin is a protein that contains iron, which binds to oxygen. This bonded oxygen is then carried around the body to the tissues and organs where it can be used for metabolism. Anything that affects hemoglobin, such as an anemic disease, also affects the body's ability to deliver oxygen to the tissues.

Hemoglobin is just one type of molecule in the blood. The blood contains many molecules, including:

  • Carbaminohemoglobin, which carries carbon dioxide
  • Glycerolipids, which are lipids that contain glycerol
  • Glucose, which is a type of carbohydrate

180.

What type of sample is preferred for laboratory alcohol testing?

  • Blood

  • Urine

  • Breath

  • Stool

Correct answer: Blood

When alcohol levels need to be attained, blood is the preferred medium for testing.

Alcohol breath tests are often used for other testing; however, they are less accurate than blood tests. Alcohol is not present in stool specimens. Alcohol may be present in urine for only a few hours, but urine cannot show levels the same way that blood testing can.

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