1. Which of the following lancet positions should a phlebotomist use for a capillary blood collection on a healthy adult patient?
A. Perpendicular to the fingerprint grooves Correct
B. Parallel to the nail bed
C. Along the lateral portion of the first digit
D. Along the medial portion of the fifth digit
Explanation
For capillary blood collection (fingerstick) on an adult, the puncture should be made on the fleshy pad of the distal segment (fingerprint area) of the middle or ring finger. The lancet should be positioned perpendicular (at a 90-degree angle) to the fingerprint grooves. This ensures proper blood flow and minimizes patient discomfort. Puncturing parallel to the grooves could cause blood to run along the grooves instead of forming a round drop.
2. If a phlebotomist's hands are visibly soiled with blood or body fluids, which of the following decontamination agents should the phlebotomist use to clean them?
A. Alcohol-based hand rub
B. Sterile water rinse
C. Soap and water Correct
D. Alcohol rinse
Explanation
When hands are visibly soiled, soap and water must be used. Alcohol-based hand rubs are effective for general hand hygiene when hands are not visibly dirty, but they are not sufficient to remove visible soil, blood, or body fluids. Soap and water provide the mechanical action needed for proper cleaning in such situations.
3. When a phlebotomist is performing a venipuncture on a patient, which of the following actions is included in aseptic technique?
A. Disposing of contaminated materials Correct
B. Performing hand hygiene once daily
C. Completing quality control procedures
D. Cleansing skin with sodium hypochlorite
Explanation
Aseptic technique aims to prevent infection by eliminating microorganisms. A key component is the proper and immediate disposal of contaminated materials (like used gauze, bandages, or gloves) to prevent cross-contamination. While hand hygiene is critical, it should be performed before and after each patient, not just once daily. Cleansing skin is part of aseptic technique, but sodium hypochlorite (bleach) is not the standard antiseptic; 70% isopropyl alcohol is typically used.
4. A phlebotomist should instruct a patient to take which of the following actions when providing a sputum specimen?
A. Collect the stool directly into a sterile container.
B. Discard the first urine of the day and collect for 24 hr.
C. Aggressively swab the inside of the cheek.
D. Take a deep breath and then expectorate. Correct
Explanation
A sputum specimen is mucus from the lower respiratory tract (lungs/bronchi), not saliva. The correct procedure is to have the patient take several deep breaths and then cough deeply to produce sputum from the lungs, which is then expectorated (spit) into a sterile container. The other options describe stool, 24-hour urine, and buccal (cheek) swab collections.
5. A phlebotomist has collected a lactic acid sample and needs to prepare the sample for processing and transportation. Which of the following methods is correct?
A. Chill the sample. Correct
B. Protect the sample from light.
C. Attach a heat block to the sample.
D. Freeze the sample.
Explanation
Lactic acid is a labile analyte. Glycolysis continues in the tube after collection, which falsely elevates lactic acid levels. To stop glycolysis and stabilize the lactate concentration, the sample must be chilled immediately (placed on ice or in a refrigerated transport container). Freezing is typically not required and could hemolyze the sample. Protection from light is not necessary for lactic acid.