Phlebotomy Nha

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Sample questions from Phlebotomy Nha

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical unit, a 68-year-old client has prescriptions for a CBC, metabolic panel, and blood cultures. The client is receiving IV antibiotics, and the cultures have not been collected. What should the nurse do first?

   • A.Collect the metabolic panel and CBC, then collect cultures from the same puncture site
   • B.Ask the provider to discontinue the cultures because antibiotics have started
   • C.Collect the blood cultures from a peripheral site before the next antibiotic dose
   • D.Collect the blood cultures from the existing IV line

   Rationale: Collecting cultures from a peripheral site before the next antibiotic dose improves the chance of identifying the organism and reduces contamination from an IV line. Drawing cultures from an existing line can introduce contaminants, and delaying cultures until after routine tests or canceling them is not appropriate. When possible, obtain cultures before antimicrobial therapy.

2. 2.In the emergency department, a 42-year-old client with fever and chills has blood cultures and a CBC prescribed. The client is alert, T 39.1 C, HR 118, RR 24, BP 106/64, and SpO2 97% on room air. Refer to the client's chart. Which actions should the nurse take? Select all that apply.

   • A.Document the collection site and time for each culture set
   • B.Use separate venipuncture sites for the culture sets when feasible
   • C.Collect the blood cultures before administering the first antibiotic dose
   • D.Clean the culture bottle tops with an appropriate antiseptic before inoculation
   • E.Draw the cultures from the client's existing peripheral IV to avoid another puncture

   Rationale: The chart shows suspected infection and a prescription for cultures, so collect them before the first antibiotic dose when this does not cause a harmful delay. Separate sites when feasible, disinfect bottle tops, and document collection details to support specimen integrity and interpretation. Drawing from an existing peripheral IV increases contamination risk and is not the preferred approach.

3. 3.During an outpatient draw, a 53-year-old client asks whether the fasting lipid panel can be collected after breakfast. The client ate 30 minutes ago; T 36.8 C, HR 76, and the order specifies a fasting specimen. What is the best response?

   • A.Ask the client to skip lunch and collect the specimen in 2 hours
   • B.Explain that the specimen should be rescheduled according to the fasting instructions
   • C.Collect the specimen now because fasting is required only for glucose tests
   • D.Collect the specimen now and note the meal in the chart

   Rationale: The order specifically requires fasting, and the client has eaten, so the nurse should clarify or reschedule according to the laboratory's instructions. Documenting the meal does not make a nonfasting specimen meet the order's requirement. A brief period without food after breakfast does not substitute for the prescribed fasting interval.

4. 4.At a community clinic, a 7-year-old child needs a CBC and lead level. The child is anxious but cooperative; T 36.9 C, HR 92, RR 20. Which actions support accurate identification and specimen handling? Select all that apply.

   • A.Ask the accompanying adult to verify the child's identity instead of checking identifiers
   • B.Use the required tube for each test and follow the laboratory's order of draw
   • C.Ask the child to state their full name and compare it with the identification band and requisition
   • D.Prelabel all tubes at the workstation before approaching the child
   • E.Label each tube at the collection site immediately after collection

   Answer and rationale are in the full material.

5. 5.A provider prescribes a serum potassium level for a 76-year-old client in long-term care. The client has fragile veins, takes an anticoagulant, and has BP 128/70 mm Hg and HR 80/min. Which assignment is appropriate?

   • A.Ask the client to collect the specimen at home and return it later
   • B.Delegate interpretation of the potassium result to the phlebotomist
   • C.Delegate the venipuncture and specimen labeling to an unlicensed assistive personnel member who has not been checked off
   • D.Ask a trained phlebotomist to collect the specimen and have the nurse verify the result is routed to the provider

   Answer and rationale are in the full material.