NHA Phlebotomy-Technician Exam Questions

The incident report should include the type of blood collection device used. For a needlestick or contaminated sharps injury, the device involved is central to exposure documentation because the facility must evaluate whether safer devices, training, handling, or disposal procedures failed. OSHA states that a sharps injury log must include, at minimum, the type and brand of device involved when known, the department or work area, and an explanation of how the incident occurred. The number and color of tubes collected may matter for specimen documentation but does not explain the exposure mechanism. The employee's primary care provider information is not the key occupational exposure detail. Proof of biohazard container fill-line adherence may be relevant only if the injury involved sharps disposal, but the broader required incident-report item is the collection device involved. The phlebotomist should immediately wash the area, report the injury, follow exposure-control policy, document the event, and obtain occupational health evaluation. Reference topics: Safety and Compliance; needlestick injury; exposure control; OSHA sharps injury log; incident reporting.

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The phlebotomist should notify the nurse or provider according to facility policy. A competent adult patient has the right to refuse a blood draw, even when the test is ordered. Proceeding against the patient's refusal is unethical and can constitute battery. Asking a family member to pressure the patient is inappropriate because consent must come from the patient or legally authorized representative when applicable, not from coercion. Using a smaller needle does not address refusal unless the patient specifically refused because of needle size and then gives consent after discussion. The phlebotomist should remain professional, clarify the patient's concern within scope, avoid arguing, document or report the refusal as required, and allow authorized clinical personnel to follow up. This question tests patient rights, consent, communication, and scope of practice. Phlebotomy is invasive, so consent is not optional. The technician's authority ends where patient refusal begins unless a specific emergency or legal policy applies through authorized medical personnel. Reference topics: Patient Preparation; patient refusal; consent; patient rights; communication; documentation.

Prolonged bleeding is the expected complication for a patient on warfarin therapy. Warfarin is an anticoagulant, meaning it interferes with normal clot formation and can increase bleeding time after venipuncture. The phlebotomist should be alert for delayed hemostasis, apply firm pressure after needle removal, avoid having the patient bend the arm sharply, and confirm that bleeding has stopped before applying a bandage and leaving the patient. Blood clotting is the opposite of the expected medication effect. Hemostasis is the normal stopping of bleeding, not a complication. Petechiae can occur from tourniquet pressure, fragile capillaries, or platelet-related issues, but in this question the medication-specific risk is prolonged bleeding. Proper technique reduces complications: release the tourniquet, withdraw the needle smoothly, activate the safety device, apply pressure, and monitor the puncture site. Reference topics: Routine Blood Collections; post-procedure care; anticoagulant therapy; bleeding complications; hemostasis; patient observation. NHA includes routine venipuncture complications and post-collection care within the CPT test plan.

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OSHA requires employers to offer the hepatitis B vaccine to employees who have occupational exposure risk to bloodborne pathogens. Phlebotomists routinely handle blood, contaminated needles, sharps, and potentially infectious materials, so they fall into the category of workers who require bloodborne pathogen protection under workplace safety standards. Hepatitis B is a bloodborne viral infection that can be transmitted through needlestick injuries, mucous membrane exposure, or contact with contaminated blood. The vaccine is an important preventive measure and must be offered according to employer exposure-control procedures. Medical insurance and life insurance are employee benefit issues, not OSHA bloodborne-pathogen requirements. Phenylketonuria screening is a newborn metabolic screening test and has no connection to employee exposure prevention. In practice, the phlebotomist must also follow standard precautions, use PPE, activate safety devices, dispose of sharps immediately, report exposures, and comply with the facility exposure-control plan. Reference topics: Safety and Compliance; OSHA Bloodborne Pathogens Standard; hepatitis B vaccination; occupational exposure; needlestick prevention.

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A critical value must be reported to the provider directly and promptly according to facility policy. Critical values represent results that may indicate an immediate threat to the patient's health, so delayed communication can create patient-safety risk. The phlebotomist should follow the organization's read-back, documentation, escalation, and notification procedure, especially when the result comes from point-of-care or waived testing performed by the phlebotomist. Waiting until all collections are completed is unsafe because critical values require timely clinical action. Asking a colleague to repeat the testing is not the correct first response unless the facility's procedure specifically requires confirmatory testing and the phlebotomist is authorized to perform it. Recording the value in the chart for later nurse review is also insufficient because it does not ensure immediate provider notification. Critical value handling is part of specimen processing, communication, patient safety, and point-of-care testing responsibility. NHA CPT competencies include reporting abnormal or critical results, communicating with clinical personnel, documenting results, and following testing protocols. Reference topics: Processing Specimens; Special Collections; point-of-care testing; critical value reporting.

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