Safety and Compliance — All Questions

Which federal agency is primarily responsible for establishing and enforcing workplace safety standards in clinical laboratories?

A phlebotomist notices that the ventilation system in the blood draw station has stopped working. Which organization’s guidelines should be consulted to determine the minimum ventilation requirements for this workspace?

Which organization develops voluntary consensus standards for laboratory procedures, including venipuncture and capillary collection guidelines?

A laboratory is preparing for an accreditation survey. The surveyors will evaluate compliance with operational standards including quality management and patient safety. Which organization most likely conducts this type of healthcare accreditation survey?

Which federal agency conducts research and makes recommendations for preventing work-related injuries and illnesses but does not have enforcement authority?

A patient asks a phlebotomist to interpret the results of a recent CBC. The phlebotomist should explain that interpreting laboratory results is outside of the phlebotomy technician’s scope of practice. Which principle does this action best demonstrate?

Which document outlines the ethical standards and professional conduct expectations for NHA certified phlebotomy technicians?

A phlebotomist is collecting blood from an outpatient and wants to ensure the venipuncture technique follows current best practice guidelines. Which organization publishes the most widely referenced standard for venipuncture collection procedures?

A laboratory director discovers that the phlebotomy department has been following an outdated venipuncture protocol that conflicts with current CLSI standards. An employee reports that the department also has not completed its annual OSHA safety training. Which issue should the director address first?

Which organization provides accreditation specifically for clinical laboratories and requires compliance with quality management standards?

A phlebotomist notices that a chemical spill has occurred near the blood draw station. To determine the proper cleanup procedure and potential hazards of the chemical, the phlebotomist should first consult which document?

A phlebotomy technician accidentally overhears a physician discussing a patient’s HIV status in the hallway. A coworker asks the phlebotomist about the patient’s diagnosis. What is the most appropriate response?

A newly hired phlebotomist is completing orientation at a hospital laboratory. The occupational health department offers the phlebotomist a vaccination at no cost as part of the onboarding process. Which vaccination is the employer required by OSHA to provide to employees with occupational exposure to blood?

A newly hired phlebotomist observes a coworker recapping used needles by hand before placing them in the sharps container. The coworker states this is how they were trained at a previous job. What should the new phlebotomist do?

During a safety audit, an inspector finds that the laboratory does not have Safety Data Sheets available for several chemicals used in the specimen processing area. Which regulation has the laboratory violated?

Which of the following activities falls within the phlebotomy technician’s scope of practice?

A phlebotomist working in an outpatient clinic discovers that the fire extinguisher nearest to the blood draw area has an expired inspection tag. What is the most appropriate action?

A phlebotomy supervisor is comparing two different sets of guidelines: one published by CLSI and one by OSHA. A new phlebotomist asks which guidelines take priority when they conflict. Which statement is most accurate?

A phlebotomist discovers that a specimen was mislabeled after the patient has already left the clinic. According to ethical standards, the phlebotomist should take which action?

The CDC publishes guidelines that are most relevant to which aspect of phlebotomy practice?

A phlebotomist begins the morning shift and checks the temperature log for the specimen storage refrigerator. The last entry was recorded two days ago by a weekend staff member. How often should refrigerator and freezer temperatures be documented in a laboratory specimen storage area?

A phlebotomist records the morning temperature of the specimen storage refrigerator and finds it reads 12 degrees Celsius. The acceptable range is 2 to 8 degrees Celsius. What should the phlebotomist do first?

What is the primary purpose of running control materials on a point-of-care glucose meter before testing patient samples?

A phlebotomist runs the low and high controls on a point-of-care coagulation analyzer. The low control result falls within the acceptable range, but the high control result is above the acceptable range. What should the phlebotomist do?

Which type of laboratory testing requires the least complex quality control procedures and is approved for use in physician office laboratories with a Certificate of Waiver?

A phlebotomist is reviewing the equipment maintenance log for a centrifuge and notices that the last preventive maintenance was performed 14 months ago. The manufacturer recommends maintenance every 12 months. What is the appropriate action?

What does calibration of a point-of-care instrument accomplish?

A phlebotomist opens a new box of glucose test strips and notices that the expiration date printed on the container was two weeks ago. The strips appear to be in good condition. What should the phlebotomist do?

A laboratory notices that glucose results from a point-of-care meter have been trending higher than results from the main laboratory analyzer over the past week. Control results on the POC meter have been within range. Which action is most appropriate?

What information should be recorded in an equipment maintenance log each time preventive maintenance is performed on laboratory equipment?

A phlebotomist is performing a CLIA-waived urine pregnancy test. The internal procedural control line on the test device does not appear. What does this indicate?

A laboratory has been experiencing an increase in hemolyzed specimens over the past month. The phlebotomist reviews the equipment logs and finds that all needles, tubes, and centrifuges are within specifications. Which pre-analytical factor should be investigated next?

Quality control materials for point-of-care testing should be stored according to which guidelines?

A phlebotomist opens the equipment inspection log for a hematology analyzer and notices that the previous technician did not record the results of yesterday’s daily function check. What is the most appropriate action?

What is the purpose of checking reference ranges when performing quality control on a point-of-care device?

During a routine inspection, a phlebotomist discovers that a box of evacuated blood collection tubes has visible cracks in several tubes. The tubes have not expired. What is the correct action?

A phlebotomist is setting up a new lot of control materials for a point-of-care hemoglobin analyzer. The package insert lists an acceptable range of 12.0 to 14.0 g/dL for the normal control. The first control run produces a result of 14.2 g/dL. What should the phlebotomist do?

What is the purpose of performing routine preventive maintenance on laboratory centrifuges?

A phlebotomist notices that the point-of-care glucose meter in the outpatient clinic consistently produces control results that are within range but always near the lower end of the acceptable range. Patient results have not been flagged as abnormal. Should any action be taken?

A phlebotomist retrieves a box of rapid strep test kits from the supply closet and notices that the kits were stored at room temperature. The manufacturer’s instructions state that the kits must be refrigerated at 2 to 8 degrees Celsius. What should the phlebotomist do?

At what fill level should a sharps disposal container be replaced?

A phlebotomist finishes a venipuncture and activates the safety device on the needle. Where should the used needle and holder assembly be disposed of immediately?

Which of the following items is classified as regulated medical waste requiring disposal in a biohazard container?

A phlebotomist accidentally drops a glass slide containing a patient blood smear, and the slide shatters on the floor. What is the correct procedure for cleaning up this broken glass?

According to the OSHA Bloodborne Pathogens Standard, which color is universally used to identify bags and containers holding biohazardous waste?

A phlebotomist is collecting blood from a patient in a hospital room and realizes there is no sharps container within arm’s reach. What is the most appropriate action?

Which of the following characteristics is required for a sharps disposal container?

A phlebotomist spills a tube of blood on the countertop in the processing area. What is the correct first step in cleaning up this blood spill?

A phlebotomist notices that a coworker routinely places used butterfly needle assemblies on the countertop between draws rather than disposing of them immediately. The coworker says it saves time during busy morning rounds. What is the best course of action?

Which disinfectant solution is commonly recommended for cleaning surfaces contaminated with blood or other potentially infectious materials?

A phlebotomist completes a blood collection using an evacuated tube system with a multi-sample needle and holder. After the last tube is drawn and the needle is removed from the patient, what should the phlebotomist do with the needle and holder?

The Needlestick Safety and Prevention Act requires employers to provide which of the following?

A phlebotomist is transporting collected specimens from a patient’s room to the laboratory. Which type of container should be used to transport the tubes through the hallway?

A phlebotomy department is evaluating two different safety-engineered butterfly needles for adoption. Device A has a manually activated shield that covers the needle after withdrawal. Device B has an automatic retraction feature that activates as the needle is withdrawn from the skin. Which factor is most important when selecting between these devices?

Which symbol must be displayed on containers used to store or transport biohazardous materials?

While performing a venipuncture, a phlebotomist accidentally punctures a lavender-top evacuated tube and blood begins to leak. What should the phlebotomist do with the leaking tube?

A phlebotomist sustains a needlestick injury from a needle used on a patient whose bloodborne pathogen status is unknown. The occupational health nurse explains the relative transmission risks of different pathogens. Which bloodborne pathogen poses the greatest risk of transmission from a single needlestick injury?

A phlebotomist finds a used, uncapped needle on the floor of a patient’s room. What is the safest method to dispose of this needle?

A hospital’s sharps injury log shows a significant increase in needlestick injuries among phlebotomists over the past quarter. Most injuries occurred during venipuncture when activating the needle safety device. Which intervention would most effectively reduce these injuries?

When a sharps container must be moved for disposal, what must be done before transporting it?

What is the first action a phlebotomist should take immediately after sustaining a needlestick injury from a contaminated needle?

A phlebotomist sustains a needlestick while drawing blood from a patient. After washing the wound with soap and water, the phlebotomist should take which step next?

If blood or other potentially infectious material splashes into a phlebotomist’s eyes, what is the correct immediate response?

A phlebotomist is removing gloves after a blood collection when a drop of blood splashes onto exposed skin on the forearm. There are no visible cuts or abrasions on the skin. What should the phlebotomist do?

An exposure control plan is required by OSHA for which purpose?

After a needlestick exposure, the occupational health physician recommends that the source patient be tested for bloodborne pathogens. The source patient refuses consent for testing. What happens next?

How often must an employer review and update the written exposure control plan?

A phlebotomist working in a clinic accidentally splashes a patient’s blood onto the mucous membranes of their mouth while opening a specimen tube. After rinsing the mouth thoroughly with water, what should the phlebotomist do next?

A phlebotomist reviews the facility’s exposure incident log and notices that three needlestick injuries occurred in the past month, all during blood collection from patients in the emergency department. Two involved butterfly needles and one involved a straight needle. All three employees reported difficulty activating the safety mechanism while wearing double gloves. Which corrective action would best address this pattern?

Which of the following is a required component of an OSHA-compliant sharps injury log?

A large blood spill occurs on the laboratory floor when a rack of specimen tubes is knocked over. Several tubes break and blood covers an area approximately two feet in diameter. What is the correct procedure for managing this spill?

Which of the following is the most effective method of hand decontamination after removing gloves following a blood collection?

A phlebotomist sustains a needlestick from a needle used on a patient known to be positive for hepatitis C virus (HCV). The phlebotomist has been vaccinated against hepatitis B but there is no vaccine for HCV. What post-exposure action is most important for HCV?

Where must eye wash stations be located in a phlebotomy work area?

A phlebotomist experiences a splash of blood to the face while uncapping a specimen tube. The phlebotomist was not wearing eye protection or a face shield at the time. The facility’s exposure control plan states that eye and face protection must be worn when there is a risk of splash or spray. Which of the following best describes this situation?

After sustaining a needlestick injury, a phlebotomist completes the initial wound care and reports to occupational health. The occupational health provider asks the phlebotomist to sign a form declining post-exposure prophylaxis. The phlebotomist is unsure whether to accept or decline treatment. What is the best advice?

Which bloodborne pathogen exposure requires initiation of post-exposure prophylaxis (PEP) as soon as possible, ideally within 2 hours of the exposure?

A phlebotomist accidentally cuts a finger on a broken specimen tube while sorting specimens in the processing area. The cut is minor but did come into contact with blood from the tube. The phlebotomist is wearing gloves. What sequence of actions should be followed?

According to OSHA, which employees must receive training on the Bloodborne Pathogens Standard?

A phlebotomist working at an outpatient blood draw station notices that the plumbed eye wash station has not been flushed in over a month. The manufacturer recommends weekly activation to ensure proper function. What should the phlebotomist do?

Standard precautions are based on the principle that all blood and body fluids should be treated as potentially infectious. When should a phlebotomist apply standard precautions?

According to CDC hand hygiene guidelines, when should a phlebotomist perform hand hygiene during a routine blood collection?

A phlebotomist is preparing to collect blood from a patient on contact precautions for methicillin-resistant Staphylococcus aureus (MRSA). In addition to gloves, which PPE should the phlebotomist put on before entering the room?

A phlebotomist is assigned to collect blood from a patient with active pulmonary tuberculosis who is on airborne precautions in a negative-pressure isolation room. Which respiratory protection is required before entering the room?

Which type of transmission-based precaution requires a patient to be placed in a private room and healthcare workers to wear a surgical mask when within 3 to 6 feet of the patient?

What is the correct order for donning (putting on) personal protective equipment before entering an isolation room?

A phlebotomist is removing PPE after collecting blood from a patient on contact and droplet precautions. The phlebotomist is wearing gloves, a gown, and a surgical mask. Which item should be removed first?

A phlebotomist finishes collecting blood from a patient and removes their gloves. The phlebotomist’s hands are not visibly soiled. Which hand hygiene method is acceptable in this situation?

When should a phlebotomist change gloves during a work shift?

A phlebotomist is preparing to draw blood from a patient on both airborne and contact precautions. The patient has active tuberculosis and a draining wound infected with MRSA. Which combination of PPE is required?

A phlebotomist has a documented latex allergy. The supply cart contains only latex gloves. What should the phlebotomist do?

Which of the following is the minimum alcohol concentration required in an alcohol-based hand sanitizer for it to be effective in a healthcare setting?

A phlebotomist arrives at a patient’s room and sees a sign indicating droplet precautions for influenza. The patient is coughing frequently. Before entering, the phlebotomist puts on gloves and a surgical mask. Upon entering, the patient sneezes and blood from the venipuncture site sprays toward the phlebotomist’s face. What additional PPE should the phlebotomist have considered wearing?

A phlebotomist notices that a coworker is reusing the same pair of gloves for multiple patients, applying hand sanitizer over the gloves between patients instead of changing them. The coworker states that this saves time and reduces glove waste. How should the phlebotomist respond?

A phlebotomist is about to use an alcohol-based hand sanitizer but notices that their hands have visible blood on them from a previous collection. What should the phlebotomist do?

During the doffing (removal) of PPE, when should hand hygiene be performed?

Which of the following diseases requires airborne precautions rather than droplet precautions?

A phlebotomist is preparing to enter the room of a patient on contact precautions. While donning the gown, the phlebotomist notices a small tear along the seam. What should the phlebotomist do?

A hospital infection control report shows an increase in Clostridioides difficile (C. diff) infections on a medical unit. The phlebotomy supervisor reminds the team about proper hand hygiene for patients with C. diff. Which hand hygiene method is most appropriate after collecting blood from a patient with C. diff?

Which type of PPE provides the highest level of respiratory protection for healthcare workers?

What is the correct compression-to-breath ratio for single-rescuer adult CPR?

A patient becomes pale, diaphoretic, and states they feel dizzy during a routine venipuncture. The phlebotomist suspects the patient is about to faint. What should the phlebotomist do first?

After a venipuncture, a patient’s puncture site continues to bleed despite 5 minutes of direct pressure. The phlebotomist should take which action?

What is the recommended rate of chest compressions during adult CPR?

A patient in the outpatient blood draw waiting area suddenly falls from the chair and hits their head on the floor. The patient is conscious and alert but has a small laceration on the forehead that is bleeding. What should the phlebotomist do first?

Which of the following signs may indicate that a patient is experiencing hypoglycemia during a blood draw?

A diabetic patient begins to exhibit confusion, trembling, and diaphoresis while waiting for a fasting blood draw. The phlebotomist suspects hypoglycemia. What is the most appropriate immediate action?

After any patient-related incident such as a fall or fainting episode, what documentation is required?

A phlebotomist is collecting blood from a seated outpatient when the patient suddenly loses consciousness and slumps in the chair. The patient is breathing and has a pulse. What should the phlebotomist do?

Which of the following signs may indicate hyperglycemia in a patient?

While working in the outpatient lab, a phlebotomist hears a code blue announcement for the waiting area. Upon arriving, the phlebotomist finds an unresponsive adult patient on the floor who is not breathing and has no pulse. An AED is available. What is the correct sequence of actions?

A phlebotomist witnesses a patient faint and fall from a draw chair. After ensuring the patient is safe and conscious, the phlebotomist begins completing the incident report. Which of the following should be included in the report?

What is the recommended depth for chest compressions during adult CPR?

A patient at an outpatient draw station begins to feel faint and says they have a history of fainting during blood draws. The phlebotomist has not yet begun the venipuncture. What is the best preventive action?

A phlebotomist is drawing blood from a patient who suddenly begins to have a seizure. The needle is still in the patient’s arm. What is the most appropriate immediate action?

Who should a phlebotomist notify after a patient experiences an adverse event such as syncope or a fall during a blood collection?

A phlebotomist working at an outpatient clinic encounters a patient in the hallway who appears disoriented, is sweating profusely, and states they are a diabetic who missed breakfast. The patient is not scheduled for any fasting laboratory tests. The patient’s hands are trembling. While waiting for medical staff to arrive, what action is most appropriate if the patient is conscious and able to swallow?

During CPR, what should the rescuer do to minimize interruptions in chest compressions?

A phlebotomist reviews the clinic’s incident reports from the past six months and notices that 80% of patient fainting episodes occurred during morning fasting draws. Most affected patients were elderly. Which recommendation would most effectively reduce the number of these incidents?

A phlebotomist applies a cold compress to a patient’s arm after noticing a hematoma forming at the venipuncture site. After the patient leaves, the phlebotomist needs to document the event. Where should this be documented?

Which accrediting organization conducts unannounced surveys of hospitals to evaluate compliance with patient safety and quality standards?

A phlebotomy technician arrives to work five minutes late for the third time this month. The supervisor has a conversation about performance expectations. Which professional attribute is the supervisor primarily addressing?

Which of the following best demonstrates proper professional etiquette for a phlebotomy technician when entering a patient’s hospital room?