NHA Phlebotomy Exam 2022-2023: Study Guide with 400 Practice Questions and Answers for National Healthcareer Association Certified Phlebotomy Technician Examination

By Mona Lindsey

Give yourself the best possible chance to succeed in one of the most important exams in your life.

 

You're almost there! Just a few more steps to finally become a full-fledged practicing phlebotomist.

 

You've fulfilled your requirements, completed your phlebotomy program, and now it's time to get certified so you can finally get to work.

 

To get certified, you'll have to pass the NHA Certified Phlebotomy Technician Exam first.

 

Without passing this test, you won't be able to practice this profession.

 

Your career as a phlebotomist is dependent on passing this exam, so you need to take it seriously.

 

So how do you prepare for it?

 

It helps to know what to expect in the exam – what topics are covered, how many questions there are, how long you have to finish it.

 

You should also know the potential questions you will find and how to best approach them.

 

This exam prep guide will synthesize all of the information you'll need on your exam into one concise study guide that you can easily refer to and practice with.

 

In NHA Phlebotomy Exam 2022-2023, you will discover:

 

• How to ease your exam nerves by thoroughly preparing for your Phlebotomy certification exam using this study guide
• An exhaustive list of possible questions to test your core knowledge about blood components, needlestick safety, vascular anatomy, and more
• A helpful way to assess your knowledge and preparedness – and track your progress as you get closer to exam time
• Detailed answer explanations that will help you understand your mistakes and avoid them in the actual exam
• Procedural and practical questions about routine blood collection that will prepare you for your future job
• Comprehensive practice tests covering each of the main subjects in the exam – from Safety and Compliance to Processing

 

And much more.

 

Even if you think you're already ready to take this exam, it doesn't hurt to get additional preparation.

 

Knowing that you've thoroughly studied and are well-prepared will give you more confidence and lessen the anxieties that come with test-taking.

 

You've got it in you to ace this challenging exam. This study guide will give you that extra boost.

 

If you want to increase your chances of success in the NHA Phlebotomy exam and finally become a certified phlebotomy technician, then you need this book today!

• Language: English
• Publisher: Hanley Publications LLC
• Release date: Jun 23, 2024
• ISBN: 9798227960399

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Please note the information contained within this document is for educational and entertainment purposes only. All effort has been executed to present accurate, up to date, and reliable, complete information. No warranties of any kind are declared or implied. Readers acknowledge that the author is not engaging in the rendering of legal, financial, medical or professional advice. The content within this book has been derived from various sources. Please consult a licensed professional before attempting any techniques outlined in this book.

By reading this document, the reader agrees that under no circumstances is the author responsible for any losses, direct or indirect, which are incurred as a result of the use of information contained within this document, including, but not limited to, — errors, omissions, or inaccuracies.

Contents

Introduction

Chapter One: Safety and Compliance

Workplace Safety Regulations

Operational Standards Regulations

HIPAA Regulations

Ethical Standards

Lab Equipment Quality Control

Standard Precautions

Transmission-Based Precautions

Exposure Control

Disposal of Biohazards and Sharps

CLIA Waived Tests

Aseptic and Infection Control

Hand Hygiene

CPR and First Aid

Documentation and Reporting

Key Takeaways of Safety and Compliance

Chapter Two: Patient Preparation

Identifying the Patient

Requisition Forms

Consent

Venipuncture Equipment

Site Selection

How to Perform Venipuncture

Requisition Forms Requirements

Patient Positioning

Variables Impacting Collection

Special Considerations

Testing Requirements

Non-Blood Specimen Collection

Minimum and Maximum Collection Amounts

Key Takeaways of Patient Preparation

Chapter Three: Routine Blood Collection

Blood Collection Devices

Device Selection

Needle Gauge Sizes and Lengths

Evacuated Tubes

Order of Draw, Tube Inversion, Angle of Insertion

Equipment Quality Control

Tourniquet Application and Removal

Palpation Techniques

Skin Integrity, Venous Sufficiency, and Contraindications

Antiseptic Agents and Application

Anchoring the Vein

Problematic Patients: Signs and Symptoms

Possible Complications of Blood Draw

Adjustments When Establishing Blood Draw

Needle Safety Devices

Capillary Collection (and Order)

Bandaging Practices

Labeling Procedures and Considerations

Post-Procedural Considerations

Key Takeaways of Routine Blood Collection

Chapter Four: Special Collections

Peripheral Blood Smears

Blood Culture Collections

Pediatric Volumes

Throat Cultures, Nasal Swabs

Nasopharyngeal (NP) Culture Swabs

Blood Alcohol Collection

Key Takeaways of Special Collections

Chapter Five: Processing

Centrifuging

Aliquoting

Handling, Storage, Transportation, and Disposal of Specimens

Chain of Custody

Critical Values for Point of Care Testing

Distribute Results

Key Takeaways of Processing

Chapter Six: Core Knowledge

Role of Phlebotomy Technicians

Terminology

Aseptic Technique

Blood Components

Blood Group Systems

Vascular Anatomy

Cardiovascular System

Hemostasis and Coagulation

Pre-Analytical Errors

Needlestick Safety and Prevention Act

Documenting and Reporting

Importance of Verbal and Nonverbal Communication

Professionalism & Ethical Standards

Key Takeaways of Core Knowledge

Practice Tests

Practice Test One

Answer Key

Answers and Explanations

Practice Test Two

Answer Key

Answers and Explanations

Practice Test Three

Answer Key

Answers and Explanations

Practice Test Four

Answer Key

Answers and Explanations

Conclusion

References

Introduction

Trust yourself, you know more than you think you do.

- Benjamin Spock

While the notion of trusting yourself is freeing, it is harder to implement. When preparing for an exam in the health field, relying on intuition is near impossible. To become a phlebotomy technician, you must become familiar with specific information in biology, chemistry, and overall clinical skills. You must understand the material and logic and remember the facts to succeed.

Phlebotomy is an important clinical job promising as a career and on-field experience for aspiring doctors, nurses, physician’s assistants, or other medical roles. Phlebotomy technicians draw blood and process it for health tests, donations, or research purposes. Such work deals with highly critical tasks that need training and practice, like inserting needles into veins, sterilizing tools, and handling samples with care. It also includes basic knowledge and understanding of vitals related to the circulation system, like pulse and blood pressure.

The phlebotomy technician is often the direct liaison between the patient and the laboratory. Because it includes regular patient contact, technicians must train in proper communication. They are responsible for explaining to patients the procedures and calming them down in preparation for taking blood samples.

To become a Certified Phlebotomy Technician, you must have a strong work ethic. That said, reaching this goal can be challenging and intimidating. While a phlebotomy training program sufficiently prepares you for the practical, hands-on side of the job, preparing for the exam is primarily up to you. Whether working or attending school while studying for the exam, you do not have time or money to waste.

This book offers a consolidated way to study for your NHA Phlebotomy Exam. Alongside comprehensive content about all the areas you need to know for the exam, you also have access to included practice exams. In this study guide, you will have a concise summary of all essential aspects of phlebotomy: safety and compliance, prepping patients, collecting routine blood samples, special collections, processing collected samples, and the core knowledge necessary for becoming a phlebotomy technician.

At the end of the study guide, you can check your progress with 350 practice questions inspired by previous NHA Phlebotomy exams.

Read this guide, take notes, and review any material you struggle with. Use the practice questions (and answers) to check if you are on the right track. As one of the leaders in full-length test prep manuals, Henley Test Prep aims to give you confidence in your knowledge and skill set. Preparing for your test is paramount to passing and becoming a full-fledged Phlebotomy Technician. Above all, trust yourself to overcome exam nerves and feel empowered by the concise resource at your disposal. Get started with your 2022-2023 NHA Phlebotomy exam preparation today.

Chapter One: Safety and Compliance

The topic of Safety and Compliance is an essential aspect of being a phlebotomist. Working with biological and chemical substances means there is a high risk for contamination of bloodborne diseases. At the very least, mishandling substances or lab equipment can lead to inaccurate blood results or harm yourself and your colleagues.

Workplace Safety Regulations

The primary workplace for the phlebotomist is in the laboratory, handling and processing blood samples and other specimens. Many risks abound in the laboratory, including the potential for biological, chemical, physical, radioactive, and musculoskeletal hazards. To avoid these dangers, the Occupational Safety and Health Administration (OSHA) provides rules and regulations nationally to ensure laboratory safety. Along with OSHA, there are also federal, state, and local safety regulations.

Follow these OSHA guidelines to prevent hazards and stay safe in the lab.

Personal protective equipment (PPE) are tools that offer a barrier between your body and harmful biological substances. The most common and crucial forms of PPE for phlebotomists are medical examination gloves and white lab coats.

Medical examination gloves are the phlebotomist’s first line of defense. Gloves provide a sufficient barrier against contaminants in the substances you handle. Contaminants may also be present on lab work surfaces or other equipment. Wearing gloves at all times ensures you protect yourself and others from contacting potential diseases from such contaminants. However, wearing gloves most of the time does not mean reusing gloves. You must remove gloves properly when you finish handling a collected sample or substance from a patient before moving on to the next patient. A standard procedure is to remove gloves to avoid contact between the contaminated gloves and your skin.

Steps to remove gloves properly:

First, take hold of the cuff of one glove (Hand #1) with your forefinger and thumb of your other hand (Hand #2) without touching the skin of your wrist.

Second, carefully pull the glove off Hand #1 until it is half off and inside-out.

Then, use your forefinger and thumb of Hand #2 to fully peel off the glove of Hand #1. As you do this, simultaneously remove the rest of Hand #1’s glove, creating a ball with the two gloves.

Throw the gloves away in a lined container.

Operational Standards Regulations

When handling blood samples, there are significant risks to watch out for:

Injuring patients during the blood draw

Failing to obtain the right specimens from patients

Inaccurate blood test results that are inconsistent from one lab or facility to another

When drawing blood, various tubes might have contaminants or additives. Thus, it is important to draw blood correctly to prevent contaminating the sample.

Order of blood draw:

Blood sample tube

Sodium citrate tube

Serum tube

Heparin tube

EDTA tube

Sodium fluoride/Potassium oxalate glycolytic inhibitor

HIPAA Regulations

All phlebotomists must be familiar with HIPAA regulations and how to apply them to their daily responsibilities. HIPAA stands for Health Insurance Portability & Accountability Act and was established in 1996 to protect patient information and give patients authority over their health documents. The ‘Portability’ aspect of HIPAA refers to the protection of health insurance for workers (and families) in the case of job loss. Under HIPAA, you must only use the minimum amount of patient information necessary for three reasons: Treatment, Payment, and Healthcare Operations (TPO). This includes any information or data that can be used to identify a patient, such as doctor’s notes or billing information.

Ethical Standards

There is a general code of ethics applicable to all healthcare workers. The code of ethical conduct is what phlebotomists must remember in their scope of practice. As a phlebotomist, you must take accountability for your clinical tasks regardless of the tools you use. The following ethical guidelines are important to remember:

Duty to the Patient: Phlebotomists should focus on their well-being by considering how they communicate with the patient. There should be an effort to reduce patient injury or any disadvantage to their person.

Duty to Profession: Phlebotomists must show a degree of respect towards their profession, including their responsibilities, tools, and workplace. This duty means performing your tasks to the best of your ability, maintaining honesty and integrity, and nurturing positive workplace relationships with other healthcare workers.

Duty to Society: Meet all expectations posed by your workplace, institution, or community.

Lab Equipment Quality Control

The equipment you use is critical to the job of a phlebotomist. All institutions or facilities must maintain the quality of their lab equipment. As phlebotomists, you are also responsible for taking care of equipment, using it for its established purpose, and disinfecting it between uses to protect yourself and your patients.

Standard Precautions

According to the Center for Disease Control, standard precautions are necessary to protect healthcare workers, including phlebotomists, from being infected by a disease via blood samples or other substances. In 1996, the CDC Infection Control and Prevention Advisory Committee created guidelines for standard precautions all healthcare workers should apply. Standard precautions are an enhancement to the original universal precautions disclosed by the CDC in the 1980s that focused on preventing exposure to HIV, HBV, and other illnesses.

Standard precautions allow extra protection across situations that universal precautions do not cover. Standard precautions designate prevention methods for cases concerning bodily fluids such as vomit, feces, urine, sputum, and nasal secretions.

Transmission-Based Precautions

To avoid transmitting bloodborne pathogens, you must take precautions that prevent diseases from spreading via droplets, contact, or air. Transmission-based precaution (or TBP) aims to reduce opportunities for such pathogens to spread (OSHA) (Occupational Safety & Health Administration, n.d.).

Exposure Control

Every medical facility, laboratory, or institution must have an Exposure Control Plan that aligns with OSHA regulations. Phlebotomists must be aware of their workplace’s plan and train in practices that control exposure to diseases.

In the case of exposure to a blood sample, remember the following methods. After physical contact with blood samples, you must wash the exposed skin and hands with soap and water. Facilities should have a sufficient supply of hand sanitizers around workstations.

Disposal of Biohazards and Sharps

Sharps must be disposed of properly after each use to avoid transmitting any bloodborne pathogens. Improperly handling sharps and other biohazards can lead to many risks. In facilities with low stock or shortage of sharps disposal containers, the alternative methods are recapping needles, recycling containers, or overfilling containers, which are hazardous to workers and patients, and lead to increased transmission rates.

The category of sharps includes needles, syringes, evacuated tube systems, and tube holders or winged butterflies. All phlebotomists are responsible for planning and handling sharps during the blood-drawing process. The World Health Organization (WHO) has clear guidelines for disposing of sharps. Your workplace should have sharps disposal containers near the sharps workstations. Sharps containers are usually red and labeled Biohazard and are resistant to leaks and punctures. Always ensure you dispose of sharps at your closest location rather than travel with the sharps to another disposal. When passing them along, place the sharps in a container first. Avoid passing sharps from one hand to another or another person. Do not manipulate, bend, break, or remove used needles. When throwing sharps in the container, close the container, keep it upright, and do not wait until it is full before replacing it. The standard is to replace the container when it is three-quarters full.

CLIA Waived Tests

CLIA stands for the Clinical Laboratory Improvement Amendments of 1988. This act designated that all lab facilities must be tested and cleared under FDA guidelines. Waived tests are test systems the FDA has allowed for use at home. Waived tests must be simple and as error-free as possible,