Free NHA CPT Exam Flashcards

Treat all blood and body fluids as potentially infectious regardless of the patient's diagnosis. This includes hand hygiene, gloves for every draw, and safe sharps handling for all patients without exception.

Requires employers to provide an exposure control plan, hepatitis B vaccination at no cost, PPE, engineering controls (safety-engineered needles), and post-exposure follow-up to protect workers from bloodborne pathogens.

Don PPE: gown, then mask, then goggles, then gloves. Doff in the order that removes the most contaminated items first: gloves, then goggles, then gown, then mask, performing hand hygiene after removal.

Activate the safety device and discard the needle immediately at the point of use into a puncture-resistant, leakproof, labeled sharps container. Never recap, bend, or break a contaminated needle.

Immediately wash the site with soap and water, report the incident to a supervisor, and begin the post-exposure protocol with prompt medical evaluation. Speed matters because some post-exposure prophylaxis is time-sensitive.

Perform hand hygiene before patient contact, before gloving, after glove removal, and between patients. Gloves are not a substitute for hand hygiene because they can have unseen defects or contaminate hands on removal.

Infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. Breaking any link prevents infection; hand hygiene and PPE primarily interrupt transmission.

Protected health information must be kept confidential and shared only on a need-to-know basis. Discussing results, leaving labeled specimens visible, or talking about patients in public areas can be a violation.

Contaminated, blood-soaked, or regulated medical waste goes into labeled biohazard containers, not regular trash. Sharps go in sharps containers. Correct segregation is required for compliant disposal.

Quality assurance is the overall system of policies ensuring reliable results; quality control is the routine checks (such as monitoring reagents and equipment) within that system. Both protect specimen and result integrity.

Employers must offer the hepatitis B vaccine series free to at-risk workers. An employee who declines must sign a declination form but may receive the vaccine later at no cost.

Confirm identity using two patient-specific identifiers (such as full name and date of birth) by having the patient state them and matching to the requisition and wristband. Room or bed number is not an acceptable identifier.

Active identification means the patient states their own name and date of birth. Passive identification (you state it and the patient nods) is less reliable and not the preferred method for an alert patient.

True fasting usually means no food or drink except water for a specified period before the draw. Confirm and document fasting status; common fasting tests include glucose and lipid panels, where eating alters results.

The median cubital vein is generally the first choice—well anchored and away from major nerves and the artery. The cephalic vein is a secondary choice; the basilic vein is used last due to proximity to the brachial artery and median nerve.

Leave the tourniquet on no longer than one minute to avoid hemoconcentration, which falsely elevates certain analytes. Release it before it has been on too long and reapply if needed.

Avoid drawing from an arm with a mastectomy on that side, an active IV line, edema, hematoma, scarring, or a fistula/graft. These sites risk inaccurate results or patient harm; choose an alternative site.

Cleanse the site with 70% isopropyl alcohol in a circular or back-and-forth motion and allow it to air dry. Drawing before it dries can cause stinging and may hemolyze the specimen.

Explain the procedure, confirm the patient consents, and address concerns before the draw. A competent patient may refuse; document the refusal and notify the appropriate provider rather than proceeding.

Before use, check that needles are sterile and unexpired with intact packaging and no defects, and that tubes are not expired. Expired tubes may have lost vacuum or additive effectiveness, compromising results.

Blood culture (yellow/SPS), then light blue (citrate), then serum/SST (red/gold), then green (heparin), then lavender (EDTA), then gray (fluoride/oxalate). The order minimizes additive carryover between tubes.

Used for coagulation studies (PT/INR, PTT). Requires a full-volume draw because the fixed citrate-to-blood ratio is critical—an underfilled tube dilutes the sample and produces inaccurate clotting results.

Anticoagulant of choice for hematology (CBC) because EDTA preserves cell morphology by binding calcium. The tube must be gently inverted several times immediately to prevent clotting.

Fluoride is a glycolytic inhibitor that preserves glucose by stopping cells from consuming it. Used for glucose and blood alcohol; oxalate is the anticoagulant.

Contains a clot activator and gel. The specimen must fully clot (typically about 30 minutes) before centrifugation; spinning too early can cause fibrin contamination and inaccurate results.

The higher the gauge number, the smaller the needle bore. A large-bore needle (low gauge number) used with a small vein can cause vein collapse; too small a bore can hemolyze the sample.

Insert the needle bevel up at a shallow angle (generally 30 degrees or less) for venipuncture. Too steep an angle risks going through the vein; too shallow may not enter it.

Rupture of red cells releasing intracellular contents. Common causes: vigorous mixing, drawing through a small needle, frothing, prolonged tourniquet time, or drawing before alcohol dries. It falsely elevates potassium and other analytes.

Blood leaking into tissue, causing swelling and bruising. Stop the draw immediately if it forms during venipuncture, remove the tourniquet and needle, and apply firm pressure.

Blind redirection of the needle (probing) can damage nerves and the artery and cause significant patient harm. If the vein is missed, withdraw slightly and redirect minimally, or stop and reattempt at another site.

Bright red, rapidly pulsing blood that fills the tube quickly suggests an inadvertent arterial puncture. Remove the needle and apply firm, prolonged pressure for at least several minutes and notify a supervisor.

If a patient feels faint or loses consciousness, immediately stop the draw, remove the needle, lower the head, and protect the patient from injury. Stay with the patient and call for help as needed.

Capillary collection order differs from venous: EDTA (lavender) first, then other additive tubes, then serum last. EDTA is collected first to ensure an adequate hematology sample before the blood begins to clot.

Use a lancet with a depth appropriate to the site and patient (shallower for infants) to avoid striking bone, which can cause osteomyelitis in neonates. Wipe away the first drop, which is contaminated with tissue fluid.

Requires more rigorous antisepsis than routine draws (e.g., chlorhexidine or iodine with full contact and dry time) to prevent skin-flora contamination, which causes false-positive cultures and unnecessary treatment.

Inoculate or fill blood culture bottles first in the order of draw to minimize contamination. Adequate volume and aseptic technique are critical for accurate organism detection.

A timed series of draws after a glucose load to assess glucose metabolism. Strict adherence to the timing schedule from the baseline draw is essential—mistimed samples invalidate the test.

Use a non-alcohol antiseptic to clean the site so the prep does not contaminate the result, fill the gray tube appropriately, and follow chain-of-custody procedures for legal specimens.

Peak and trough levels must be drawn at precise times relative to the dose (trough just before the next dose; peak after administration). Documenting the exact collection time is essential for interpretation.

Puncture the medial or lateral plantar surface of the heel, avoiding the central arch and posterior curvature, to prevent bone injury. Warming the site increases blood flow for collection.

Apply free-flowing blood drops to fill each circle completely from one side only, do not layer or smear, and let it air dry. Improperly collected cards are rejected and require recollection.

A documented, unbroken record of specimen handling for legal/forensic samples (such as drug screens), tracking every person who possessed the specimen. A break can render the result legally inadmissible.

Label tubes at the patient's side immediately after collection, never before drawing or away from the patient, to prevent misidentification—a leading cause of serious transfusion and treatment errors.

Minimum label data includes patient full name, a unique identifier (such as date of birth or medical record number), date and time of collection, and the collector's initials. Missing data is grounds for rejection.

Centrifuge balanced tubes only after a serum specimen has fully clotted, at the specified speed and time. Never re-spin a gel tube or open the lid while it is spinning; improper handling causes inaccurate results.

Reject hemolyzed, clotted (in anticoagulant tubes), underfilled coagulation tubes, mislabeled or unlabeled, or improperly transported specimens. Recollection is safer than reporting an inaccurate result.

Analytes such as bilirubin degrade with light exposure and must be protected (e.g., amber tube or foil) during transport. Failure to protect them produces falsely low results.

Certain tests (such as ammonia or lactic acid) require transport on ice or in a slurry to slow metabolism. Using ice when not required, or omitting it when required, can compromise the result.

Many analytes are time-sensitive; delays in transport, centrifugation, or testing can degrade the specimen. Prompt processing within the lab's stated time limits preserves accuracy.

An aliquot is a portion of a specimen transferred to a labeled secondary tube for separate testing. The aliquot must carry the same identifiers as the primary tube to prevent mismatched results.