NHA CPT Exam
Certification exam for entry-level phlebotomy technicians.
Getting Started: Your CPT Exam Journey
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NHA Certified Phlebotomy Technician (CPT) — key terms, tricks & tips
Everything from the course in one searchable place: 217 entries. Use it to review before a practice test or look up a word you forgot.
217 results
Content Domains
Major subject areas covered on the exam, with specific weightings.
Getting Started: Your CPT Exam Journey
Multiple-choice
Question format where you select one best answer from options.
Getting Started: Your CPT Exam Journey
Scaled Score
A converted raw score used to ensure consistent passing standards.
Getting Started: Your CPT Exam Journey
Pretest Questions
Unscored questions used by NHA to evaluate for future exams.
Getting Started: Your CPT Exam Journey
Passing Score
The minimum scaled score (390) required to pass the exam.
Getting Started: Your CPT Exam Journey
Understanding the NHA CPT Exam Format
Remember 'S-P-C' for the main content areas: Safety (15%), Patient Prep (20%), Collections (65%). SPC: Safety, Patient, Collections!
Getting Started: Your CPT Exam Journey
Understanding the NHA CPT Exam Format
The NHA CPT exam is nationally recognized, and passing it is a key step towards meeting phlebotomy certification requirements in California, which often include additional state-specific practical experience or training hours beyond the NHA exam itself. Remember that California has specific licensure requirements for phlebotomists, and passing the NHA CPT exam is typically a prerequisite, not the sole requirement.
Getting Started: Your CPT Exam Journey
Understanding the NHA CPT Exam Format
Not understanding the percentage weighting of content areas, leading to inefficient study.
Getting Started: Your CPT Exam Journey
Understanding the NHA CPT Exam Format
Spending too much time on a single difficult question during the exam, running out of time.
Getting Started: Your CPT Exam Journey
Understanding the NHA CPT Exam Format
Leaving questions unanswered because there's no penalty for guessing on the NHA CPT exam.
Getting Started: Your CPT Exam Journey
Learning Style
Preferred way an individual absorbs, processes, and retains information.
Getting Started: Your CPT Exam Journey
Study Plan
A structured schedule outlining topics, times, and methods for exam preparation.
Getting Started: Your CPT Exam Journey
Practice Test
Simulated exam used to assess knowledge and familiarize with format.
Getting Started: Your CPT Exam Journey
Test Anxiety
Physiological and psychological distress experienced before or during an exam.
Getting Started: Your CPT Exam Journey
Active Recall
Retrieving information from memory rather than passively re-reading it.
Getting Started: Your CPT Exam Journey
Spaced Repetition
Reviewing material at increasing intervals to enhance long-term memory.
Getting Started: Your CPT Exam Journey
Mnemonic Device
Memory aid that helps recall larger pieces of information.
Getting Started: Your CPT Exam Journey
Strategies for Effective Exam Preparation
To remember the key study steps: 'P-L-A-N-T' your success! Plan, Learn, Assess, Nurture (yourself), Test.
Getting Started: Your CPT Exam Journey
Strategies for Effective Exam Preparation
The NHA CPT exam emphasizes practical application. When studying, always consider how a concept translates to real-world phlebotomy procedures. For example, don't just memorize the order of draw; understand *why* it's important to prevent additive contamination.
Getting Started: Your CPT Exam Journey
Strategies for Effective Exam Preparation
Cramming all material the night before the exam instead of consistent study.
Getting Started: Your CPT Exam Journey
Strategies for Effective Exam Preparation
Only re-reading notes without actively testing knowledge or practicing recall.
Getting Started: Your CPT Exam Journey
Strategies for Effective Exam Preparation
Ignoring practice test results and not using them to identify weak areas.
Getting Started: Your CPT Exam Journey
Pathogen
A microorganism capable of causing disease.
Module 1: Safety and Compliance Essentials
Reservoir
The natural habitat where a pathogen lives and multiplies.
Module 1: Safety and Compliance Essentials
Standard Precautions
Minimum infection prevention practices for all patient care.
Module 1: Safety and Compliance Essentials
PPE
Personal Protective Equipment; barriers to prevent exposure.
Module 1: Safety and Compliance Essentials
Hand Hygiene
Washing hands with soap/water or using alcohol-based rub.
Module 1: Safety and Compliance Essentials
Mode of Transmission
The way an infectious agent is transferred to a host.
Module 1: Safety and Compliance Essentials
Nosocomial Infection
An infection acquired in a healthcare setting (HAI).
Module 1: Safety and Compliance Essentials
Infection Control: Principles and Practices
Remember the Chain of Infection with 'PRPMPS': Pathogen, Reservoir, Portal of Exit, Mode of Transmission, Portal of Entry, Susceptible Host. Break any link, stop the spread!
Module 1: Safety and Compliance Essentials
Infection Control: Principles and Practices
The NHA CPT exam frequently tests the appropriate PPE for different types of Transmission-Based Precautions. Memorize which PPE is required for Contact, Droplet, and Airborne precautions. Also, know that for C. difficile, handwashing with soap and water is mandatory, not just alcohol rub.
Module 1: Safety and Compliance Essentials
Infection Control: Principles and Practices
Forgetting to perform hand hygiene immediately after removing gloves.
Module 1: Safety and Compliance Essentials
Infection Control: Principles and Practices
Reusing PPE, especially gloves, between patients or tasks.
Module 1: Safety and Compliance Essentials
Infection Control: Principles and Practices
Not selecting appropriate PPE for the anticipated exposure (e.g., not wearing eye protection for a splash risk).
Module 1: Safety and Compliance Essentials
Universal Precautions
Treat all blood/body fluids as infectious.
Module 1: Safety and Compliance Essentials
Sharps Container
Puncture-resistant container for sharp waste.
Module 1: Safety and Compliance Essentials
Bloodborne Pathogens
Infectious microorganisms in blood.
Module 1: Safety and Compliance Essentials
SDS (Safety Data Sheet)
Document with chemical hazard info.
Module 1: Safety and Compliance Essentials
Syncope
Temporary loss of consciousness; fainting.
Module 1: Safety and Compliance Essentials
RACE
Fire safety acronym: Rescue, Alarm, Contain, Extinguish/Evacuate.
Module 1: Safety and Compliance Essentials
PASS
Fire extinguisher use: Pull, Aim, Squeeze, Sweep.
Module 1: Safety and Compliance Essentials
Workplace Safety and Emergency Procedures
For fire safety, remember: 'RACE to the PASS.' Rescue, Alarm, Contain, Extinguish/Evacuate, and then Pull, Aim, Squeeze, Sweep with the extinguisher!
Module 1: Safety and Compliance Essentials
Workplace Safety and Emergency Procedures
The California Occupational Safety and Health Administration (Cal/OSHA) Bloodborne Pathogens Standard (Title 8, Section 5193) requires employers to establish an Exposure Control Plan. This plan must include engineering and work practice controls, PPE, hepatitis B vaccination, post-exposure evaluation and follow-up, hazard communication, and recordkeeping. Memorize the components of an Exposure Control Plan.
Module 1: Safety and Compliance Essentials
Workplace Safety and Emergency Procedures
Forgetting to activate the needle's safety mechanism immediately after use, increasing the risk of a needle stick.
Module 1: Safety and Compliance Essentials
Workplace Safety and Emergency Procedures
Not wearing appropriate PPE (e.g., gloves, eye protection) for procedures with potential for blood splash.
Module 1: Safety and Compliance Essentials
Workplace Safety and Emergency Procedures
Overfilling sharps containers, which creates a significant hazard for sharps injuries during disposal.
Module 1: Safety and Compliance Essentials
Quality Assurance (QA)
Systematic process to ensure quality standards are met.
Module 1: Safety and Compliance Essentials
Quality Control (QC)
Specific checks and techniques to verify test accuracy.
Module 1: Safety and Compliance Essentials
Pre-analytical Phase
Steps before lab analysis, like collection and transport.
Module 1: Safety and Compliance Essentials
Post-analytical Phase
Steps after lab analysis, like reporting and interpretation.
Module 1: Safety and Compliance Essentials
Hemolysis
Rupture of red blood cells, affecting specimen integrity.
Module 1: Safety and Compliance Essentials
Competency Assessment
Evaluation of staff skills and knowledge.
Module 1: Safety and Compliance Essentials
Root Cause Analysis
Method to identify underlying causes of errors.
Module 1: Safety and Compliance Essentials
Quality Assurance in Phlebotomy
QA: Q-uality A-lways! Always ensure quality in every step.
Module 1: Safety and Compliance Essentials
Quality Assurance in Phlebotomy
The NHA CPT exam emphasizes understanding the entire 'vein-to-brain' process, including how pre-analytical errors, which phlebotomists directly influence, can impact patient care. Memorize the correct order of draw as a critical QA measure.
Module 1: Safety and Compliance Essentials
Quality Assurance in Phlebotomy
Confusing Quality Assurance (the whole system) with Quality Control (the checks within the system).
Module 1: Safety and Compliance Essentials
Quality Assurance in Phlebotomy
Underestimating the impact of pre-analytical errors on patient results.
Module 1: Safety and Compliance Essentials
Quality Assurance in Phlebotomy
Failing to document errors or incidents, which prevents identifying trends and improving processes.
Module 1: Safety and Compliance Essentials
Informed Consent
Patient understanding and voluntary agreement to a procedure.
Module 1: Safety and Compliance Essentials
HIPAA
Law protecting patient health information (PHI).
Module 1: Safety and Compliance Essentials
Confidentiality
Protecting sensitive patient information from unauthorized access.
Module 1: Safety and Compliance Essentials
Scope of Practice
Procedures a healthcare professional is legally permitted to perform.
Module 1: Safety and Compliance Essentials
Incident Report
Documenting unexpected events to improve safety and quality.
Module 1: Safety and Compliance Essentials
Beneficence
Ethical principle of doing good for the patient.
Module 1: Safety and Compliance Essentials
Non-maleficence
Ethical principle of doing no harm.
Module 1: Safety and Compliance Essentials
Autonomy
Ethical principle respecting a patient's self-determination.
Module 1: Safety and Compliance Essentials
Legal and Ethical Responsibilities in Phlebotomy
For HIPAA, think: 'Hush! Information Protected, Always!'
Module 1: Safety and Compliance Essentials
Legal and Ethical Responsibilities in Phlebotomy
The NHA CPT exam will test your knowledge of HIPAA, especially regarding what constitutes protected health information (PHI) and the consequences of its breach. Memorize that patient refusal of treatment must always be respected and documented.
Module 1: Safety and Compliance Essentials
Legal and Ethical Responsibilities in Phlebotomy
Discussing patient information in public areas or with unauthorized family members.
Module 1: Safety and Compliance Essentials
Legal and Ethical Responsibilities in Phlebotomy
Performing a procedure without verifying patient identity with two identifiers.
Module 1: Safety and Compliance Essentials
Legal and Ethical Responsibilities in Phlebotomy
Failing to report an incident because it seemed minor or you feared repercussions.
Module 1: Safety and Compliance Essentials
Patient Identifier
Unique piece of information used to identify a patient.
Module 2: Patient Preparation for Phlebotomy
CLSI
Clinical and Laboratory Standards Institute; sets healthcare standards.
Module 2: Patient Preparation for Phlebotomy
NHA
National Healthcareer Association; administers CPT exam.
Module 2: Patient Preparation for Phlebotomy
Inpatient
Patient admitted to a hospital for overnight stay or longer.
Module 2: Patient Preparation for Phlebotomy
Outpatient
Patient receiving care without being admitted to a hospital.
Module 2: Patient Preparation for Phlebotomy
Requisition Form
Paper or electronic order for laboratory tests.
Module 2: Patient Preparation for Phlebotomy
Identification Armband
Bracelet worn by inpatients with identifying information.
Module 2: Patient Preparation for Phlebotomy
Accurate Patient Identification
Two IDs for YOU: Name and DOB will do!
Module 2: Patient Preparation for Phlebotomy
Accurate Patient Identification
The NHA CPT exam will specifically test your knowledge of using two unique patient identifiers. Remember, room numbers are NEVER acceptable identifiers. Always ask the patient to state their name and DOB, do not just ask 'Are you...?'
Module 2: Patient Preparation for Phlebotomy
Accurate Patient Identification
Using a room number or bed number as an identifier.
Module 2: Patient Preparation for Phlebotomy
Accurate Patient Identification
Asking 'Are you [Patient's Name]?' instead of asking the patient to state their name.
Module 2: Patient Preparation for Phlebotomy
Accurate Patient Identification
Proceeding with a blood draw when there is a discrepancy in identification.
Module 2: Patient Preparation for Phlebotomy
Accurate Patient Identification
Not checking the patient's armband for inpatients.
Module 2: Patient Preparation for Phlebotomy
Pre-analytical variables
Factors affecting specimen quality before lab analysis.
Module 2: Patient Preparation for Phlebotomy
Hemoconcentration
Increased concentration of blood components due to fluid loss.
Module 2: Patient Preparation for Phlebotomy
Fasting
Abstaining from food/drink (except water) for a specified period.
Module 2: Patient Preparation for Phlebotomy
Diurnal variation
Normal daily fluctuations in body chemistry.
Module 2: Patient Preparation for Phlebotomy
Iatrogenic anemia
Anemia caused by excessive blood draws.
Module 2: Patient Preparation for Phlebotomy
Patient Assessment and Pre-Analytical Variables
FASTING: F-Fasting status, A-Allergies, S-Site issues, T-Timed tests, I-IVs/Infusions, N-Nerves (fainting), G-General condition.
Module 2: Patient Preparation for Phlebotomy
Patient Assessment and Pre-Analytical Variables
The NHA CPT exam often asks about specific causes of hemolysis and hemoconcentration, and how to prevent them. Memorize common analytes affected by these conditions (e.g., potassium elevated by hemolysis).
Module 2: Patient Preparation for Phlebotomy
Patient Assessment and Pre-Analytical Variables
Not confirming fasting status for tests that require it.
Module 2: Patient Preparation for Phlebotomy
Patient Assessment and Pre-Analytical Variables
Leaving the tourniquet on for longer than one minute, causing hemoconcentration.
Module 2: Patient Preparation for Phlebotomy
Patient Assessment and Pre-Analytical Variables
Vigorously shaking tubes instead of gently inverting them, leading to hemolysis.
Module 2: Patient Preparation for Phlebotomy
Antecubital Fossa (AC)
The bend of the arm, primary venipuncture site.
Module 2: Patient Preparation for Phlebotomy
Median Cubital Vein
Preferred vein in the AC, large and stable.
Module 2: Patient Preparation for Phlebotomy
Cephalic Vein
Located on the thumb side of the arm.
Module 2: Patient Preparation for Phlebotomy
Basilic Vein
Located on the pinky side, deeper, near nerves/arteries.
Module 2: Patient Preparation for Phlebotomy
Palpation
Feeling for a vein to assess its suitability.
Module 2: Patient Preparation for Phlebotomy
Edematous
Swollen with fluid, a contraindication for venipuncture.
Module 2: Patient Preparation for Phlebotomy
Fistula/Graft
Surgical connection for dialysis, never draw from this arm.
Module 2: Patient Preparation for Phlebotomy
Mastectomy
Surgical breast removal, avoid drawing from that side's arm.
Module 2: Patient Preparation for Phlebotomy
Optimal Site Selection Techniques
For vein selection, remember 'My Cousin Barry': Median cubital (best), Cephalic (good), Basilic (risky).
Module 2: Patient Preparation for Phlebotomy
Optimal Site Selection Techniques
The NHA exam often tests on contraindications for venipuncture. Memorize the 'no-go' zones: IV site, fistula/graft, mastectomy side, and any areas with infection, swelling, or scarring. Keywords to spot: 'IV infusion,' 'dialysis shunt,' 'post-mastectomy.'
Module 2: Patient Preparation for Phlebotomy
Optimal Site Selection Techniques
Attempting to draw blood from an arm with an active IV line, which can dilute the sample or cause complications.
Module 2: Patient Preparation for Phlebotomy
Optimal Site Selection Techniques
Failing to adequately palpate a vein, leading to missed sticks or arterial punctures.
Module 2: Patient Preparation for Phlebotomy
Optimal Site Selection Techniques
Ignoring patient history (e.g., mastectomy, fistula) and attempting to draw from a contraindicated arm.
Module 2: Patient Preparation for Phlebotomy
Therapeutic Communication
Goal-directed communication to build trust and gather information in healthcare.
Module 2: Patient Preparation for Phlebotomy
Active Listening
Fully concentrating on what is being said, both verbally and non-verbally.
Module 2: Patient Preparation for Phlebotomy
Empathy
Understanding and sharing the feelings of another person.
Module 2: Patient Preparation for Phlebotomy
Medical Jargon
Specialized terms used in medicine, often not understood by the public.
Module 2: Patient Preparation for Phlebotomy
Non-Verbal Communication
Conveying messages through body language, facial expressions, and gestures.
Module 2: Patient Preparation for Phlebotomy
Cultural Competence
Ability to understand and interact effectively with people from diverse cultures.
Module 2: Patient Preparation for Phlebotomy
Effective Patient Communication and Education
TRUST: T-Talk clearly, R-Reassure, U-Understand, S-Smile (genuinely!), T-Thank them.
Module 2: Patient Preparation for Phlebotomy
Effective Patient Communication and Education
The NHA exam emphasizes patient rights and safety. Remember that obtaining informed consent is a critical step; failure to do so can lead to legal issues. Keyword to spot: 'patient's right to refuse'.
Module 2: Patient Preparation for Phlebotomy
Effective Patient Communication and Education
Using medical jargon without explanation, confusing the patient.
Module 2: Patient Preparation for Phlebotomy
Effective Patient Communication and Education
Ignoring non-verbal cues of anxiety or discomfort.
Module 2: Patient Preparation for Phlebotomy
Effective Patient Communication and Education
Failing to confirm patient understanding of the procedure or post-care instructions.
Module 2: Patient Preparation for Phlebotomy
Antecubital Fossa
The triangular area on the anterior elbow, primary site for venipuncture.
Module 3: Mastering Specimen Collection Routines
Tourniquet
A constricting device applied to distend veins for easier access.
Module 3: Mastering Specimen Collection Routines
Order of Draw
Specific sequence for collecting blood tubes to prevent additive carryover.
Module 3: Mastering Specimen Collection Routines
Bevel
The slanted opening at the tip of a needle, always inserted facing up.
Module 3: Mastering Specimen Collection Routines
Flashback
Appearance of blood in the needle hub, indicating successful vein entry.
Module 3: Mastering Specimen Collection Routines
Venipuncture: Procedure, Best Practices, & Safety
B-L-R-G-L-G: Big Little Red Guys Love Grapes! (Blood culture, Light blue, Red/Gold, Green, Lavender, Gray)
Module 3: Mastering Specimen Collection Routines
Venipuncture: Procedure, Best Practices, & Safety
The NHA CPT exam emphasizes the exact order of draw. Memorize the standard order: Blood Culture, Light Blue, Red/Gold/Tiger Top, Green, Lavender, Gray. Any deviation can lead to incorrect results and patient harm.
Module 3: Mastering Specimen Collection Routines
Venipuncture: Procedure, Best Practices, & Safety
Not confirming patient identity with two unique identifiers.
Module 3: Mastering Specimen Collection Routines
Venipuncture: Procedure, Best Practices, & Safety
Re-palpating the site after antiseptic application without re-cleaning.
Module 3: Mastering Specimen Collection Routines
Venipuncture: Procedure, Best Practices, & Safety
Leaving the tourniquet on for more than one minute, leading to hemoconcentration.
Module 3: Mastering Specimen Collection Routines
Capillary Puncture
Blood collection from capillaries, typically fingertips or heels.
Module 3: Mastering Specimen Collection Routines
Lancet
A small, sterile, sharp instrument used to puncture the skin.
Module 3: Mastering Specimen Collection Routines
Osteomyelitis
Inflammation of bone or bone marrow, a risk of deep heel sticks.
Module 3: Mastering Specimen Collection Routines
POCT
Point-of-care testing; performed at or near the patient's bedside.
Module 3: Mastering Specimen Collection Routines
Distal Phalanx
The bone at the tip of the finger or toe.
Module 3: Mastering Specimen Collection Routines
Capillary Puncture Techniques
F-I-N-G-E-R: First drop, Ignore; Nerves, avoid; Gently squeeze; EDTA first; Right site.
Module 3: Mastering Specimen Collection Routines
Capillary Puncture Techniques
For infants, the maximum depth for a heel stick lancet is 2.0 mm. Always avoid the posterior curvature of the heel due to major nerves and arteries.
Module 3: Mastering Specimen Collection Routines
Capillary Puncture Techniques
Squeezing the finger too hard ('milking') which can cause hemolysis and dilute the sample with tissue fluid.
Module 3: Mastering Specimen Collection Routines
Capillary Puncture Techniques
Not discarding the first drop of blood, leading to contamination with tissue fluid.
Module 3: Mastering Specimen Collection Routines
Capillary Puncture Techniques
Puncturing the wrong site or too deeply, especially in infants, risking bone damage or nerve injury.
Module 3: Mastering Specimen Collection Routines
Blood Culture
Test to detect microorganisms in the blood, indicating sepsis.
Module 3: Mastering Specimen Collection Routines
Sepsis
Life-threatening condition caused by the body's response to infection.
Module 3: Mastering Specimen Collection Routines
Aseptic Technique
Practices to prevent contamination by microorganisms.
Module 3: Mastering Specimen Collection Routines
ABG
Arterial Blood Gas; measures O2, CO2, and pH in arterial blood.
Module 3: Mastering Specimen Collection Routines
Heparinized Syringe
Syringe coated with heparin to prevent blood clotting for ABG samples.
Module 3: Mastering Specimen Collection Routines
Modified Allen Test
Test to assess collateral blood flow to the hand before radial artery puncture.
Module 3: Mastering Specimen Collection Routines
Coagulation Studies
Tests that assess the blood's ability to clot.
Module 3: Mastering Specimen Collection Routines
TDM
Therapeutic Drug Monitoring; measures drug levels to optimize dosage.
Module 3: Mastering Specimen Collection Routines
Special Collections: Blood Cultures, ABGs, & More
For Blood Cultures: 'A-S-A-P': Aseptic, Sites (two), Anaerobic first, Prompt transport.
Module 3: Mastering Specimen Collection Routines
Special Collections: Blood Cultures, ABGs, & More
The NHA CPT exam frequently tests the order of draw for blood cultures and coagulation tubes. Remember that blood cultures are always first in the order of draw (sterile collection), and light blue-top (coagulation) tubes are critical for fill volume and specific placement in the order of draw.
Module 3: Mastering Specimen Collection Routines
Special Collections: Blood Cultures, ABGs, & More
Not allowing antiseptic to dry completely before blood culture collection, leading to contamination.
Module 3: Mastering Specimen Collection Routines
Special Collections: Blood Cultures, ABGs, & More
Incorrectly filling coagulation tubes (light blue-top), which can cause inaccurate results due to improper blood-to-anticoagulant ratio.
Module 3: Mastering Specimen Collection Routines
Special Collections: Blood Cultures, ABGs, & More
Failing to immediately place ABG samples on ice or transport them quickly, leading to inaccurate gas measurements.
Module 3: Mastering Specimen Collection Routines
Gauge
Measurement of a needle's lumen diameter; higher number = smaller lumen.
Module 3: Mastering Specimen Collection Routines
Evacuated Tube System
Method using vacuum tubes for blood collection.
Module 3: Mastering Specimen Collection Routines
Anticoagulant
Substance preventing blood from clotting.
Module 3: Mastering Specimen Collection Routines
Microcollection Tube
Small tube for collecting capillary blood samples.
Module 3: Mastering Specimen Collection Routines
EDTA
Anticoagulant in lavender tubes, preserves cell morphology.
Module 3: Mastering Specimen Collection Routines
Specimen Collection Equipment: Selection & Use
Remember the order of draw with: 'Stop Light Red Stay Put Green Light Go!' (Sterile/Blood Culture, Light Blue, Red/Serum, PST/Green, Lavender, Gray)
Module 3: Mastering Specimen Collection Routines
Specimen Collection Equipment: Selection & Use
The NHA CPT exam emphasizes the Order of Draw for evacuated tubes to prevent additive cross-contamination. Memorize the standard order: Blood Culture, Light Blue, Red/Gold/Tiger, Green, Lavender, Gray.
Module 3: Mastering Specimen Collection Routines
Specimen Collection Equipment: Selection & Use
Using an expired tube, which may have compromised vacuum or additive integrity.
Module 3: Mastering Specimen Collection Routines
Specimen Collection Equipment: Selection & Use
Selecting the wrong tube color for the ordered test, leading to inaccurate results.
Module 3: Mastering Specimen Collection Routines
Specimen Collection Equipment: Selection & Use
Recapping a used needle, significantly increasing the risk of needlestick injury.
Module 3: Mastering Specimen Collection Routines
Hematoma
Localized collection of blood outside blood vessels.
Module 3: Mastering Specimen Collection Routines
QNS
Quantity Not Sufficient; insufficient amount of blood for testing.
Module 3: Mastering Specimen Collection Routines
Petechiae
Small, pinpoint red spots on the skin due to capillary hemorrhage.
Module 3: Mastering Specimen Collection Routines
Nerve Injury
Damage to a nerve from needle insertion, causing pain or numbness.
Module 3: Mastering Specimen Collection Routines
Arterial Puncture
Accidental puncture of an artery instead of a vein.
Module 3: Mastering Specimen Collection Routines
Troubleshooting and Complications During Collection
S.A.F.E. for Syncope: Stop, Assist, Fan, Elevate. Remember these steps to react quickly!
Module 3: Mastering Specimen Collection Routines
Troubleshooting and Complications During Collection
Memorize the maximum number of venipuncture attempts by one phlebotomist: two. If unsuccessful, another phlebotomist must be called. This is a common exam question.
Module 3: Mastering Specimen Collection Routines
Troubleshooting and Complications During Collection
Ignoring patient complaints of pain or dizziness, which can escalate into more serious complications.
Module 3: Mastering Specimen Collection Routines
Troubleshooting and Complications During Collection
Attempting more than two venipuncture draws on a single patient, increasing patient discomfort and risk.
Module 3: Mastering Specimen Collection Routines
Troubleshooting and Complications During Collection
Failing to properly label tubes at the bedside, leading to misidentification and specimen rejection.
Module 3: Mastering Specimen Collection Routines
Troubleshooting and Complications During Collection
Not applying adequate pressure after needle removal, increasing the risk of hematoma.
Module 3: Mastering Specimen Collection Routines
Centrifugation
Process using centrifugal force to separate fluids by density.
Module 4: Specimen Handling and Documentation
Plasma
Liquid portion of anticoagulated blood after centrifugation.
Module 4: Specimen Handling and Documentation
Serum
Liquid portion of clotted blood after centrifugation.
Module 4: Specimen Handling and Documentation
Aliquoting
Dividing a specimen into smaller portions for testing or storage.
Module 4: Specimen Handling and Documentation
Fibrin strands
Protein threads formed during clotting; indicates incomplete clotting.
Module 4: Specimen Handling and Documentation
Buffy coat
Thin layer of WBCs and platelets between plasma/serum and RBCs.
Module 4: Specimen Handling and Documentation
Balance tube
Tube of water used to balance a centrifuge when an odd number of specimens.
Module 4: Specimen Handling and Documentation
Specimen Processing: Centrifugation & Aliquoting
C-A-L-M: Centrifuge, Aliquot, Label, Maintain integrity. Remember these four steps for perfect specimen processing!
Module 4: Specimen Handling and Documentation
Specimen Processing: Centrifugation & Aliquoting
NHA CPT exam tip: Remember that serum tubes (like red tops or SSTs) require clotting time before centrifugation, while plasma tubes (like lavender or light blue) can be centrifuged immediately. The exam often tests this distinction and the consequences of improper timing.
Module 4: Specimen Handling and Documentation
Specimen Processing: Centrifugation & Aliquoting
Centrifuging serum tubes before they have fully clotted.
Module 4: Specimen Handling and Documentation
Specimen Processing: Centrifugation & Aliquoting
Failing to properly balance the centrifuge, leading to damage or hemolysis.
Module 4: Specimen Handling and Documentation
Specimen Processing: Centrifugation & Aliquoting
Pouring rather than pipetting when aliquoting, risking contamination or disturbing layers.
Module 4: Specimen Handling and Documentation
Specimen Integrity
Quality of a sample suitable for testing.
Module 4: Specimen Handling and Documentation
Biohazard Bag
Leak-proof bag for transporting infectious materials.
Module 4: Specimen Handling and Documentation
Chain of Custody
Documentation of specimen handling and transfer.
Module 4: Specimen Handling and Documentation
Light-Sensitive
Degrades or changes when exposed to light.
Module 4: Specimen Handling and Documentation
Time-Sensitive
Requires prompt processing to maintain accuracy.
Module 4: Specimen Handling and Documentation
Ice Slurry
Mixture of ice and water for rapid chilling.
Module 4: Specimen Handling and Documentation
Safe and Timely Specimen Transport
T.I.M.E. for Transport: T - Temperature (control), I - Integrity (protect), M - Movement (minimize), E - Expedite (timeliness).
Module 4: Specimen Handling and Documentation
Safe and Timely Specimen Transport
The NHA CPT exam often emphasizes specific handling for common analytes. Remember that ammonia and lactic acid require transport on ice slurry, while cold agglutinins and cryofibrinogen need to be kept warm (37°C). Bilirubin and folate are light-sensitive.
Module 4: Specimen Handling and Documentation
Safe and Timely Specimen Transport
Transporting specimens without a biohazard bag or absorbent pad.
Module 4: Specimen Handling and Documentation
Safe and Timely Specimen Transport
Leaving time-sensitive specimens (e.g., coagulation tests) sitting for extended periods.
Module 4: Specimen Handling and Documentation
Safe and Timely Specimen Transport
Exposing light-sensitive specimens (e.g., bilirubin) to ambient light during transport.
Module 4: Specimen Handling and Documentation
Analyte
The substance being measured in a laboratory test.
Module 4: Specimen Handling and Documentation
Photodegradation
Breakdown of a substance due to exposure to light.
Module 4: Specimen Handling and Documentation
Room Temperature
Typically 20-25°C (68-77°F) for specimen storage.
Module 4: Specimen Handling and Documentation
Refrigeration
Storage at 2-8°C (36-46°F) to preserve specimens.
Module 4: Specimen Handling and Documentation
Freezing
Storage at -20°C (-4°F) or colder for long-term preservation.
Module 4: Specimen Handling and Documentation
Pre-analytical Error
Errors occurring before laboratory analysis, like improper storage.
Module 4: Specimen Handling and Documentation
Proper Specimen Storage Requirements
R.I.P. F.L.A.S.H. for special handling: R-Room temp, I-Ice, P-Protect from light, F-Frozen, L-Light-sensitive, A-Ammonia, S-Special (e.g., cold agglutinins), H-Hot (incubate).
Module 4: Specimen Handling and Documentation
Proper Specimen Storage Requirements
The NHA CPT exam emphasizes the exact temperature ranges for common storage conditions (room temperature, refrigeration, freezing) and specific handling for light-sensitive and cold-agglutinin specimens. Memorize these ranges and specific exceptions.
Module 4: Specimen Handling and Documentation
Proper Specimen Storage Requirements
Leaving light-sensitive specimens exposed to light.
Module 4: Specimen Handling and Documentation
Proper Specimen Storage Requirements
Not chilling ammonia or lactic acid specimens immediately.
Module 4: Specimen Handling and Documentation
Proper Specimen Storage Requirements
Storing specimens at room temperature when refrigeration is required.
Module 4: Specimen Handling and Documentation
Proper Specimen Storage Requirements
Delaying transport or storage of specimens.
Module 4: Specimen Handling and Documentation
Mislabeling
Incorrectly identifying a specimen, leading to patient safety risks.
Module 4: Specimen Handling and Documentation
Patient identification
Process of confirming a patient's identity using multiple identifiers.
Module 4: Specimen Handling and Documentation
Specimen rejection
Laboratory refusing to test a specimen due to errors.
Module 4: Specimen Handling and Documentation
Medical record number (MRN)
Unique identifier assigned to each patient in a healthcare system.
Module 4: Specimen Handling and Documentation
Accurate Documentation and Labeling
L.A.B.E.L. IT: L-Label at Bedside, A-All info present, B-Before leaving, E-Every tube, L-Legible, I-ID checked, T-Time/date.
Module 4: Specimen Handling and Documentation
Accurate Documentation and Labeling
The NHA CPT exam emphasizes that labeling must occur at the patient's bedside immediately after collection. Keywords to look for are 'at the bedside' and 'immediately after collection.'
Module 4: Specimen Handling and Documentation
Accurate Documentation and Labeling
Labeling tubes before collection, which can lead to applying the wrong label to a specimen.
Module 4: Specimen Handling and Documentation
Accurate Documentation and Labeling
Labeling tubes away from the patient's bedside, increasing the risk of mix-ups.
Module 4: Specimen Handling and Documentation
Accurate Documentation and Labeling
Forgetting to include the phlebotomist's initials or the exact time of collection on the label.
Module 4: Specimen Handling and Documentation