Title: Phlebotomy Certification Nha Ascp — LearnCoachAssist

Q: What is the correct order of draw for venipuncture (ETS)?
A: 1. Blood cultures (yellow SPS)
2. Light blue (sodium citrate)
3. Serum tubes (red/gold, SST)
4. Green (heparin)
5. Lavender (EDTA)
6. Gray (sodium fluoride)

Q: Why must the order of draw be followed?
A: To prevent cross-contamination of additives between tubes, which can alter test results.

Q: Which tube is drawn first in the order of draw?
A: Blood culture bottles/tubes (yellow SPS) to maintain sterility.

Q: Which tube is drawn immediately after blood cultures?
A: The light blue sodium citrate tube (coagulation studies).

Q: Why is the light blue coagulation tube drawn early in the order of draw?
A: To minimize contamination by tissue thromboplastin and other additives that could affect clotting results.

Q: Where do serum separator tubes (SST, gold/tiger top) fall in the order of draw?
A: After light blue and before tubes containing anticoagulants like heparin, EDTA, and fluoride.

Q: Where does the green top (heparin) tube fall in the order of draw?
A: After serum tubes and before lavender (EDTA) and gray (fluoride) tubes.

Q: Where does the lavender top (EDTA) tube fall in the order of draw?
A: After green (heparin) and before gray (sodium fluoride).

Q: Which tube is drawn last in the standard order of draw?
A: The gray top tube (sodium fluoride/potassium oxalate).

Q: What is the order of draw when using a winged (butterfly) collection set for a coagulation tube first?
A: A discard tube (non-additive or another citrate tube) is drawn first to clear air from the tubing before the light blue tube.

Q: Does the order of draw differ for a syringe draw compared to a tube holder draw?
A: No — the same CLSI order of draw sequence applies when filling tubes from a syringe.

Q: What mnemonic is commonly used to remember the order of draw?
A: "Stop Light Red Green Yellow Gray" for Sterile (blood culture), Light blue, Red/SST, Green, Yellow/Lavender, Gray.

Q: Why are additive tubes drawn after non-additive (red) tubes?
A: To prevent additive carryover that could contaminate serum tests and affect analyte results.

Q: What happens if the order of draw is not followed correctly?
A: Cross-contamination can cause erroneous results such as falsely elevated potassium or altered coagulation values.

Q: In order of draw, where does the yellow ACD tube (for blood bank/DNA studies) fall?
A: After light blue and before green heparin tubes, typically grouped with serum tubes' position depending on protocol.

Q: What additive is in a lavender/purple top tube and what is it used for?
A: EDTA — an anticoagulant that binds calcium; used for hematology tests like the CBC.

Q: What is the correct order of draw for a light blue top tube?
A: Light blue (sodium citrate) is drawn second, after blood culture bottles and before serum/red tubes.

Q: What additive is in a light blue top tube and its primary use?
A: Sodium citrate; used for coagulation testing (PT/INR, PTT).

Q: What is the additive in a gray top tube and what is it used for?
A: Sodium fluoride/potassium oxalate; inhibits glycolysis, used for glucose and lactate testing.

Q: What is the additive in a green top tube and its use?
A: Heparin (sodium, lithium, or ammonium); used for STAT chemistry and plasma tests.

Q: What is in a red top (plain) tube and its use?
A: No additive; blood clots naturally, used for serum chemistry, serology, and blood bank testing.

Q: What is in a gold/tiger top (SST) tube and its use?
A: Clot activator and gel separator; used for serum chemistry testing.

Q: What is in a light green (PST) tube and its use?
A: Lithium heparin with gel separator; used for plasma chemistry (e.g., STAT electrolytes).

Q: What is the additive in a royal blue top tube and its use?
A: May contain EDTA or no additive (special trace-element-free); used for trace element, toxicology, and nutrient testing.

Q: What is the additive in a yellow top SPS tube and its use?
A: Sodium polyanethol sulfonate (SPS); used for blood cultures.

Q: What is the additive in a yellow top ACD tube and its use?
A: Acid citrate dextrose; used for blood bank studies (HLA typing), DNA testing, and paternity testing.

Q: What is the additive in a pink top tube and its use?
A: K2EDTA with a special label; used for blood bank type and crossmatch testing.

Q: What is the additive in a tan top tube and its use?
A: K2EDTA; used for lead testing (certified lead-free tube).

Q: What is the additive in a black top tube and its use?
A: Sodium citrate (buffered, 3.8%); used for Westergren erythrocyte sedimentation rate (ESR).

Q: What is the additive in a white top (PPT) tube and its use?
A: K2EDTA with gel separator; used for molecular diagnostic (PCR) plasma testing.

Q: How does EDTA prevent coagulation?
A: It chelates (binds) calcium, an essential cofactor in the coagulation cascade.

Q: How does sodium citrate prevent coagulation?
A: It binds calcium reversibly, allowing recalcification during coagulation testing.

Q: How does heparin prevent coagulation?
A: It potentiates antithrombin III, inactivating thrombin and other clotting factors.

Q: What is the correct fill ratio for a sodium citrate (light blue) tube?
A: A 9:1 ratio of blood to citrate; the tube must be filled completely for accurate coag results.

Q: What is the recommended number of inversions for an EDTA (lavender) tube?
A: 8 inversions.

Q: What is the primary vein of choice for venipuncture?
A: The median cubital vein in the antecubital fossa.

Q: What are the three main veins in the antecubital fossa used for venipuncture?
A: The median cubital, cephalic, and basilic veins.

Q: Why is the median cubital vein preferred for venipuncture?
A: It is large, well-anchored, and less likely to roll, and is generally less painful to puncture.

Q: Which antecubital vein is the second choice for venipuncture and why?
A: The cephalic vein — it is less anchored but still relatively safe.

Q: Why is the basilic vein the last choice for venipuncture?
A: It is close to the brachial artery and median nerve, increasing risk of nerve/artery injury.

Q: What structure lies beneath the basilic vein that increases puncture risk?
A: The brachial artery and median nerve.

Q: What are the three layers of a vein wall from outer to inner?
A: Tunica adventitia (outer), tunica media (middle), tunica intima (inner).

Q: What is the function of venous valves?
A: They prevent backflow of blood, ensuring one-directional flow toward the heart.

Q: What distinguishes veins from arteries in venipuncture assessment?
A: Veins are compressible, lack a pulse, and have valves; arteries are pulsatile, elastic, and not typically punctured.

Q: What is the term for a vein that moves away from the needle during puncture?
A: A "rolling" vein.

Q: What anatomical landmark is used to locate the median cubital vein?
A: The antecubital fossa (bend of the elbow).

Q: Why should the area near the wrist (inner) be avoided for routine venipuncture?
A: Increased risk of nerve, tendon, and artery damage due to lack of tissue protection.

Q: What are common alternative venipuncture sites when arm veins are unavailable?
A: The hand (dorsal metacarpal veins) and, rarely, the foot/ankle (with physician approval).

Q: Why are foot and ankle veins avoided for venipuncture unless necessary?
A: Increased risk of tissue damage, thrombosis, and slower healing, especially in diabetic patients.

Q: What is the function of the tunica media in a vein?
A: It contains smooth muscle and elastic tissue that helps regulate vessel diameter.

Q: What does it mean for a vein to be "anchored"?
A: The vein is supported by surrounding tissue and does not roll easily when punctured.

Q: What is edema and how does it affect vein selection?
A: Edema is tissue swelling with fluid; it obscures veins and can alter test results, so another site should be chosen.

Q: Why should a vein in an arm with a hematoma be avoided?
A: The hematoma can alter test results and cause additional pain or further bruising.

Q: What is the danger zone in the antecubital area during venipuncture?
A: The area with underlying nerves and the brachial artery, particularly near the basilic vein.

Q: What is a sclerosed vein?
A: A vein that is hardened and scarred from repeated venipunctures, making it a poor choice for draws.

Q: What is the recommended angle of needle insertion for venipuncture?
A: 15 to 30 degrees from the skin surface.

Q: How long should a tourniquet remain applied before release?
A: No longer than 1 minute to avoid hemoconcentration.

Q: What is the purpose of applying a tourniquet before venipuncture?
A: To engorge veins with blood, making them easier to palpate and puncture.

Q: How far above the venipuncture site should the tourniquet be applied?
A: 3 to 4 inches (7.5–10 cm) above the site.

Q: What is hemoconcentration and how can it be caused during venipuncture?
A: A relative increase in nonfilterable blood components caused by prolonged tourniquet application (over 1 minute).

Q: What angle should the bevel of the needle face during venipuncture?
A: The bevel should face up.

Q: What is the correct cleaning technique for a routine venipuncture site?
A: Clean with 70% isopropyl alcohol in a circular motion from the center outward, and allow to air dry.

Q: What antiseptic is used instead of alcohol for blood culture or blood alcohol collections?
A: Chlorhexidine gluconate or povidone-iodine (not alcohol, for blood alcohol tests specifically avoid alcohol entirely).

Q: Why must the alcohol-cleaned site be allowed to air dry before puncture?
A: To prevent stinging pain, hemolysis, and specimen contamination.

Q: What is the correct patient arm position during venipuncture?
A: The arm should be extended in a straight, downward-sloping line from shoulder to wrist.

Q: What should the phlebotomist do if a vein cannot be palpated?
A: Try the other arm, apply warm compress, have the patient make a fist, or ask a colleague for assistance.

Q: Why should a patient avoid pumping their fist repeatedly during blood draw?
A: It can cause hemoconcentration and falsely elevated potassium, ionized calcium, and lactate levels.

Q: What is the maximum recommended number of venipuncture attempts by one phlebotomist?
A: Two attempts; after that, another phlebotomist should be asked to try.

Q: What should be done immediately after removing the needle from the vein?
A: Apply pressure with gauze to the site immediately, without bending the arm.

Q: Why should the patient not bend their arm after venipuncture instead of applying pressure?
A: Bending the arm does not stop bleeding effectively and can increase risk of hematoma.

Q: What is the correct technique for tube activation using an evacuated tube system?
A: Push the tube onto the needle inside the holder until the stopper is punctured, allowing the vacuum to draw blood.

Q: What should be checked on a needle before use?
A: The expiration date, sterility of packaging, and gauge size appropriate for the vein.

Q: What gauge needle is typically used for routine adult venipuncture?
A: 21 to 22 gauge.

Q: What gauge needle is typically used for pediatric or fragile veins?
A: 23 gauge (butterfly/winged infusion set).

Q: What is the purpose of a winged infusion (butterfly) set?
A: Provides more control and flexibility for small, fragile, or difficult veins such as in children or elderly patients.

Q: What is the maximum depth for a heel stick puncture on an infant?
A: No more than 2.0 mm in depth.

Q: Where on the foot should heel sticks be performed?
A: On the medial or lateral plantar surface of the heel, avoiding the posterior curvature.

Q: Why should the posterior curvature of the heel be avoided during heel stick?
A: Risk of penetrating the calcaneus (bone), causing osteomyelitis.

Q: What is the preferred site for capillary puncture in adults?
A: The distal, palmar surface of the middle or ring finger.

Q: Why should the thumb, index finger, and pinky be avoided for fingersticks?
A: Thumb and index have more calluses/nerve endings; the pinky has insufficient tissue depth.

Q: What is the recommended puncture direction relative to fingerprint lines?
A: Perpendicular (across) the fingerprint ridges, not parallel.

Q: What is the maximum depth for an adult fingerstick puncture?
A: Approximately 2.0 to 3.0 mm, depending on device.

Q: Why must the first drop of blood be wiped away during capillary puncture?
A: It may contain excess tissue fluid, diluting the specimen and skewing results.

Q: What order of draw is used for capillary/dermal specimens?
A: 1. Blood gases
2. EDTA (slides/CBC)
3. Other additive tubes
4. Serum tubes

Q: Why is the order of draw reversed (EDTA before other additives) in capillary collection compared to venipuncture?
A: Because capillary blood clots quickly, so EDTA tubes for hematology must be filled early to prevent microclots.

Q: What condition contraindicates heel stick on a specific area?
A: Previous puncture sites, bruising, infection, or edema at the site.

Q: What is the purpose of warming the site before capillary puncture?
A: Warming increases blood flow (arterializes) up to sevenfold, improving specimen quality.

Q: What is the term for squeezing the finger excessively during capillary collection, and why is it discouraged?
A: "Milking" the finger; it causes hemolysis and tissue fluid contamination.

Q: At what age is a heel stick typically preferred over a finger stick?
A: In infants under 1 year of age (or until walking), due to insufficient finger tissue depth.

Q: What device is commonly used for capillary puncture to control depth?
A: A retractable lancet with a safety mechanism.

Q: What are the two identifiers required to confirm patient identity before venipuncture?
A: Full name and date of birth (or medical record number), verified against the requisition/wristband.

Q: What should be done if a patient's wristband information does not match the requisition?
A: Do not proceed; resolve the discrepancy with nursing staff before collecting the specimen.

Q: How should an outpatient with no wristband be identified?
A: Ask the patient to state and spell their full name and date of birth, and verify against photo ID if required.

Q: Why is active patient identification (asking the patient to state their name) preferred over passive identification?
A: It avoids the risk of the patient simply agreeing to an incorrectly stated name (yes/no bias).

Q: What should be done if a patient is unconscious or unable to state their identity?
A: Verify identity via wristband and a second staff member or family member per facility policy.

Q: When must labels be attached to specimen tubes?
A: At the patient's bedside, immediately after collection, before leaving the room.

Q: What information must appear on a properly labeled specimen tube?
A: Patient's full name, date of birth/ID number, date and time of collection, and phlebotomist's initials.

Q: What is a mislabeled or unlabeled specimen considered?
A: A critical/sentinel event that requires immediate correction and often recollection.

Q: What is the Joint Commission's requirement regarding patient identifiers?
A: At least two patient identifiers must be used, neither being the patient's room number.

Q: Why is patient identification considered the most critical step in phlebotomy?
A: Misidentification can lead to wrong diagnosis, treatment errors, or transfusion reactions, some of which are fatal.

Q: What should a phlebotomist do if a specimen was collected but not labeled before leaving the patient?
A: Discard the specimen and recollect it — never label away from the patient.

Q: What is the purpose of a patient ID band in inpatient settings?
A: Provides a reliable, wearable identifier to confirm patient identity at the bedside.

Q: Why must certain specimens be protected from light during transport?
A: Analytes like bilirubin and vitamin B12 degrade when exposed to light, causing falsely low results.

Q: What is the recommended handling for a specimen that requires chilling on ice?
A: Tests such as ammonia, lactic acid, and blood gases require immediate immersion in ice slurry.

Q: Which common test requires the specimen to be transported warm (37°C)?
A: Cold agglutinins testing.

Q: What is the standard time frame within which serum must be separated from cells?
A: Within 2 hours of collection (per CLSI guidelines) to prevent analyte changes.

Q: What is the correct centrifugation practice for blood specimens?
A: Centrifuge after complete clotting (for serum), following manufacturer's time/speed guidelines, with tube stoppers on.

Q: Why should tube stoppers remain on during centrifugation?
A: To prevent aerosol formation, evaporation, and contamination.

Q: What is the effect of failing to separate serum from cells promptly?
A: Glycolysis and cell metabolism continue, causing falsely low glucose and falsely elevated potassium.

Q: How should specimens for coagulation testing be handled to preserve accuracy?
A: Kept at room temperature and tested/separated within a specific time frame (often 1-4 hours), never chilled.

Q: What is proper technique for transporting specimens to the lab?
A: Transport upright, in a leak-proof biohazard bag, gently to avoid hemolysis or agitation.

Q: What is a chain of custody and when is it required?
A: A documented, unbroken record of specimen handling and transfer, required for legal/forensic specimens (e.g., drug testing).

Q: What documentation is required for a forensic/legal chain-of-custody specimen?
A: Signatures/initials of every person who handled the specimen, with date/time at each transfer.

Q: What temperature range defines "room temperature" storage for most routine specimens?
A: Approximately 20–25°C (68–77°F).

Q: What is the correct action if a specimen tube is received without a matching requisition?
A: The specimen should be rejected or held for clarification and not processed until identity is confirmed.

Q: What are common criteria for specimen rejection?
A: Hemolysis, clots in anticoagulated tubes, insufficient volume (QNS), improper labeling, or wrong tube type.

Q: What does QNS mean in specimen processing?
A: Quantity Not Sufficient — an inadequate specimen volume for testing.

Q: Why must EDTA tubes be checked for clots before hematology testing?
A: Clots indicate improper mixing and will produce inaccurate cell counts.

Q: What is the purpose of an aliquot in specimen processing?
A: A portion of the original specimen transferred to a secondary container for testing or storage, preserving the primary sample.

Q: How long should a clot activator (SST/gold top) tube sit before centrifugation?
A: At least 30 minutes to allow complete clot formation.

Q: What is hemolysis and how does it affect lab results?
A: Rupture of red blood cells, releasing intracellular contents (like potassium) and causing falsely elevated results for several analytes.

Q: What are common causes of hemolysis during venipuncture?
A: Using a needle that is too small, vigorous mixing, drawing through an existing IV, pulling back on a syringe plunger too fast, or a partially filled tube.

Q: What is a hematoma and what causes it?
A: A collection of blood under the skin (bruise) caused by blood leaking from the vein during or after puncture.

Q: What immediate action should be taken if a hematoma begins forming during draw?
A: Release the tourniquet, remove the needle immediately, and apply firm pressure to the site.

Q: What are common causes of hematoma formation?
A: Excessive probing, needle going through the vein, insufficient pressure after draw, or using too large a needle for a small vein.

Q: What are signs of nerve injury during venipuncture?
A: Sharp, shooting pain, tingling, numbness, or electric shock sensation radiating down the arm.

Q: What should a phlebotomist do if a patient reports sharp shooting pain or tingling during venipuncture?
A: Stop the procedure immediately and remove the needle.

Q: Which nerves are at risk during antecubital venipuncture?
A: The median, radial, and ulnar nerves.

Q: What is iatrogenic nerve injury?
A: Nerve damage caused by a medical procedure, such as improper needle placement during venipuncture.

Q: What is the term for excessive probing/redirecting the needle to find a vein?
A: "Probing" — it increases risk of nerve damage, hematoma, and patient discomfort.

Q: What causes petechiae and what do they indicate?
A: Tiny red spots from capillary bleeding under the skin, often indicating a bleeding/clotting disorder or fragile capillaries.

Q: What is thrombophlebitis?
A: Inflammation of a vein with clot formation, sometimes resulting from repeated venipuncture at the same site.

Q: What is the risk of drawing blood from an edematous arm?
A: Specimen may be contaminated with tissue fluid, leading to inaccurate results.

Q: What complication can occur from prolonged or repeated tourniquet application?
A: Hemoconcentration, causing falsely elevated levels of large molecules and cellular elements.

Q: Why should you avoid drawing blood from an arm with a hematoma, mastectomy, or IV line?
A: Risk of inaccurate results, further injury, or specimen contamination.

Q: What is the recommended action if blood flow stops during venipuncture?
A: Slightly adjust needle position or angle; if unsuccessful after minor adjustment, discontinue and try another site.

Q: What is a vasovagal reaction (syncope) during blood draw?
A: A fainting response triggered by anxiety or pain, causing a drop in heart rate/blood pressure.

Q: What should a phlebotomist do if a patient feels faint or begins to faint during draw?
A: Stop the draw, lower the patient's head or have them lie down, apply cold compress, and monitor.

Q: What is an allergic reaction risk associated with venipuncture supplies?
A: Latex allergy from gloves or tourniquets, or allergy to adhesive bandages/antiseptics.

Q: Why is it important to avoid drawing above an existing IV line?
A: The specimen may be diluted or contaminated by IV fluids, skewing results.

Q: What does OSHA stand for and what is its role in phlebotomy?
A: Occupational Safety and Health Administration — regulates workplace safety, including bloodborne pathogen exposure control.

Q: What is the OSHA Bloodborne Pathogens Standard?
A: A regulation (29 CFR 1910.1030) requiring employers to protect employees from occupational exposure to blood and body fluids.

Q: What are the three primary bloodborne pathogens of concern in healthcare?
A: HIV, Hepatitis B (HBV), and Hepatitis C (HCV).

Q: What is Standard Precautions (Universal Precautions)?
A: The practice of treating all blood and body fluids as potentially infectious, regardless of patient diagnosis.

Q: What is PPE and what does it typically include for phlebotomy?
A: Personal Protective Equipment — gloves, and as needed gown, mask, and face shield.

Q: What is the correct order for removing PPE (doffing)?
A: Gloves first, then gown, then mask/eye protection last, followed by hand hygiene.

Q: What should be done immediately after a needlestick injury?
A: Wash the area with soap and water, report the incident immediately, and seek medical evaluation/follow-up per facility protocol.

Q: What is a sharps container and what are its requirements?
A: A puncture-resistant, leak-proof, labeled biohazard container used to dispose of needles and other sharps immediately after use.

Q: What is the fill limit for a sharps container before it must be replaced?
A: When filled to approximately three-quarters (3/4) full.

Q: Why should needles never be recapped by hand?
A: To prevent accidental needlestick injury; if recapping is unavoidable, a one-handed "scoop" technique should be used.

Q: What color and symbol designate biohazardous waste?
A: Orange or red bags/containers with the biohazard symbol.

Q: What is the purpose of hand hygiene before and after every patient contact?
A: To prevent the spread of infection between patients and healthcare workers.

Q: What is the CDC-recommended minimum duration for handwashing with soap and water?
A: At least 20 seconds.

Q: What is an exposure control plan?
A: A written OSHA-required document outlining an employer's plan to minimize employee exposure to bloodborne pathogens.

Q: What vaccination must be offered free of charge to employees at risk of bloodborne pathogen exposure?
A: The Hepatitis B vaccine.

Q: What does CLIA stand for?
A: Clinical Laboratory Improvement Amendments.

Q: What is the purpose of CLIA regulations?
A: To ensure quality laboratory testing and accurate, reliable, and timely patient results across all U.S. labs.

Q: What are the three complexity categories under CLIA?
A: Waived, moderate complexity, and high complexity testing.

Q: What is a CLIA-waived test?
A: A simple test with low risk of error, such as a glucometer or urine dipstick, approved for use with minimal training.

Q: What is quality control (QC) in the laboratory?
A: The process of testing known control samples alongside patient specimens to verify test system accuracy and precision.

Q: What is the difference between quality control and quality assurance?
A: QC monitors test accuracy using known samples; QA is the broader system ensuring overall process and outcome quality throughout the testing cycle.

Q: What are the three phases of the total testing process?
A: Preanalytical, analytical, and postanalytical phases.

Q: What occurs during the preanalytical phase of testing?
A: Steps before testing, including test ordering, patient identification, specimen collection, and transport.

Q: What occurs during the analytical phase of testing?
A: The actual testing/analysis of the specimen in the laboratory.

Q: What occurs during the postanalytical phase of testing?
A: Result reporting, interpretation, and result delivery to the ordering provider.

Q: In which phase do most laboratory errors occur?
A: The preanalytical phase (e.g., mislabeling, hemolysis, wrong tube).

Q: What is a proficiency testing (PT) program?
A: An external quality assessment where labs test unknown samples to verify accuracy against peer laboratories.

Q: What is a Levey-Jennings chart used for?
A: To graphically track QC results over time and detect trends or shifts indicating testing problems.

Q: What is Westgard's rule violation, such as the "1-3s" rule, used to detect?
A: Random or systematic errors in quality control data.

Q: What is a critical (panic) value?
A: A test result that is life-threatening and requires immediate notification to the healthcare provider.

Q: What does the term "venipuncture" mean?
A: The puncture of a vein, typically to collect a blood specimen.

Q: What does the prefix "hemo-" or "hema-" mean?
A: Blood.

Q: What does the suffix "-emia" mean?
A: Referring to a condition of the blood (e.g., anemia, hyperglycemia).

Q: What does "anticoagulant" mean?
A: A substance that prevents blood from clotting.

Q: What does "hemostasis" mean?
A: The process by which the body stops bleeding through clot formation.

Q: What does "antecubital" refer to?
A: The area in front of (ante-) the elbow (cubital), i.e., the bend of the elbow.

Q: What does "lipemia" mean?
A: The presence of excess lipids (fat) in the blood, causing turbid/milky serum or plasma.

Q: What does "icterus" mean in the context of specimen appearance?
A: A yellow discoloration of serum/plasma due to elevated bilirubin.

Q: What does "hemolyzed" describe about a specimen?
A: A specimen with ruptured red blood cells, giving it a pink/red tinge.

Q: What does the term "phlebotomy" literally mean?
A: "Phlebo-" (vein) + "-tomy" (incision/cutting) — the practice of drawing blood from a vein.

Q: What does "iatrogenic" mean?
A: A condition caused by medical treatment or examination, such as an injury from a procedure.

Q: What does "syncope" mean?
A: Fainting or a temporary loss of consciousness.

Q: What does "hematoma" mean?
A: A localized collection of blood outside a blood vessel, often under the skin.

Q: What does "nosocomial" mean?
A: Relating to an infection acquired in a hospital or healthcare setting.

Q: What does "aliquot" mean in laboratory terminology?
A: A measured portion of a larger specimen used for a specific test.

Q: What is informed consent in the context of phlebotomy?
A: The patient's voluntary agreement, based on adequate information, to undergo the blood draw procedure.

Q: What constitutes assault in a legal/phlebotomy context?
A: The threat or attempt to touch a patient without consent, causing fear of harm.

Q: What constitutes battery in a legal/phlebotomy context?
A: Unauthorized physical contact with a patient, such as performing venipuncture without consent.

Q: What is negligence in a legal/healthcare context?
A: Failure to act with the standard of care a reasonably prudent person would exercise, resulting in harm.

Q: What are the four elements required to prove negligence (the "4 Ds")?
A: Duty, Dereliction (breach) of duty, Direct cause, and Damages.

Q: What does HIPAA stand for and what does it protect?
A: Health Insurance Portability and Accountability Act — protects patient privacy and confidentiality of health information.

Q: What is a breach of patient confidentiality?
A: Unauthorized disclosure of a patient's protected health information (PHI) to someone without a need to know.

Q: What is the statute of limitations in a legal context?
A: The time period during which a lawsuit can be filed after an alleged incident.

Q: What is a patient's right to refuse a procedure called?
A: The right of informed refusal; patients may decline venipuncture even after explanation.

Q: What should a phlebotomist do if a patient refuses the blood draw?
A: Respect the refusal, do not proceed, and document/report it to the appropriate nursing staff/supervisor.

Q: What does "scope of practice" mean for a phlebotomist?
A: The defined boundaries of tasks and procedures a phlebotomist is legally and professionally authorized to perform.

Q: What is an incident report and when should it be completed?
A: A formal document completed after an adverse event (e.g., needlestick, patient injury, mislabeled specimen) for legal and quality purposes.

Q: Why is proper documentation considered a legal safeguard for phlebotomists?
A: It provides evidence that proper procedure was followed, protecting both patient and practitioner in disputes.

Q: What is malpractice?
A: Professional negligence by a healthcare provider that results in substandard care and patient harm.

Q: Why is it important for a phlebotomist to introduce themselves and explain the procedure to the patient?
A: It establishes trust, ensures informed consent, and reduces patient anxiety, supporting professional and legal standards of care.