NCCT - National Certified Phlebotomy Technician Non-Blood Specimen Collection Questions and Answers 1 — Questions and Answers
Question 1: A patient is provided with a collection jug and instructions for a 24-hour urine specimen. Which of the following instructions is most critical for ensuring the accuracy of the collection?
- Keep the collection jug at a consistent room temperature throughout the 24 hours.
- Discard the first morning specimen, start the timing, and then collect all subsequent urine, including the first morning specimen on the final day. (Correct answer)
- Collect the very first specimen of the day, note the time, and then collect all urine for the next 24 hours.
- Ensure the final volume is at least 3 liters to be considered an adequate sample.
Correct answer: Discard the first morning specimen, start the timing, and then collect all subsequent urine, including the first morning specimen on the final day.
The 24-hour collection period must begin with an empty bladder to be accurate. Therefore, the patient should void and discard the first morning specimen, note that time as the start time, and then collect all urine for the next 24 hours, ending with the collection of the first morning specimen on the following day.
Question 2: A phlebotomist is instructing a patient on how to collect a sputum specimen for a suspected tuberculosis infection. To obtain a high-quality specimen, what is the MOST important instruction to provide?
- "Collect the sample in the evening after you have been active all day."
- "Spit saliva into the cup until it is about half full."
- "First thing in the morning, before eating, rinse your mouth with water, take a few deep breaths, and then produce a deep cough from your lungs into the cup." (Correct answer)
- "Rinse your mouth thoroughly with antiseptic mouthwash just before coughing into the container."
Correct answer: "First thing in the morning, before eating, rinse your mouth with water, take a few deep breaths, and then produce a deep cough from your lungs into the cup."
A proper sputum specimen must come from deep within the lungs and should not be confused with saliva. A first-morning collection is ideal because secretions accumulate overnight. Rinsing with water removes oral contaminants without killing organisms, which mouthwash might do. A deep, productive cough is necessary to bring up the required phlegm.
Question 3: Which of the following is a mandatory procedure for a urine specimen collected for a Department of Transportation (DOT) drug screen to ensure its integrity?
- The patient must provide a photo ID after the collection is complete.
- The specimen must be immediately refrigerated at 2-8°C.
- The collector must check the specimen's temperature within four minutes of collection. (Correct answer)
- The collection cup must be filled to the brim to prevent air exposure.
Correct answer: The collector must check the specimen's temperature within four minutes of collection.
According to DOT regulations (49 CFR Part 40), the collector must check the urine specimen's temperature no later than four minutes after the employee provides the specimen. The acceptable temperature range is 32–38 °C (90–100 °F). This step is crucial to verify that the sample is fresh and has not been substituted or adulterated.
Question 4: A male patient submits a semen specimen for fertility analysis. Which of the following handling procedures by the phlebotomist or receiving laboratory staff is correct?
- Documenting the time of collection and keeping the specimen close to body temperature (approx. 37°C). (Correct answer)
- Immediately placing the specimen on a cold pack to preserve sperm motility.
- Rejecting the specimen if it is delivered more than 15 minutes after collection.
- Centrifuging the specimen immediately upon arrival to separate seminal fluid.
Correct answer: Documenting the time of collection and keeping the specimen close to body temperature (approx. 37°C).
Semen specimens for fertility testing must be protected from extreme temperatures and kept as close to body temperature as possible to maintain sperm viability and motility. The specimen must be delivered to the lab promptly, typically within 1 hour of collection, and the exact time of collection must be recorded for accurate analysis.
Question 5: When instructing a patient for collection of a stool sample for a guaiac-based fecal occult blood test (gFOBT), the phlebotomist should advise the patient to avoid which of the following for three days prior to collection?
- Poultry, fish, and dairy products.
- High-fiber foods like whole wheat bread.
- Red meat, horseradish, and raw broccoli. (Correct answer)
- Caffeinated beverages and chocolate.
Correct answer: Red meat, horseradish, and raw broccoli.
Guaiac-based tests detect blood based on peroxidase activity. Red meat contains hemoglobin, and certain raw vegetables like horseradish, radishes, and broccoli have high peroxidase activity, all of which can cause a false-positive result.
Question 6: A physician performs a lumbar puncture and collects cerebrospinal fluid (CSF) into four sterile, sequentially numbered tubes. According to common laboratory protocol, which tube is typically sent to the microbiology department for culture and sensitivity testing?
- Tube #4
- Tube #1
- Tube #3
- Tube #2 (Correct answer)
Correct answer: Tube #2
CSF is collected sequentially. Tube #1 is most likely to be contaminated with skin flora from the puncture site and is generally used for chemistry. Tube #2 is preferred for microbiology because it is less likely to be contaminated than the first tube. Tube #3 is often used for hematology (cell counts), and Tube #4 may be used for special tests or stored.
