Phlebotomy bloodborne pathogens and needlestick safety practice questions, with every answer explained

1. Hepatitis C virus
2. Hepatitis B virus
3. HIV
4. They all have the same risk

Answer: B. Hepatitis B carries the highest transmission risk after a needlestick in an unvaccinated person, which is why vaccination is strongly encouraged.

Why not A: Hepatitis C risk is lower than hepatitis B.

Why not C: HIV risk after a needlestick is lower than hepatitis B and C.

Why not D: The risks differ between viruses.

Exam tactic: Riskiest stick: hepatitis B.

1. They must pay for the vaccine
2. The employer must still provide it at no cost
3. They can never receive it through the employer after signing a declination form
4. They must wait five years

Answer: B. An employee who first declines can later request the vaccine, and the employer must then provide it at no cost.

Why not A: The vaccine remains free to the employee.

Why not C: Declining once does not end the right to the vaccine.

Why not D: There is no waiting period.

Exam tactic: Changed your mind? Still free.

1. Unscrew the needle and keep the holder
2. Unscrew the needle into the container's slot, then throw the holder in the regular trash
3. Discard the needle and holder together as one unit in the sharps container
4. Rinse the holder and return it to the tray

Answer: C. Tube holders with the needle attached are single use and discarded as a unit. Unscrewing the needle exposes the back end and causes needlesticks.

Why not A: Removing the needle from the holder is a needlestick risk.

Why not B: The holder is contaminated and is not separated from the needle.

Why not D: Holders are not reused.

Exam tactic: Needle and holder: one unit, one trip.

1. Fluorescent orange or orange-red
2. Bright green
3. Blue and white
4. Yellow with black text only

Answer: A. OSHA requires biohazard labels to be fluorescent orange or orange-red, with the symbol and lettering in a contrasting color. Red bags may be used instead of labels.

Why not B: Green is not the biohazard label color.

Why not C: Blue and white is not the biohazard label color.

Why not D: Yellow is not the required biohazard color.

Exam tactic: Biohazard: orange or orange-red.

1. Post-exposure treatment works best when started early
2. The manager will only accept same-week reports
3. Reports are optional if the patient looked healthy and denied any infections
4. It only needs to be written in a personal diary

Answer: A. Post-exposure prophylaxis for HIV, when indicated, is most effective when started within hours. Prompt reporting also documents the source patient for testing under the exposure control plan.

Why not B: The timing matters for treatment, not for paperwork deadlines.

Why not C: A healthy appearance or the patient's own history does not rule out bloodborne infection.

Why not D: Exposures must be formally documented per the exposure control plan.

Exam tactic: Report now: treatment is time sensitive.

1. No testing is ever needed
2. A test of their blood type and Rh factor for the record
3. A single chest X-ray only
4. Baseline testing, then follow-up tests

Answer: D. Post-exposure evaluation includes baseline testing of the exposed worker, source patient testing where permitted, counseling, and follow-up testing on a schedule.

Why not A: Follow-up testing is part of the protocol.

Why not B: Blood type is not relevant to exposure follow-up.

Why not C: A chest X-ray is not the standard exposure evaluation.

Exam tactic: Exposure: baseline plus follow-up.

1. Keep running it to spin off the blood
2. Pour water into the rotor
3. Wait for aerosols to settle before opening, then clean per policy
4. Open it immediately and pick up glass by hand

Answer: C. The centrifuge is left closed to let aerosols settle, then cleaned with PPE, tools for broken glass, and disinfectant per the lab's spill procedure.

Why not A: Continuing to spin spreads contamination.

Why not B: Water spreads the spill and does not disinfect.

Why not D: Opening immediately exposes staff to aerosols; hands should never pick up broken glass.

Exam tactic: Broken tube in centrifuge: wait, then clean safely.

1. Wearing a lab coat
2. Washing hands at the sink in the work area
3. Labeling specimens
4. Eating, drinking or applying lip balm

Answer: D. OSHA prohibits eating, drinking, smoking, applying cosmetics or lip balm, and handling contact lenses where exposure is likely.

Why not A: Lab coats are appropriate protective clothing.

Why not B: Hand hygiene is encouraged.

Why not C: Labeling is a normal work task.

Exam tactic: No food or lip balm in the work area.

1. A sharps container
2. Not recapping used needles
3. A needle with a built-in safety device
4. A biosafety cabinet installed in the specimen processing area

Answer: B. Work practice controls change how a task is done, such as not recapping needles. Engineering controls are devices that isolate or remove the hazard.

Why not A: A sharps container is an engineering control.

Why not C: A safety needle is an engineering control.

Why not D: A biosafety cabinet is an engineering control.

Exam tactic: Behavior = work practice. Device = engineering.

1. A written warning
2. A bill for the testing
3. A confidential medical evaluation and follow-up at no cost to the employee
4. A transfer to another department as a disciplinary step

Answer: C. OSHA requires the employer to provide a confidential medical evaluation and follow-up, including testing and treatment as indicated, at no cost to the worker.

Why not A: Reporting an exposure is not grounds for discipline.

Why not B: The worker is not charged for post-exposure care.

Why not D: Exposure follow-up is medical care, not discipline.

Exam tactic: Exposure follow-up: free and confidential.