Over 3 months, a core laboratory records four blood splash exposures, all while technologists pulled caps off tubes by hand at the open processing bench. Each person wore gloves and a fluid-resistant lab coat but no eye or face protection, and two of the splashes reached the eyes. The bench uncaps about 1,500 tubes a day, and every staff member completed bloodborne pathogens training this year. The safety committee reviews four proposals. Under the OSHA Bloodborne Pathogens Standard, which proposal is the preferred control, ranking highest in the hierarchy of controls?

Install automated decappers and fixed splash shields

Require face shields for all staff at the bench

Add a splash warning to the bench procedure manual

Retrain staff to uncap under gauze, facing away

A new phlebotomist declines hepatitis B vaccination and signs the declination form. Eight months later, still in the same job, she asks to be vaccinated. The employer must:

Provide the vaccine series then, at no cost to her

Provide it only after she has a documented exposure

Refuse, because the declination form is binding

Provide it only if she pays for the doses herself

A technologist plans to take his lab coat, which has a few blood spots on it, home to wash. Under OSHA rules, this is:

Not allowed; the employer must launder or dispose of it

Allowed once the visible blood has dried

Allowed if he washes it separately in hot water

Allowed if he soaks it in bleach before washing

Which of these is an engineering control under the OSHA Bloodborne Pathogens Standard?

A fixed acrylic splash shield on the bench

A rule against recapping used needles

Annual bloodborne pathogens training

Face shields issued to every technologist

Safety programs: bloodborne pathogens, PPE, safe work practices

12 ASCP MLS practice questions on Safety programs: bloodborne pathogens, PPE, safe work practices, part of Laboratory Operations. The first 12 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
Over 3 months, a core laboratory records four blood splash exposures, all while technologists pulled caps off tubes by hand at the open processing bench. Each person wore gloves and a fluid-resistant lab coat but no eye or face protection, and two of the splashes reached the eyes. The bench uncaps about 1,500 tubes a day, and every staff member completed bloodborne pathogens training this year. The safety committee reviews four proposals. Under the OSHA Bloodborne Pathogens Standard, which proposal is the preferred control, ranking highest in the hierarchy of controls?
1. AInstall automated decappers and fixed splash shields
2. BRequire face shields for all staff at the bench
3. CAdd a splash warning to the bench procedure manual
4. DRetrain staff to uncap under gauze, facing away
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Answer: A · Install automated decappers and fixed splash shields
The hierarchy of controls ranks measures by how well they remove the hazard without relying on people: elimination, then engineering controls, then work practice and administrative controls, and finally PPE. The OSHA standard requires engineering and work practice controls to be used first, with PPE added for any exposure that remains. Automated decappers and fixed splash shields put a barrier between the worker and the spray, whatever the person's technique or attention. The repeated splashes after this year's training show that training alone is not enough, and because splashes are clearly expected, face protection must also be worn until the new equipment is in place.
- B: Face shields are PPE, the last line of defense; they are needed until the equipment arrives but rank lowest.
- C: A written warning is an administrative measure and does nothing to remove the hazard.
- D: Uncapping under gauze is a work practice control that depends on every person doing it every time.
Question 2 · Medium
In the CDC sequence for removing personal protective equipment, which item is taken off last?
1. AGoggles or face shield
2. BGloves
3. CGown
4. DMask or respirator
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Answer: D · Mask or respirator
CDC sequences start with the most contaminated items, the gloves (alone or together with the gown), and remove eye protection and the gown before the mask. The mask or respirator comes off last, handled only by its ties or straps, because its front may be contaminated and it protects the airway until the end. Hand hygiene follows at once. Putting PPE on follows a different order: gown, mask, eye protection, then gloves last.
- A: Eye protection is removed by its band or earpieces before the mask.
- B: Gloves are the most contaminated item and come off first.
- C: The gown comes off with or after the gloves, before the mask.
Question 3 · Hard
A new phlebotomist declines hepatitis B vaccination and signs the declination form. Eight months later, still in the same job, she asks to be vaccinated. The employer must:
1. AProvide it only after she has a documented exposure
2. BProvide the vaccine series then, at no cost to her
3. CRefuse, because the declination form is binding
4. DProvide it only if she pays for the doses herself
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Answer: B · Provide the vaccine series then, at no cost to her
Under the OSHA Bloodborne Pathogens Standard, a worker who declined the vaccine may change her mind at any time while she still has occupational exposure. The employer must then make the series available at no cost. The declination form only records that the vaccine was offered and refused; it does not remove the right to it later. Vaccination records are kept with the employee's confidential medical records.
- A: Pre-exposure vaccination does not wait for an exposure.
- C: The declination is not permanent; OSHA lets the worker accept later.
- D: The cost must never be passed to the employee.
Question 4 · Medium
A technologist plans to take his lab coat, which has a few blood spots on it, home to wash. Under OSHA rules, this is:
1. AAllowed once the visible blood has dried
2. BAllowed if he washes it separately in hot water
3. CAllowed if he soaks it in bleach before washing
4. DNot allowed; the employer must launder or dispose of it
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Answer: D · Not allowed; the employer must launder or dispose of it
OSHA requires the employer to clean, launder, repair or dispose of personal protective equipment at no cost to the employee. Contaminated laundry is bagged where it was used, in labeled or color-coded leakproof bags, and handled as little as possible. Taking it home would carry contamination to family members and outside the controlled setting. Lab coats are also removed before leaving the work area.
- A: Dried blood can still carry hepatitis B virus, which survives for days on surfaces.
- B: Hot water at home does not meet the rule that the employer launders PPE.
- C: Soaking at home still takes contaminated items out of the workplace.
Question 5 · Medium
Which of these is an engineering control under the OSHA Bloodborne Pathogens Standard?
1. AA rule against recapping used needles
2. BAnnual bloodborne pathogens training
3. CA fixed acrylic splash shield on the bench
4. DFace shields issued to every technologist
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Answer: C · A fixed acrylic splash shield on the bench
Engineering controls isolate or remove the hazard itself, for example sharps containers, self-sheathing needles, biological safety cabinets and fixed splash shields. Work practice controls change how a task is done, such as no recapping and hand hygiene. PPE such as a face shield protects the wearer but leaves the hazard in place. Training is an administrative requirement.
- A: A no-recapping rule is a work practice control.
- B: Training is an administrative measure, not an engineering control.
- D: Face shields are personal protective equipment.
Question 6 · Easy
Under OSHA rules, a laboratory's written exposure control plan for bloodborne pathogens must be reviewed and updated at least:
1. AOnce a year
2. BOnce every 2 years
3. COnce every 5 years
4. DOnly after an exposure incident
Answer and explanation in LearnFree account
Question 7 · Hard
After two needlesticks from conventional phlebotomy needles in one month, the laboratory updates its exposure control plan. OSHA's needlestick rules require the update to:
1. ABan phlebotomy by staff with under a year of experience
2. BRequire double gloves for every venipuncture
3. CRecord the names of injured staff on a posted list
4. DDocument safer-device evaluation, with frontline staff input
Answer and explanation in LearnFree account
Question 8 · Easy
Under the OSHA Bloodborne Pathogens Standard, hepatitis B vaccine for laboratory staff with occupational exposure must be:
1. AGiven only after an exposure incident has occurred
2. BRequired, with no option for the employee to decline
3. COffered by the employer at no cost to the employee
4. DPaid for by the employee as a condition of hire
Answer and explanation in LearnFree account
Question 9 · Hard
A stool container from a patient with Clostridioides difficile infection leaks onto a technologist's gloves and wrist. After he removes the gloves, the best hand hygiene is:
1. AApplying a benzalkonium hand foam
2. BRubbing in an alcohol-based hand rub
3. CWiping the hands with diluted bleach
4. DWashing with soap and running water
Answer and explanation in LearnFree account
Question 10 · Easy
Under standard precautions, which specimens are handled as potentially infectious?
1. AOnly specimens labelled with a biohazard warning sticker
2. BOnly specimens from patients in isolation rooms
3. CSpecimens from every patient, whatever the diagnosis
4. DOnly specimens from patients with a known infection
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Question 11 · Easy
Which practice is prohibited in laboratory work areas where specimens are handled?
1. AApplying lip balm or cosmetics
2. BWearing closed-toe, fluid-resistant shoes
3. CTying back long hair
4. DUsing a mechanical pipetting aid
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Question 12 · Medium
Standard precautions widened the older universal precautions mainly by also covering:
1. AAirborne organisms such as Mycobacterium tuberculosis only
2. BBody fluids, secretions and excretions even without visible blood
3. COnly patients known to carry a bloodborne virus
4. DOnly blood and fluids visibly contaminated with blood
Answer and explanation in LearnFree account

Safety programs: bloodborne pathogens, PPE, safe work practices

In the CDC sequence for removing personal protective equipment, which item is taken off last?

A new phlebotomist declines hepatitis B vaccination and signs the declination form. Eight months later, still in the same job, she asks to be vaccinated. The employer must:

A technologist plans to take his lab coat, which has a few blood spots on it, home to wash. Under OSHA rules, this is:

Which of these is an engineering control under the OSHA Bloodborne Pathogens Standard?

Under OSHA rules, a laboratory's written exposure control plan for bloodborne pathogens must be reviewed and updated at least:

After two needlesticks from conventional phlebotomy needles in one month, the laboratory updates its exposure control plan. OSHA's needlestick rules require the update to:

Under the OSHA Bloodborne Pathogens Standard, hepatitis B vaccine for laboratory staff with occupational exposure must be:

A stool container from a patient with Clostridioides difficile infection leaks onto a technologist's gloves and wrist. After he removes the gloves, the best hand hygiene is:

Under standard precautions, which specimens are handled as potentially infectious?

Which practice is prohibited in laboratory work areas where specimens are handled?

Standard precautions widened the older universal precautions mainly by also covering: