Certified Phlebotomy Technician Exam Basic 5 — Questions and Answers
Question 1: A requisition lists the patient's name as 'John Smith' but the wristband reads 'Jonathan Smith.' What should the phlebotomist do?
- Draw the blood since the last name matches
- Draw only the most urgent tests and clarify later
- Stop and clarify the discrepancy with nursing staff before drawing (Correct answer)
- Ask the patient to verbally confirm and proceed
Correct answer: Stop and clarify the discrepancy with nursing staff before drawing
Any discrepancy between the requisition and patient identification must be resolved before specimen collection to prevent a patient identification error.
Question 2: What is the purpose of the 'discard tube' sometimes used with a butterfly needle set?
- To check the butterfly needle for patency before the real draw
- To fill the tubing dead space with blood so additive ratios in subsequent tubes are accurate (Correct answer)
- To collect a specimen for quality control testing
- To flush residual anticoagulant from prior collections
Correct answer: To fill the tubing dead space with blood so additive ratios in subsequent tubes are accurate
A discard tube (or wasting into a plain red tube) fills the butterfly tubing volume so the first additive tube receives the correct blood-to-additive ratio.
Question 3: Which of the following is NOT an acceptable patient identifier before phlebotomy?
- Full name
- Date of birth
- Room number (Correct answer)
- Medical record number
Correct answer: Room number
Room number is not an acceptable identifier because patients can be moved; only unique patient-specific identifiers such as name, DOB, and MRN are acceptable.
Question 4: What is hemolysis in a blood specimen and which analyte is most critically affected?
- Clotting of the specimen; most affects glucose
- Rupture of red blood cells releasing intracellular contents; most critically affects potassium (Correct answer)
- Bacterial contamination of the tube; most affects white cell count
- Lipemia from fats; most affects sodium
Correct answer: Rupture of red blood cells releasing intracellular contents; most critically affects potassium
Hemolysis releases intracellular potassium from RBCs into the serum, causing falsely elevated potassium results and potentially triggering unnecessary treatment.
Question 5: A physician orders a timed specimen for a 2-hour postprandial glucose. What is the phlebotomist's responsibility regarding timing?
- Draw whenever the patient is available within a 4-hour window
- Note the collection time on the tube and requisition to reflect exactly 2 hours post-meal (Correct answer)
- Draw 30 minutes early to ensure the lab has processing time
- Ask the nurse to set the time, then draw at any point afterward
Correct answer: Note the collection time on the tube and requisition to reflect exactly 2 hours post-meal
Timed specimens must be collected at the exact specified interval and the time precisely documented, as glucose levels change rapidly and timing affects result interpretation.
Question 6: Which organization accredits phlebotomy training programs and certifies phlebotomy technicians in the US?
- OSHA and the FDA
- ASCP, NHA, and NCCT among others (Correct answer)
- The Joint Commission exclusively
- CMS and the CDC jointly
Correct answer: ASCP, NHA, and NCCT among others
Several organizations — including ASCP (American Society for Clinical Pathology), NHA (National Healthcareer Association), and NCCT — offer nationally recognized phlebotomy certification examinations.
Question 7: When is it acceptable to re-use a needle during phlebotomy?
- When drawing multiple tubes from the same patient in a single collection
- When the needle has been soaked in isopropyl alcohol for 30 seconds
- Never — needles are single-use only (Correct answer)
- When the patient requests it to reduce discomfort
Correct answer: Never — needles are single-use only
Needles are strictly single-use medical devices; reuse risks patient infection, needlestick injury, and violates OSHA and manufacturer guidelines.
Certified Phlebotomy Technician Exam Basic 5
A requisition lists the patient's name as 'John Smith' but the wristband reads 'Jonathan Smith.' What should the phlebotomist do?