National Healthcareer Association (NHA) Certified Phlebotomy Technician (CPT) Exam — Questions and Answers

Question 1: A phlebotomist has just drawn a serum separator tube (SST) for a chemistry panel. What is the correct minimum time the tube should be allowed to clot before centrifugation?

30 minutes (Correct answer)
10 minutes
Immediately
60 minutes

Correct answer: 30 minutes

Serum separator tubes require adequate time for complete clot formation to ensure proper separation of serum from cellular components during centrifugation. The standard recommended minimum clotting time is 30 minutes at room temperature.

Question 2: During a venipuncture, the patient's vein collapses. Which corrective action should the phlebotomist take FIRST?

Switch immediately to a smaller gauge needle
Release the tourniquet and reduce vacuum pressure (Correct answer)
Apply more pressure to the insertion site
Insert a new needle at a steeper angle

Correct answer: Release the tourniquet and reduce vacuum pressure

Releasing the tourniquet reduces pressure on the vein wall, allowing it to re-expand so blood can flow again.

Question 3: A patient's arm shows signs of a hematoma forming during blood draw. What is the FIRST action to take?

Release the tourniquet and remove the needle immediately (Correct answer)
Apply more pressure to the tourniquet
Redirect the needle to find the vein
Continue drawing to complete the collection

Correct answer: Release the tourniquet and remove the needle immediately

A forming hematoma indicates blood is leaking into surrounding tissue; the tourniquet must be released and the needle removed to stop further extravasation.

Question 4: A phlebotomist is tasked with cleaning a small blood spill on a laboratory countertop. Which of the following is an appropriate disinfectant?

70% isopropyl alcohol
Sterile saline solution
Soap and water
A 1:10 dilution of household bleach (Correct answer)

Correct answer: A 1:10 dilution of household bleach

A 1:10 dilution of household bleach (sodium hypochlorite) is a commonly used and effective disinfectant for cleaning up blood spills in a healthcare setting. Soap and water can clean but not disinfect. 70% isopropyl alcohol is not recommended for blood spills as it can cause proteins to coagulate, potentially trapping infectious particles. Saline is not a disinfectant.

Question 5: If blood flow stops after initially starting well during venipuncture, which corrective action should be attempted FIRST?

Apply additional tourniquet pressure
Gently rotate the needle 180 degrees (Correct answer)
Squeeze the patient's fist repeatedly
Remove the needle and try a new site

Correct answer: Gently rotate the needle 180 degrees

Rotating the needle 180 degrees may reposition the bevel away from the vein wall and restore blood flow without restarting the procedure.

Question 6: Normal arterial blood gas values at sea level breathing room air include which of the following pH ranges?

7.30–7.40
7.45–7.55
7.35–7.45 (Correct answer)
7.25–7.35

Correct answer: 7.35–7.45

Normal arterial pH is 7.35–7.45; values below this range indicate acidosis and above indicate alkalosis.

Question 7: A laboratory's QA program identifies that STAT order turnaround times frequently exceed the 60-minute target. The MOST effective initial intervention is to:

Map the current STAT process to identify the specific step causing delay (Correct answer)
Mandate that all STAT specimens be run before routine tests without exception
Increase the STAT TAT target to 90 minutes to reduce perceived failures
Purchase additional laboratory analyzers immediately

Correct answer: Map the current STAT process to identify the specific step causing delay

Process mapping visualizes each step in the STAT workflow, identifying the specific bottleneck causing delays before implementing targeted, effective interventions.

Question 8: A heelstick is performed on a 3-day-old full-term newborn. Which of the following actions is INCORRECT?

Warming the heel for 3–5 minutes before puncture
Using a blade depth no greater than 2.0 mm
Collecting the specimen in the medial plantar area
Puncturing the posterior curve (back) of the heel (Correct answer)

Correct answer: Puncturing the posterior curve (back) of the heel

The posterior curve of the heel is an unacceptable site because the calcaneus is very close to the skin surface there, posing a high risk of bone puncture and osteomyelitis.

Question 9: What is the recommended tourniquet application time limit to avoid hemoconcentration?

2 minutes
30 seconds
5 minutes
1 minute (Correct answer)

Correct answer: 1 minute

Tourniquets should be released within 1 minute of application to prevent hemoconcentration, which falsely elevates cellular and protein-based analytes.

Question 10: How often must the AMCA Phlebotomy Technician Certification be renewed?

Every 2 years (Correct answer)
Every 5 years
Every 1 year
Every 3 years

Correct answer: Every 2 years

The AMCA Phlebotomy Technician Certification (PTC) requires renewal every two years. To maintain active certification, professionals must typically complete continuing education requirements and pay a renewal fee. This regular renewal process ensures that certified phlebotomists stay updated with current best practices and advancements in the field.

Question 11: A sharps container is three-quarters full. What is the correct action?

Transfer needles to a new container using forceps
Press the contents down to create more space
Seal and replace the container according to facility policy (Correct answer)
Continue using it until it is completely full

Correct answer: Seal and replace the container according to facility policy

OSHA and most facility policies require sharps containers to be replaced when they reach the designated fill line (usually three-quarters full) to prevent overfilling and injury.

Question 12: A patient in respiratory isolation sneezes directly toward the phlebotomist who is not wearing a mask. Which link in the chain of infection has been exploited?

Susceptible host
Portal of entry
Reservoir
Mode of transmission (Correct answer)

Correct answer: Mode of transmission

The sneeze represents the mode of transmission—the mechanism by which the pathogen traveled from the source to the potential host.

Question 13: Which class of fire extinguisher should be used on an electrical fire in the phlebotomy lab?

Class C (Correct answer)
Class A
Class D
Class B

Correct answer: Class C

Class C extinguishers are designed for electrical fires and use non-conductive agents that will not worsen the hazard.

Question 14: What is the purpose of a biohazard label on a specimen bag?

To indicate the specimen requires refrigeration
To indicate the specimen is for STAT processing
To warn handlers that the contents may contain infectious material (Correct answer)
To identify the ordering physician

Correct answer: To warn handlers that the contents may contain infectious material

Biohazard labels warn all personnel who handle the bag that the contents may be infectious and that PPE should be used.

Question 15: When a blood culture is ordered, the skin must be disinfected with 70% isopropyl alcohol followed by which agent to achieve the highest level of antisepsis?

Hydrogen peroxide
Saline solution
Benzalkonium chloride
Povidone-iodine or chlorhexidine gluconate (Correct answer)

Correct answer: Povidone-iodine or chlorhexidine gluconate

Blood culture sites require a two-step prep using alcohol followed by povidone-iodine or chlorhexidine to reduce skin flora and minimize contamination.

Question 16: In a laboratory with multiple analyzers running the same test, which QA practice ensures consistency of results across instruments?

Correlation studies comparing patient or QC results between instruments (Correct answer)
Running QC only on the primary analyzer
Calibrating each analyzer with different calibrator lots
Using different reference ranges for each analyzer

Correct answer: Correlation studies comparing patient or QC results between instruments

Instrument correlation studies compare results from multiple analyzers to verify they produce equivalent results; significant differences must be investigated and resolved before using both instruments simultaneously.

Question 17: What credential is awarded by the National Center for Competency Testing (NCCT) for phlebotomy professionals?

National Certified Phlebotomy Technician (NCPT) (Correct answer)
Accredited Phlebotomy Specialist (APS)
Licensed Blood Collection Specialist (LBCS)
Certified Phlebotomy Technician (CPT)

Correct answer: National Certified Phlebotomy Technician (NCPT)

The National Center for Competency Testing (NCCT) specifically awards the National Certified Phlebotomy Technician (NCPT) credential. This certification validates an individual's competency in phlebotomy practices according to NCCT's national standards. Each certification body has its unique designation, and NCPT is the one associated with NCCT for phlebotomy professionals.

Question 18: An ABG shows: pH 7.30, PCO2 55 mmHg, HCO3 26 mEq/L. The phlebotomist correctly identifies this as:

Respiratory acidosis (uncompensated) (Correct answer)
Normal arterial blood gas values
Respiratory alkalosis
Metabolic acidosis with respiratory compensation

Correct answer: Respiratory acidosis (uncompensated)

pH 7.30 (acidotic), PCO2 55 (elevated—respiratory parameter), HCO3 26 (normal—no metabolic compensation yet) indicates uncompensated respiratory acidosis.

Question 19: Which finding at the venipuncture site indicates accidental arterial puncture?

Bright red blood pulsating into the tube (Correct answer)
Absence of blood return
Visible bruising immediately
Dark, slowly draining blood

Correct answer: Bright red blood pulsating into the tube

Arterial blood is bright red and may enter the tube rapidly in a pulsatile manner due to the higher pressure in arteries.

Question 20: What is the consequence of over-inverting an EDTA tube more than the recommended number of times?

Calcium re-enters the sample, causing partial clotting
The tube stopper can loosen, creating a biohazard risk
EDTA degrades and loses anticoagulant activity
Platelet clumping and hemolysis may occur, affecting platelet count and CBC results (Correct answer)

Correct answer: Platelet clumping and hemolysis may occur, affecting platelet count and CBC results

Excessive inversion can mechanically damage platelets and red blood cells, causing platelet clumping and hemolysis that invalidate CBC and platelet count results.

Question 21: What is the term for the deliberate reduction of microbial contamination on inanimate surfaces using chemical or physical methods?

Antisepsis
Disinfection (Correct answer)
Sterilization
Sanitization

Correct answer: Disinfection

Disinfection reduces or eliminates pathogenic microorganisms on inanimate objects; unlike sterilization, it does not necessarily destroy all microbial life.

Question 22: A physician orders a lactic acid level. Which tube and special handling does this test require?

SST; centrifuged within 30 minutes
Lavender top; kept at room temperature
Gray top (sodium fluoride/oxalate); transported on ice immediately (Correct answer)
Light blue top; inverted gently 3–4 times

Correct answer: Gray top (sodium fluoride/oxalate); transported on ice immediately

Lactic acid tubes (gray top) contain sodium fluoride to stop glycolysis, and samples must be transported on ice to prevent continued lactate production.

Question 23: A phlebotomist labels a specimen tube after collection but BEFORE leaving the patient's room. This practice is:

Correct—tubes must be labeled at the bedside in the patient's presence before leaving the room (Correct answer)
Incorrect—prelabeled tubes must always be used to save time
Acceptable if the phlebotomist remembers which specimen is from which patient
Incorrect—tubes must be labeled at the nursing station to avoid interruptions

Correct answer: Correct—tubes must be labeled at the bedside in the patient's presence before leaving the room

CLSI GP47 requires that all specimens be labeled at the bedside in the patient's presence immediately after collection—this is a non-negotiable patient safety standard.

Question 24: When reconstituting a lyophilized (freeze-dried) control or reagent, which technique ensures the most accurate result?

Heat the vial at 56°C for 5 minutes
Gently swirl and roll the vial until fully dissolved without introducing bubbles (Correct answer)
Add double the specified diluent volume to ensure complete dissolution
Shake the vial vigorously to dissolve quickly

Correct answer: Gently swirl and roll the vial until fully dissolved without introducing bubbles

Gentle swirling prevents foaming and bubble formation that can trap undissolved material, ensuring complete reconstitution and accurate analyte concentrations.

Question 25: A phlebotomist notices the needle bevel is facing downward during insertion. What problem will likely occur?

Hemolysis of the sample
Petechiae at the site
Air bubbles in the tube
Failure to enter the vein or poor blood flow (Correct answer)

Correct answer: Failure to enter the vein or poor blood flow

The bevel must face upward to allow smooth entry into the vein; a downward bevel causes the needle tip to press against the vein wall, impeding flow.

Question 26: What does PST stand for in phlebotomy and what color is it typically associated with?

Plasma Sodium Tube; gray
Plasma Separator Tube; light green (Correct answer)
Potassium Serum Tube; gold
Pre-filled Sterile Tube; white

Correct answer: Plasma Separator Tube; light green

PST stands for Plasma Separator Tube; it is typically light green and contains lithium heparin with a gel separator that produces plasma (rather than serum) for rapid chemistry testing.

Question 27: A blood culture collected from a central venous catheter (CVC) is most likely to show which pre-analytical problem compared to a peripheral draw?

Higher contamination rate from catheter hub colonization (Correct answer)
Insufficient volume due to line resistance
Falsely low white cell counts
Hemolysis due to line pressure

Correct answer: Higher contamination rate from catheter hub colonization

Central catheters are colonized by biofilm organisms that can inoculate the blood culture bottle and produce a false-positive result.

Question 28: Which condition is a contraindication to using the antecubital vein on the same side as a mastectomy?

Lymphedema risk (Correct answer)
Dehydration
Anemia
Thrombocytopenia

Correct answer: Lymphedema risk

Venipuncture on the same side as a mastectomy risks introducing infection or worsening lymphedema due to compromised lymphatic drainage.

Question 29: A clot forms in an EDTA tube submitted for a CBC. The MOST likely cause is:

Using a butterfly needle set
Insufficient mixing immediately after collection (Correct answer)
Patient was fasting at the time of collection
Too much blood added to the tube

Correct answer: Insufficient mixing immediately after collection

If an EDTA tube is not mixed promptly and thoroughly after blood enters, the EDTA cannot chelate calcium effectively and micro-clots form, making the specimen unsuitable for CBC.

Question 30: A laboratory is investigating a systematic positive bias in sodium results compared to proficiency testing. Which of the following is MOST likely to be the cause?

Expired control material causing erroneous results only in QC
Random pipetting errors in individual samples
Calibrator drift or incorrect calibration assignment (Correct answer)
Hemolysis in patient samples causing elevated sodium

Correct answer: Calibrator drift or incorrect calibration assignment

Systematic bias (consistently too high) in an electrolyte analyzer most commonly results from calibrator drift, where the reference solution's concentration has shifted, causing all results to be offset.

Question 31: What needle gauge is most commonly used for routine adult venipuncture?

25 gauge
23 gauge
18 gauge
21 gauge (Correct answer)

Correct answer: 21 gauge

A 21-gauge needle provides an optimal balance of blood flow rate and patient comfort for routine adult venipuncture.

Question 32: Plasma specimens differ from serum specimens because plasma:

Contains no red blood cells
Is always collected in a red-top tube
Has a lower concentration of all electrolytes
Retains clotting factors that have been removed from serum (Correct answer)

Correct answer: Retains clotting factors that have been removed from serum

Plasma is obtained from anticoagulated blood and retains fibrinogen and other clotting factors, whereas serum is the liquid that remains after blood has clotted and those factors are consumed.

Question 33: According to CLSI standards, which two patient identifiers must be used before performing a blood draw?

Room number and date of birth
Floor number and diagnosis
Full name and date of birth (or medical record number) (Correct answer)
Physician name and insurance ID

Correct answer: Full name and date of birth (or medical record number)

CLSI and TJC require at least two patient identifiers — most commonly full name and date of birth or medical record number — before any specimen collection.

Question 34: Which anticoagulant is used in yellow-topped ACD (acid citrate dextrose) tubes and what are they primarily used for?

Sodium heparin — used for chromosome analysis
Acid citrate dextrose — used for blood bank and paternity testing (Correct answer)
Potassium oxalate — used for lead testing
EDTA — used for hormone panels

Correct answer: Acid citrate dextrose — used for blood bank and paternity testing

ACD tubes contain acid citrate dextrose, which preserves red blood cell viability, making them ideal for blood bank, DNA, and paternity studies.

Question 35: Which specimen type is MOST sensitive to temperature fluctuations and must be processed within 30 minutes without exception?

Ammonia (plasma) (Correct answer)
TSH (thyroid-stimulating hormone)
Lipid panel (fasting plasma)
Serum electrolytes in SST

Correct answer: Ammonia (plasma)

Ammonia levels rise rapidly in unprocessed whole blood because red blood cells continuously produce ammonia; the specimen must be placed on ice and centrifuged within 15–30 minutes.

Question 36: What angle of needle insertion is recommended for standard adult venipuncture?

15–30 degrees (Correct answer)
45 degrees
60 degrees
5–10 degrees

Correct answer: 15–30 degrees

A 15–30 degree angle allows the needle to enter the vein cleanly without going through the back wall.

Question 37: A Levey-Jennings chart plots control values over time against which reference points?

The patient's normal range for each analyte
The manufacturer's stated acceptable QC ranges
The previous day's QC values as a baseline
The mean and standard deviations (±1SD, ±2SD, ±3SD) of the control material (Correct answer)

Correct answer: The mean and standard deviations (±1SD, ±2SD, ±3SD) of the control material

Levey-Jennings charts plot consecutive control values against established mean ±1, 2, and 3 standard deviation (SD) lines, allowing visual detection of trends and rule violations.

Question 38: A heparin tube (green top) is positioned in the order of draw after the SST. Why is heparin drawn before EDTA but after SST?

Heparin carryover into EDTA tubes is less harmful than EDTA carryover into heparin tubes (Correct answer)
SST activates clotting that heparin must neutralize before EDTA collection
Heparin must clot before EDTA tubes are drawn
CLSI mandates this order to reduce patient discomfort from multiple sticks

Correct answer: Heparin carryover into EDTA tubes is less harmful than EDTA carryover into heparin tubes

Small amounts of heparin carryover into EDTA tubes have minimal clinical impact, whereas EDTA carryover into heparin tubes would chelate calcium and critically disrupt chemistry results.

Question 39: A specimen is received with two different patient names on the label and the requisition. The phlebotomist should:

Call the patient to determine the correct name
Reject the specimen and request a recollection with correct labeling (Correct answer)
Use the requisition name and discard the tube label
Process the specimen and note the discrepancy in the results

Correct answer: Reject the specimen and request a recollection with correct labeling

Mismatched patient identifiers constitute a labeling error; the specimen must be rejected and recollected to prevent potential misidentification and patient harm.

Question 40: Which of the following best describes the correct technique for mixing an EDTA tube after venipuncture?

Shake vigorously for 10 seconds
Vortex at low speed for 30 seconds
Leave undisturbed for 5 minutes then invert once
Gently invert 8–10 times (Correct answer)

Correct answer: Gently invert 8–10 times

EDTA tubes should be gently inverted 8–10 times immediately after collection to ensure thorough anticoagulant mixing without causing hemolysis.

Question 41: The ethical principle of 'Nonmaleficence' as it applies to phlebotomy is best described as:

The duty to 'do no harm' to the patient. (Correct answer)
Acting in the best interest of the patient.
Ensuring the patient understands and agrees to the procedure.
Treating all patients fairly and equitably.

Correct answer: The duty to 'do no harm' to the patient.

The principle of nonmaleficence is a core ethical tenet in healthcare, meaning to avoid causing unnecessary pain or harm to a patient. For a phlebotomist, this involves using proper technique, following safety protocols, and preventing complications like infection or nerve damage.

Question 42: What does the acronym 'RACE' stand for in a fire emergency response?

Remove, Alarm, Contain, Extinguish (Correct answer)
Run, Alarm, Close doors, Exit
Rescue, Alert, Cover, Evacuate
Report, Activate, Call, Escape

Correct answer: Remove, Alarm, Contain, Extinguish

RACE stands for Rescue patients in immediate danger, Alarm (activate the fire alarm), Contain the fire by closing doors, and Extinguish if safe to do so.

Question 43: A patient's arm shows a hematoma at the venipuncture site. The phlebotomist should FIRST:

Remove the needle and apply firm pressure (Correct answer)
Notify the physician immediately
Continue drawing blood from the same site
Apply a warm compress

Correct answer: Remove the needle and apply firm pressure

When a hematoma forms, the needle must be removed immediately and firm pressure applied to minimize bruising.

Question 44: A timed glucose tolerance test (GTT) requires multiple draws. If the 2-hour post-glucose draw is collected at 2 hours 15 minutes, this is considered:

A post-analytical error requiring repeat testing
A pre-analytical error that should be documented (Correct answer)
Within the 15-minute grace period allowed by all labs
Acceptable within the standard 30-minute tolerance window

Correct answer: A pre-analytical error that should be documented

Draws outside the specified collection window in timed tests constitute a pre-analytical error that must be documented so clinicians can interpret results correctly.

Question 45: How should a phlebotomist handle a patient who is hard of hearing during the identification process?

Write the questions down or use visual communication aids (Correct answer)
Skip verbal identification and rely on the wristband alone
Ask a nearby patient to translate
Shout louder and repeat the same question

Correct answer: Write the questions down or use visual communication aids

Written communication or other assistive methods ensure accurate patient identification when verbal communication is not effective.

Question 46: What is the purpose of inverting blood collection tubes after filling?

To mix the blood with the tube additive thoroughly (Correct answer)
To remove air bubbles from the sample
To separate serum from cells immediately
To activate the clotting process in all tube types

Correct answer: To mix the blood with the tube additive thoroughly

Gentle inversions mix blood with the tube's additive (anticoagulant or clot activator) to ensure proper sample preparation.

Question 47: What does 'chain of custody' mean in phlebotomy practice?

Documentation tracking specimen handling from collection to result (Correct answer)
The sequence of patient identification steps
The order in which tubes are filled
The hierarchy of phlebotomy staff supervisors

Correct answer: Documentation tracking specimen handling from collection to result

Chain of custody is the unbroken documentation trail ensuring specimen integrity, especially for forensic or drug testing samples.

Question 48: What is one benefit of earning the AMCA Phlebotomy Technician Certification?

Recognition of professional competency by healthcare employers (Correct answer)
Automatic eligibility for supervisory roles
Guaranteed employment in healthcare facilities
Exemption from continuing education requirements

Correct answer: Recognition of professional competency by healthcare employers

Earning the AMCA Phlebotomy Technician Certification provides official recognition of an individual's professional competency in phlebotomy. This credential assures healthcare employers that the phlebotomist has met established standards of knowledge and skill, making them a more desirable candidate for employment. It signifies a commitment to quality patient care and professional excellence.

Question 49: During a capillary puncture on an adult, which site is preferred?

Medial aspect of the heel
Fingertip center
Lateral aspect of the fingertip (Correct answer)
Earlobe

Correct answer: Lateral aspect of the fingertip

The lateral (side) aspect of the fingertip is preferred because it is less sensitive and has a better capillary bed than the center, which has dense nerve endings.

Question 50: What is the primary reason that EDTA tubes are collected FIRST in the capillary order of draw?

Lab policy requires EDTA first regardless of clinical rationale
To ensure the hematology specimen is collected before platelet clumping and activation occur (Correct answer)
EDTA prevents clotting of the entire collection
EDTA stabilizes glucose levels in the sample

Correct answer: To ensure the hematology specimen is collected before platelet clumping and activation occur

In capillary collection, EDTA tubes are first because the trauma of skin puncture activates platelets immediately; early collection captures the most representative sample before significant platelet clumping occurs.

Question 51: A conscious patient verbally refuses a blood draw. What is the appropriate response?

Call security immediately
Restrain the patient and continue
Proceed anyway to fulfill the physician's order
Respect the refusal, document it, and notify the nurse or physician (Correct answer)

Correct answer: Respect the refusal, document it, and notify the nurse or physician

Competent adult patients have the right to refuse medical procedures; the phlebotomist must document the refusal and inform the care team.

Question 52: Which micro-collection tube (Microtainer) color is used for hematology testing (CBC) in capillary collection?

Light blue (sodium citrate)
Gold (serum separator)
Lavender/purple (EDTA) (Correct answer)
Green (heparin)

Correct answer: Lavender/purple (EDTA)

Lavender/purple Microtainer tubes contain EDTA anticoagulant, the same additive used in full-draw lavender-top tubes for CBC and hematology testing.

Question 53: Which personal protective equipment (PPE) is ALWAYS required when performing a venipuncture, regardless of the patient's infection status?

Impermeable gown
Gloves (Correct answer)
N95 respirator
Full face shield

Correct answer: Gloves

Standard precautions require gloves during all venipunctures because blood is always considered potentially infectious.

Question 54: What does the term 'fomite' refer to in the context of infection control?

A vector such as a mosquito
A blood-borne virus
An airborne pathogen
An inanimate object that can harbor and transmit pathogens (Correct answer)

Correct answer: An inanimate object that can harbor and transmit pathogens

A fomite is any inanimate object (e.g., doorknob, phlebotomy tray) that can carry infectious agents and facilitate their transfer.

Question 55: The Westgard 10x̄ rule is used to detect which type of QC error?

Systematic error (bias) (Correct answer)
Precision error
Gross error
Random error

Correct answer: Systematic error (bias)

The 10x̄ rule detects systematic bias: when 10 consecutive control values fall on the same side of the mean, it indicates the method has shifted from its calibrated target.

Question 56: A phlebotomist performs a fingerstick and squeezes the finger excessively to obtain enough blood. This practice can cause which test result to be FALSELY ELEVATED?

Potassium (Correct answer)
Hemoglobin
Sodium
Glucose

Correct answer: Potassium

Excessive squeezing (milking) causes cell lysis and release of intracellular potassium, and introduces tissue fluid—both of which falsely elevate potassium in the sample.

Question 57: When performing a heelstick on a preterm neonate (born at 28 weeks gestation), the maximum lancet depth should be:

1.0 mm or less
No heelstick—always use venipuncture for preterm infants
2.0 mm (same as full-term)
0.65 mm (the shallowest commercially available device) (Correct answer)

Correct answer: 0.65 mm (the shallowest commercially available device)

Preterm neonates have extremely thin skin and very little subcutaneous tissue; the shallowest commercially available neonatal lancet (0.65–0.85 mm) should be used to avoid bone puncture.

Question 58: What is the primary reason sodium fluoride (gray-top) tubes are used for glucose testing?

It anticoagulates the specimen better than EDTA
Sodium fluoride inhibits glycolysis, preventing cells from consuming glucose (Correct answer)
Fluoride activates enzymes that stabilize glucose molecules
Fluoride enhances colorimetric glucose reactions for more accurate readings

Correct answer: Sodium fluoride inhibits glycolysis, preventing cells from consuming glucose

Sodium fluoride is a glycolytic inhibitor that blocks red blood cell glycolysis, preventing the breakdown of glucose and preserving the specimen's glucose concentration for up to 24 hours.

Question 59: When is it acceptable for a phlebotomist to draw blood from a site with an IV line running?

Never — IV sites are always off-limits
Whenever veins in the other arm are inaccessible
Only with physician authorization and below the IV site after stopping the infusion for at least 2 minutes (Correct answer)
Only if the IV fluid is normal saline

Correct answer: Only with physician authorization and below the IV site after stopping the infusion for at least 2 minutes

If no alternative site exists, blood may be drawn from the arm with an IV only with physician order, distal to the IV site, after stopping the infusion for 2 minutes and discarding the first 5 mL.

Question 60: When performing a fingerstick on an adult patient, which finger is the PREFERRED site?

Middle or ring finger (Correct answer)
Thumb
Little finger
Index finger

Correct answer: Middle or ring finger

The middle (third) and ring (fourth) fingers are preferred for adult fingersticks because they have adequate tissue depth and fewer nerve endings than the index finger.

Question 61: During a venipuncture, the tourniquet should be released:

After withdrawing the needle
As soon as blood flow is established (Correct answer)
Only after all tubes are filled
Before inserting the needle

Correct answer: As soon as blood flow is established

The tourniquet should be released as soon as blood begins to flow to prevent hemoconcentration.

Question 62: Light-sensitive specimens such as bilirubin or vitamin B12 should be:

Frozen within 5 minutes of collection
Refrigerated immediately after centrifugation
Processed at 37°C before analysis
Wrapped in foil or placed in amber containers to block light exposure (Correct answer)

Correct answer: Wrapped in foil or placed in amber containers to block light exposure

Bilirubin and certain vitamins degrade rapidly when exposed to fluorescent or UV light, so wrapping tubes in aluminum foil or using amber containers preserves analyte stability.

Question 63: Which of the following lab tests would be MOST affected by prolonged tourniquet application?

Potassium (Correct answer)
Creatinine
Glucose
Sodium

Correct answer: Potassium

Potassium leaks from cells during venous stasis caused by prolonged tourniquet use, falsely elevating potassium levels (pseudohyperkalemia).

Question 64: A patient refuses to have blood drawn. According to ASCP ethical guidelines, the phlebotomist should:

Proceed with the draw since the physician ordered it
Ask another phlebotomist to attempt the draw immediately
Explain that refusal could result in legal consequences
Document the refusal and notify the nursing staff or physician (Correct answer)

Correct answer: Document the refusal and notify the nursing staff or physician

Competent patients have the right to refuse procedures; the phlebotomist must document the refusal and inform the care team.

Question 65: When labeling a blood specimen tube, which piece of information is NOT typically required on the tube label?

Patient's insurance information (Correct answer)
Date and time of collection
Patient's full name
Phlebotomist's initials or ID

Correct answer: Patient's insurance information

Insurance information is an administrative/billing detail and is not required on the specimen label itself; specimen labels require patient identifiers, collection time, and collector ID.

Question 66: A lavender (purple) top tube is used PRIMARILY for:

Complete blood count (CBC) (Correct answer)
Blood culture collection
Blood glucose testing
Coagulation studies

Correct answer: Complete blood count (CBC)

Lavender/purple top tubes contain EDTA, which preserves cellular morphology, making them ideal for CBC and differential count testing.

Question 67: In the context of phlebotomy ethics, 'justice' primarily refers to:

Fair and equitable treatment of all patients regardless of background (Correct answer)
The patient's right to sue for malpractice
Reporting unethical behavior to law enforcement
Following all state and federal phlebotomy laws

Correct answer: Fair and equitable treatment of all patients regardless of background

Justice as an ethical principle requires providing impartial, equitable care to all patients without discrimination.

Question 68: Which type of isolation precaution is required for a patient diagnosed with active pulmonary tuberculosis?

Reverse isolation
Contact precautions
Airborne precautions (Correct answer)
Droplet precautions

Correct answer: Airborne precautions

Airborne precautions are required for TB because the bacteria are transmitted via tiny droplet nuclei that remain suspended in the air.

Question 69: A patient reports feeling faint and breaks into a cold sweat during venipuncture. This is most likely a sign of:

Vasovagal syncope (Correct answer)
Nerve injury
Hematoma
Anaphylaxis

Correct answer: Vasovagal syncope

Vasovagal syncope is a common reaction characterized by fainting, pallor, diaphoresis, and bradycardia triggered by needle anxiety or pain.

Question 70: How many continuing education units (CEUs) must NHA-certified phlebotomy technicians complete before renewing their certification?

20 CEUs
15 CEUs
25 CEUs
10 CEUs (Correct answer)

Correct answer: 10 CEUs

NHA CPT holders must complete 10 CEUs every two years to maintain their certification.

Question 71: A laboratory QA review finds that the specimen rejection rate for hemolysis has increased from 2% to 8% over the past month. The FIRST step in the quality improvement process is to:

Report the increase to the medical director and close the investigation
Accept the new rate as reflective of sicker patients in the hospital
Investigate the root cause by analyzing rejection data by phlebotomist, time of day, and patient unit (Correct answer)
Immediately retrain all phlebotomists on hemolysis prevention

Correct answer: Investigate the root cause by analyzing rejection data by phlebotomist, time of day, and patient unit

Root cause analysis must precede intervention—the rejection rate data must be stratified to identify where and why the increase is occurring before choosing the appropriate corrective action.

Question 72: Which additive tube must NEVER be inverted after collection?

Sodium citrate (light blue)
EDTA (lavender)
Red/gold serum separator
None — all tubes require inversion (Correct answer)

Correct answer: None — all tubes require inversion

All additive tubes require gentle inversion immediately after collection to mix the additive thoroughly with the blood.

Question 73: Which collection method is used to diagnose malaria by examining thick and thin blood smears?

Fingerstick or venipuncture with smears made immediately (Correct answer)
Urine midstream catch
Arterial puncture into a heparinized syringe
Venipuncture into an EDTA tube only

Correct answer: Fingerstick or venipuncture with smears made immediately

Fresh blood smears—thick for parasite detection and thin for species identification—can be made from either a fingerstick or venipuncture collected in EDTA.

Question 74: What is the blood-to-additive ratio required for a light blue-top coagulation tube?

9:1 (Correct answer)
1:1
4:1
5:1

Correct answer: 9:1

The correct ratio is 9 parts blood to 1 part sodium citrate; underfilling invalidates coagulation results by diluting the specimen.

Question 75: Turnaround time (TAT) monitoring is classified as which type of quality indicator?

Analytical quality indicator
Process quality indicator covering all phases (Correct answer)
Pre-analytical quality indicator
Post-analytical quality indicator

Correct answer: Process quality indicator covering all phases

TAT spans all phases—from order to specimen collection (pre-analytical), analysis (analytical), and result reporting (post-analytical)—making it a comprehensive process quality indicator.

Question 76: Which legal term describes a written false statement that damages a person's reputation?

Assault
Battery
Slander
Libel (Correct answer)

Correct answer: Libel

Libel refers to defamation in written or published form, while slander refers to spoken defamation.

Question 77: A patient with dementia cannot provide informed consent for a non-emergency blood draw. Who is the appropriate person to provide consent?

The patient's legally designated healthcare proxy or power of attorney (Correct answer)
The phlebotomist may proceed without consent
Any available family member present in the waiting room
The laboratory director

Correct answer: The patient's legally designated healthcare proxy or power of attorney

When a patient lacks decision-making capacity, a legally designated surrogate or power of attorney provides consent.

Question 78: Which of the following is the correct way to mix an anticoagulant tube after collection?

Leave undisturbed for 5 minutes
Centrifuge immediately without mixing
Gently invert 8–10 times (Correct answer)
Shake vigorously 10 times

Correct answer: Gently invert 8–10 times

Gentle inversion 8–10 times ensures the additive is thoroughly mixed with the blood without causing hemolysis.

Question 79: After performing a venipuncture, a phlebotomist accidentally sustains a needlestick injury. What is the IMMEDIATE first step the phlebotomist should take?

Report the incident to a supervisor.
Wash the wound with soap and water. (Correct answer)
Seek post-exposure prophylaxis (PEP).
Fill out an incident report.

Correct answer: Wash the wound with soap and water.

The immediate priority after a needlestick injury is to decontaminate the site to reduce the risk of infection. The wound should be immediately and thoroughly washed with soap and running water. Reporting the incident, filling out a report, and seeking medical evaluation are all crucial subsequent steps, but the first action is to clean the injury.

Question 80: Why must lithium heparin tubes NOT be used for lithium level tests?

Heparin destroys lithium ions
Lithium levels require serum, not plasma
Heparin causes lithium to precipitate
The additive lithium will falsely elevate the patient's lithium result (Correct answer)

Correct answer: The additive lithium will falsely elevate the patient's lithium result

The lithium in lithium heparin additive would be added to the patient's own lithium, causing a falsely elevated serum lithium measurement.

Question 81: Which of the following actions violates standard precautions when drawing blood?

Wearing gloves for every venipuncture
Recapping a used needle using the one-handed scoop technique
Disposing of sharps immediately in a puncture-resistant container
Recapping a used needle by holding the cap with the other hand (Correct answer)

Correct answer: Recapping a used needle by holding the cap with the other hand

Two-handed recapping is prohibited under standard precautions because it significantly increases the risk of needlestick injury.

Question 82: During a blood draw, gloves become visibly contaminated with blood. What is the appropriate action?

Remove gloves, complete the draw barehanded, then perform hand hygiene
Stop, remove gloves, perform hand hygiene, and re-glove before continuing (Correct answer)
Wipe gloves with an alcohol swab and continue
Continue the draw and change gloves after completing the collection

Correct answer: Stop, remove gloves, perform hand hygiene, and re-glove before continuing

Visibly contaminated gloves must be removed immediately; hands must be sanitized before donning new gloves to prevent cross-contamination.

Question 83: Which of the following is an example of an engineering control used to prevent needlestick injuries in phlebotomy?

Wearing double gloves
Using a self-sheathing safety needle (Correct answer)
Performing hand hygiene after every collection
Placing biohazard labels on specimen bags

Correct answer: Using a self-sheathing safety needle

A self-sheathing safety needle is an engineering control—a device designed to isolate or remove the hazard from the worker.

Question 84: What is a key responsibility of a National Certified Phlebotomy Technician (NCPT)?

Developing lab testing protocols
Supervising other laboratory staff
Prescribing diagnostic tests
Drawing blood samples and ensuring proper handling (Correct answer)

Correct answer: Drawing blood samples and ensuring proper handling

A National Certified Phlebotomy Technician (NCPT) is primarily responsible for performing venipuncture and other blood collection procedures accurately and safely. This includes proper patient identification, site preparation, sample collection, and ensuring specimens are correctly labeled and handled according to laboratory protocols. Their role is crucial for obtaining quality samples for diagnostic testing.

Question 85: The antecubital fossa is located at which anatomical position?

Back of the knee
Inner aspect of the ankle
Front of the wrist
Inner aspect of the elbow (Correct answer)

Correct answer: Inner aspect of the elbow

The antecubital fossa is the triangular area on the anterior (inner) surface of the elbow and is the primary site for routine venipuncture.

Question 86: A phlebotomist is preparing to draw blood from a patient in an isolation room. Which of the following pieces of Personal Protective Equipment (PPE) is the minimum requirement before entering the room?

Gloves, gown, and mask
Gloves and gown (Correct answer)
Gloves only
Gloves, gown, mask, and face shield

Correct answer: Gloves and gown

Standard Precautions require gloves for all phlebotomy procedures. However, when a patient is in an isolation room, there is a higher risk of exposure to infectious agents. Therefore, a gown is also required to protect the phlebotomist's clothing and skin from potential contamination. Masks and face shields are required when there is a risk of splashing or aerosol generation, but a gown and gloves are the minimum for entering an isolation setting.

Question 87: A phlebotomist must draw blood for a coagulation test, a complete blood count (CBC), and a serum chemistry panel. Which is the correct order of draw using the evacuated tube system?

Red top (serum), Lavender top (EDTA), Light Blue top (sodium citrate)
Red top (serum), Light Blue top (sodium citrate), Lavender top (EDTA)
Light Blue top (sodium citrate), Red top (serum), Lavender top (EDTA) (Correct answer)
Lavender top (EDTA), Light Blue top (sodium citrate), Red top (serum)

Correct answer: Light Blue top (sodium citrate), Red top (serum), Lavender top (EDTA)

The correct order of draw is critical to prevent cross-contamination of additives between tubes. For these tests, the Light Blue top (sodium citrate for coagulation) must be drawn first. The Red top (serum tube, which may have a clot activator but no anticoagulant) comes next. Finally, the Lavender top (EDTA) is drawn for the CBC.

Question 88: A QC control value plots at +2.3SD on the Levey-Jennings chart. According to Westgard rules, this result is:

A rejection requiring immediate corrective action
A warning (1₂s violation)—investigate before running patient samples (Correct answer)
Within acceptable limits—no action required
An indication of random error requiring instrument recalibration

Correct answer: A warning (1₂s violation)—investigate before running patient samples

A value between ±2SD and ±3SD triggers the 1₂s warning rule—not an automatic rejection, but a signal to investigate before proceeding with patient testing.

Question 89: When collecting a blood spot specimen for newborn screening, which action is considered unacceptable and could lead to specimen rejection?

Wiping away the first drop of blood after the heel puncture
Allowing a large drop of blood to form before touching it to the paper
Applying blood to only one side of the filter paper
Touching the filter paper directly to the baby's heel to speed up collection (Correct answer)

Correct answer: Touching the filter paper directly to the baby's heel to speed up collection

The filter paper should not be pressed against the puncture site. Instead, a large drop of blood should be allowed to form and then touched gently to the paper, allowing the blood to soak through and completely fill the circle by capillary action. Touching the paper to the skin can cause smearing, contamination, and incomplete saturation.

Question 90: What information is the MINIMUM required on a specimen label according to best practice standards?

Barcode only if computer-generated
Patient name only
Patient name and ward number
Patient name, date of birth, and collection date/time (Correct answer)

Correct answer: Patient name, date of birth, and collection date/time

Minimum labeling requires patient name, date of birth, and collection date/time to ensure accurate patient-sample matching.

Question 91: A glucose tolerance test (GTT) requires the patient to fast for how long before the baseline draw?

24 hours
4 hours
8–12 hours (Correct answer)
2 hours

Correct answer: 8–12 hours

Standard GTT protocol requires an 8–12 hour fast to establish a reliable fasting baseline glucose level.

Question 92: Proficiency testing (PT) is an EXTERNAL quality assessment tool that primarily evaluates:

Daily QC performance over a 30-day period
The accuracy of a laboratory's test methods by comparing results with peer laboratories (Correct answer)
Individual phlebotomist's specimen collection technique
The laboratory's compliance with OSHA safety regulations

Correct answer: The accuracy of a laboratory's test methods by comparing results with peer laboratories

Proficiency testing sends unknown specimens to a laboratory and compares its results against peer laboratory results and target values to assess method accuracy.

Question 93: Which anticoagulant is found in a light-blue top tube used for coagulation studies?

EDTA
Sodium fluoride
Sodium citrate (Correct answer)
Heparin

Correct answer: Sodium citrate

Light-blue top tubes contain sodium citrate, which chelates calcium to prevent clotting for PT and aPTT tests.

Question 94: A phlebotomist must prepare a specimen for transport to a reference lab that requires chilled handling. What is the proper technique for chilling the specimen?

Storing the tube in the refrigerator for 30 minutes before transport.
Placing the tube directly on a large block of ice.
Attaching a cold pack to the outside of the transport bag.
Submerging the tube in a mixture of crushed ice and water. (Correct answer)

Correct answer: Submerging the tube in a mixture of crushed ice and water.

For proper chilling, the specimen tube must be fully surrounded by the cooling medium to ensure rapid and consistent temperature reduction. A slurry of crushed ice and water provides the most effective contact with the entire surface of the tube.

Question 95: How should an ABG specimen be transported to the laboratory if analysis will be delayed beyond 30 minutes?

At room temperature in a sealed syringe cap
In iced slush or ice water to slow cellular metabolism (Correct answer)
In a biohazard bag without ice at ambient temperature
In a warming block at 37°C to simulate body temperature

Correct answer: In iced slush or ice water to slow cellular metabolism

ABG specimens must be transported in iced slush/ice water to slow cellular metabolism (O2 consumption and CO2 production) that would otherwise alter blood gas values.

Question 96: What condition can result from excessive fist pumping by a patient during venipuncture?

Thrombocytopenia
Pseudohyperkalemia (Correct answer)
Hemodilution
Hypoglycemia

Correct answer: Pseudohyperkalemia

Repeated fist pumping causes potassium to leak from muscle cells, falsely elevating serum potassium (pseudohyperkalemia).

Question 97: What is the correct centrifuge speed and time for most routine serum separation in a standard clinical laboratory?

5,000 × g for 20 minutes
500 × g for 2 minutes
1,000–1,500 × g for 5 minutes
2,000–3,000 × g for 10 minutes (Correct answer)

Correct answer: 2,000–3,000 × g for 10 minutes

Most clinical laboratories centrifuge routine serum or plasma specimens at 2,000–3,000 × g for approximately 10 minutes to achieve complete separation without damaging cells.

Question 98: To break the chain of infection, what is the single most effective means of preventing the spread of pathogens?

Proper hand hygiene (Correct answer)
Isolating infected patients
Wearing gloves
Using safety-engineered needles

Correct answer: Proper hand hygiene

While all options are important infection control measures, frequent and proper hand hygiene is recognized by the CDC and other health organizations as the single most effective way to prevent the spread of infections in a healthcare setting. It removes or destroys microorganisms picked up from other people, surfaces, or contaminated body fluids.

Question 99: Which hepatitis virus is primarily transmitted through the fecal-oral route and poses the least occupational risk to phlebotomists?

Hepatitis A (Correct answer)
Hepatitis D
Hepatitis C
Hepatitis B

Correct answer: Hepatitis A

Hepatitis A is transmitted via the fecal-oral route, not blood, so it poses minimal occupational risk during routine phlebotomy.

Question 100: Which of the following describes the CORRECT skin antiseptic technique before venipuncture?

Clean in a concentric circle moving outward from the center (Correct answer)
Wipe in a back-and-forth scrubbing motion
Apply antiseptic and wipe immediately
Use soap and water only

Correct answer: Clean in a concentric circle moving outward from the center

Cleaning from the center outward in a spiral motion prevents reintroducing contaminants from the surrounding skin back to the puncture site.

Question 101: When using the evacuated tube system, what is the correct action if blood stops flowing before the tube is full?

Gently rotate the tube and slightly advance or retract the needle (Correct answer)
Apply more tourniquet pressure
Discard the tube and start over from the beginning
Remove the needle and switch arms immediately

Correct answer: Gently rotate the tube and slightly advance or retract the needle

Gently adjusting needle position and rotating the tube can restore blood flow without restarting the draw.

Question 102: How long is the NCPT certification valid before requiring renewal?

2 years
1 year
3 years (Correct answer)
5 years

Correct answer: 3 years

The NCPT certification, awarded by the NCCT, is valid for a period of three years. To maintain their certification status, professionals are typically required to complete continuing education units (CEUs) and submit a renewal application before the expiration date. This ensures that certified phlebotomists stay current with best practices and advancements in the field.

Question 103: A phlebotomist overhears a coworker discussing a patient's HIV-positive status loudly in the hallway. This is a violation of:

HIPAA Privacy Rule (Correct answer)
OSHA regulations
CDC reporting guidelines
CLIA standards

Correct answer: HIPAA Privacy Rule

Discussing a patient's protected health information in a public area violates the HIPAA Privacy Rule.

Question 104: Which tube additive is matched CORRECTLY with its function?

EDTA – promotes clotting
Sodium citrate – binds calcium to prevent coagulation (Correct answer)
Heparin – causes platelet aggregation
Sodium fluoride – prevents hemolysis

Correct answer: Sodium citrate – binds calcium to prevent coagulation

Sodium citrate reversibly binds calcium ions, preventing the coagulation cascade and preserving the sample for coagulation studies.

Question 105: A phlebotomist needs to collect a capillary specimen from a patient with severe bilateral hand edema. The BEST alternative site would be:

The forehead
The forearm
The earlobe (Correct answer)
The upper arm

Correct answer: The earlobe

The earlobe is an acceptable alternative capillary puncture site when finger sites are compromised by edema, burns, or inadequate circulation.

Question 106: A requisition slip lists a 'STAT' order. In a clinical laboratory context, STAT means:

Standard turnaround time
Scheduled for the next routine run
Immediate processing — results needed urgently (Correct answer)
Send to tertiary analysis testing

Correct answer: Immediate processing — results needed urgently

STAT (from Latin statim) signals that the specimen must be collected and results returned as quickly as possible.

Question 107: Westgard's 1₃ₛ rule states that a QC run is rejected when:

The range between two controls exceeds 4SD
Ten consecutive controls fall on the same side of the mean
One control value exceeds ±3SD (Correct answer)
Two consecutive controls exceed ±2SD

Correct answer: One control value exceeds ±3SD

The 1₃s (one-three-sigma) Westgard rule rejects a run when any single control value exceeds 3 standard deviations from the mean, indicating a probable random error.

Question 108: A phlebotomist notices a centrifuged SST tube has a very thin serum layer. This is MOST consistent with:

Lipemia causing density changes
Specimen was spun at too high a speed
Polycythemia (elevated hematocrit) (Correct answer)
Diluted specimen from excessive saline flush

Correct answer: Polycythemia (elevated hematocrit)

Polycythemia results in a higher proportion of red blood cells relative to plasma, producing a thin serum layer after centrifugation of a clotted specimen.

Question 109: Which of the following best describes the APT's role in continuing professional development (CPD)?

The APT requires a minimum of 100 CPD hours per year
CPD is only mandatory for APT members working in private clinics
The APT prohibits members from attending non-APT training events
The APT encourages members to maintain and record ongoing CPD activities (Correct answer)

Correct answer: The APT encourages members to maintain and record ongoing CPD activities

The APT promotes lifelong learning by encouraging members to engage in and document CPD to maintain competency.

Question 110: In workplace drug testing phlebotomy, the collector must verify the specimen temperature within how many minutes of collection?

4 minutes (Correct answer)
30 minutes
15 minutes
60 minutes

Correct answer: 4 minutes

Federal workplace drug testing guidelines (DOT) require temperature verification within 4 minutes to detect specimen tampering.

Question 111: What angle should the needle be inserted for routine antecubital venipuncture?

45–60 degrees
90 degrees
15–30 degrees (Correct answer)
5–10 degrees

Correct answer: 15–30 degrees

A 15–30 degree angle (bevel up) allows smooth entry into the vein without passing through the posterior wall.

Question 112: Which OSHA standard specifically mandates the use of engineered sharps injury protections and a sharps injury log in healthcare settings?

OSHA Hazard Communication Standard (HazCom)
OSHA Personal Protective Equipment Standard
OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) (Correct answer)
OSHA Respiratory Protection Standard

Correct answer: OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030)

The OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) requires exposure control plans, engineering controls, PPE, and maintenance of a sharps injury log.

Question 113: Which document type in a laboratory quality management system describes step-by-step instructions for performing a specific procedure?

Quality policy
Standard operating procedure (SOP) (Correct answer)
Control chart
Quality manual

Correct answer: Standard operating procedure (SOP)

Standard operating procedures (SOPs) provide detailed, step-by-step instructions for performing specific laboratory procedures consistently and correctly.

Question 114: What is the primary purpose of the Exposure Control Plan mandated by OSHA's Bloodborne Pathogens Standard?

To eliminate or minimize employee exposure to blood and other potentially infectious materials (Correct answer)
To outline disciplinary actions for PPE non-compliance
To document all patients' infectious disease status
To schedule annual hepatitis B vaccinations

Correct answer: To eliminate or minimize employee exposure to blood and other potentially infectious materials

The Exposure Control Plan is a written document outlining procedures to eliminate or minimize occupational exposure to bloodborne pathogens.

Question 115: How often should phlebotomy technicians renew their certification to remain current in their field?

Every 5 years
Every 3 years (Correct answer)
Certification does not require renewal
Every 2 years

Correct answer: Every 3 years

Phlebotomy technicians certified through organizations like the APT typically need to renew their certification every three years. This renewal process usually involves completing continuing education units (CEUs) to ensure they remain current with best practices and advancements in the field. Regular renewal helps maintain professional competency and patient safety.

Question 116: What is the correct order of donning (putting on) PPE before entering an isolation room?

Mask, gloves, gown, eye protection
Gloves, gown, mask, eye protection
Eye protection, gown, gloves, mask
Gown, mask, eye protection, gloves (Correct answer)

Correct answer: Gown, mask, eye protection, gloves

CDC guidelines specify gown first, then mask/respirator, then eye protection, then gloves last so gloves cover the gown cuffs.

Question 117: What is the maximum time a whole blood specimen should remain at room temperature before centrifugation?

2 hours
15 minutes
60 minutes (Correct answer)
30 minutes

Correct answer: 60 minutes

Whole blood specimens should be centrifuged within 60 minutes of collection to prevent cellular metabolism from altering analyte levels.

Question 118: A patient's ABG specimen was left at room temperature for 2 hours before analysis. Which result is MOST likely to be falsely altered?

No significant changes occur within 2 hours at room temperature
pH falsely decreased, PO2 falsely decreased, PCO2 falsely increased (Correct answer)
Only pH changes; PO2 and PCO2 remain stable
pH falsely elevated, PO2 falsely elevated, PCO2 falsely decreased

Correct answer: pH falsely decreased, PO2 falsely decreased, PCO2 falsely increased

Cellular metabolism continues after collection: WBCs and platelets consume O2 (↓PO2), produce CO2 (↑PCO2), and generate acidic byproducts (↓pH)—all in the same direction over time.

Question 119: A physician's order is required before a phlebotomist can collect blood because:

It ensures the phlebotomist gets proper credit
Lab tests are considered medical procedures requiring a licensed provider's authorization (Correct answer)
State law mandates phlebotomists work only during business hours
Insurance companies require it for scheduling

Correct answer: Lab tests are considered medical procedures requiring a licensed provider's authorization

Blood tests are diagnostic medical procedures that legally require authorization from a licensed provider such as a physician or NP.

Question 120: In capillary puncture, the lancet should be positioned perpendicular to the fingerprint lines. Why?

To allow the wound to seal faster after collection
To reduce the risk of nerve damage
To maximize lancet depth penetration
To ensure the wound opens freely and blood flows more easily (Correct answer)

Correct answer: To ensure the wound opens freely and blood flows more easily

Puncturing perpendicular (across) the fingerprint lines allows the wound to gape slightly and blood to flow freely; puncturing parallel to the lines tends to seal the wound shut.

National Healthcareer Association (NHA) Certified Phlebotomy Technician (CPT) Exam

The NHA Certified Phlebotomy Technician (CPT) exam certifies individuals in the skills and knowledge required to perform phlebotomy procedures safely and effectively.

120

Questions

120 min

Time Limit

70%

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