NRCMA Phlebotomy 2 — Questions and Answers
Question 1: Which vein is considered the FIRST choice for venipuncture in most adult patients?
- Basilic vein
- Cephalic vein
- Median cubital vein (Correct answer)
- Dorsal hand vein
Correct answer: Median cubital vein
The median cubital vein is preferred because it is large, well-anchored, and least likely to roll.
Question 2: A patient reports feeling dizzy and lightheaded during venipuncture. What is the FIRST action the MA should take?
- Remove the needle immediately and apply pressure (Correct answer)
- Ask the patient to breathe deeply and continue
- Call for emergency assistance before doing anything else
- Loosen the tourniquet and continue drawing
Correct answer: Remove the needle immediately and apply pressure
Removing the needle immediately prevents injury if the patient faints, and pressure stops bleeding.
Question 3: What does the term 'hemoconcentration' refer to in phlebotomy?
- Increased red blood cell destruction
- Falsely elevated analyte levels due to prolonged tourniquet use (Correct answer)
- Low platelet count in the specimen
- Clotting of blood in the collection tube
Correct answer: Falsely elevated analyte levels due to prolonged tourniquet use
Prolonged tourniquet application (>1 minute) causes fluid to shift out of capillaries, concentrating blood components.
Question 4: Which additive is found in a royal blue-top tube used for trace element testing?
- Sodium citrate
- EDTA or no additive (trace-element free) (Correct answer)
- Lithium heparin
- Sodium fluoride
Correct answer: EDTA or no additive (trace-element free)
Royal blue-top tubes contain either EDTA or no additive and are made with trace-element-free materials to prevent contamination.
Question 5: When performing a capillary puncture on an infant, which site is recommended?
- Fingertip of the index finger
- Heel (plantar surface, medial or lateral) (Correct answer)
- Earlobe
- Big toe
Correct answer: Heel (plantar surface, medial or lateral)
The medial or lateral plantar surface of the heel is the standard capillary puncture site for infants to avoid bone injury.
Question 6: Which of the following is the correct angle for inserting a needle during routine venipuncture?
- 5–10 degrees
- 15–30 degrees (Correct answer)
- 45–60 degrees
- 90 degrees
Correct answer: 15–30 degrees
A 15–30 degree angle allows the needle to enter the vein without passing through it.
Question 7: A specimen labeled 'QNS' means:
- Quality not sufficient
- Quantity not sufficient (Correct answer)
- Quick needle stick
- Quality noncompliant specimen
Correct answer: Quantity not sufficient
QNS stands for Quantity Not Sufficient, indicating too little sample was collected for testing.
NRCMA Phlebotomy 2
Which vein is considered the FIRST choice for venipuncture in most adult patients?