NPA Phlebotomy Technician Certification Exam — Questions and Answers

Question 1: A patient has an IV infusion in the left arm. Where should the phlebotomist preferably draw blood?

Below the IV in the left arm without stopping the infusion
The opposite (right) arm (Correct answer)
Above the IV site in the left arm
Directly from the IV line without a discard

Correct answer: The opposite (right) arm

Drawing from the opposite arm avoids contamination and dilution of the specimen by IV fluid.

Question 2: A patient says they feel faint while the needle is in the arm. What should the phlebotomist do first?

Finish the draw quickly, then help the patient
Remove the tourniquet and needle, then lower the patient's head and call for help (Correct answer)
Give the patient a drink of water
Have the patient stand up and walk

Correct answer: Remove the tourniquet and needle, then lower the patient's head and call for help

Stopping the draw right away and lowering the head protects the patient from injury and restores blood flow to the brain.

Question 3: A butterfly set is being used and a light blue citrate tube is the first tube needed. What should the phlebotomist plan to do?

Draw the lavender tube first
Tap the tube to remove air after filling
Draw a discard tube first to fill the tubing's dead space (Correct answer)
Fill the citrate tube only halfway

Correct answer: Draw a discard tube first to fill the tubing's dead space

Air in the butterfly tubing would underfill the citrate tube and throw off the 9:1 blood-to-additive ratio.

Question 4: What is the purpose of noting the collection site, such as 'left antecubital', on some records?

To decide the patient's bill
To pick the patient's diet
To determine the test's turnaround time
To support follow-up if complications such as a hematoma occur (Correct answer)

Correct answer: To support follow-up if complications such as a hematoma occur

Recording the site helps with follow-up if bruising, nerve injury, or other complications occur.

Question 5: In what year was the Needlestick Safety and Prevention Act signed into law?

2000 (Correct answer)
1991
2010
1996

Correct answer: 2000

The Needlestick Safety and Prevention Act of 2000 required employers to use safer sharps devices and involve frontline workers in selecting them.

Question 6: What is the primary method for preventing needle-stick injuries?

Recapping the needle immediately after use
Proper disposal of needles in a sharps container (Correct answer)
Wearing gloves during the procedure
Using larger needles

Correct answer: Proper disposal of needles in a sharps container

The most effective method for preventing needle-stick injuries is the immediate and proper disposal of used needles into an approved, puncture-resistant sharps container. This eliminates the risk of accidental sticks to healthcare workers or others. Recapping needles is a dangerous practice and should always be avoided as it is a leading cause of such injuries.

Question 7: An elderly patient has thin, fragile hand veins. Which equipment should the phlebotomist plan to use?

A lancet for a capillary puncture
A 21-gauge multisample needle with 10 mL tubes
A 16-gauge needle with large tubes
A 23-gauge butterfly with small-volume tubes (Correct answer)

Correct answer: A 23-gauge butterfly with small-volume tubes

A small-gauge butterfly with low-vacuum tubes keeps fragile veins from collapsing.

Question 8: What is the purpose of using anticoagulants in blood specimens?

To increase blood flow during collection
To improve the color of the blood sample
To reduce the volume of blood collected
To preserve blood plasma for testing (Correct answer)

Correct answer: To preserve blood plasma for testing

Anticoagulants are substances that prevent blood from clotting. In blood specimens, their purpose is to keep the blood in a liquid state, allowing for the separation of plasma or serum, which is then used for various diagnostic tests. This preservation ensures that the cellular components do not interfere with the analysis of the liquid portion of the blood.

Question 9: How should a specimen and its requisition be packaged in a biohazard transport bag?

Requisition taped to the tube's stopper
Requisition and specimen loose together in an unsealed bag
Specimen in the sealed compartment and requisition in the separate outer pocket (Correct answer)
Requisition wrapped around the tube inside the sealed bag

Correct answer: Specimen in the sealed compartment and requisition in the separate outer pocket

Keeping paperwork in the separate pocket prevents contamination if the specimen leaks.

Question 10: According to CLSI, which tube is drawn FIRST in the order of draw for evacuated tube venipuncture?

Red (serum, no additive)
Light blue (sodium citrate)
Blood culture bottles or sterile tubes (Correct answer)
Lavender (EDTA)

Correct answer: Blood culture bottles or sterile tubes

Sterile blood cultures are collected first to prevent microbial contamination.

Question 11: Which method is preferred for chilling a specimen?

Placing it on top of solid ice cubes
Putting it in the freezer for 10 minutes
Immersing it in a mixture of crushed ice and water (Correct answer)
Placing it next to a cold pack in a dry bag

Correct answer: Immersing it in a mixture of crushed ice and water

An ice-water slurry gives even contact with the tube without freezing the specimen.

Question 12: A patient who speaks only Spanish arrives for a draw, and her 10-year-old son offers to translate. What should the phlebotomist do?

Postpone the draw until the patient learns basic English terms
Use the son as interpreter since he is fluent
Request a qualified medical interpreter or approved language-line service (Correct answer)
Use hand gestures only and proceed

Correct answer: Request a qualified medical interpreter or approved language-line service

Qualified interpreters should be used because minors and family members may translate inaccurately and compromise privacy.

Question 13: Which practice best prevents falls during outpatient blood collection?

Letting patients sit on a stool with no back
Drawing from patients while they stand
Drawing in the waiting room to save time
Seating patients in a draw chair with a locking arm bar (Correct answer)

Correct answer: Seating patients in a draw chair with a locking arm bar

A phlebotomy chair with a protective arm bar keeps a patient from falling if they faint.

Question 14: The largest artery in the human body is the:

Aorta (Correct answer)
Carotid artery
Pulmonary artery
Femoral artery

Correct answer: Aorta

The aorta is the largest artery in the body, arising directly from the left ventricle and distributing oxygenated blood to the systemic circulation.

Question 15: A coworker is being shocked by faulty equipment. What should be done first?

Throw water on the equipment
Shut off the electrical source before touching the victim (Correct answer)
Begin CPR while the victim still touches the source
Pull the victim away with bare hands

Correct answer: Shut off the electrical source before touching the victim

Cutting the power first prevents the rescuer from also being electrocuted.

Question 16: Specimens requiring refrigeration should be stored at what temperature range?

2-8°C (Correct answer)
20-25°C
-20 to -10°C
15-20°C

Correct answer: 2-8°C

Standard laboratory refrigeration is 2-8°C, monitored and logged daily for quality control.

Question 17: When warming a site before a capillary puncture, how long should the warm compress be applied?

30 seconds at any temperature
Warming is never recommended
3–5 minutes at no more than 42°C (Correct answer)
15 minutes at 50°C

Correct answer: 3–5 minutes at no more than 42°C

A moderate warm compress for 3–5 minutes increases blood flow without burning the skin.

Question 18: Why should a specimen for potassium NOT be chilled?

Chilling makes the sample hemolyze instantly
Chilling destroys the clot activator
Chilling causes potassium to precipitate out of solution
Chilling inhibits the transport pump, letting potassium leak out of cells and falsely elevating results (Correct answer)

Correct answer: Chilling inhibits the transport pump, letting potassium leak out of cells and falsely elevating results

Cold inhibits the Na+/K+ pump, so potassium leaks from red cells into the serum.

Question 19: A patient who is blind arrives for a draw. Which approach is best?

Guide them by grabbing their arm without warning
Speak to their companion instead of the patient
Announce yourself, describe each step before doing it, and offer your arm for guidance (Correct answer)
Avoid telling them when the needle goes in to prevent tensing

Correct answer: Announce yourself, describe each step before doing it, and offer your arm for guidance

Verbal descriptions and offered guidance respect autonomy and prevent startling the patient.

Question 20: If a phlebotomist makes an error on a paper requisition or log, what is the correct way to correct it?

Draw a single line through it, write the correction, and initial and date it (Correct answer)
Tear up the page and start over
Scribble it out completely
Use correction fluid and rewrite it

Correct answer: Draw a single line through it, write the correction, and initial and date it

A single line keeps the original entry legible, which is required for legal documentation.

Question 21: An ammonia specimen should be handled in which way after collection?

Kept at body temperature
Placed immediately in an ice-water slurry and delivered promptly (Correct answer)
Wrapped in aluminum foil only
Left at room temperature for 2 hours

Correct answer: Placed immediately in an ice-water slurry and delivered promptly

Chilling slows metabolic processes that would falsely raise ammonia levels.

Question 22: When is it safe to open the centrifuge lid after a run?

Only after the rotor has come to a complete stop (Correct answer)
When the rotor has slowed to half speed
After pressing the brake button while spinning
As soon as the timer ends

Correct answer: Only after the rotor has come to a complete stop

Opening before a full stop risks injury and release of aerosols from broken tubes.

Question 23: An inpatient is asleep when you arrive for a timed draw. What should you do?

Leave and return when the patient wakes naturally
Gently wake the patient, identify them, and explain the procedure (Correct answer)
Ask the roommate to confirm the patient's identity
Draw the blood without waking the patient

Correct answer: Gently wake the patient, identify them, and explain the procedure

Patients must be awake and properly identified before venipuncture.

Question 24: Which disinfectant is commonly recommended for cleaning a blood spill?

Hydrogen peroxide 3%
70% isopropyl alcohol
1:10 dilution of household bleach (Correct answer)
Soap and water only

Correct answer: 1:10 dilution of household bleach

A freshly prepared 1:10 bleach solution is effective against bloodborne pathogens.

Question 25: Why is re-centrifuging a gel-separator tube after the barrier has formed discouraged?

It destroys all glucose in the sample
It permanently seals the stopper
It may release cell-derived substances such as potassium into the serum (Correct answer)
It converts serum into plasma

Correct answer: It may release cell-derived substances such as potassium into the serum

Respinning can disrupt cells trapped above or near the gel, falsely altering results like potassium.

Question 26: Why is patient confidentiality important in phlebotomy?

To maintain better communication with family members.
To protect patients' personal information from unauthorized disclosure. (Correct answer)
To reduce the time spent with patients.
To speed up the blood collection process.

Correct answer: To protect patients' personal information from unauthorized disclosure.

Patient confidentiality is a fundamental ethical and legal principle in healthcare, mandated by regulations like HIPAA. It ensures that sensitive medical information, including test results and personal details, remains private and protected from unauthorized disclosure. Upholding confidentiality builds patient trust and prevents misuse of their health information.

Question 27: A specimen that appears milky or cloudy after centrifugation is described as:

Hemolyzed
Lipemic (Correct answer)
Clotted
Icteric

Correct answer: Lipemic

Lipemia results from high fat content, often after a non-fasting collection.

Question 28: Which statement violates a patient's right to dignity during a draw?

Closing the curtain before beginning
Explaining each step before doing it
Addressing the patient by "honey" or "sweetie" (Correct answer)
Asking the patient's preferred name

Correct answer: Addressing the patient by "honey" or "sweetie"

Terms of endearment like "honey" are unprofessional and can feel condescending, while the other options support dignity.

Question 29: Why is the basilic vein considered the last choice in the antecubital area?

It drains only superficial tissue and gives hemolyzed samples
It is located on the thumb side of the arm
It rolls easily and lies close to the brachial artery and median nerve (Correct answer)
It is too small for a 21-gauge needle

Correct answer: It rolls easily and lies close to the brachial artery and median nerve

The basilic vein is near the brachial artery and median nerve and tends to roll, raising injury risk.

Question 30: For a lactose tolerance test, what is measured in the serial blood samples?

Glucose (Correct answer)
Galactose antibodies
Lactose
Lactic acid

Correct answer: Glucose

Lactase breaks lactose into glucose and galactose, so a flat glucose curve suggests lactase deficiency.

Question 31: A patient asks you to draw from their left arm, but there is a mastectomy on that side. What should you do?

Draw from the left arm using a smaller needle
Explain kindly why the other arm is safer, and consult the provider if no other site is available (Correct answer)
Refuse the draw and leave
Honor the request since the patient chose it

Correct answer: Explain kindly why the other arm is safer, and consult the provider if no other site is available

Drawing on the mastectomy side risks complications such as lymphedema, so explain and seek alternatives or provider approval.

Question 32: How long should a serum tube without clot activator generally be allowed to clot at room temperature before centrifugation?

30-60 minutes (Correct answer)
2-3 hours
5-10 minutes
It should be centrifuged immediately

Correct answer: 30-60 minutes

Complete clotting typically takes 30-60 minutes; spinning too early can leave fibrin strands in the serum.

Question 33: After completing a draw, which communication is most appropriate?

Tell the patient their results will be normal
Ask the patient to dispose of the needle
Leave without saying anything
Instruct the patient on site care, such as keeping pressure and the bandage on, and thank them (Correct answer)

Correct answer: Instruct the patient on site care, such as keeping pressure and the bandage on, and thank them

Post-procedure instructions help prevent hematoma and close the interaction professionally.

Question 34: Which large veins return deoxygenated blood from the body to the right atrium of the heart?

Coronary veins
Superior and inferior vena cava (Correct answer)
Pulmonary veins
Hepatic portal vein

Correct answer: Superior and inferior vena cava

The superior vena cava drains blood from the upper body and the inferior vena cava from the lower body, both emptying into the right atrium.

Question 35: A patient states he feels faint before the needle is inserted. What should the phlebotomist communicate and do first?

Tell him to hold still and finish quickly
Have him hold his breath during the draw
Reassure him, ensure he is seated or lying down safely, and pause the procedure (Correct answer)
Ask him to stand up and walk around

Correct answer: Reassure him, ensure he is seated or lying down safely, and pause the procedure

Patient safety comes first; positioning the patient to prevent falls and pausing reduces risk of syncope injury.

Question 36: Which best describes a fomite?

A living vector such as a mosquito
Airborne particles smaller than 5 microns
An inanimate object that can carry infectious agents (Correct answer)
A person who carries a disease without symptoms

Correct answer: An inanimate object that can carry infectious agents

A fomite is a nonliving object, such as a tourniquet or countertop, that can transmit pathogens.

Question 37: Which special handling is needed for a bilirubin specimen?

Freeze it right away
Shake it hard to mix
Keep it at body temperature
Protect it from light (Correct answer)

Correct answer: Protect it from light

Light breaks down bilirubin, which gives falsely low results.

Question 38: What should be done if a blood specimen is clotted?

Add more blood to the specimen
Test the sample anyway
Refrigerate it before re-collecting (Correct answer)
Discard the specimen immediately

Correct answer: Refrigerate it before re-collecting

If a blood specimen is clotted when it shouldn't be (e.g., in an anticoagulant tube), it indicates an issue with collection or mixing, and the sample is unsuitable for many tests. The correct procedure is to refrigerate the clotted specimen to preserve it while a new, properly collected specimen is obtained. The clotted sample cannot be used for tests requiring whole blood or plasma.

Question 39: Which item must be included on every venipuncture specimen label?

Patient's diagnosis code
Patient's insurance number
Patient's full name, unique ID, collection date and time, and collector's initials (Correct answer)
Ordering physician's phone number

Correct answer: Patient's full name, unique ID, collection date and time, and collector's initials

Labels must have two patient identifiers, collection date/time, and collector identification, applied at the bedside.

Question 40: What is the most important assessment step to do before every blood collection?

Checking the patient's temperature
Taking the patient's blood pressure
Positively identifying the patient with at least two identifiers (Correct answer)
Asking for the patient's insurance information

Correct answer: Positively identifying the patient with at least two identifiers

Positive patient identification using at least two identifiers prevents mislabeled samples and samples drawn from the wrong patient.

Question 41: A cold agglutinin specimen should be maintained at what temperature until serum is separated?

2-8°C
Body temperature, 37°C (Correct answer)
Frozen at -20°C
Room temperature, about 22°C

Correct answer: Body temperature, 37°C

Cold agglutinins attach to red cells at lower temperatures, so the sample is kept warm to avoid false results.

Question 42: An inpatient's ID band is missing, but the nurse says, "That's Mr. Lopez in bed 4." What should the phlebotomist do?

Draw the sample and attach a note that the ID band was missing
Ask the nurse to have an ID band put on the patient before drawing (Correct answer)
Check the name on the door card and then draw
Draw the sample, since the nurse confirmed the patient's identity

Correct answer: Ask the nurse to have an ID band put on the patient before drawing

Inpatients must wear an attached ID band before collection, and a verbal ID from staff or a door card is not acceptable.

Question 43: A patient on anticoagulant therapy keeps bleeding 5 minutes after the needle is removed. What should the phlebotomist do?

Have the patient bend the arm upward
Keep applying pressure until bleeding stops, and notify the nurse if it continues (Correct answer)
Put the tourniquet back on over the site
Put on a bandage and leave

Correct answer: Keep applying pressure until bleeding stops, and notify the nurse if it continues

Patients on anticoagulants need longer direct pressure, and bleeding that won't stop must be reported.

Question 44: Per CLSI guidelines, serum or plasma should generally be separated from cells within what time frame?

2 hours (Correct answer)
15 minutes
8 hours
24 hours

Correct answer: 2 hours

Separating within 2 hours limits changes such as glucose loss and potassium leakage from cells.

Question 45: Protamine sulfate is used to reverse the effect of which drug?

Heparin (Correct answer)
Digoxin
Aspirin
Insulin

Correct answer: Heparin

Protamine sulfate binds and neutralizes heparin.

Question 46: A specimen requires protection from light, such as bilirubin. What should the label or documentation reflect?

That it was centrifuged twice
That it was stored in a sunny window
That it was protected from light, per lab requirements (Correct answer)
Nothing, light doesn't matter

Correct answer: That it was protected from light, per lab requirements

Light-sensitive analytes like bilirubin break down in light, so handling should be noted.

Question 47: Which test monitors patients on warfarin (Coumadin) therapy?

Platelet function assay
PT/INR (Correct answer)
aPTT
D-dimer

Correct answer: PT/INR

PT/INR is the standard test to monitor warfarin anticoagulation.

Question 48: A patient taking clopidogrel (Plavix) has just had a venipuncture. What should the phlebotomist do?

Have the patient bend the arm tightly upward
Apply a tourniquet over the site
Leave immediately since the patient is on medication
Apply pressure longer and confirm bleeding has stopped before bandaging (Correct answer)

Correct answer: Apply pressure longer and confirm bleeding has stopped before bandaging

Antiplatelet drugs prolong bleeding, so extended pressure and checking the site are required.

Question 49: Which term describes the range between the lowest effective drug level and the level at which toxicity occurs?

Bioavailability
Therapeutic range (Correct answer)
Reference interval
Half-life

Correct answer: Therapeutic range

The therapeutic range is the blood concentration window where a drug is effective without being toxic.

Question 50: How can contamination of a blood specimen be prevented?

By avoiding gloves during specimen collection
By properly cleaning the site before blood collection (Correct answer)
By reusing needles after sterilization
By using a separate needle for each patient

Correct answer: By properly cleaning the site before blood collection

Contamination of a blood specimen, particularly with skin flora, can lead to inaccurate test results, especially for blood cultures. Properly cleaning the venipuncture site with an antiseptic before the draw significantly reduces the presence of microorganisms on the skin. This ensures the collected blood is representative of the patient's internal state and prevents false positive results.

Question 51: Peak levels for most intravenously administered drugs are generally drawn when?

Six hours after the infusion
At the patient's next meal
About 30 minutes after the infusion is completed (Correct answer)
Right before the infusion starts

Correct answer: About 30 minutes after the infusion is completed

IV peaks are usually drawn about 30 minutes after infusion ends, though the timing varies by drug.

Question 52: How long does a typical fasting requirement for a fasting glucose test last?

48 hours
24 hours
8-12 hours (Correct answer)
2-4 hours

Correct answer: 8-12 hours

A fasting glucose test usually requires 8-12 hours with no food or drinks other than water.

Question 53: Drawing an EDTA tube before a green heparin tube can falsely cause which result in the chemistry sample?

Decreased sodium
Increased glucose
Decreased potassium and increased calcium
Increased potassium and decreased calcium (Correct answer)

Correct answer: Increased potassium and decreased calcium

K2/K3 EDTA carryover raises potassium and chelates calcium, lowering it.

Question 54: What is the normal resting pulse rate range for a healthy adult?

40-60 beats per minute
100-120 beats per minute
60-100 beats per minute (Correct answer)
50-70 beats per minute

Correct answer: 60-100 beats per minute

A normal adult resting heart rate is 60-100 beats per minute.

Question 55: How long should a tourniquet remain in place before it is released?

No more than 1 minute (Correct answer)
Up to 3 minutes
Up to 5 minutes
Until all tubes are filled, regardless of time

Correct answer: No more than 1 minute

Leaving the tourniquet on longer than 1 minute causes hemoconcentration and can alter test results.

Question 56: What is the primary role of erythrocytes (red blood cells)?

Fight infection and produce antibodies
Produce clotting factors in the liver
Facilitate blood clotting at injury sites
Transport oxygen and carbon dioxide (Correct answer)

Correct answer: Transport oxygen and carbon dioxide

Erythrocytes contain hemoglobin, which binds oxygen for transport to tissues and carries carbon dioxide back to the lungs.

Question 57: When documenting in an electronic health record, why must phlebotomists never share login credentials?

Every entry must be traceable to the person who made it (Correct answer)
It slows down the computer
It is only discouraged on weekends
Shared passwords expire faster

Correct answer: Every entry must be traceable to the person who made it

Unique logins create an audit trail that ties each entry to one accountable user.

Question 58: How often must an employer's Exposure Control Plan be reviewed and updated under OSHA?

Every 5 years
At least annually (Correct answer)
Every 3 months
Only after an exposure incident

Correct answer: At least annually

OSHA requires the Exposure Control Plan to be reviewed and updated at least once a year.

Question 59: If blood must be drawn below an IV site, what should be done first?

Raise the IV flow rate
Draw right away without any special steps
Remove the IV catheter yourself
Have the nurse stop the IV for at least 2 minutes, then apply the tourniquet below the IV (Correct answer)

Correct answer: Have the nurse stop the IV for at least 2 minutes, then apply the tourniquet below the IV

CLSI guidance calls for the nurse to stop the infusion for at least 2 minutes before a draw below the IV site.

Question 60: What is the main purpose of an antimicrobial removal device (ARD) or resin-containing blood culture bottle?

To prevent clotting in the bottle
To neutralize antibiotics already in the patient's blood (Correct answer)
To preserve glucose
To speed up transport

Correct answer: To neutralize antibiotics already in the patient's blood

Resins or ARDs bind antibiotics that could otherwise inhibit bacterial growth in the culture.

Question 61: When entering an inpatient room, which sequence reflects proper professional etiquette?

Knock, introduce yourself and your department, explain why you are there, then identify the patient (Correct answer)
Enter quietly and check the ID band before speaking
Identify the patient from the chart outside, then enter and draw
Enter, turn on the overhead light, then begin identification

Correct answer: Knock, introduce yourself and your department, explain why you are there, then identify the patient

Knocking, introducing yourself, and explaining the purpose respects the patient's privacy and dignity before identification.

Question 62: What is the maximum lancet depth recommended for an infant heel puncture?

0.5 mm
2.0 mm (Correct answer)
4.0 mm
3.0 mm

Correct answer: 2.0 mm

CLSI recommends a heel puncture depth of no more than 2.0 mm to avoid hitting bone.

Question 63: Which federal regulation sets quality standards for all U.S. laboratory testing performed on human specimens?

EMTALA
FERPA
CLIA '88 (Correct answer)
HIPAA

Correct answer: CLIA '88

The Clinical Laboratory Improvement Amendments of 1988 regulate quality standards for clinical laboratory testing.

Question 64: When choosing a vein by touch, what should a good vein feel like?

Bouncy and elastic (Correct answer)
Hard and cord-like
Pulsating
Rolling with no resistance

Correct answer: Bouncy and elastic

A healthy vein feels soft, bouncy, and springy, while a hard, cord-like vein is sclerosed and should be avoided.

Question 65: A teenage outpatient (age 15) arrives alone for a routine draw. What is generally required?

The minor can always consent independently
No consent is needed for routine tests
Verbal consent from the receptionist
Consent from a parent or legal guardian, unless state law provides an exception (Correct answer)

Correct answer: Consent from a parent or legal guardian, unless state law provides an exception

Minors generally require parental or guardian consent except where state laws allow minors to consent to specific services.

Question 66: Which ethical principle is most directly applicable to clinical assessment methods?

Prioritize speed over thoroughness
Maximize facility revenue
Follow the most convenient protocol
Beneficence — acting in the patient's best interest (Correct answer)

Correct answer: Beneficence — acting in the patient's best interest

Beneficence, the principle of acting in the patient's best interest, is fundamental to ethical practice in clinical assessment methods.

Question 67: According to the CDC, how long should hands be rubbed with soap during handwashing?

10 seconds
2 minutes
At least 20 seconds (Correct answer)
5 seconds

Correct answer: At least 20 seconds

The CDC recommends at least 20 seconds of friction with soap for effective handwashing.

Question 68: A patient has an MRSA-infected wound and is on contact precautions. What PPE is required to enter the room for a venipuncture?

N95 respirator
Gown and gloves (Correct answer)
Surgical mask only
Negative-pressure room and mask

Correct answer: Gown and gloves

Contact precautions require a gown and gloves because MRSA spreads by direct and indirect contact.

Question 69: A physician enters the room while the phlebotomist is mid-draw and asks to examine the patient. What should the phlebotomist do?

Politely inform the physician the draw will take a moment and complete it if safe to do so (Correct answer)
Ignore the physician
Remove the needle immediately and leave
Hand the tourniquet to the physician and step out

Correct answer: Politely inform the physician the draw will take a moment and complete it if safe to do so

Completing an in-progress draw safely while courteously communicating avoids an additional stick for the patient.

Question 70: Under HIPAA, which action by a phlebotomist is appropriate?

Leaving labeled tubes on the waiting room counter
Discussing a patient's HIV test in the elevator
Posting a funny patient story on social media without names
Sharing patient information only with those directly involved in care (Correct answer)

Correct answer: Sharing patient information only with those directly involved in care

HIPAA limits disclosure of protected health information to those with a need to know.

Question 71: In the context of National Phlebotomy Association Certification, what is the primary goal of treatment planning?

Cost reduction for the facility
Provider convenience
Optimal patient outcomes and safety (Correct answer)
Administrative efficiency

Correct answer: Optimal patient outcomes and safety

The primary goal of treatment planning in National Phlebotomy Association Certification is always to achieve optimal patient outcomes while maintaining safety standards.

Question 72: If a specimen is collected from an arm with an IV running above the site, what should be documented?

Only the IV fluid brand
That the specimen was drawn below the IV and the IV was stopped per policy (Correct answer)
Nothing special
The nurse's home phone number

Correct answer: That the specimen was drawn below the IV and the IV was stopped per policy

Documenting IV-arm collection helps the lab and provider spot possible contamination or dilution.

Question 73: What is the most common vein used for venipuncture?

Basilic vein
Cephalic vein
Median cubital vein (Correct answer)
Jugular vein

Correct answer: Median cubital vein

The median cubital vein is the most common and preferred site for venipuncture due to its large size, superficial location, and typically well-anchored position in the antecubital fossa. These characteristics make it generally easier to access and less prone to rolling, leading to a higher success rate and reduced patient discomfort during blood collection.

Question 74: Phenytoin (Dilantin) is a drug often monitored through blood levels because it is used to treat:

Hypothyroidism
Seizures (Correct answer)
Bacterial infections
High cholesterol

Correct answer: Seizures

Phenytoin is an anticonvulsant with a narrow therapeutic range.

Question 75: Which needle gauge is standard for routine adult venipuncture?

21-gauge (Correct answer)
16-gauge
25-gauge
30-gauge

Correct answer: 21-gauge

A 21-gauge needle balances flow rate against patient comfort and the risk of hemolysis.

Question 76: Under OSHA, when must an employer offer the hepatitis B vaccine to an employee with occupational exposure risk?

Only to employees over age 40
Only after an exposure incident
Within 10 working days of initial assignment at no cost (Correct answer)
Within 90 days at the employee's expense

Correct answer: Within 10 working days of initial assignment at no cost

OSHA requires the hepatitis B vaccine series be offered free within 10 working days of initial assignment.

Question 77: What is the correct way to aliquot serum into a secondary tube?

Use a syringe and needle to draw it off
Use a disposable transfer pipette and label the aliquot tube properly (Correct answer)
Decant it into an unlabeled cup for the lab to label
Pour directly from the primary tube

Correct answer: Use a disposable transfer pipette and label the aliquot tube properly

Transfer pipettes reduce splashing and aerosols, and every aliquot must carry the same patient identification.

Question 78: A patient scheduled for a fasting glucose says they ate breakfast an hour ago. What should the phlebotomist do?

Refuse service and send the patient home without telling anyone
Wait 30 minutes and then draw the sample as fasting
Draw the sample and label it as fasting
Tell the provider or lab and follow their instructions, documenting that the patient was not fasting (Correct answer)

Correct answer: Tell the provider or lab and follow their instructions, documenting that the patient was not fasting

Non-fasting status must be reported and documented so the result isn't misread.

Question 79: What should be done after using a needle during blood collection?

Dispose of the needle in a sharps container (Correct answer)
Recap the needle and store it safely
Dispose of it in a regular trash bin
Leave the needle on the counter for the next use

Correct answer: Dispose of the needle in a sharps container

After using a needle, it must be immediately disposed of in a puncture-resistant sharps container. This prevents accidental needle-stick injuries, which can transmit bloodborne pathogens to healthcare workers. Recapping needles is strictly prohibited as it is a common cause of such injuries and poses a significant safety risk.

Question 80: Which OSHA regulation is the Bloodborne Pathogens Standard?

29 CFR 1926.501
29 CFR 1910.1200
29 CFR 1910.134
29 CFR 1910.1030 (Correct answer)

Correct answer: 29 CFR 1910.1030

29 CFR 1910.1030 is the OSHA Bloodborne Pathogens Standard; 1910.1200 is Hazard Communication and 1910.134 is Respiratory Protection.

Question 81: Which artery is most commonly used to take a routine adult pulse?

Carotid
Radial (Correct answer)
Popliteal
Femoral

Correct answer: Radial

The radial artery on the thumb side of the wrist is the standard site for a routine adult pulse.

Question 82: Which ethical principle is most directly applicable to patient safety protocols?

Beneficence — acting in the patient's best interest (Correct answer)
Prioritize speed over thoroughness
Follow the most convenient protocol
Maximize facility revenue

Correct answer: Beneficence — acting in the patient's best interest

Beneficence, the principle of acting in the patient's best interest, is fundamental to ethical practice in patient safety protocols.

Question 83: What is the purpose of running quality control on a point-of-care glucose meter?

To confirm the meter and test strips give accurate results (Correct answer)
To record the patient's identity
To calibrate the patient's insulin dose
To clean the device

Correct answer: To confirm the meter and test strips give accurate results

Quality control checks the meter against known control solutions to confirm it is accurate before patient results are reported.

Question 84: After a draw, a patient reports a sharp, shooting, electric pain down the arm. What is the most likely cause?

The patient is having a vasovagal reaction
The tourniquet is too loose
The needle has contacted a nerve (Correct answer)
A hematoma is forming

Correct answer: The needle has contacted a nerve

Shooting or electric pain means a nerve was touched, and the needle must be removed right away to prevent permanent injury.

Question 85: When should a sharps disposal container be replaced?

When completely full
When half full
When three-quarters full or at the fill line (Correct answer)
Once a week regardless of contents

Correct answer: When three-quarters full or at the fill line

Sharps containers should be closed and replaced at the fill line, about three-quarters full, to prevent overfill injuries.

Question 86: Which pulmonary vessel is unique in that it carries deoxygenated blood?

Pulmonary arteries (Correct answer)
Superior vena cava
Aorta
Pulmonary veins

Correct answer: Pulmonary arteries

The pulmonary arteries carry deoxygenated blood from the right ventricle to the lungs — the only arteries in the body that carry deoxygenated blood.

Question 87: Which specimen should be planned for transport on ice right after collection?

CBC
Cold agglutinins
Bilirubin
Ammonia (Correct answer)

Correct answer: Ammonia

Chilling slows metabolism in the cells, which would otherwise falsely raise ammonia levels.

Question 88: A patient is chewing gum when the phlebotomist arrives. What should be done before the draw?

Give the patient a mint instead
Nothing; gum is harmless
Have the patient remove the gum to prevent choking if they faint (Correct answer)
Delay the draw for 24 hours

Correct answer: Have the patient remove the gum to prevent choking if they faint

Gum or food in the mouth is a choking hazard if the patient faints during collection.

Question 89: In forensic or legal blood alcohol testing, what document tracks every person who handles the specimen?

Chain-of-custody form (Correct answer)
Quality control log
Requisition slip
Incident report

Correct answer: Chain-of-custody form

A chain-of-custody form records every transfer of the specimen so it holds up in court.

Question 90: Which is an example of active listening?

Preparing your equipment while the patient speaks
Paraphrasing what the patient said to confirm understanding (Correct answer)
Nodding while thinking about your next draw
Interrupting to correct the patient

Correct answer: Paraphrasing what the patient said to confirm understanding

Paraphrasing shows the patient you heard and understood them.

Question 91: When using a fire extinguisher with the PASS technique, where should the nozzle be aimed?

At the base of the fire (Correct answer)
At the top of the flames
At the wall behind the fire
At the smoke layer

Correct answer: At the base of the fire

Aiming at the base of the fire puts the extinguishing agent on the fuel source.

Question 92: What is the standard of care requirement for diagnostic procedures in clinical practice?

Whatever the practitioner feels is adequate
The level of care a reasonably competent practitioner would provide (Correct answer)
The most aggressive treatment available
The minimum effort needed to avoid a lawsuit

Correct answer: The level of care a reasonably competent practitioner would provide

The standard of care is defined as what a reasonably competent practitioner with similar training would provide under similar circumstances.

Question 93: How is centrifuge speed verified as part of routine quality control?

By weighing the tubes after spinning
By measuring rotor speed with a tachometer (Correct answer)
By listening to the motor sound
By checking the timer setting

Correct answer: By measuring rotor speed with a tachometer

A tachometer confirms the actual RPM matches the set speed, and results are recorded in a maintenance log.

Question 94: A patient had a left mastectomy with lymph node removal. Where should blood be drawn?

The right arm, unless a physician authorizes otherwise (Correct answer)
The left arm, because the veins there are larger
The left hand, using a butterfly set
Either arm, as long as a small needle is used

Correct answer: The right arm, unless a physician authorizes otherwise

After lymph node removal, the arm on that side is prone to lymphedema and infection, so draw from the other side unless a physician approves.

Question 95: How should blood specimens be stored for long-term preservation?

In a refrigerated area or a freezer for long-term storage (Correct answer)
In a warm, dry place
In direct sunlight to prevent bacterial growth
At room temperature in an open container

Correct answer: In a refrigerated area or a freezer for long-term storage

For long-term preservation, blood specimens (or components like plasma/serum) are typically stored in a freezer, often at -20°C or -80°C, to halt degradation processes. Short-term storage usually involves refrigeration (2-8°C). Proper temperature control is crucial to maintain the stability of analytes and cellular components for future testing or research, ensuring reliable results over time.

Question 96: If a chemical splashes into a worker's eyes, how long should the eyes be flushed at an eyewash station?

60 minutes
At least 15 minutes (Correct answer)
2 minutes
5 minutes

Correct answer: At least 15 minutes

Eyes should be flushed with water for at least 15 minutes, then medical evaluation sought.

Question 97: A hematoma begins forming rapidly during venipuncture. What is the correct action?

Release the tourniquet, remove the needle, and apply pressure (Correct answer)
Apply a second tourniquet
Push the needle deeper
Continue collecting and ice it afterward

Correct answer: Release the tourniquet, remove the needle, and apply pressure

A rapidly forming hematoma means blood is leaking; stop the draw and apply pressure.

Question 98: What is the standard adult glucose load for a diagnostic 2-hour oral glucose tolerance test in non-pregnant adults?

50 g
25 g
75 g (Correct answer)
100 g

Correct answer: 75 g

The ADA/WHO diagnostic OGTT uses a 75 g anhydrous glucose load.

Question 99: Performing a procedure that is outside a phlebotomist's training and job description, such as an arterial puncture without authorization, is acting outside the:

Scope of practice (Correct answer)
Chain of custody
Statute of limitations
Code of conduct for patients

Correct answer: Scope of practice

Scope of practice defines the procedures a health worker is trained and authorized to perform.

Question 100: What is the standard of care requirement for pharmacology basics in clinical practice?

Whatever the practitioner feels is adequate
The most aggressive treatment available
The minimum effort needed to avoid a lawsuit
The level of care a reasonably competent practitioner would provide (Correct answer)

Correct answer: The level of care a reasonably competent practitioner would provide

The standard of care is defined as what a reasonably competent practitioner with similar training would provide under similar circumstances.

NPA Phlebotomy Technician Certification Exam

This exam certifies individuals as competent phlebotomy technicians, capable of performing venipuncture and other blood collection procedures safely and effectively.

100

Questions

120 min

Time Limit

70%

To Pass

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