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ASCP BOC Exam Study Guide – Practice Questions &
Answers
1. The most common white blood cell in a healthy adult is:
A) Neutrophil
B) Lymphocyte
C) Monocyte
D) Eosinophil
Answer: A – Neutrophils make up 50–70% of circulating WBCs.
2. A patient has microcytic, hypochromic anemia. The most likely cause is:
A) Vitamin B12 deficiency
B) Iron deficiency
C) Hemolytic anemia
D) Acute blood loss
Answer: B – Microcytic, hypochromic anemia is characteristic of iron deficiency.
3. The normal adult hemoglobin A1c range is:
A) 2–4%
B) 4–6%
C) 6–8%
D) 8–10%
Answer: B – HbA1c reflects average blood glucose over 2–3 months.
4. A left shift in a WBC differential indicates:
A) Increased mature lymphocytes
B) Increased immature neutrophils (bands)
C) Decreased monocytes
D) Increased eosinophils
Answer: B – Left shift indicates bacterial infection or inflammation.
5. A platelet count below 150,000/μL is termed:
A) Thrombocytosis
B) Thrombocytopenia
C) Leukocytosis
D) Leukopenia
Answer: B – Normal platelet range is 150,000–450,000/μL.
6. Which stain is commonly used to identify reticulocytes?
A) Wright-Giemsa
B) New Methylene Blue
C) Gram stain
D) Acid-fast stain
Answer: B – Reticulocytes stain blue due to residual RNA.
7. Hemolytic anemia is characterized by all EXCEPT:
A) Increased reticulocytes
B) Decreased bilirubin
C) Increased LDH
2026 2027 GRADED A+
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D) Hemoglobinuria
Answer: B – Hemolysis increases indirect bilirubin.
8. A patient’s blood smear shows target cells. This is most consistent with:
A) Iron deficiency anemia
B) Thalassemia
C) Aplastic anemia
D) Megaloblastic anemia
Answer: B – Target cells are common in thalassemia.
9. Which test evaluates intrinsic coagulation pathway?
A) PT
B) aPTT
C) Bleeding time
D) Fibrinogen
Answer: B – aPTT assesses factors VIII, IX, XI, XII.
10. A schistocyte on a blood smear indicates:
A) Immune thrombocytopenia
B) Microangiopathic hemolytic anemia
C) Iron deficiency
D) Hemophilia
Answer: B – Schistocytes are fragmented RBCs from mechanical damage.
11. Reticulocyte production index (RPI) corrects for:
A) WBC count
B) RBC lifespan
C) Hemoglobin levels
D) Platelet count
Answer: B – RPI adjusts reticulocyte count for degree of anemia.
12. All of the following are megaloblastic anemia causes EXCEPT:
A) Vitamin B12 deficiency
B) Folate deficiency
C) Iron deficiency
D) Pernicious anemia
Answer: C – Iron deficiency causes microcytic, not macrocytic anemia.
13. The Coombs test detects:
A) Platelet antibodies
B) Autoantibodies or alloantibodies against RBCs
C) Fibrinogen levels
D) Vitamin B12 levels
Answer: B – Direct Coombs detects antibodies on RBC surface; indirect detects
antibodies in serum.
14. Howell-Jolly bodies indicate:
A) Normal RBC maturation
B) Splenic dysfunction or asplenia
C) Iron deficiency
D) Thalassemia
Answer: B – Nuclear remnants are removed by the spleen.
2026 2027 GRADED A+
ASCP BOC Exam Study Guide – Practice Questions &
Answers
1. The most common white blood cell in a healthy adult is:
A) Neutrophil
B) Lymphocyte
C) Monocyte
D) Eosinophil
Answer: A – Neutrophils make up 50–70% of circulating WBCs.
2. A patient has microcytic, hypochromic anemia. The most likely cause is:
A) Vitamin B12 deficiency
B) Iron deficiency
C) Hemolytic anemia
D) Acute blood loss
Answer: B – Microcytic, hypochromic anemia is characteristic of iron deficiency.
3. The normal adult hemoglobin A1c range is:
A) 2–4%
B) 4–6%
C) 6–8%
D) 8–10%
Answer: B – HbA1c reflects average blood glucose over 2–3 months.
4. A left shift in a WBC differential indicates:
A) Increased mature lymphocytes
B) Increased immature neutrophils (bands)
C) Decreased monocytes
D) Increased eosinophils
Answer: B – Left shift indicates bacterial infection or inflammation.
5. A platelet count below 150,000/μL is termed:
A) Thrombocytosis
B) Thrombocytopenia
C) Leukocytosis
D) Leukopenia
Answer: B – Normal platelet range is 150,000–450,000/μL.
6. Which stain is commonly used to identify reticulocytes?
A) Wright-Giemsa
B) New Methylene Blue
C) Gram stain
D) Acid-fast stain
Answer: B – Reticulocytes stain blue due to residual RNA.
7. Hemolytic anemia is characterized by all EXCEPT:
A) Increased reticulocytes
B) Decreased bilirubin
C) Increased LDH
2026 2027 GRADED A+
, 2|Page
D) Hemoglobinuria
Answer: B – Hemolysis increases indirect bilirubin.
8. A patient’s blood smear shows target cells. This is most consistent with:
A) Iron deficiency anemia
B) Thalassemia
C) Aplastic anemia
D) Megaloblastic anemia
Answer: B – Target cells are common in thalassemia.
9. Which test evaluates intrinsic coagulation pathway?
A) PT
B) aPTT
C) Bleeding time
D) Fibrinogen
Answer: B – aPTT assesses factors VIII, IX, XI, XII.
10. A schistocyte on a blood smear indicates:
A) Immune thrombocytopenia
B) Microangiopathic hemolytic anemia
C) Iron deficiency
D) Hemophilia
Answer: B – Schistocytes are fragmented RBCs from mechanical damage.
11. Reticulocyte production index (RPI) corrects for:
A) WBC count
B) RBC lifespan
C) Hemoglobin levels
D) Platelet count
Answer: B – RPI adjusts reticulocyte count for degree of anemia.
12. All of the following are megaloblastic anemia causes EXCEPT:
A) Vitamin B12 deficiency
B) Folate deficiency
C) Iron deficiency
D) Pernicious anemia
Answer: C – Iron deficiency causes microcytic, not macrocytic anemia.
13. The Coombs test detects:
A) Platelet antibodies
B) Autoantibodies or alloantibodies against RBCs
C) Fibrinogen levels
D) Vitamin B12 levels
Answer: B – Direct Coombs detects antibodies on RBC surface; indirect detects
antibodies in serum.
14. Howell-Jolly bodies indicate:
A) Normal RBC maturation
B) Splenic dysfunction or asplenia
C) Iron deficiency
D) Thalassemia
Answer: B – Nuclear remnants are removed by the spleen.
2026 2027 GRADED A+
