OHIO SCHOOL OF PHLEBOTOMY FINAL EXAM 2026/2027 |
131 Questions and Verified Answers | Newest Edition |
Phlebotomy Certification | Pass Guaranteed - A+ Graded
Section 1: Phlebotomy Fundamentals & Safety (Questions 1-20)
Q1: A phlebotomist is preparing to draw blood from an inpatient. The patient is alert and
has a wristband. Which identification procedure is correct according to CLSI standards?
A. Ask the patient to state their name and room number, then verify against the
wristband
B. Check the wristband and ask the patient to state their full name and date of birth
[CORRECT]
C. Accept the patient's stated name only if they appear alert and oriented
D. Verify the medical record number against the census sheet without disturbing the
patient
Correct Answer: B
Rationale: CLSI GP41 requires two positive patient identifiers (name and DOB or MRN)
obtained from the patient and verified against the wristband. Room number is not an
acceptable identifier per Joint Commission National Patient Safety Goal
NPSG.01.01.01.
Q2: During a blood draw for legal blood alcohol testing, the phlebotomist must maintain
chain of custody. Which action is required?
A. Seal the tube with wax and store at room temperature for 48 hours
B. Document every person who handles the specimen using tamper-evident seals
[CORRECT]
C. Transport the specimen in a standard biohazard bag without additional
documentation
D. Allow law enforcement to label the tube after collection
Correct Answer: B
Rationale: Chain of custody requires tamper-evident seals and documentation of all
individuals handling the specimen from collection to analysis. This maintains legal
,integrity for forensic testing per Ohio School of Phlebotomy curriculum and CLSI
standards.
Q3: The laboratory rejects a specimen for potassium testing because it arrived severely
hemolyzed. What caused this rejection?
A. The tourniquet was applied for less than 30 seconds
B. Red blood cells ruptured, releasing intracellular potassium into the serum [CORRECT]
C. The patient ate a high-potassium meal before the draw
D. The tube was centrifuged immediately after collection
Correct Answer: B
Rationale: Hemolysis releases intracellular potassium (concentration 20-30x higher than
plasma), causing falsely elevated results. CLSI GP41 specifies hemolyzed specimens
must be rejected for potassium, LDH, and other intracellular markers.
Q4: Which represents the correct order of draw for vacuum tube collection according to
CLSI GP41?
A. Lavender, green, gold, light blue
B. Light blue, red/gold, green, lavender, gray [CORRECT]
C. Green, lavender, gray, light blue
D. Gray, lavender, green, red
Correct Answer: B
Rationale: CLSI GP41 order: 1) Blood cultures, 2) Light blue (sodium citrate), 3) Serum
tubes (red/gold), 4) Heparin (green), 5) EDTA (lavender/pink), 6) Glycolytic inhibitors
(gray). This prevents additive cross-contamination.
Q5: A specimen arrives in the laboratory unlabeled. What is the appropriate action?
A. Ask the nursing station to identify the specimen based on the requisition
B. Reject the specimen and request recollection [CORRECT]
C. Label the tube with information from the requisition form
D. Process the specimen if the phlebotomist remembers drawing it
Correct Answer: B
Rationale: Unlabeled specimens pose serious patient safety risks and must be rejected
per CLSI GP41 and Ohio School protocols. Relabeling or accepting unlabeled tubes
violates patient identification standards.
,Q6: Which patient identification method is unacceptable for routine venipuncture?
A. Patient stating their full name and date of birth while verifying wristband
B. Driver's license verification for outpatient with photo ID
C. Using the patient's room number as a primary identifier [CORRECT]
D. Verifying name and DOB against wristband for unconscious patients with nurse
confirmation
Correct Answer: C
Rationale: Room number is not a patient-specific identifier per Joint Commission
standards. Two patient-specific identifiers (name, DOB, or MRN) are required. Room
numbers change and can lead to misidentification.
Q7: A phlebotomist needs to collect a PT/INR and CBC from the same patient. Which
tube selection and sequence is correct?
A. Lavender first, then light blue
B. Light blue first, then lavender [CORRECT]
C. Green tube for both tests
D. Collect in red top, then transfer to both tubes
Correct Answer: B
Rationale: CLSI GP41 mandates light blue (coagulation) before lavender (EDTA)
because EDTA can contaminate and alter coagulation results if drawn first. Light blue
must fill completely (9:1 ratio).
Q8: Which scenario requires specimen rejection due to improper collection?
A. Serum tube collected first when only chemistry tests are ordered
B. Light blue tube filled to 50% capacity for coagulation studies [CORRECT]
C. Lavender tube gently inverted 8 times
D. Gray top tube placed on ice immediately after collection
Correct Answer: B
Rationale: Light blue tubes must fill completely to maintain 9:1 blood-to-anticoagulant
ratio. Underfilled tubes yield inaccurate coagulation results due to excess citrate and
must be rejected per CLSI guidelines.
Q9: Chain of custody documentation is primarily required for which type of specimen?
A. Complete blood count for routine monitoring
B. Therapeutic drug monitoring
C. Forensic toxicology and blood alcohol testing [CORRECT]
, D. Routine chemistry panel
Correct Answer: C
Rationale: Chain of custody procedures ensure legal documentation for forensic
specimens (blood alcohol, drug testing) by tracking every handler and maintaining
tamper-evident seals per Ohio School curriculum and legal standards.
Q10: A phlebotomist notices the patient has an IV line in the left antecubital vein. Where
should the venipuncture be performed?
A. Draw from the IV line after flushing with saline
B. Distal to the IV site on the same arm
C. The opposite arm or below the IV site if necessary [CORRECT]
D. Draw above the IV line using a tourniquet
Correct Answer: C
Rationale: Drawing above or through an IV line contaminates the specimen with IV
fluids. The opposite arm is preferred; if unavoidable, draw distal to the IV (below) per
CLSI GP41 to avoid contamination.
Q11: Which additive is present in a gray-top tube and what is its purpose?
A. EDTA for hematology testing
B. Sodium citrate for coagulation studies
C. Sodium fluoride and potassium oxalate as glycolytic inhibitors [CORRECT]
D. Heparin for plasma chemistry
Correct Answer: C
Rationale: Gray-top tubes contain sodium fluoride (glycolytic inhibitor preserving
glucose) and potassium oxalate (anticoagulant). Used for glucose, lactate, and blood
alcohol testing per CLSI standards.
Q12: A phlebotomist is collecting blood cultures. Which procedure is correct?
A. Cleanse the site with 70% alcohol only
B. Draw the anaerobic bottle first, then aerobic
C. Use chlorhexidine or iodine scrub and inoculate aerobic bottle first [CORRECT]
D. Collect in a lavender tube first, then transfer to culture bottles
Correct Answer: C
131 Questions and Verified Answers | Newest Edition |
Phlebotomy Certification | Pass Guaranteed - A+ Graded
Section 1: Phlebotomy Fundamentals & Safety (Questions 1-20)
Q1: A phlebotomist is preparing to draw blood from an inpatient. The patient is alert and
has a wristband. Which identification procedure is correct according to CLSI standards?
A. Ask the patient to state their name and room number, then verify against the
wristband
B. Check the wristband and ask the patient to state their full name and date of birth
[CORRECT]
C. Accept the patient's stated name only if they appear alert and oriented
D. Verify the medical record number against the census sheet without disturbing the
patient
Correct Answer: B
Rationale: CLSI GP41 requires two positive patient identifiers (name and DOB or MRN)
obtained from the patient and verified against the wristband. Room number is not an
acceptable identifier per Joint Commission National Patient Safety Goal
NPSG.01.01.01.
Q2: During a blood draw for legal blood alcohol testing, the phlebotomist must maintain
chain of custody. Which action is required?
A. Seal the tube with wax and store at room temperature for 48 hours
B. Document every person who handles the specimen using tamper-evident seals
[CORRECT]
C. Transport the specimen in a standard biohazard bag without additional
documentation
D. Allow law enforcement to label the tube after collection
Correct Answer: B
Rationale: Chain of custody requires tamper-evident seals and documentation of all
individuals handling the specimen from collection to analysis. This maintains legal
,integrity for forensic testing per Ohio School of Phlebotomy curriculum and CLSI
standards.
Q3: The laboratory rejects a specimen for potassium testing because it arrived severely
hemolyzed. What caused this rejection?
A. The tourniquet was applied for less than 30 seconds
B. Red blood cells ruptured, releasing intracellular potassium into the serum [CORRECT]
C. The patient ate a high-potassium meal before the draw
D. The tube was centrifuged immediately after collection
Correct Answer: B
Rationale: Hemolysis releases intracellular potassium (concentration 20-30x higher than
plasma), causing falsely elevated results. CLSI GP41 specifies hemolyzed specimens
must be rejected for potassium, LDH, and other intracellular markers.
Q4: Which represents the correct order of draw for vacuum tube collection according to
CLSI GP41?
A. Lavender, green, gold, light blue
B. Light blue, red/gold, green, lavender, gray [CORRECT]
C. Green, lavender, gray, light blue
D. Gray, lavender, green, red
Correct Answer: B
Rationale: CLSI GP41 order: 1) Blood cultures, 2) Light blue (sodium citrate), 3) Serum
tubes (red/gold), 4) Heparin (green), 5) EDTA (lavender/pink), 6) Glycolytic inhibitors
(gray). This prevents additive cross-contamination.
Q5: A specimen arrives in the laboratory unlabeled. What is the appropriate action?
A. Ask the nursing station to identify the specimen based on the requisition
B. Reject the specimen and request recollection [CORRECT]
C. Label the tube with information from the requisition form
D. Process the specimen if the phlebotomist remembers drawing it
Correct Answer: B
Rationale: Unlabeled specimens pose serious patient safety risks and must be rejected
per CLSI GP41 and Ohio School protocols. Relabeling or accepting unlabeled tubes
violates patient identification standards.
,Q6: Which patient identification method is unacceptable for routine venipuncture?
A. Patient stating their full name and date of birth while verifying wristband
B. Driver's license verification for outpatient with photo ID
C. Using the patient's room number as a primary identifier [CORRECT]
D. Verifying name and DOB against wristband for unconscious patients with nurse
confirmation
Correct Answer: C
Rationale: Room number is not a patient-specific identifier per Joint Commission
standards. Two patient-specific identifiers (name, DOB, or MRN) are required. Room
numbers change and can lead to misidentification.
Q7: A phlebotomist needs to collect a PT/INR and CBC from the same patient. Which
tube selection and sequence is correct?
A. Lavender first, then light blue
B. Light blue first, then lavender [CORRECT]
C. Green tube for both tests
D. Collect in red top, then transfer to both tubes
Correct Answer: B
Rationale: CLSI GP41 mandates light blue (coagulation) before lavender (EDTA)
because EDTA can contaminate and alter coagulation results if drawn first. Light blue
must fill completely (9:1 ratio).
Q8: Which scenario requires specimen rejection due to improper collection?
A. Serum tube collected first when only chemistry tests are ordered
B. Light blue tube filled to 50% capacity for coagulation studies [CORRECT]
C. Lavender tube gently inverted 8 times
D. Gray top tube placed on ice immediately after collection
Correct Answer: B
Rationale: Light blue tubes must fill completely to maintain 9:1 blood-to-anticoagulant
ratio. Underfilled tubes yield inaccurate coagulation results due to excess citrate and
must be rejected per CLSI guidelines.
Q9: Chain of custody documentation is primarily required for which type of specimen?
A. Complete blood count for routine monitoring
B. Therapeutic drug monitoring
C. Forensic toxicology and blood alcohol testing [CORRECT]
, D. Routine chemistry panel
Correct Answer: C
Rationale: Chain of custody procedures ensure legal documentation for forensic
specimens (blood alcohol, drug testing) by tracking every handler and maintaining
tamper-evident seals per Ohio School curriculum and legal standards.
Q10: A phlebotomist notices the patient has an IV line in the left antecubital vein. Where
should the venipuncture be performed?
A. Draw from the IV line after flushing with saline
B. Distal to the IV site on the same arm
C. The opposite arm or below the IV site if necessary [CORRECT]
D. Draw above the IV line using a tourniquet
Correct Answer: C
Rationale: Drawing above or through an IV line contaminates the specimen with IV
fluids. The opposite arm is preferred; if unavoidable, draw distal to the IV (below) per
CLSI GP41 to avoid contamination.
Q11: Which additive is present in a gray-top tube and what is its purpose?
A. EDTA for hematology testing
B. Sodium citrate for coagulation studies
C. Sodium fluoride and potassium oxalate as glycolytic inhibitors [CORRECT]
D. Heparin for plasma chemistry
Correct Answer: C
Rationale: Gray-top tubes contain sodium fluoride (glycolytic inhibitor preserving
glucose) and potassium oxalate (anticoagulant). Used for glucose, lactate, and blood
alcohol testing per CLSI standards.
Q12: A phlebotomist is collecting blood cultures. Which procedure is correct?
A. Cleanse the site with 70% alcohol only
B. Draw the anaerobic bottle first, then aerobic
C. Use chlorhexidine or iodine scrub and inoculate aerobic bottle first [CORRECT]
D. Collect in a lavender tube first, then transfer to culture bottles
Correct Answer: C
