NHA Certified Phlebotomy Technician (CPT)
Certification Examination – Complete Practice
Questions and Detailed Answers
1. A phlebotomist is preparing to perform a venipuncture on a patient who has an IV in the
right arm and a left-sided mastectomy. Which of the following is the most appropriate site for
blood collection?
A. The right arm above the IV site
B. The left arm below the mastectomy
C. The right arm below the IV site
D. The left hand or wrist area
Correct Answer: C
Explanation: Drawing below an IV site is acceptable if the IV is turned off for a specific
period and the draw is performed below the infusion point to prevent specimen dilution.
Mastectomy sites should be avoided due to the risk of lymphedema and potential infection,
and typically require physician approval for draw. Drawing above an IV is never
recommended as it will lead to contamination of the sample with IV fluids.
2. When performing a dermal puncture on an infant, what is the maximum recommended
depth of the lancet to avoid bone injury?
A. 2.0 mm
B. 1.0 mm
,C. 3.0 mm
D. 0.5 mm
Correct Answer: A
Explanation: The Clinical and Laboratory Standards Institute (CLSI) recommends a
maximum depth of 2.0 mm for infant heel sticks to prevent hitting the calcaneus (heel
bone). Exceeding this depth can cause osteomyelitis or permanent bone damage.
Phlebotomists must ensure they select a lancet specifically designed for infants to maintain
this safety standard.
3. Which of the following tubes should be collected first in the order of draw for a
venipuncture procedure?
A. Lavender top
B. Yellow top (SPS)
C. Light blue top
D. Red top
Correct Answer: B
Explanation: Yellow top tubes containing Sodium Polyanethol Sulfonate (SPS) are for
blood cultures and must be collected first to ensure sterility. Following the correct order of
draw prevents cross-contamination of additives between tubes. Failure to follow this
sequence can lead to erroneous test results, such as false potassium elevations if an EDTA
tube is drawn before a serum tube.
, 4. A phlebotomist encounters a patient who is unconscious and has no identification band.
How should the phlebotomist proceed with identification?
A. Use the name provided on the bed rail label
B. Ask the patient’s roommate to identify them
C. Contact a nurse to identify the patient and place a new ID band
D. Proceed with the draw and label it ‘John Doe’
Correct Answer: C
Explanation: Proper patient identification requires a match between the requisition and
the patient’s ID band; if the band is missing, a nurse must verify the identity and attach a
new band before the draw. Never rely on non-permanent identifiers like bed labels or
verbal confirmation from non-staff. This protocol is critical for patient safety and
preventing life-threatening transfusion or diagnostic errors.
5. While performing a venipuncture, the phlebotomist notices a hematoma beginning to
form. Which of the following actions should be taken first?
A. Release the tourniquet and withdraw the needle
B. Adjust the needle to a deeper position
C. Ask the patient to pump their fist
D. Apply a warm compress immediately
Correct Answer: A
Certification Examination – Complete Practice
Questions and Detailed Answers
1. A phlebotomist is preparing to perform a venipuncture on a patient who has an IV in the
right arm and a left-sided mastectomy. Which of the following is the most appropriate site for
blood collection?
A. The right arm above the IV site
B. The left arm below the mastectomy
C. The right arm below the IV site
D. The left hand or wrist area
Correct Answer: C
Explanation: Drawing below an IV site is acceptable if the IV is turned off for a specific
period and the draw is performed below the infusion point to prevent specimen dilution.
Mastectomy sites should be avoided due to the risk of lymphedema and potential infection,
and typically require physician approval for draw. Drawing above an IV is never
recommended as it will lead to contamination of the sample with IV fluids.
2. When performing a dermal puncture on an infant, what is the maximum recommended
depth of the lancet to avoid bone injury?
A. 2.0 mm
B. 1.0 mm
,C. 3.0 mm
D. 0.5 mm
Correct Answer: A
Explanation: The Clinical and Laboratory Standards Institute (CLSI) recommends a
maximum depth of 2.0 mm for infant heel sticks to prevent hitting the calcaneus (heel
bone). Exceeding this depth can cause osteomyelitis or permanent bone damage.
Phlebotomists must ensure they select a lancet specifically designed for infants to maintain
this safety standard.
3. Which of the following tubes should be collected first in the order of draw for a
venipuncture procedure?
A. Lavender top
B. Yellow top (SPS)
C. Light blue top
D. Red top
Correct Answer: B
Explanation: Yellow top tubes containing Sodium Polyanethol Sulfonate (SPS) are for
blood cultures and must be collected first to ensure sterility. Following the correct order of
draw prevents cross-contamination of additives between tubes. Failure to follow this
sequence can lead to erroneous test results, such as false potassium elevations if an EDTA
tube is drawn before a serum tube.
, 4. A phlebotomist encounters a patient who is unconscious and has no identification band.
How should the phlebotomist proceed with identification?
A. Use the name provided on the bed rail label
B. Ask the patient’s roommate to identify them
C. Contact a nurse to identify the patient and place a new ID band
D. Proceed with the draw and label it ‘John Doe’
Correct Answer: C
Explanation: Proper patient identification requires a match between the requisition and
the patient’s ID band; if the band is missing, a nurse must verify the identity and attach a
new band before the draw. Never rely on non-permanent identifiers like bed labels or
verbal confirmation from non-staff. This protocol is critical for patient safety and
preventing life-threatening transfusion or diagnostic errors.
5. While performing a venipuncture, the phlebotomist notices a hematoma beginning to
form. Which of the following actions should be taken first?
A. Release the tourniquet and withdraw the needle
B. Adjust the needle to a deeper position
C. Ask the patient to pump their fist
D. Apply a warm compress immediately
Correct Answer: A
