Ohio School of Phlebotomy Exam Prep 2026/2027 —
Phlebotomy Program Test Bank, ACTUAL-Style
Practice Questions & Answers, Venipuncture, Order
of Draw, Specimen Handling, Patient Safety,
Medical Terminology & Mock Exams
Question 1: Which of the following is the primary purpose of
applying a tourniquet during venipuncture?
A. To prevent arterial blood flow into the site
B. To increase venous pressure and make the vein more visible and
palpable
C. To reduce patient pain during needle insertion
D. To sterilize the skin prior to puncture
CORRECT ANSWER: B. To increase venous pressure and make the
vein more visible and palpable
Rationale: A tourniquet is applied to impede venous return, which engorges
the vein with blood, making it easier to locate and enter. It does not sterilize
the site, reduce pain, or block arterial flow.
Question 2: According to the standard order of draw for venous
blood collection, which tube must be collected FIRST?
A. Light blue sodium citrate tube
B. Serum separator tube (SST)
C. Lavender EDTA tube
D. Blood culture bottle or tube
CORRECT ANSWER: D. Blood culture bottle or tube
Rationale: Blood cultures must be drawn first to prevent contamination
from non-sterile tube stoppers and to maximize recovery of
microorganisms. The CLSI order of draw begins with culture media,
followed by coagulation tubes, then serum tubes, heparin tubes, and finally
EDTA and fluoride tubes.
Question 3: A phlebotomist notices a patient beginning to sweat,
become pale, and report dizziness during a blood draw. What is the
MOST appropriate immediate action?
A. Continue the draw quickly to finish before the patient faints
B. Stop the draw, release the tourniquet, and assist the patient to a safe
,position
C. Ignore the symptoms as they are common and will pass
D. Apply a cold compress to the venipuncture site
CORRECT ANSWER: B. Stop the draw, release the tourniquet, and
assist the patient to a safe position
Rationale: These signs indicate impending syncope. The phlebotomist must
immediately stop the procedure, release the tourniquet, and ensure patient
safety by positioning them to prevent injury from a fall. Continuing the draw
risks patient harm.
Question 4: Which of the following identifiers is REQUIRED for
positive patient identification before specimen collection?
A. Patient's room number and bed assignment
B. Patient's full name and date of birth
C. Patient's insurance provider and policy number
D. Patient's primary care physician's name
CORRECT ANSWER: B. Patient's full name and date of birth
Rationale: Positive patient identification requires at least two unique
identifiers. The patient's full name and date of birth are the standard
accepted identifiers. Room numbers and physician names are not
acceptable primary identifiers because they can change or apply to multiple
patients.
Question 5: Which needle gauge is MOST commonly appropriate
for routine adult venipuncture when the vein is of average size?
A. 16 gauge
B. 18 gauge
C. 21 gauge
D. 25 gauge
CORRECT ANSWER: C. 21 gauge
Rationale: A 21-gauge needle is the standard choice for routine adult
venipuncture. It is large enough to allow adequate blood flow without
excessive hemolysis while being small enough to minimize patient
discomfort. 16 and 18 gauge are typically reserved for blood donation or
trauma; 25 gauge is too small for most venous collections.
,Question 6: What is the correct procedure for labeling a blood
specimen after collection?
A. Label the tube before entering the patient's room
B. Label the tube at the patient's bedside, immediately after collection, in
the patient's presence
C. Label the tube after returning to the laboratory to ensure accuracy
D. Label only the requisition form and leave the tube unlabeled until testing
CORRECT ANSWER: B. Label the tube at the patient's bedside,
immediately after collection, in the patient's presence
Rationale: Specimen labeling must occur immediately after collection at the
patient's side to prevent mislabeling errors. Labeling in advance or away
from the patient increases the risk of specimen misidentification, which is a
critical patient safety event.
Question 7: Which of the following anticoagulants is present in a
lavender-top tube?
A. Sodium citrate
B. Heparin
C. EDTA (ethylenediaminetetraacetic acid)
D. Sodium fluoride
CORRECT ANSWER: C. EDTA (ethylenediaminetetraacetic acid)
Rationale: Lavender-top tubes contain EDTA, which chelates calcium and
prevents coagulation. EDTA tubes are used for hematology tests such as
complete blood count (CBC). Sodium citrate is in light blue tubes, heparin
in green tubes, and sodium fluoride in gray tubes.
Question 8: A phlebotomist is asked to draw blood from a patient
with a known history of fainting during blood draws. What is the
BEST preventive measure?
A. Perform the draw with the patient standing to finish faster
B. Have the patient lie down or recline during the procedure
C. Use a larger needle to reduce procedure time
D. Skip the tourniquet to reduce anxiety
CORRECT ANSWER: B. Have the patient lie down or recline during
the procedure
, Rationale: For patients with a history of syncope, positioning them supine
or reclined prevents injury if fainting occurs. Standing or sitting positions
increase the risk of falling and injury. Needle size and tourniquet use do not
prevent vasovagal syncope.
Question 9: Which of the following is the correct angle of needle
insertion for a routine venipuncture?
A. 5 to 10 degrees
B. 15 to 30 degrees
C. 45 to 60 degrees
D. 90 degrees
CORRECT ANSWER: B. 15 to 30 degrees
Rationale: The standard angle for venipuncture with an evacuated tube
system is 15 to 30 degrees. This angle allows the needle to enter the vein
smoothly without going through it. A 5-10 degree angle is too shallow for
most veins; 45 degrees or greater increases the risk of vein puncture
through the posterior wall.
Question 10: What is the maximum recommended time a
tourniquet should remain applied before venipuncture is
performed?
A. 30 seconds
B. 1 minute
C. 3 minutes
D. 5 minutes
CORRECT ANSWER: B. 1 minute
Rationale: A tourniquet should not remain in place for more than one
minute. Prolonged application causes hemoconcentration, which alters
laboratory results by increasing concentrations of potassium, proteins, and
other analytes. If more time is needed, the tourniquet should be released
and reapplied.
Question 11: Which of the following complications is characterized
by a painful, swollen, and discolored area at the venipuncture site
caused by blood leaking into surrounding tissue?
A. Syncope
B. Hematoma
Phlebotomy Program Test Bank, ACTUAL-Style
Practice Questions & Answers, Venipuncture, Order
of Draw, Specimen Handling, Patient Safety,
Medical Terminology & Mock Exams
Question 1: Which of the following is the primary purpose of
applying a tourniquet during venipuncture?
A. To prevent arterial blood flow into the site
B. To increase venous pressure and make the vein more visible and
palpable
C. To reduce patient pain during needle insertion
D. To sterilize the skin prior to puncture
CORRECT ANSWER: B. To increase venous pressure and make the
vein more visible and palpable
Rationale: A tourniquet is applied to impede venous return, which engorges
the vein with blood, making it easier to locate and enter. It does not sterilize
the site, reduce pain, or block arterial flow.
Question 2: According to the standard order of draw for venous
blood collection, which tube must be collected FIRST?
A. Light blue sodium citrate tube
B. Serum separator tube (SST)
C. Lavender EDTA tube
D. Blood culture bottle or tube
CORRECT ANSWER: D. Blood culture bottle or tube
Rationale: Blood cultures must be drawn first to prevent contamination
from non-sterile tube stoppers and to maximize recovery of
microorganisms. The CLSI order of draw begins with culture media,
followed by coagulation tubes, then serum tubes, heparin tubes, and finally
EDTA and fluoride tubes.
Question 3: A phlebotomist notices a patient beginning to sweat,
become pale, and report dizziness during a blood draw. What is the
MOST appropriate immediate action?
A. Continue the draw quickly to finish before the patient faints
B. Stop the draw, release the tourniquet, and assist the patient to a safe
,position
C. Ignore the symptoms as they are common and will pass
D. Apply a cold compress to the venipuncture site
CORRECT ANSWER: B. Stop the draw, release the tourniquet, and
assist the patient to a safe position
Rationale: These signs indicate impending syncope. The phlebotomist must
immediately stop the procedure, release the tourniquet, and ensure patient
safety by positioning them to prevent injury from a fall. Continuing the draw
risks patient harm.
Question 4: Which of the following identifiers is REQUIRED for
positive patient identification before specimen collection?
A. Patient's room number and bed assignment
B. Patient's full name and date of birth
C. Patient's insurance provider and policy number
D. Patient's primary care physician's name
CORRECT ANSWER: B. Patient's full name and date of birth
Rationale: Positive patient identification requires at least two unique
identifiers. The patient's full name and date of birth are the standard
accepted identifiers. Room numbers and physician names are not
acceptable primary identifiers because they can change or apply to multiple
patients.
Question 5: Which needle gauge is MOST commonly appropriate
for routine adult venipuncture when the vein is of average size?
A. 16 gauge
B. 18 gauge
C. 21 gauge
D. 25 gauge
CORRECT ANSWER: C. 21 gauge
Rationale: A 21-gauge needle is the standard choice for routine adult
venipuncture. It is large enough to allow adequate blood flow without
excessive hemolysis while being small enough to minimize patient
discomfort. 16 and 18 gauge are typically reserved for blood donation or
trauma; 25 gauge is too small for most venous collections.
,Question 6: What is the correct procedure for labeling a blood
specimen after collection?
A. Label the tube before entering the patient's room
B. Label the tube at the patient's bedside, immediately after collection, in
the patient's presence
C. Label the tube after returning to the laboratory to ensure accuracy
D. Label only the requisition form and leave the tube unlabeled until testing
CORRECT ANSWER: B. Label the tube at the patient's bedside,
immediately after collection, in the patient's presence
Rationale: Specimen labeling must occur immediately after collection at the
patient's side to prevent mislabeling errors. Labeling in advance or away
from the patient increases the risk of specimen misidentification, which is a
critical patient safety event.
Question 7: Which of the following anticoagulants is present in a
lavender-top tube?
A. Sodium citrate
B. Heparin
C. EDTA (ethylenediaminetetraacetic acid)
D. Sodium fluoride
CORRECT ANSWER: C. EDTA (ethylenediaminetetraacetic acid)
Rationale: Lavender-top tubes contain EDTA, which chelates calcium and
prevents coagulation. EDTA tubes are used for hematology tests such as
complete blood count (CBC). Sodium citrate is in light blue tubes, heparin
in green tubes, and sodium fluoride in gray tubes.
Question 8: A phlebotomist is asked to draw blood from a patient
with a known history of fainting during blood draws. What is the
BEST preventive measure?
A. Perform the draw with the patient standing to finish faster
B. Have the patient lie down or recline during the procedure
C. Use a larger needle to reduce procedure time
D. Skip the tourniquet to reduce anxiety
CORRECT ANSWER: B. Have the patient lie down or recline during
the procedure
, Rationale: For patients with a history of syncope, positioning them supine
or reclined prevents injury if fainting occurs. Standing or sitting positions
increase the risk of falling and injury. Needle size and tourniquet use do not
prevent vasovagal syncope.
Question 9: Which of the following is the correct angle of needle
insertion for a routine venipuncture?
A. 5 to 10 degrees
B. 15 to 30 degrees
C. 45 to 60 degrees
D. 90 degrees
CORRECT ANSWER: B. 15 to 30 degrees
Rationale: The standard angle for venipuncture with an evacuated tube
system is 15 to 30 degrees. This angle allows the needle to enter the vein
smoothly without going through it. A 5-10 degree angle is too shallow for
most veins; 45 degrees or greater increases the risk of vein puncture
through the posterior wall.
Question 10: What is the maximum recommended time a
tourniquet should remain applied before venipuncture is
performed?
A. 30 seconds
B. 1 minute
C. 3 minutes
D. 5 minutes
CORRECT ANSWER: B. 1 minute
Rationale: A tourniquet should not remain in place for more than one
minute. Prolonged application causes hemoconcentration, which alters
laboratory results by increasing concentrations of potassium, proteins, and
other analytes. If more time is needed, the tourniquet should be released
and reapplied.
Question 11: Which of the following complications is characterized
by a painful, swollen, and discolored area at the venipuncture site
caused by blood leaking into surrounding tissue?
A. Syncope
B. Hematoma
