NCCT Phlebotomy Exam (Problems
and Corrections) Questions and
Answers
While performing a venipuncture, the phlebotomist gets a tiny amount of blood and then
nothing else. A hematoma starts to develop. Which of the following is the phlebotomist's
best course of action?
A. Gently pull the needle back and continue the blood draw.
B. Gently push the needle further into the vein and continue the blood draw.
C. Release tourniquet and stop the procedure.
D. Turn the needle since the bevel is down. - Answer- Release tourniquet and stop the
procedure.
Rationale
Whenever a hematoma begins to form during a venipuncture, the procedure should be
terminated and direct pressure applied to the area. A hematoma can cause injury to
vessels, nerves and tissues in the area and even cause compartment syndrome if not
controlled. Also, future use of the area for venipuncture may be compromised. Once the
bruise begins to develop, adjusting the needle will only aggravate the situation. The
needle should be inserted bevel up and is never turned while in the vein.
Which of the following is a likely complication from repeated phlebotomy procedures in
the same area?
A. thrombosis
B. sclerosed veins
C. petechiae
D. varicose veins - Answer- sclerosed veins
Rationale
When venipunctures are repeated on the same veins in the same area, scar tissue
(sclerosing) can develop. This makes veins difficult to puncture and can affect patient
results due to impaired circulation. Although thrombosis may be produced in a
sclerosed vein, it is not a typical result of veinipuncture. Varicose veins are not induced
by venipunctures. Petechiae are small red spots under the skin formed by lengthy
tourniquet time or bleeding disorders.
Small red dots on a patients skin due to a blood clotting abnormality are referred to as
A. purpura.
B. petechiae.
C. hemolysis.
, D. hematoma. - Answer- petechiae: a condition in which small, flat red or purple dots
appear on the skin as a result of leaking capillaries
Rationale
Petechiae are small red dots appearing on the skin upon tourniquet application most
commonly caused by capillary or platelet defects. Purpura is bruising under the skin
caused by defective platelets. A hematoma is a bruise caused by bleeding under the
skin. Hemolysis is the destruction of red blood cells releasing hemoglobin into the
plasma.
The doctor has ordered a dermal puncture on an infant. During the draw the infant
suddenly moves and the phlebotomist punctures the calcaneus (the heel bone). Which
of the following complications is likely to arise from this incident?
A. petechiae
B. Achilles tendon rupture
C. osteomyelitis
D. osteotome - Answer- osteomyelitis
Rationale
Puncturing the calcaneus (heel bone) on an infant can cause the child to acquire a
serious bacterial infection known as osteomyelitis. It is imperative to use the correct
lancet and safety measures to prevent this from occurring. If difficulty in safely
restraining a child is anticipated, the phlebotomist should ask for help before beginning
the procedure. Petechiae are tiny red dots resulting from ruptured capillaries that form
under the skin. This may be the result of prolonged or too tight tourniquet application or
a patient's clotting deficiency. An Achilles tendon rupture is an injury to the back of the
leg - most commonly from recreational sports. An osteome is a surgical instrument for
cutting bone, typically resembling a chisel and is not used for collecting blood by dermal
puncture.
While finishing a draw on an outpatient with diabetes, the patient starts to complain of
lightheadedness. Which of the following should the phlebotomist do next?
A. Check the patient's glucose level.
B. Lay the patient on the floor.
C. Give the patient orange juice.
D. Call for assistance. - Answer- Lay the patient on the floor.
Rationale
It is not uncommon for patients to feel lightheaded when having blood drawn. This is
especially true for those who have been fasting. After the tourniquet has been loosened
and the needle removed, it is important to place the patient in a prone position so that
he does not fall and suffer an injury. Checking the glucose level or giving orange juice
can only be done with a doctor's permission. Assistance should be called for, if needed.
A phlebotomist is drawing blood on a geriatric patient. When completing the draw, the
phlebotomist notices the formation of a hematoma. Which of the following should the
phlebotomist do next?
and Corrections) Questions and
Answers
While performing a venipuncture, the phlebotomist gets a tiny amount of blood and then
nothing else. A hematoma starts to develop. Which of the following is the phlebotomist's
best course of action?
A. Gently pull the needle back and continue the blood draw.
B. Gently push the needle further into the vein and continue the blood draw.
C. Release tourniquet and stop the procedure.
D. Turn the needle since the bevel is down. - Answer- Release tourniquet and stop the
procedure.
Rationale
Whenever a hematoma begins to form during a venipuncture, the procedure should be
terminated and direct pressure applied to the area. A hematoma can cause injury to
vessels, nerves and tissues in the area and even cause compartment syndrome if not
controlled. Also, future use of the area for venipuncture may be compromised. Once the
bruise begins to develop, adjusting the needle will only aggravate the situation. The
needle should be inserted bevel up and is never turned while in the vein.
Which of the following is a likely complication from repeated phlebotomy procedures in
the same area?
A. thrombosis
B. sclerosed veins
C. petechiae
D. varicose veins - Answer- sclerosed veins
Rationale
When venipunctures are repeated on the same veins in the same area, scar tissue
(sclerosing) can develop. This makes veins difficult to puncture and can affect patient
results due to impaired circulation. Although thrombosis may be produced in a
sclerosed vein, it is not a typical result of veinipuncture. Varicose veins are not induced
by venipunctures. Petechiae are small red spots under the skin formed by lengthy
tourniquet time or bleeding disorders.
Small red dots on a patients skin due to a blood clotting abnormality are referred to as
A. purpura.
B. petechiae.
C. hemolysis.
, D. hematoma. - Answer- petechiae: a condition in which small, flat red or purple dots
appear on the skin as a result of leaking capillaries
Rationale
Petechiae are small red dots appearing on the skin upon tourniquet application most
commonly caused by capillary or platelet defects. Purpura is bruising under the skin
caused by defective platelets. A hematoma is a bruise caused by bleeding under the
skin. Hemolysis is the destruction of red blood cells releasing hemoglobin into the
plasma.
The doctor has ordered a dermal puncture on an infant. During the draw the infant
suddenly moves and the phlebotomist punctures the calcaneus (the heel bone). Which
of the following complications is likely to arise from this incident?
A. petechiae
B. Achilles tendon rupture
C. osteomyelitis
D. osteotome - Answer- osteomyelitis
Rationale
Puncturing the calcaneus (heel bone) on an infant can cause the child to acquire a
serious bacterial infection known as osteomyelitis. It is imperative to use the correct
lancet and safety measures to prevent this from occurring. If difficulty in safely
restraining a child is anticipated, the phlebotomist should ask for help before beginning
the procedure. Petechiae are tiny red dots resulting from ruptured capillaries that form
under the skin. This may be the result of prolonged or too tight tourniquet application or
a patient's clotting deficiency. An Achilles tendon rupture is an injury to the back of the
leg - most commonly from recreational sports. An osteome is a surgical instrument for
cutting bone, typically resembling a chisel and is not used for collecting blood by dermal
puncture.
While finishing a draw on an outpatient with diabetes, the patient starts to complain of
lightheadedness. Which of the following should the phlebotomist do next?
A. Check the patient's glucose level.
B. Lay the patient on the floor.
C. Give the patient orange juice.
D. Call for assistance. - Answer- Lay the patient on the floor.
Rationale
It is not uncommon for patients to feel lightheaded when having blood drawn. This is
especially true for those who have been fasting. After the tourniquet has been loosened
and the needle removed, it is important to place the patient in a prone position so that
he does not fall and suffer an injury. Checking the glucose level or giving orange juice
can only be done with a doctor's permission. Assistance should be called for, if needed.
A phlebotomist is drawing blood on a geriatric patient. When completing the draw, the
phlebotomist notices the formation of a hematoma. Which of the following should the
phlebotomist do next?
