NHA Phlebotomy PRACTICE FINAL EXAM
2026/2027 AND PRACTICE QUESTIONS
COMPLETE ACCURATE EXAM REAL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (RELIABLE SOLUTIONS)
CURRENTLY UPDATED VERSION 2026 EDITION
A phlebotomist collects a cryofibrinogen specimen, places the specimen
in a biohazard specimen bag, then onto slurry of ice and water and
transports it to the laboratory in a timely manner. In this case the
phlebotomist
A. performed proper specimen handling.
B. should have protected the specimen from light.
C. should have kept the specimen at 37˚C.
D. should have aliquoted the specimen before transport.
should have kept the specimen at 37˚C.
Rationale
Many types of specimens are required to be kept at certain temperatures
for accurate test results to be obtained by the laboratory.
Cryofibrinogen, cryoglobulin and cold agglutinins must be kept at 37o C
(body temperature). Tests requiring protection from light include:
bilirubin, carotene, porphyrins and vitamins A, B2, and C. Specimens that
require chilling on an ice slurry are ammonia, lactic acid, pH & blood
gases among others. Consult your facility's policies for the correct
procedures to follow. Aliquoting of the specimen (dividing it into parts) is
done during or after processing in the laboratory.
,Which of the following should the phlebotomist do when collecting
blood via finger stick?
A. Position the lancet across the fingerprint lines.
B. Wipe off any remaining alcohol from the finger before insertion.
C. Disinfect the patient's finger with povidone-iodine.
D. Milk the finger during the blood collection.
Position the lancet across the fingerprint lines.
Rationale
Capillary puncture can be performed on the palmar surface of the distal
segment of the 3rd digit (middle finger) or 4th digit (ring finger). Lancet
must be placed across (perpendicular) to the fingerprint whorls in order
to allow blood to form round drops as it is collected. Placing the lancet
along (parallel to) the fingerprint whorls will allow the blood to channel
away from the puncture site into the grooves and make collection very
difficult. Never wipe, fan or blow at a site that has been cleansed. Alcohol
must air dry to allow time for it to work and inhibit bacteria. Wiping can
prevents alcohol from work properly and can introduce more microbes.
Fanning creates air turbulence and can introduce more microbes.
Blowing introduces microbes from the mouth into the cleansed site.
Capillary puncture does not require higher degree of antisepsis such as
iodine. Iodine should not be used for capillary puncture as it can affect
BURPP—bilirubin, uric acid, phosphorus and potassium tests. Milking is
contraindicated during capillary puncture as it will increase specimen
hemolysis and tissue fluid contamination.
,Which of the following standards are being violated when a phlebotomist
fails to use proper handwashing technique?
A. HIPAA
B. OSHA
C. CMS
D. NAACLS
OSHA
Rationale
Proper hand washing violations are associated with OSHA standards. The
Occupational Safety and Health Administration (OSHA) is the federal
agency charged with the enforcement of safety and health legislation in
the United States. The Clinical Laboratory Improvement Amendments
(CLIA) is how the Centers for Medicare and Medicaid Services (CMA)
regulates laboratory testing of human samples within the United States.
The Joint Commission (JC- formerly JCAHO) sets performance and
quality standards of health care organizations. The National Accrediting
Agency for Clinical Laboratory Sciences (NAACLS) is associated with
education program accreditation in the clinical laboratory. HIPAA is the
Health Insurance Portability and Accountability Act of 1996 that was
enacted to protect patient privacy of personal health information.
, The phlebotomist is instructed to perform a capillary stick for newborn
screening. Which of the following collection devices should the
phlebotomist use?
A. heel stick lancet
B. butterfly needle and syringe
C. evacuated tube
D. finger stick lancet
heel stick lancet
Rationale
The heel stick lancet (e.g., Tenderfoot) is required for infants. If a heelstick
in an infant is being performed, the phlebotomist should apply a warming
device for approximately 3-5 minutes to the heel to increase blood flow
to the area, which will facilitate the collection of the capillary specimen.
The bones of the distal phalanx (located in the thickest part of the finger)
may be injured or damaged by a traditional finger stick lancet puncture.
2026/2027 AND PRACTICE QUESTIONS
COMPLETE ACCURATE EXAM REAL QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES (RELIABLE SOLUTIONS)
CURRENTLY UPDATED VERSION 2026 EDITION
A phlebotomist collects a cryofibrinogen specimen, places the specimen
in a biohazard specimen bag, then onto slurry of ice and water and
transports it to the laboratory in a timely manner. In this case the
phlebotomist
A. performed proper specimen handling.
B. should have protected the specimen from light.
C. should have kept the specimen at 37˚C.
D. should have aliquoted the specimen before transport.
should have kept the specimen at 37˚C.
Rationale
Many types of specimens are required to be kept at certain temperatures
for accurate test results to be obtained by the laboratory.
Cryofibrinogen, cryoglobulin and cold agglutinins must be kept at 37o C
(body temperature). Tests requiring protection from light include:
bilirubin, carotene, porphyrins and vitamins A, B2, and C. Specimens that
require chilling on an ice slurry are ammonia, lactic acid, pH & blood
gases among others. Consult your facility's policies for the correct
procedures to follow. Aliquoting of the specimen (dividing it into parts) is
done during or after processing in the laboratory.
,Which of the following should the phlebotomist do when collecting
blood via finger stick?
A. Position the lancet across the fingerprint lines.
B. Wipe off any remaining alcohol from the finger before insertion.
C. Disinfect the patient's finger with povidone-iodine.
D. Milk the finger during the blood collection.
Position the lancet across the fingerprint lines.
Rationale
Capillary puncture can be performed on the palmar surface of the distal
segment of the 3rd digit (middle finger) or 4th digit (ring finger). Lancet
must be placed across (perpendicular) to the fingerprint whorls in order
to allow blood to form round drops as it is collected. Placing the lancet
along (parallel to) the fingerprint whorls will allow the blood to channel
away from the puncture site into the grooves and make collection very
difficult. Never wipe, fan or blow at a site that has been cleansed. Alcohol
must air dry to allow time for it to work and inhibit bacteria. Wiping can
prevents alcohol from work properly and can introduce more microbes.
Fanning creates air turbulence and can introduce more microbes.
Blowing introduces microbes from the mouth into the cleansed site.
Capillary puncture does not require higher degree of antisepsis such as
iodine. Iodine should not be used for capillary puncture as it can affect
BURPP—bilirubin, uric acid, phosphorus and potassium tests. Milking is
contraindicated during capillary puncture as it will increase specimen
hemolysis and tissue fluid contamination.
,Which of the following standards are being violated when a phlebotomist
fails to use proper handwashing technique?
A. HIPAA
B. OSHA
C. CMS
D. NAACLS
OSHA
Rationale
Proper hand washing violations are associated with OSHA standards. The
Occupational Safety and Health Administration (OSHA) is the federal
agency charged with the enforcement of safety and health legislation in
the United States. The Clinical Laboratory Improvement Amendments
(CLIA) is how the Centers for Medicare and Medicaid Services (CMA)
regulates laboratory testing of human samples within the United States.
The Joint Commission (JC- formerly JCAHO) sets performance and
quality standards of health care organizations. The National Accrediting
Agency for Clinical Laboratory Sciences (NAACLS) is associated with
education program accreditation in the clinical laboratory. HIPAA is the
Health Insurance Portability and Accountability Act of 1996 that was
enacted to protect patient privacy of personal health information.
, The phlebotomist is instructed to perform a capillary stick for newborn
screening. Which of the following collection devices should the
phlebotomist use?
A. heel stick lancet
B. butterfly needle and syringe
C. evacuated tube
D. finger stick lancet
heel stick lancet
Rationale
The heel stick lancet (e.g., Tenderfoot) is required for infants. If a heelstick
in an infant is being performed, the phlebotomist should apply a warming
device for approximately 3-5 minutes to the heel to increase blood flow
to the area, which will facilitate the collection of the capillary specimen.
The bones of the distal phalanx (located in the thickest part of the finger)
may be injured or damaged by a traditional finger stick lancet puncture.
