NHCO PHLEBOTOMY EXAMS SET FEATURING SOLVED QUESTIONS AND ACCURACY CHECKED ANSWERS

NHCO PHLEBOTOMY EXAMS SET
FEATURING SOLVED QUESTIONS AND
ACCURACY CHECKED ANSWERS
NHCO Phlebotomy Certification Practice Exam
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Question 1 mn



Why is it important for a phlebotomist to verify the patient's identity before performing a venip
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uncture?
• A) To ensure the correct billing information is applied.
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• B) To comply with HIPAA regulations regarding patient privacy.
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• C) To guarantee the safety and accuracy of laboratory results for the correct patient.
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• D) To determine the patient's preferred language for communication.
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Correct Answer: C mn mn



Explanation: Patient identification is the single most critical step in phlebotomy to prevent mislabelin
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g and transfusion errors, which directly impacts patient safety and the accuracy of diagnostic testing.
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Question 2 mn



Which of the following needle gauges has the LARGEST lumen (bore)?
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• A) 18-gauge mn



• B) 20-gauge mn



• C) 21-gauge mn



• D) 22-gauge mn




Correct Answer: A mn mn



Explanation: In needle sizing, the smaller the gauge number, the larger the diameter (lumen) of the ne
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edle. An 18-gauge needle is larger than a 22-gauge needle.
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Question 3 mn



A phlebotomist is preparing to collect a Blood Culture specimen. What is the correct order of d
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raw for the bottles?
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• A) Aerobic bottle first, then Anaerobic bottle.
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• B) Anaerobic bottle first, then Aerobic bottle.
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• C) SPS (Yellow) tube first, then Blood Culture bottles.
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• D) The order does not matter as long as they are filled to the correct volume.
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Correct Answer: B mn mn



Explanation: When using a butterfly needle, the anaerobic bottle should be filled first to prevent air fr
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om entering the line. When using a regular straight needle, the aerobic bottle is often filled first to pre
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vent backflow. However, standard CLSI guidelines for syringe draws specify anaerobic first to avoid i
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ntroducing air. mn




Question 4 mn



What is the primary anticoagulant found in a Light Blue top tube, and what is its primary labo
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ratory use? mn



• A) EDTA; used for Hematology (CBC).
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• B) Sodium Heparin; used for Chemistry panels.
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• C) Sodium Citrate; used for Coagulation studies (PT/PTT).
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• D) Potassium Oxalate; used for Glucose testing.
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,Correct Answer: C mn mn



Explanation: The light blue top tube contains Sodium Citrate, which binds calcium to prevent clotting
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. It is specifically used for coagulation testing where the plasma must remain in its original state.
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Question 5 mn



The bevel of the needle should be facing which direction during a routine venipuncture?
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• A) Downward, parallel to the skin. mn mn mn mn mn



• B) Upward, away from the skin. mn mn mn mn mn



• C) Sideways, toward the patient's body.
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• D) Any direction is acceptable. mn mn mn mn




Correct Answer: B mn mn



Explanation: The bevel (the slanted opening of the needle) should be facing upward. This allows for t
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he smoothest entry into the vein with the least amount of trauma and pain for the patient.
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Question 6 mn



Which of the following is the BEST site for collecting a capillary sample on an infant?
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• A) The heel mn mn



• B) The great toe mn mn mn



• C) The index finger mn mn mn



• D) The earlobe mn mn




Correct Answer: A mn mn



Explanation: The heel is the recommended site for capillary puncture on infants under 1 year old bec
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ause they have not yet developed sufficient tissue in their fingers, and using the heel minimizes the ris
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k of bone injury.
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Question 7 mn



If a patient is fasting for a lipid panel, how long should they typically refrain from eating or dr
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inking anything other than water?
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• A) 2-4 hours mn mn



• B) 8-12 hours mn mn



• C) 16-20 hours mn mn



• D) 24 hours mn mn




Correct Answer: B mn mn



Explanation: A standard fasting period of 8- mn mn mn mn mn mn



12 hours is required for accurate lipid panel results (such as LDL and triglycerides) to avoid false elev
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ations caused by recent food intake.
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Question 8 mn



What is the first action a phlebotomist should take if they accidentally stick themselves with a u
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sed needle?mn



• A) Report the incident to the CDC. mn mn mn mn mn mn



• B) Complete an incident report immediately.
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• C) Wash the site with soap and water and seek immediate medical evaluation.
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• D) Squeeze the wound to express blood and apply a bandage.
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Correct Answer: C mn mn



Explanation: According to OSHA guidelines, the immediate action is to wash the affected area with s
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oap and water (or use an antiseptic), then immediately report the exposure to a supervisor and seek po
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st-exposure prophylaxis. mn




Question 9 mn



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,A phlebotomist notices that the patient has an IV line in the right arm. How should they procee
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d with the venipuncture?
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• A) Draw from the right arm below the IV site.
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• B) Use the left arm, unless contraindicated.
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• C) Draw from the right arm above the IV site.
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• D) Use the dorsum of the hand on the right arm.
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Correct Answer: B mn mn



Explanation: You should never draw blood from an arm with an active IV line due to the risk of cont
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aminating the sample with the IV fluid. The preferred practice is to use the opposite arm (the left arm)
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if no other contraindications exist.
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Question 10 mn



What does "Hemolysis" refer to in a blood specimen?
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• A) The clotting of blood inside the tube.
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• B) The breakdown of red blood cells, releasing hemoglobin into the plasma/serum.
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• C) The separation of serum from the blood cells.
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• D) The formation of a fibrin clot. mn mn mn mn mn mn




Correct Answer: B mn mn



Explanation: Hemolysis occurs when red blood cells are damaged, releasing their contents (including
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hemoglobin) into the liquid portion of the blood. This can occur due to shaking the tube, using a small
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needle, or forcing the blood into the tube, and it often leads to specimen rejection.
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Question 11 mn



Which of the following is NOT a required component of a properly filled out laboratory requisi
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tion form? mn



• A) Patient's full name and date of birth.
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• B) Date and time of collection. mn mn mn mn mn



• C) Patient's Social Security Number.
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• D) Ordering physician's name. mn mn mn




Correct Answer: C mn mn



Explanation: While unique identifiers (like a medical record number) are required, a Social Security
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Number is rarely required for lab testing and may be protected under privacy laws.
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Question 12 mn



When preparing a peripheral blood smear from a capillary puncture, what should the phleboto
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mist do? mn



• A) Smear the blood using the first drop that appears.
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• B) Wipe away the first drop and use the second drop.
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• C) Scoop the blood from the skin surface using the spreader slide.
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• D) Apply a large drop of blood for an even smear.
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Correct Answer: B mn mn



Explanation: The first drop of capillary blood contains tissue fluid and may contain traces of alcohol,
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which can alter the results. It should be wiped away, and the second drop should be used for the smea
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r.

Question 13 mn



Which additive is found in a Green top tube?
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• A) Sodium Citrate mn mn



• B) Lithium Heparin mn mn



• C) Potassium EDTA mn mn



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, • D) Clot Activator
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Correct Answer: B mn mn



Explanation: Green top tubes contain Heparin (either sodium, lithium, or ammonium). It is used for c
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hemistry tests that require plasma. mn mn mn mn




Question 14 mn



A phlebotomist is using a 5 mL syringe and a 21-
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gauge needle. After drawing blood, what should they do?
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• A) Transfer the blood from the syringe to the tubes by pushing the plunger forcefully.
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• B) Let the blood flow from the needle hub into the tubes without pressure.
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• C) Use a safety transfer device to avoid needle stick injuries.
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• D) Recap the needle gently before transferring.
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Correct Answer: C mn mn



Explanation: It is unsafe to transfer blood by forcefully pushing the plunger as it can cause hemolysis
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. A safety transfer device (like a Luer-
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Lok connector) should be used to allow the vacuum of the tube to draw the blood from the syringe to
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prevent injury. mn




Question 15 mn



What position is a patient placed in to help prevent syncope (fainting)?
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• A) Prone position mn mn



• B) Lithotomy position mn mn



• C) Supine position (lying down flat) mn mn mn mn mn



• D) Sitting with legs dangling mn mn mn mn




Correct Answer: C mn mn



Explanation: Having a patient lie down (supine) prevents the blood from pooling in the lower extremi
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ties, which helps maintain adequate blood flow to the brain and reduces the risk of fainting.
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continue with question 16 to 100 mn mn mn mn mn



Here is the complete continuation of the NHCO Phlebotomy Practice Exam, featuring Questions 16 thr
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ough 100. Each question is followed by the correct answer and a brief explanation to reinforce key co
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ncepts.

Question 16 mn



Which of the following is the MOST common complication of venipuncture?
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• A) Hematoma mn



• B) Hemolysis mn



• C) Nerve damage mn mn



• D) Thrombophlebitis mn




Correct Answer: A mn mn



Explanation: A hematoma (bleeding under the skin) is the most frequent complication, usually caused
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by going through the vein, incomplete puncture, or failure to apply adequate pressure after needle rem
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oval.

Question 17 mn



What is the proper angle of insertion for a routine venipuncture using a straight needle?
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• A) 5 to 10 degrees mn mn mn mn



• B) 15 to 30 degrees mn mn mn mn



• C) 45 to 60 degrees mn mn mn mn



• D) 90 degrees mn mn




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